Journal of Pharmaceutical Research International 2022-01-24T13:18:01+00:00 Journal of Pharmaceutical Research International Open Journal Systems <p style="text-align: justify;"><strong>Journal of Pharmaceutical Research International (ISSN:&nbsp;2456-9119)</strong> is dedicated to publish&nbsp;high quality papers (<a href="/index.php/JPRI/general-guideline-for-authors">Click here for Types of paper</a>)&nbsp;in all areas of pharmaceutical Science including pharmaceutical drugs, community pharmacy, hospital pharmacy, clinical pharmacy, compounding pharmacy, consultant pharmacy, internet pharmacy, veterinary pharmacy, nuclear pharmacy, military pharmacy, pharmacy informatics, pharmaceutics, medicinal chemistry, pharmacognosy, pharmacotherapy, pharmacodynamics, pharmacokinetics, clinical pharmacology, neuropharmacology, psychopharmacology, pharmacogenetics, pharmacogenomics, pharmacoepidemiology, toxicology, theoretical pharmacology, posology, pharmacognosy, behavioral pharmacology, environmental pharmacology, medicine development and safety testing, drug legislation and safety, pharmaceutical microbiology, pharmaceutical molecular biology, pharmaceutical biotechnology.&nbsp;The journal also encourages the submission of useful reports of negative results. This is a quality controlled,&nbsp;OPEN&nbsp;peer reviewed, open access INTERNATIONAL journal.</p> A Rare Case of Lymphatic Filariasis 2022-01-17T05:39:21+00:00 J. Vijay N. Anuradha Viknesh Prabhu Patel Harshvardhan Anilbhai <p>Lymphatic filariasis is a parasitic infection caused by <em>Wuchereria bancrofti, Brugia malayi and Brugia timori.</em>Asymptomatic microfilaria, acute lymphatic filariasis, chronic lymphatic filariasis, tropical pulmonary eosinophilia are the different presentations of lymphatic filariasis. Systemic manifestation can involve joint, kidney, heart and nerve. This article is a case report of lymphatic filariasis with a rare presentation of anasarca and nephritic syndrome.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Rehabilitation of a 55-year-old Man’s Inter Trochanteric Fracture: A Case Report 2022-01-18T04:20:55+00:00 Shivani Uttamchandani Neha Chitlange Mithushi Deshmukh <p><strong>Background: </strong>The most common fractures seen in senior osteoporotic patients are intertrochanteric (IT) fractures, which are usually caused by a simple fall in the house. The number of old patients is expected to double by 2040 due to an increase in the number of elderly patients with osteoporosis. Understanding key aspects of IT fracture, therapy such as stability, reduction, and the involvement of posterior medial and lateral walls, will aid in implant selection for a better outcome.This fracture interferes with the normal functioning of the body in day-to-day life. Therefore, physiotherapy rehabilitation after surgery is essential to get back to normal functioning.</p> <p><strong>Case Presentation: </strong>A 55- year-old male patient who came with complaints of pain and swelling in right hip, unable to walk. Patient was under the influence of alcohol when he fell from the bed. He experienced sudden and severe pain in right hip and was unable to stand. His relatives brought him to Acharya Vinobha Bhave Rural Hospital (AVBRH), Sawangi, Wardha, Maharashtra for further management. Dynamic Hip Screw was applied for the fixation of Intertrochanteric Fracture. Further on rehabilitation was started, which aimed to restore mobility, regain full range of motion and develop muscle strength.</p> <p><strong>Conclusion:</strong> The Intertrochanteric fracture of femur is a form of fracture with a high occurrence. The above case presentation concludes that a traditional surgical procedure combined with timely planned physiotherapy rehabilitation contributed to progressive improvement in functional goals, which is an important factor in achieving a good recovery in such post-operative cases.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## A Case Report of Capitellum Fracture Treated using Herbert Screw 2022-01-22T04:15:52+00:00 Vijay Narasimman Reddy . Mervinrosario . Kushwanth <p>Capitellar fractures are intra-articular elbow injury &amp; it is an uncommon type of elbow injuries that can cause and affect severe functional limitation if not treated correctly. Various treatment options have evolved over the years, from cast immobilization to closed reduction fixation and now finally open reduction fixation is used as a better treatment option. Open reduction internal fixation provides excellent fixation to the fracture site and helps in achieving a stable joint that help in early mobilization of the elbow joint after trauma. Which also prevents late complications such as myositis ossificans. This is a case report of capitellar fracture, a typical type -1 Hahn-Steinthal fracture of left elbow joint in a 14 year old adolescent male treated using Herbert’s screw fixation. Here after three months of post-op follow-up it shows good interfragmental compression, early mobilization, excellent recovery &amp; Implant removal is rarely necessary.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Case Report on Sacro-Coccygeal Teratoma in 5 Year Old Girl: A Case Report of Late Presentation 2022-01-24T07:08:28+00:00 Priyanka Rewatkar Madhuri Shambharkar <p><strong>Introduction: </strong>The Sacro-coccygeal teratoma is rare tumour that appears near the distal end of the tailbone in new-borns (coccyx). It's the most common congenital tumour, and it can appear at any time throughout pregnancy. It occurs in about 1/35000 to 1/40000 of all live births. Female new-borns are more likely to have this birth defect than male ones. Sacro-coccygeal teratoma can cause critical disturbance in defecation function of infant although this disease is extremely rare benign tumour. Appropriate early recognition can prevent progression to this devastating outcome. In this case report, we present a Sacro-coccygeal teratoma originating from gluteal region. The case is used to highlight important nursing management, clinical consideration and how to prevent further complications. We describe a Case of Sacro-coccygeal teratoma in 5 year girl child presenting with increased gluteal swelling of 15 days duration. In addition she had difficulty in passing stool and urine and also difficulty in sitting.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## A Rare Finding of Abundant Crystals in Thyroid FNAC 2022-01-24T07:38:53+00:00 Devikala Kumaresan Mary Lilly <p>Thyroid is a versatile endocrine organ. Fine needle aspiration cytology is the famous technique which is safe, easy to perform, cost effective and more accurate in diagnosing benign and malignant thyroid lesions. Our case shows a rare presentation of numerous calcium oxalate crystals within the colloid in thyroid smear which indicates degenerative and atrophic changes in the follicles, and can also be seen in numerous other benign and systemic conditions which roots the underlying pathology and helps in treatment as well as stays as a unique rare finding.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## A Systematic Review: The Relationship between Fixed Prosthodontics and Dental Sensitivity 2022-01-17T05:45:55+00:00 Ghith Fayez Aldhahri Shaima Abdulaziz Nass Abdulrahman Abdullah Alrefaei Ali Hussain Albouri Hanouf Saad Alqethami Mahmood Hamdan Abdulla Radhi Abdulraouf Abdulaziz Alhojaily Wijdan Ahmed Alghamdi Ali Mohammed Alqahtani Mohamed A. Qudaih Fatima Sultana <p>Dental prosthetics that are permanently attached (fixed) to the teeth are called fixed prosthetics. Crowns, bridges (fixed dentures), onlays, inlays, and veneers are also referred to as indirect restorations. Professionals in prosthodontics have trained in this area from academic institutions. With fixed prosthodontics, a single tooth or multiple teeth can be restored over areas where teeth are missing. A common oral health issue is trauma-induced tooth hypersensitivity following preparation of the tooth. Dental hypersensitivity is caused by a sudden onset of sharp pain on contact with exposed dentin, usually in response to heat, evaporation, pressure, or cold and is not attributed to any other dental problem or condition." Despite a lack of literature on the subject, post-cementation sensitivity has not been definitively studied. When dentinal tubules are separated during the preparation of teeth, a certain degree of pulpal trauma will result. An important decision is whether to carry out elective endodontic treatment for the tooth's vital abutments or proceed with the pulp preservation procedure.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## The Effect of Dental Care during Orthodontic Treatment: Systematic Review 2022-01-18T08:11:22+00:00 Laila Mohammed Alanazi Dalal Jumah Alturaif Raed Saud Alhuzaimi Nouf Abdullah Alarwan Rawan Abdulaziz Almubarak Aljawharah Alabsi Sahar Alothman Manal Alrubayqi Ghith Fayez Aldhahri Amatulrehman Bahaziq Fatima Sultana <p>The maintenance of stringent oral hygiene practices is imperative during orthodontic treatment in order to prevent plaque from accumulating over braces and other orthodontic appliances, leading to gingivitis inflammation and periodontal disease. Consequently, an orthodontist is responsible for providing advice to patients about oral hygiene to maintain periodontal health and for monitoring plaque control measures. In spite of their orthodontist's recommendation, most orthodontic patients do not follow their recommended instructions on how to maintain a satisfactory level of plaque control. We conducted our systematic review of literature in English. During the initial re-examination phase, there were no filters applied to ensure all studies were available for subsequent screening. Filters like human studies were added later, with English language studies being the only ones added. We found nine articles related to orthodontic treatment, and their relation to dental care, during our literature review. It is essential to maintain good oral hygiene during orthodontic treatment to reduce iatrogenic demineralization and caries. When a patient's DMFS score is high, prophylaxis programs are necessary during orthodontic treatment.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Management of Hypertension through Shodhana & Shamana Chikitsa: A Systematic Review 2022-01-20T04:06:37+00:00 Vaishnavi Paraskar Punam Sawarkar Gaurav Sawarkar <p>Hypertension or high blood pressure is a complex disease that may affect other organs resulting in renal dysfunction, neuropathy, cerebral disorders, and many other complications. These are further complicated due to the side effects of established antihypertensive medicines used for it’s treatment. A significant rise in cases of hypertension has been noted in the era of modernization.&nbsp; Some alternative or adjuvant modalities require time for the prevention and management of hypertension. As per two basic modules of <em>Ayurveda, i.e., Hetu, Linga</em>, it is easy to correlate the Hypertension with multiple terminologies such <em>as&nbsp; Shonitdushti, Raktavruuta Prana</em> or <em>Vyanavrutta Prana,</em> etc. Using these principles of <em>Ayurveda</em>, treatment of hypertension is possible safely at a primary stage. Also, it can be used as an adjuvant in the management of advanced-stage disease.&nbsp; This meta-analysis reflects on <em>Ayurvedic</em> interventions like <em>Shodhana </em>or <em>Shamana Chikitsa</em> used to manage hypertension. This analysis included 14 clinical studies conducted on 995 participants at different places. <em>Shodhana &amp; Shamana Chikitsa</em> were found to play a primary or adjuvant role in the effective management of hypertension. This study dictates the need for scientific multi-centric research on hypertension.&nbsp;</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Radiological and Laboratory Modalities for Diagnosis of COVID-19: A Systematic Review 2022-01-20T04:20:30+00:00 Bhavesh Modi Komal Shah Mahalaqua Nazli Khatib Deepak Shukla Abhay Gaidhane Deepak Saxena <p>The world has witnessed the dreadful COVID-19 pandemic and the rapid rate of its spread across countries. The key measures in pandemic control includes early detection of cases, isolation of cases to prevent spread and appropriate management of confirmed cases. The present diagnostic criteria for COVID-19 in India is based on RT-PCR. This technique has its own limitations. There are ongoing debates to the cost, time taken and type of diagnostic sensitivity and predictive values of RT-PCR. Researchers across globe have been exploring alternative methods to enhance the mainstay of protocols for identifying suspected cases of COVID-19. With media news of too many asymptomatic positive results from community in New Delhi, Ahmedabad and other places in India, along with prompt withdrawal of antibody based tests by ICMR after questions on validity, such test raises concerns and urgent need for exploring the need for rethinking the diagnostic algorithm. This is a systematic review to explore possibility of novel diagnostic approaches for a suspected case of COVID-19 with an objective to early detection of case and using appropriate methods to halt the chain of transmission.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Effect of Mulligan Mobilization on Proprioception in Osteoarthritis of Knee Joint - A Systematic Review 2022-01-20T06:59:42+00:00 Makesh Babu Subramanian Preethi Rajesh . Sudhakar <p><strong>Background: </strong>Osteoarthritis (OA) of the knee is a degenerative disorder that affects the joint which causes pain, stiffness, swelling, muscle weakness, and functional impairments. Proprioception in the OA knee seems to be impaired when compared with the normal counterparts. Manual therapy is one of the hands-on therapies delivered by physiotherapists. However, there is not much information on how manual therapy affects joint proprioception, although some studies show a positive response. Mulligan’s mobilization technique is common for spinal and peripheral joints to correct positional faults.</p> <p><strong>Aim: </strong>To systematically identify and to evaluate the effects of mulligan mobilization on the proprioception of the OA knee.</p> <p><strong>Methods: </strong>Various electronic databases like PubMed Central, Medline, Google Scholar, ProQuest and CINAHL are searched from 2001 to 2021. Multiple search criteria were used in the search of relevant articles based on the selection criteria used. Four articles that fit the criteria were taken based on the PEDro Scores of above 5. The two specialists analysed all the papers. The articles which cover mulligan’s mobilization and proprioception of the knee were only selected.</p> <p><strong>Results: </strong>Four articles that fit the criteria were reviewed which demonstrated baseline comparability and reported point estimates and measures of variability.</p> <p><strong>Conclusion: </strong>This systematic review has concluded that the knee joint proprioception was improved with applying the Mulligan’s manual therapy, whereas the neurophysiological activity is not well understood.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Prevalence of Untreated Mesio-Buccal 2 Canal in Maxillary First Molars Reported in KSA Since 2010: A Systematic Review 2022-01-22T04:54:28+00:00 Laila Mohammed Alanazi Sahar Alothman Amal Taha Alsomaly Abdulelah Khalid Alanazi Abdulmohsen Khalid Alanazi Saleh Mohammed Alghufaili Wesam Yousef Alibrahim Shahzeb H. Ansari Fatima Sultana <p>Several aspects are involved in the success of an endodontic therapy. Because root canal treatment is so complicated, it can't be evaluated using two-dimensional radiographs. Endodontic failure can occur if any section of the canal is overlooked and left untreated. The root canals of the first and second molars are the most complicated of all the maxillary teeth. Locating the mesio buccal (mb2) canal in the maxillary teeth for endodontic treatment is difficult. The mb2 canals are located utilizing three-dimensional technology and cone beam computed tomography (CBCT). The primary goal of this research is to conduct a systematic evaluation of publications that have reported on the occurrence of mb2 canal in maxillary first molars. Many studies in Saudi Arabia have found that the incidence of mb2 in maxillary first molars ranges from 23.3 percent to 70.6 percent, and that the incidence in maxillary second molars is about 19.8%. A few studies also found that direct viewing of the root, followed by troughing, was used to find an mb2 canal that was not visible on a CBCT scan.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Benign Paroxysmal Postural Vertigo (BPPV): A Review 2022-01-24T04:49:05+00:00 Arju Fatema B. Lakhani Sakshi K. Katariya Sagar Gaurkar <p><strong>Background</strong><strong>:</strong> Benign paroxysmal postural vertigo is considered as the most frequent cause of vertigo worldwide because of which various times patient suffers the most dreaded complication which is not just because of vertigo but is due to the loss of balance during activities (such as driving and crossing the road,even while climbing up the stairs) and which is often misdiagnosed as a neurologic condition which further worsen the prognosis. This can be avoided by a simple OPD based manoeuver (series of movements) as a diagnostic procedure in most cases. Once diagnosed another series of movements (manoeuver) can be performed to afford symptomatic relief.</p> <p><strong>Objective: </strong>To create a complete systematic review of the prevalent reason of dizziness&nbsp; i.e. benign paroxysmal postural vertigo (BPPV) along with its historic background, diagnostic modality (associated with various manoeuvers ). Also, alternative methods of management considering their success rate and prognosis associated with precautions and primary measures (I.e prevention or decrease of risk factors, precautions and even to educate the patient about the disease.</p> <p><strong>Methodology: </strong>This article is reviewed from data taken from various articles found on various search engines like Google Scholars , PubMed , Research Gate along with the data taken from various books on he respective topics. Also,&nbsp; the data searched from various search engines using the terms like BPPV, Vertigo, VOR, Dix - Hallpike Maneuver, Posterior Semicircular Canal, Superior Semicircular Canal.</p> <p><strong>Conclusion&nbsp;: </strong>BPPV is a simple disorder that can be misdiagnosed if the history is not taken properly or examination is not done correctly, it can severely affect the patients day to day activity and can be a very problematic condition if the attack is precipitated while activities like driving&nbsp; or&nbsp; crossing the road, or even climbing,which can lead to dreaded complications. Henceforth it is a great topic of concern to resolve this disease which can be usually resolved by a simple OPD based management and can bring a great difference in the patient’s life for GOOD.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## A Systematic Review: Prevalence of C Shaped Configuration in Upper-maxilaryand Lower-mandibular First Premolar 2022-01-24T06:02:32+00:00 Nadia Buraik Abdulaziz Abdullah Alnafjan Fahad Khalid Almana Amani Essam Najjar Abdulelah Mesfer Alrubayqi Roqiah Zaki Alkhamis Amirah Abdulaziz Alotaibi Mohammed Thafar Aldosari Dalal Jumah Alturaif Laila Mohammad Alanazi Ahmed M. Elmarakby Fatima Sultana <p>In most cases, the C-shaped pattern is found in mandibular second molars. Additionally, C-shaped canals can also occur in mandibular premolars, maxillary molars, and mandibular third molars. It poses challenges like debridement, obturation, and possibly the outcome of root canal treatment. The purpose of this study is to make a systematic review of studies related to the prevalence and morphology of C shaped canals in premolar teeth. Using pre-designed forms, data were extracted from online databases such as Medline and PubMed Central. We extracted citations and characteristics of studies, such as names of authors, date of publication, country, title, definition of C shaped canal configuration, and classification of C shaped canal configuration in upper and lower first premolars. Even though they are rare, mandibular premolars are also known to have C-shaped canal systems. Approximately 10-18% of mandibular first premolars have C-shaped canals, according to studies. Treatment is more challenging for patients with C-shaped canals. The frequency of C-shaped configurations in premolar teeth is likely to be affected by regional characteristics and gender of the population. Having these factors in mind before surgery allows dentists to better plan, coordinate, and perform complex morphologies.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## A Brief Study on Diabetes Mellitus: Pathophysiology and Diagnosis 2022-01-21T07:42:47+00:00 Harsh Verma Swarupa Chakole Guddi Laishram <p><strong>Background: </strong>This article reviews published articles and existing diagnostic and therapeutic techniques relevant to adolescents with obesity and diabetes mellitus.</p> <p>Obesity, in addition to DIABETES MELLITUS, is a crucial risk factor for the occurrence of future chronic and noncommunicable diseases.</p> <p>Obese and overweight teenagers are more prone to acquire Adult Onset Diabetes, formerly rare among the younger population. However, a global trend of Adult Onset Diabetes was noted in the late 1990s and early 2000s. In the United States and the United Kingdom, and other developing and developed countries, this is particularly true. Adult Onset Diabetes is nearly as common as Insulin Dependent Diabetes in some locations. There has been a significant surge in the prevalence and severity of obesity in several population groups in teenagers.</p> <p><strong>Objective and Methodology: </strong>To read and review the existing literature on the prevalence of Diabetes Mellitus and obesity in adolescence. About 15 articles and literature were studied using the PubMed and Google Scholar search engine to produce a detailed review article on the topic of interest so chosen.</p> <p><strong>Results and Conclusion: </strong>After reviewing the articles, we can agree that TYPE-2 DIABETES MELLITUS is linked easily to young adults who are obese, that is, having a Body Mass Index of more than 30 or more than 30. TYPE-2 DIABETES MELLITUS&nbsp;&nbsp; causes destruction of receptors for insulin which results in an increased level of glucose, causing various diseases. Obesity in young adults is a critical factor in the occurrence of Adult Onset Diabetes which makes them at risk of developing severe diseases in the 3rd or 4th decade of life.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Role of Medicinal Plants in the Management of Diabetes Mellitus: A Review 2022-01-24T12:03:57+00:00 Navjot Sharma Kundan Singh Bora <p>Diabetes mellitus is a worse metabolic condition in which level of glucose and lipid increased in blood circulation due to insufficient insulin functionality that may lead to worse the complication like atherosclerosis, dyslipidemia, gangrene, limb amputation, kidney failure, and many more. Furthermore, high concentration of glucose in blood stream can directly produce reactive oxygen species which ultimately more worsen the conditions like dyslipidemia, atherosclerosis etc. This disorder is expected to affect 9.3% of the global population in 2019, increasing to 10.2%&nbsp; by 2030 and increasing 10.9 % by 2045. Medicinal plants are used as medicine to treat many ailments since a long time ago. But now they have been rediscovered with having specific constituents to treat diseases and many more yet to discover. There are so many active phytoconstituents of plants which are being extracted, purified, tested and formulated for patient convenience. In the present review, various plants used to treat diabetes mellitus due to have negligible side effects as compared to allopathic treatment (oral hypoglycemic drugs) are described. Many plants with hypoglycemic effect of many plants have been reported, and the mechanisms of action of these plants with these hypoglycemic behaviors are being examined through in vitro and in vivo studies. Some of these 22 medicinal plants and their active constituents related to antidiabetic activity are discussed in this review.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Oral Candidiasis with Subcutaneaous Emphyema Associated With Sari Following Post COVID 19: A Case Report 2022-01-17T05:41:51+00:00 Shiwani Padmakarrao Dandade Vaishali Taksande <p><strong>Background:</strong> Over the last few decades, the covid 19 has increased all over the world. More issues are likely to be observed as covid 19 rate increases. The major cause of morbidity and mortality is infection. Oral Candidiasis With Subcutaneaous Emphyema and SARI are very rare complications in Covid 19 patient. The final cause is infection, but sometimes it causes due to allergic or inflammatory reaction of the drugs. If it occurs after post covid 19 then creates very serious issues with the peoples health.</p> <p><strong>Case Presentation:</strong> Here we are mentioning a very rare case of Oral Candidiasis With Subcutaneaous Emphyema and SARI after Covid 19 positive patient. In this case, on physical examination and investigation, it was found that, after covid 19 patient has developed Oral Candidiasis, Subcutaneous Emphysema , severe breathlessness, cough, fever, nausea, vomiting, throat infection and loss of appetide. To overcome this sudden issue, emergency exploratory medical and surgical treatment was done. During Covid 19 treament her HRCT Score was 21/25 and the infection was severe. There was no any sign of oral candidiasis, subcutaneous emphysema, or tissue or organ damage or no any other abnormality was detected during Covid 19 tratment. No bacterial growth or fungal growth observed on investigation. After some days and treatment of covid 19 the patient was developed a Oral Candidiasis and Subcutaneous Emphysema and SARI. The working diagnosis was finalized by doctors i.e. Oral Candidiasis With Subcutaneaous Emphyema and SARI. After expert medical management and excellent nursing care patient was discharged with full recovery.</p> <p><strong>Conclusion:</strong> In this study, we mainly focus on expert medical management and excellent nursing care helped in managing the complicated case very nicely. All the patient response was positive for conservative and nursing management and after treatment the patient was discharged without any complications and satisfaction with full recovery.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Documentation, Clinical Validation, Safety Assessment and Efficacy of Siddha Treatment in COVID 19 SARS-CoV-2: A Case Series 2022-01-17T05:47:04+00:00 J. Jeyavenkatesh P. Saravanapandian C. Yogeswari S. Roja Ramani R. Shanmuga Priya <p><strong>Aims: </strong>To evaluate clinical validation, safety assessment and efficacy of Siddha line of treatment in COVID-19 patients.</p> <p><strong>Presentation of the Case: </strong>Open labelled, interventional, prospective cohort study conducted in Covid ward, Kokila Siddha Hospital and Research Centre, Madurai between June and Aug 2021. Among 22 registered in the trial 5 (22.72%) developed breathing difficulty, treated with oxygen support, 10 (45.5%) were male, 12 (54.5%) were female. At the time of admission, maximum 9 (40.9 %) had fever, followed by dry cough 18 (81.8%), dyspnea 8 (36.4%), malaise 16 (72.7%), anorexia 8 (36.4%), headache 4 (18.2%), Type-2DM 5 (23%), and 2 (9%) had hypertension as comorbidity. Hematology, LFT, RFT, D-Dimer, PTT, CRP were taken before and after 5 days of treatment.</p> <p><strong>Discussion:</strong> The mean hospital stay was 7 days and discharged on a minimum of 4th day and a maximum of 16<sup>th</sup> day. The mean hospital stay for hypoxic patients was 10 days. Paired sample test analysis has been carried out to find a significant difference in the counts of lymphocytes, ESR, CRP and PTT after the administration of the intervention.</p> <p><strong>Conclusion:</strong> The medications chosen according to the pathology of <em>Kaba suram</em> and administered starting on first day of admission, depending on the stage and severity of the infection. Patients were provided with appropriate food, exercise, therapy in conjunction with medications and found the patient's condition has not deteriorated further. It is reasonable to conclude that the treatment of COVID-19 with selective Siddha medications stopped the disease progress more critical.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Case Report on Ebstein Anomaly 2022-01-18T04:15:10+00:00 Saleha Shahid Ansari Ranjana Sharma <p><strong>Introduction:</strong> Ebstein anomaly, also known as Ebstein malformation, is a congenital (existing at birth) heart defect that affects a small percentage of people. The tricuspid valve (the valve that connects the chambers on the right side of the heart) does not close properly in people with Ebstein abnormality [1].</p> <p><strong>Patient History:</strong>&nbsp; A 25-years female patient was admitted in Acharya Vinoba Bhave Rural Hospital in medicine ward. She was admitted with the complaint of breathlessness on exertion, and weakness since 2 months. patient is a known case of severe ASD since birth. After coming to the ward all investigations done like blood test, ECG, 2D Echo, chest x-ray etc. then final diagnosis is conformed as severe ASD with Ebstein anomaly.</p> <p><strong>Past History:</strong> Patient is a known case of ASD. And not having any other history of communicable disease, asthma, tuberculosis.</p> <p><strong>Management:</strong> Tablet- Lasilactone (20/60)) A diuretic, Tablet- Neurobion Fort, Tablet- Pan 40mg a antacid are prescribed the doctor .</p> <p><strong>Nursing Management:</strong> vital sign checked and documented, comfortable position given as patient having breathing difficulty. Fowlers position given. intake and output of patient recorded. Assessed the patient for anxiety, depression.</p> <p><strong>Conclusion:</strong> Patient was admitted to the hospital with the major complaints of trouble breathing and generalised weakness, and her situation was critical. Immediate treatment was initiated by a member of the health team, and all available treatments were administered, and the patient's condition has improved.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Case Report on Subacute Sclerosing Panencephalitis 2022-01-18T04:26:33+00:00 Sweta Chavhan Archana Maurya Amruta Kothe <p><strong>Introduction: </strong>Subacute sclerosing panencephalitis (SSPE), frequently referred as Dawson disease, is a kind of sclerosing&nbsp; panencephalitis<strong>, </strong>and is an uncommon long-term, continuous cerebral inflammatory condition triggered by a gradual infection with particular faulty types of hyper mutated measles virus.</p> <p><strong>Main Symptoms and/or Important Clinical Findings: </strong>Patient came with the complaint of gait abnormalities, sudden fall while walking, loss of speech, staring look, abnormal smile and loss of bladder control, hemiplegia and contracture of all four limbs, seizures, Grade III Malnutrition.</p> <p><strong>The Main Diagnoses, Therapeutic Interventions, and Outcomes: </strong>Patient undergone investigation i.e. Blood Test: Hb- 9.8 gm%, TLC- 14,700/mm, Platelet- 2.24 lacs /, Total Protein- 8.4 g/dl, HCT- 29.8, Serum Bilirubin- 1.0mg/dl, ALP- 99IU/L, Serum Urea-32mg/dl,SerumCreatinine-0.5mg/dl,SerumSodium-153meq/L,SerumPotassium-.2mmol/L. .CSF igg Measles test was done EEG which revealed burst of periodic complexes with well-preserved back ground activity. Doctor manages with Tab. Valparin 200mg BD, Tab. Frisium 5mg BD, Tab. Baclofen10mgBD,Tab. Samion D3 OD, Syp Q-Carni 5ml BD, Tab. Augment375mg BD.</p> <p><strong>Outcome: </strong>After treatment, the child showed some improvement. The patient was admitted to Pediatric Ward No- 22, AVBRH with known case of Subacute sclerosing panencephalitis (SSPE) and he had complaint of swelling over right jaw with caries tooth since4month.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Erythema Dyschromicum Perstans: The Spotty Possibility – A Rare Case Report 2022-01-18T04:30:25+00:00 M. Naga Meena Lochini F. K. Jasima Nilofer S. Mary Lilly <p>Erythema Dyschromicum Perstans (EDP) / Ashy Dermatosis are a less common dermatological disorder with an unknown etiology. It is characterized by asymptomatic, grey, symmetric and confluent macules all over the body. Herein, we report a case of a 50 years old man who presented clinically, with diffuse, patchy pigmentation having ill-defined, erythematous borders involving bilateral arms and forearms. Histopathological examination of the lesion biopsy demonstrates vacuolar degeneration of the basal cell layer, dermal perivascular mononuclear cell infiltrate and increased epidermal melanin pigment and presence of dermal melanophages. For the present case, treatment with Clofazimine has proven to be effective<strong>.</strong></p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Case Report on Nursing Management of a Client with Peripheral Arterial Disease 2022-01-18T04:31:35+00:00 Vishakha Meshram Vaishali Tembhare Achita Sawarkar Madhuri Shambharkar Arati Raut Prerana Sakharwade <p>Peripheral artery disease is a frequent cardiovascular ailment in which constricted arteries restrict blood flow to our limbs. When we have Peripheral Artery Disease&nbsp;in our limbs, our legs haven't had enough flow of blood to increase production. The capillaries that nourish the lower legs narrow and stiffen in peripheral vascular disease, making walking harder. Reduced blood flow can cause cartilage and necrosis in the limbs. Peripheral arterial disease (PAD) is usually caused by multilevel atherosclerotic disease, typically in patients with a history of cigarette smoking, diabetes mellitus, or both. Intermittent claudication (IC), an early manifestation of PAD, commonly leads to reduced quality of life for patients who are limited in their ambulation. Percutaneous intervention for peripheral artery disease has evolved from balloon angioplasty for single lesions. To achieve good long-term efficacy, a close follow-up including objective tests of both the arterial lesion and hemodynamic status, surveillance of secondary preventive measures, and risk factor control.</p> <p>A 65-year-old man was admitted to the hospital with the following symptoms: worsening left severe calf pain, fatigue, cramping, aching, pain in the legs or arms that worsens when walking or using the arms, tightness in the muscles of the legs that worsens with exercise and improves with rest. He has a diabetes mellitus history. The lower extremity pulse was diminished or absent on physical examination, but all other vital signs were typical. Pulses in the left dorsalispedis and posterior tibialis could not be felt. The results of the cardiac examination were average. The patient has numbness in one leg, pain in both legs, decreased energy in both upper and lower limbs, ulceration, gangrene in the lower extremities, Hair loss, weakness, and dependent rubor (redness caused by swelling) present. He had audible bruits, a nonhealing lower extremity wound, and a delayed capillary refill, so he started treatment as soon as possible.</p> <p>The primary focus of this study is on professional management and outstanding nursing care, which may provide the holistic care that peripheral arterial disease necessitates while also effectively managing the challenging case.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Case Report on Benign Spindle Cell Tumour 2022-01-18T04:44:37+00:00 Manisha P. Mandaokar Ranjana Sharma <p><strong>Introduction:</strong> It's an extremely uncommon cancer. First, the epidermis, soft tissues, and connective tissues are impacted. Breast benign spindle cell lesions include a wide range of tumor-like or malignant fibroblastic and myofibroblastic entities. They should be made up entirely of Spindle cells (pure spindle cell lesions) are defined as lesions with no mixed epithelial component.</p> <p><strong>Clinical Finding :</strong></p> <p>Most Common Symptoms Of Spindle Cell Sarcoma.</p> <ul> <li>• Bone ache. The most frequent sign of spindle cell sarcoma is bone discomfort. The most often afflicted bones by spindle cell sarcoma are those of the...</li> <li>Swelling And Tenderness.</li> <li>Reduced Mobility.</li> <li>Fatigue And Malaise.</li> <li>Lump Or Mass.</li> </ul> <p><strong>Diagnostic Evaluation: </strong>HB-6.7, TLC:-16, 200, PLT:-15, 000, MCV:-67.0, SR. BILIRUBIN:-0.7</p> <p><strong>Therapeutic Intervention –</strong> Tab. Allopuraznol 300mg BD, Inj. Emset:- 1.8mg TDS.&nbsp; Inj. Pantop 12mg BD, Inj. Ceftraxon 20ml NS 1 mg BD.</p> <p><strong>Outcome- </strong>Spindle cell tumours are uncommon cancers that develop in the peripheral and deep tissues of the body. According to a CT scan, a massive tumour encompassed the whole abdomen and pelvis. According to a CT scan, a massive tumour encompassed the whole abdomen and pelvis.</p> <p><strong>Conclusion: </strong>The patient is admitted to Acharya vinoba bhave rural hospital sawangi (meghe) wardha, under the USG department, where he will get ongoing medical and nursing care, and his health is currently stable and under monitoring.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Case Report on Sickle Cell Anemia in Children 2022-01-18T05:06:07+00:00 Subodh Itkalwar Ruchira Ankar Ranjana Sharma <p><strong>Introduction:</strong> Sickle cell anemia is a kind of severe hemolytic anemia caused by the sickle haemoglobin (HbS) gene, which results in a faulty haemoglobin molecule. The term "sickle cell disease" refers to a set of genetic illnesses affecting red blood cells. People with sickle cell disease have irregularly formed red blood cells, which might be troublesome since they don't stay as long as healthy blood cells once they reach the state of blood arteries.</p> <p><strong>Clinical findings:</strong></p> <ul> <li>Progressive Anemia</li> <li>Mild jaundice</li> <li>Fever</li> <li>Headache</li> <li>Growth retardation</li> <li>Superaded bacterial infection</li> <li>Enlarge hurt<br><br>Non healing ulcer</li> </ul> <ul> <li>Organ failure</li> <li>Abdominal pain with distension</li> <li>Joint pain</li> </ul> <p><strong>Diagnostic Evaluation: </strong>Abdominal pain, fever, Hb (8.5 gm%), Abdomen swelling, Increase abdominal girth, pain in joint and irritability.</p> <p><strong>Ultrasonography:&nbsp; </strong>Abdominal USG.</p> <p><strong>Therapeutic Investigation: </strong>Inj. Ceftriaxone 1mg BD, Inj pantoprazole 20mg OD, Inj. Neomole 30ml SOS, Inj. Tramadol 0.4mg TD S, Cap. Hydra 500mg OD, syr. syncoria 5ml OD, Tab. Folic Acid 5mg OD.</p> <p><strong>Outcome: </strong>All the investigation of the patient is done and the patient is diagnosed as sickle cell anemia.</p> <p>He showed significant progress after receiving therapy, and the treatment was kept ongoing until my last date of care.</p> <p><strong>Conclusion: </strong>A male child of 8 yrs was brought to AVBRH on by his parents with a complaint of abdomen pain with distension, Pain in joints, irritability and he was admitted to pediatric ward. All the investigation of the patient is done and the patient is diagnosed as sickle cell anemia. He improved dramatically after receiving therapy, and the treatment was continued until my final date of care.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Case Report on Cellulitis 2022-01-18T05:10:47+00:00 Minal Ughade Prerana Sakharwade Darshana Kumari Archana Taksande Sheetal Sakharkar Vaishali Tembhare Ruchira Ankar Achita Sawarkar <p><strong>Introduction</strong><strong>:</strong> Cellulitis is a bacterial infection that causes an inflammatory condition of the skin that affects the dermis and subcutaneous tissues. 2016 (Lee and Levell). Cellulitis of the lower limbs is a potentially dangerous condition (Halpern et al, 2008). Rubor or erythema, which is warm to the touch and often combined with a degree of localised oedema, is the most common symptom. However, because diagnosis is dependent exclusively on clinical data, it is commonly misdiagnosed [1]. There are a number of different illnesses that have symptoms that are similar to cellulitis. The purpose of this page is to provide information on the clinical symptoms of lower limb cellulitis as well as treatment options ensuring that practitioners are capable of making an accurate diagnosis and developing successful treatment programmes [2].</p> <p><strong>Clinical Findings: </strong>Fever, pain over right lower leg, wound present right dorsal foot, weariness, malaise, and swelling were the patient’s main complaints.</p> <p><strong>Diagnostic Evaluation: </strong>Haemoglobin 14.7%,total RBC count 4.77, total WBC count 16100, platelet count 1.56, KFT – UREA -57 CREATININE -2.0 potassium- 4.6, LFT ALKALINE PHOSPHATE -105, ALBUMIN3- 0 TOTAL BILIRUBIN- 1.4 micro report is normal. His liver function and coagulation studies were normal. A diagnostic work-up that includes blood cultures, dengue, malaria smear, typhoid, and other tests. The following tests were sent: leptospirosis, monospot and stool investigations, and Clostridium difficile PCR [3].</p> <p><strong>Therapeutic Intervention: </strong>Four primary analgesic drugs, antibiotics drug in penicillin.</p> <p><strong>Conclusion: </strong>My patient, a 65-year-old man, was hospitalised to the&nbsp; Hospital's medicine ward on June12, 2021.Fever, pain over right lower leg, wound present right dorsal foot, fatigue, malaise, and edema were among the symptoms that the patient had. His health improved when he received appropriate treatment. The patient was follow up after 1 weak [4].</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Case Report on Alcohol Dependence Syndrome 2022-01-18T05:24:12+00:00 Suhani Nagdeote Shalini Lokhande <p><strong>Introduction:</strong> Alcohol dependence is psychiatric problem in which a person is psychologically and physically dependent upon alcohol consumption.&nbsp; “A chronic disease in which a person craves that contains alcohol and is unable to control his or her drinking”.</p> <p><strong>Clinical Finding:</strong> Without drink patient feel discomfort, anxious, loss of appetite, sleeping disturbance.</p> <p><strong>Diagnostic Evaluation:</strong> Blood test: Amylase – 31U/L, RBS (glucose-plasma-random) – 92mg%, CBC Investigation (Hb -13%, MCV – 84.3fl, MCH – 29.7picogm, total RBC count – 4.55millions/, total WBC count –, monocytes – 04%, granulocytes – 70%, lymphocytes – 25%, eosinophil – 01%, total platelets count – 3.38lac/</p> <p><strong>Therapeutic Intervention: </strong>Inj. Lorazepam 4mg × TDS, Inj. Thiamine 200 mg × TDS , Inj. Neurbion fort × OD, Inj. Pantop&nbsp; 40mg × OD, Inj. Emset, Inj. Avil, Tab. Paracetamol 500 mg × S0S.&nbsp;&nbsp;&nbsp;</p> <p><strong>Outcome:</strong> After treatment, patient shows improvement. His increase appetite, decrease the feeling of discomfort.</p> <p><strong>Conclusion:</strong> My patient was admitted to psychiatric male ward in AVBRH with a known case of alcohol dependence syndrome and he had complain related to disease condition and after taking appropriate treatment&nbsp; his condition was improved.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Prosthetic Rehabilitation of a Hemimandibulectomy Case by Non-Surgical Approach- A Case Report 2022-01-18T07:02:51+00:00 Mirella Vaz Mridula Joshi Mahesh Ghadage Gunjan Daphale <p>Hemimandibulectomy can have several consequences such as disoriented masticatory cycle, eccentric occlusion, distorted speech and facial disfigurement depending on the severity of the defect. It is challenging for the prosthodontist to rehabilitate the patients in whom osseous reconstruction has not been carried out. This clinical report describes the Prosthetic management of a patient who had undergone hemimandibulectomy due to moderately differentiated squamous cell carcinoma involving left buccal mucosa, gingivobuccal sulcus and retromolar trigone. A non- surgical approach was carried out to rehabilitate this patient, which included the fabrication of a maxillary guide flange prosthesis for correction of the frontal plane rotation and a twin occlusion prosthesis for ease of mastication. The appearance of the patient was improved drastically by the fabrication of an extraoral prosthesis.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Post Mastectomy and Radiation Therapy - Complex Regional Pain Syndrome -A Case Report 2022-01-18T08:00:46+00:00 Jeshnu Prakash Tople S. Krishnendu <p>Complex regional pain syndrome which is a rare syndrome following an injury or trauma, is an extremely painful condition. Diagnosis of this condition is not easy. They present with various symptoms like allodynia, hyperalgesia, asymmetry of temperature and sweating ,restricted range of motion. Identifying and treating this condition at earlier stage is important. There are different treatment options like pharmacological (NSAIDs, Anticonvulsants, Antidepressants, neuromodulators) and interventional techniques like Stellate ganglion block, Thoracic Sympathetic Ganglion block, Lumbar sympathetic block, Neurostimulation.</p> <p>In this case report we present a case of 52 year old female post mastectomy and radiation therapy developing CRPS of left upper limb, which was diagnosed and managed successfully with diagnostic thoracic sympathetic ganglion block followed by therapeutic radiofrequency ablation.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## A Case Report on Nursing Care of Craniopharyngioma 2022-01-18T08:10:40+00:00 Pornima Dnyaneshwarro Zade Prerana Sakharwade Samruddhi Gujar Achita Sawarkar Jaya Khandar Archana Dhengare Kavita Gomase Pooja Kasturkar <p>We present a case of a rare craniopharyngioma in the left temporal lobe that developed after no prior brain trauma or surgery. Craniopharyngiomas are slow-growing benign tumours that affect the sellar and parasellar portions of the central nervous system. The incidence of this tumour is roughly 2/100,000. The majority of individuals experience neurological (headaches, visual abnormalities) and endocrine (growth retardation, rapid puberty) disorders over time 13.</p> <p><strong>Case presentation: </strong>After undergoing biopsy, M.R.I., and C.T., a 45 year old man was admitted to Acharya Vinoba Bhave Rural Hospital on 13/02 2021 with the main complaint of blurring of vision in right eye, headache, polyurea since 5 month, polydipsia, and altered behavior since 2 month. After a C.T. Scan, the patient was diagnosed with a craniopharyngioma.</p> <p><strong>Conclusion:</strong> The patient was admitted to Acharya Vinoba Bhave Rural Hospital with blurred vision in the right eye, headache, polyurea, polydipsia, and altered conduct as his known causes. Going to follow all of the tests, the patient was diagnosed with a craniopharyngioma still the patient requires medical attention and appropriate nursing care.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Case Report on Tricuspid Atresia 2022-01-18T08:12:23+00:00 Himanshu Jawanjal Savita Pohekar <p>The absence of the tricuspid valve is one of the more unusual types of congenital heart illness. Before the introduction of heart surgery, it was only of scholarly interest, However, now that such conditions may be alleviated medically, the problem has taken on more significance, and every effort must be made to identify the anatomical weakness in cases of congenital cardiac disease.<sup>[1]</sup></p> <p><strong>Clinical Findings:</strong> &nbsp;Cyanosis, feeding difficulties, cyanosis, shortness of breath and fast breathing, sluggish development, and a heart murmur are the most common symptoms.</p> <p><strong>Therapeutic Intervention</strong>: Tab .Lasix 40mg OD, dioxin drop0.5ml, Furoped drop 0.5 ml ,Syp A-2.5ML</p> <p><strong>Outcomes</strong>: &nbsp;After treatment, the patient shows improvement. His breathing difficulty and heart rate arebeing improved.</p> <p><strong>Conclusion:</strong> My child was admitted to the AVBRH's pediatric ICU with cyanosis of blurred vision and breathing difficulties. His condition has improved upon obtaining adequate therapy.<a href="#_ftnref1" name="_ftn1"></a></p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Urolithiasis Presenting as Right Flank Pain 2022-01-19T09:25:38+00:00 Vipul Umare Shabanam N. Sheikh Roshan Umate Chetan Mahatme <p><strong>Introduction:</strong> Urolithiasis is a term that refers to the formation of calculi or stones in the urinary tract. Calcifications arise in the urinary system, generally in the kidneys or ureters, but they can also damage the bladder and/or urethra. It's a prevalent ailment that leads to a high number of hospital visits. It is generally avoidable by modifying risk factors, and there are a variety of treatment methods available. Clinicians should be aware of the signs, symptoms, potential consequences, and therapeutic suggestions. In urolithiasis, diagnostic imaging techniques such as double-contrast cystography, ultrasonography, radiography, and, potentially, computed tomography are used.</p> <p><strong>Presenting Complaints and Investigations:</strong> A 50-year-old male was admitted in AVBRH on 13/02/2021 with chief complaints of severe pain in the side, which spread to the lower abdomen and groin, pain in urination, nausea, vomiting for 15 days. Investigations included hematology and radiological&nbsp; tests including Hemoglobin 7.5 gm/dl, Sodium: 19.1 mg/dl, creatinine: 5.4 mg, calcium: 11.5 mg/dl. Urine analysis, cystoscopy, ultrasound, KFT, LFT were carried out.</p> <p><strong>Main Diagnosis: </strong>Urolithiasis.</p> <p><strong>Therapeutic Interventions: </strong>Included Tab. Ibuprofen, Syp. Cystone.</p> <p><strong>Conclusion</strong><strong>:</strong>&nbsp; Urolithiasis is harder to treat in the aged since they have more complications and become less likely to show with classical renal colic complaints. This could result in a later presentation with larger, more complicated stones. Individuals with significant back and flank discomfort should consider acute care and preventive efforts in patients with renal calculi, as it might lead to hydro nephrosis and kidney failure.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## A Case Report on Malaria 2022-01-22T04:36:03+00:00 Dhanshree A. Selukar Sonali Kolhekar Darshana Kumari Ruchira Ankar Sheetal Sakharkar Savita Pohekar Achita Sawarkar Pradnya Sakale <p><strong>Introduction: </strong>Malaria is caused by the parasitic protozoan Plasmodium. It is a vector-borne disease which is transmitted from person to person&nbsp;via bites from infected mosquitoes. Following a mosquito bite the parasites multiply in the liver and subsequently infect red blood cells. It is a mosquito-borne illness. Fever or flu symptoms include shivering chills, headaches, and muscle pains. Anemia, jaundice, nausea, and diarrhea are some of the symptoms of malaria.</p> <p><strong>Main Symptoms and Important Clinical Findings:</strong> A 24-year-old woman was admitted in. Acharya vinoba bhave rural hospital with chief complaint of stomach pain as her primary complaint. Then after several days Fever, pain, fatigue, headache occur. Several diagnostic evaluations done which shows total Red blood cells count: 4.8 million cu mm; white cell count: 11.810 cells mm3; lymphocytes: 11.2% platelets drop on smear, RBCs are moderated.</p> <p><strong>The Main Diagnoses, Therapeutic Interventions, and Outcomes: </strong>24 years old women admitted in Acharya vinoba bhave rural hospital with the chief complaint of stomach pain, fever, fatigue, headache and after all investigation she has diagnosed as malaria. Doctor manage with Iv fluids, cap. Doxycycline 100 mg, tab.dolo 650 mg, tab.larigo 650 mg, emset 4 mg injection Once a day, she was also given the Calcium Tab. Her condition has improved as a result of the treatment. The fever and agony had subsided.</p> <p><strong>Conclusion: </strong>My patient was admitted to Acharya vinoba bhave rural hospital with a known case of malaria and a fever and discomfort complaint. Her condition improved after she received proper therapy.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Effect of Neurodevelopmental Therapy on Functional Recovery in a Patient with Subacute Stroke: An Interesting Case Report 2022-01-24T05:45:57+00:00 Maitri Thamke Rakesh Krishna Kovela Mohammed Irshad Qureshi Ragini Dadgal Rebecca Timothy Snehal Samal <p>Stroke is defined as a clinical illness characterised by a sudden onset of cerebral impairment that lasts more than 24 hours or results in death with no obvious explanation other than a vascular origin.Every year, around 800,000 people have a stroke, or one every 40 seconds. Strokes are caused by difficulties with the brain's blood supply: either the blood supply is cut off or a blood artery within the brain bursts, killing brain tissue. A stroke is a medical emergency that requires immediate medical attention. Present case report is of a 39-year-old male with right side weakness. Patient’s right upper limb recovery stage was 1 going towards 2, and lower limb recovery stage was 2 going towards 3 on first day of assessment. Patient was treated with Neurodevelopmental therapy combined with conventional physiotherapy for a period of 8 weeks. Balance, Gait parameters and tone evaluated on day 1 and on last day of treatment. There was tremendous improvement in balance and gait parameters along with normalisation of tone. Thugs wee would like to conclude that early NDT along with conventional therapy can improve gross motor function in patients with subacute stroke.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Effect of Threshold Inspiratory Muscle Training Device on Inspiratory Muscle Strength in Upper Abdominal Surgery Patient: A Case Report 2022-01-24T05:51:12+00:00 Neha Arya Vishnu Vardhan <p><strong>Background:</strong> Surgical care plays a crucial role in the treatment of a wide spectrum of ailments, as well as in the relief of human suffering. Gastrectomy, pancreatectomy, hepatic resection, cholecystectomy, and splenectomy were among the upper abdominal surgeries performed. The maximum inspiratory pressure (PImax) is an important metric for assessing the strength of the inspiratory muscles. Respiratory muscle training device increase the capacity for activity, strength, and endurance of respiratory muscles. Pressure Threshold IMT devices are typically spring-loaded handheld devices that is obstructed at various intensities. As a result, the current study aims to show the effect of Inspiratory Muscle Training in patients undergoing Upper Abdominal Surgery. Materials and Methods: On Day 1, maximal inspiratory pressure (PI Max) was measured by a Hand held pressure manometer before intervention. Threshold Inspiratory Muscle Training device was administered on Day 1, and continued for one week two sessions per day. Post treatment maximum inspiratory pressure. (PImax) was measured. Each session lasted 15 minutes, including breaks.</p> <p><strong>Conclusion:</strong> The study concluded that Threshold inspiratory muscle training device shows improvement in Maximal Inspiratory Pressure in upper abdominal surgery patient.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Impact of Short-term Exercise Program on Functional Independence in Patient with Hydropneumothorax: A Case Study 2022-01-24T05:58:18+00:00 Vaishnavi Chawake Vaishnavi Yadav Moli Jain Tasneem Lakkadsha Pallavi Bhakaney <p><strong>Background:</strong> Hydro-pneumothorax is a rare variant of pneumothorax. It occurs when both free fluid and air is present within the pleural space. The goal of the treatment is to relieve the pressure on the lung, allowing it to re-expand. Treatment options may involve solely observation or needle aspiration or intercostal tube drainage (ICD), along with antibiotic cover, all of this anchored with physiotherapeutic management.</p> <p><strong>Case presentation:</strong> A 54 years old male visited hospital with complaints of dyspnea (MMRC grade II), dry cough and high-grade fever since one month along with a history of chronic alcohol consumption and tobacco chewing since more than 10 years.</p> <p><strong>Investigations:</strong> Laboratory investigations include Chest X-ray which showed fairly large opacities with fluid level in right side. The costo-phrenic angle on the right side was obliterated, multiple small patchy opacities are also seen in right lower zones. Along with these findings, there was contralateral mediastinal shift.</p> <p><strong>Treatment:</strong> Physiotherapy intervention included patient education, breathing retraining, airway clearance techniques, positioning, walking program with supplemented oxygen and psychological support. Outcome measures have shown improvement in functional independence and performance of activities of daily living.</p> <p><strong>Conclusion:</strong> Physiotherapy management showed efficient results in improving the lung function, quality of life, inducing relaxation and early return to pre-disease life in patient with hydro pneumothorax.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Early Mobilization is the Key towards Early Functional Independence in a Patient Undergone Aortic Valve Replacement: A Case Study 2022-01-24T06:04:28+00:00 Gunjan Ingale Vaishnavi Dilip Yadav Moli Jai Jain Vishnu Vardhan <p>Heart disease due to valvular anomaly has increased prevalence along with increasing age. Rheumatic heart disease is a condition in which the heart valves have been permanently damaged post rheumatic fever. We report a patient with Aortic valve replacement using TTK CH 25 prosthetic valve who underwent post-operative physiotherapy which comprises 2 weeks of phase I cardiac rehabilitation, a home exercise program after discharge, and follow-up after 2 weeks. During follow up patient has a high level of independence, improvement in quality of life, lung function, and symptoms. This case report aims to highlight the significance of prompt diagnosis; treatment and most importantly rehabilitation incorporating early mobilization to get the patient back to his functional state. A scheduled exercise program benefits the patient and also minimizes complications after surgery.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Physiotherapeutic Rehabilitation of a 48-Year Male with Buccal Mucosa Carcinoma of Squamous Cell: A Case Report 2022-01-24T06:17:55+00:00 Shrutika H. Wankhade Shubhangi Patil Rupali Thorat <p>Buccal mucosa carcinoma of squamous cell is an uncommon kind of oral cavity cancer that is known to be dangerous. It's also linked to a high probability of local regional recurrence, and it's more likely in persons who chew tobacco and/or smoke, whether or not they drink alcohol. A 48-year patient is an elderly man who works as a farmer, mesomorphic built with right-hand dominance came to the tertiary care hospital with complaints of painful ulcers in upper left Jaw's front portion, which was relatively small initially and further increases to 6 x 4 cm approx., since last 4 months. Patient was complaining of pain, difficulty in mastication and manipulations etc. He has history of kharra chewing and tobacco chewing since last 10 years. With these complaints patient has come to the oral surgery department with buccal mucosa skin involvement and underwent surgery as compartmental resection of lesion, Modified Radical neck dissection and segmental mandibulectomy. Following surgical procedure patient has complaints of discomfort, limitation of movements at the operated site, chest pain, and limited mouth opening. For these complaints, programmed physiotherapy treatment was given to the patient which mainly concentrates on mouth opening and increasing range of motion of affected side.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Physiotherapy Intervention in Post Hysterectomy Patient with Urinary Incontinence: A Case Report 2022-01-21T04:26:30+00:00 Gunjan Ingale Shubhangi Patil Rupali Thorat <p>The uterus and cervix are removed during a total abdominal hysterectomy. The majority of hysterectomies are performed to address fibroids, endometriosis, adenomyosis, pelvic organ prolapse, and malignancy. The second most common procedure on the female genital system is hysterectomy. Patients who have this treatment are at risk for problems that can be avoided with preventative interventions such as physiotherapy. A 48 year old who had undergone total abdominal hysterectomy with bilateral salphingo opherectomy was referred for physiotherapy. Patient complained of pain in lower abdomen and difficulty in bed mobility and constant dripping of urine. Apart from medicinal intervention, physiotherapy was given for six days a week along with pain management activities, respiratory exercises, home exercise program and ergonomic advice for 4 weeks. A comprehensive rehabilitation plan including home exercise regimen can help in early recovery and restoration of daily activities rapidly and improve the quality of life of the patient.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Case Report on Fibroid Uterus 2022-01-24T11:48:18+00:00 Harshada Bhoge Archana Maurya <p>Uterine fibroids are also known as leiomyomas or myomas are muscular tumors that can form on the uterus. They seldom become malignant, and having them does not increase your risk of uterine cancer. Fibroids come in a variety of sizes, shapes, and locations. They can be found inside your uterus, on the surface, or in the uterine wall. They may also have a stalk or stem-like structure that connects them to the uterus.</p> <p><strong>Main symptoms and/or important clinical findings: </strong>Constipation, backache, or leg discomfort since 4 month, monthly bleeding for more than a week since 4 month, pelvic pressure or discomfort since 4 month, frequent urination since 4 month, difficulties emptying the bladder.</p> <p><strong>Nursing perspectives: </strong>fluid replacement that has been administered, i.e. DNS and RL checked vital signs and blood pressure every hour, kept an intake and output chart, and made sure the patient had enough rest and sleep. Medication was administered in accordance with the doctor's orders.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Case Report on Congestive Cardiac Failure with Pneumonia with Bronchial Asthma 2022-01-24T12:10:35+00:00 Chaitanya Gabhane Manjusha Mahakarkar Ruchira Ankar <p><strong>Introduction</strong><strong>:</strong> Congestive cardiac failure is a pathophysiologic state when the heart is not able to maintain its cardiac output to meet the demand of metabolizing tissues. Pneumonia is the inflammation of parenchyma of lungs. Bronchial Asthma is a diseases of airway produced by hypersensitivity inflammatory response of tracheobronchial tree to a variety of stimuli resulting in reversible narrowing of the air passages.</p> <p><strong>Clinical Finding:</strong> Patient having pain in chest since 2-3 days and it radiating to back and shoulder. Patient is experiencing breathlessness even at rest stage. Patient is also having a diagnosis of Asthma since 1 year.</p> <p><strong>Diagnostic Evaluation</strong><strong>: </strong>Patient had undergone the Respective Diagnostic evaluation. Complete Blood Count, MRI, chest X- ray and 2D Echo.</p> <p><strong>Therapeutic Intervention</strong><strong>: </strong>Patient have been prescribed the following Medication. Inj. Lasix 400mgX BD, Inj. Sodabicarb in 100ml saline stat, Inj. Doxy 100mgX BD, Inj. Piptaz 20mgX BD, Inj. PAN 40mgX TDS, Tab. Flucon 150 mg X OD.</p> <p><strong>Outcome</strong><strong>: </strong>After the providing the nursing care the pain level in chest had been minimized and patient is not having any breathlessness in resting stage and his condition also has been improved after the care provided.</p> <p><strong>Conclusion: </strong>The patient was admitted in Medicine Intensive Care Unit [MICU] AVBRH, Sawangi (Meghe), Wardha with the known case of Congestive Cardiac failure with Pneumonia and Bronchial Asthma. After providing appropriate nursing care his condition has been improved.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Application of Visagism Concept to Assess the Co-Relation between the Temperament and Smile Esthetics: A Clinical Study 2022-01-17T05:35:18+00:00 Poorvi Jain Surekha Godbole Seema Sathe Kambala Chetan Mahatme <p><strong>Background: </strong>Ability of a person to express a wide range of emotions with the movement of teeth and lips is called as a smile. Dentogenic concept considers gender, personality, age in harmonizing shapes of teeth with the face. Personality is unique for an individual. Unveiling personality traits, desires of the individual, translating them into natural tooth shapes to maintain the psychodentofacial harmony poses a major challenge to the clinician in designing a smile. Visagism is a novel concept that helps the dentists in providing restorations that involve esthetics psychological and social features of the created image, which influences the individual’s emotions. It involves the customization of an image.</p> <p><strong>Aim and Objectives: </strong>To assess the co-relation between the smile esthetics and mental temperaments or personalities through the application of the concept of visagism.</p> <p><strong>Methodology: </strong>A Digital camera (DSLR) for capturing the photographs and smile designing software will be used. Each subject will be instructed to occlude the teeth while capturing photographs<u>. </u>A validated questionnaire study will be conducted that will help to discover temperament of the subject. The answers will be evaluated and maximum score of the responses out of the list will be dominant temperament in that individual.</p> <p><strong>Expected Outcome:</strong> Co-relation between this study might help clinicians to accurately assess the correlation between the temperament and the smile esthetics and eventually develop proper customisation of a smile with respect to the personality of the patient.</p> <p><strong>Conclusion:</strong> If computer-assisted smile design and application of visagism concept would be accurate and reproducible, this might help and improve the planning of smile designing, the oral rehabilitations.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Comparative Evaluation of the Efficacy of Hydrocortisone Suppository and Durvadi gudavarti in Raktarsha: A Management Protocol 2022-01-17T05:37:13+00:00 Biswas Nitin Jajoo Suhas Jaiswal Reena S. R. Kapse <p>The most common diagnosis for any anorectal complaint particularly of rectal bleeding in adults is haemorrhoidal disease. Regardless of grading conservative treatment is used primarily in symptomatic haemorrhoids. In Ayurveda, <em>Sthanik Chikitsa</em> (Local application) in the management of <em>Arsha</em> (Hemorrhoids) includes <em>pralepa/pratisaran</em> (Paste application). Instead of applying the <em>lepa</em> in the clinics by the clinician/proctologist, those formulations could be developed into <em>Gudavarti </em>(traditional suppository) &amp; used in the management of <em>Raktarsha</em> (bleeding piles) for better compliance. Hence, development of ‘<em>Durvadi Gudavarti’ </em>using the indigenous medicinal herbs mentioned in Charaka Sanhita (Classical Ayurveda text) for <em>pratisaran/pralepa </em>in <em>Raktarsha </em>&amp; its efficacy will be evaluated.</p> <p><strong>Objectives:</strong> To study &amp; compare the efficacy in patient treated with standard- Hydrocortisone suppository group &amp; interventional-<em> Durvadi Gudavarti</em> group in the management of <em>Raktarsha</em> (Bleeding piles).</p> <p><strong>Methodology: </strong>130 patients of 2<sup>nd</sup> grade hemorrhoids will be selected and will be allocated into two equal groups by computer randomization. Experimental group will be treated with <em>Durvadi Gudavarti</em> &amp; control group with Hydrocortisone based suppository for 2 weeks. Following Symptoms- PR Bleeding, Anal Pain, Prolapse of Pile mass/Lump, Anal pruritus, Mucous discharge &amp; Constipation will be assessed subjectively and Size/ (Volume in cubic millimeter) of pile mass will be the objective parameter for study. Clinical evaluation will be done at Baseline and 3<sup>rd</sup>, 5<sup>th</sup>, 10<sup>th</sup>, 15<sup>th</sup> day after treatment onset. Proportion of patients that would respond clinically on 10<sup>th</sup> day will be the main end point, determined via disappearance of the clinical symptoms &amp; more than or equal to 50 % reduction in the initial size of pile mass/lump. Time to response &amp; need for any oral/ parenteral medication for pain, bleeding and constipation would be the secondary variables. Side effects (type, duration &amp; severity) will be registered carefully.</p> <p><strong>Expected Results: </strong><em>Durvadi Gudavarti</em> contains indigenous herbs having anti-inflammatory, analgesic, haemostatic, wound healing, astringent, &amp; laxative properties. Hence, it is expected to be as efficacious as Hydrocortisone suppository with lesser side effect in the management of <em>Raktarsha. </em>Results will be assessed on the basis of clinical assessment criteria using proper statistical values and tools. Changes will be observed in objective outcomes.</p> <p><strong>Conclusion: </strong><em>Durvadi Gudavarti</em> will be efficacious in the management of <em>Raktarsha.</em></p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Evaluation of Antimicrobial Efficacy of Triphala Oral Spray in Patients Undergoing Orthodontic Treatment- A Randomized Clinical Trial 2022-01-17T05:38:42+00:00 Nishi Malviya Nilima Thosar Nilesh Rathi Monika Khubchandani V. G. Meshram <p><strong>Background: </strong>Malocclusion is one of the most susceptible causes of the development of periodontal diseases and dental caries in young individuals undergoing fixed orthodontic treatment. It provides a surface area for the accumulation of food particles, which further leads to plaque formation. Various mechanical and chemical aids are used regularly to decrease the microbial load and accumulation of plaque. Chemical adjuncts such as chlorhexidine mouthwash are widely used as antimicrobial agents that have significant efficacy against oral Streptococci and Actinomyces species. Herbal agents have replaced conventional medications due to the development of antibiotic resistance. Among herbal medicaments, <em>Triphala</em> is the well-known drug formulation that can be used as an adjuvant for commercially available chemical aid. Chlorhexidine mouth wash requires the assistance of the caregivers. Therefore, there is a need for a newer modality to maintain oral hygiene in patients undertaking orthodontic corrections.</p> <p><strong>Objectives: </strong>1. To evaluate the antimicrobial efficacy of <em>Triphala </em>oral spray on Streptococcus mutants levels in children undergoing orthodontic treatment. 2. To evaluate the efficacy of <em>Triphala </em>oral spray in reducing dental plaque in children undergoing orthodontic treatment. 3. To evaluate the efficacy of <em>Triphala</em> oral spray reducing gingivitis in children undergoing orthodontic treatment.</p> <p><strong>Methodology: </strong>A randomized control trial will be done among – participants with the age group of 10 to 15 years of age. A total of 25 children were included in the study. The participants will be told to use the spray two times a day for one week. After 7 days, plaque index and the gingival index will be re-recorded, and plaque samples will be collected for post-intervention microbial analysis.</p> <p><strong>Results:</strong> <em>Triphala-based oral spray will effectively reduce plaque score, reduce gingival inflammation, and</em> show inhibitory effects on microbial count.</p> <p><strong>Conclusion:</strong> <em>Triphala</em> oral spray can be used as an adjuvant by the orthodontic patients for reduction of the microbial load. It also provides better acceptability by the children as it does not require any assistance of the caregivers.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Efficacy of New Vibration Device in Reduction of Injection Pain among Children-A Randomized Control Trial 2022-01-18T04:34:03+00:00 Archana Maurya Jayant Vagha Tessy Sebastian <p>Needle-related procedures considered as the very crucial sources of pain in children. Pain management during invasive procedure is a challenge to direct health care providers. Unnecessary pain can spoil the nurse-patient relationship. Injections usually reason for some level of pain at the injection site. To develop and validation of the new vibration device for reduction of injection pain and compare the injection pain score among children between experimental and the control group. We will base this study on Analytical intervention approach. A hospital-based Randomized Controlled Trial will consider the effect of a new vibration device in intervention and routine care in the control group for reduction of injection pain. The sample will be children of the age Group 4 years to 12 years. Researcher will take before data collection selection of children as per inclusion criteria, detail explanation about nature and purpose of the study the written consent from the child’s parent. The computerized randomized sampling technique will use for the group formation. The setting of the study will be Hospital Wardha. There will be an efficacy of interventions on children's outcomes reduce injection pain and stable emotional behaviour and stable physiological parameter. Researcher will draw conclusion after the analysis of data collected from the predetermined sample size. Researcher will publish the findings of the study in an open access peer-reviewed Journal.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## To Assess the Effectiveness of Video Assisted Teaching Programme on Knowledge Regarding Prevention of COVID-19 among Antenatal Mother 2022-01-18T04:37:22+00:00 Shalini H. Moon Biswas Anupriya Krishna Pada Bombale Maheshwari Prakashrao Bhalkar Shubhangi Shradrao Bhokre Sai Vijayrao K. Pahune Devendra <p><strong>Introduction: </strong>Since the year 2019, COVID-19 (Corona Virus Disease 2019) has sparked numerous discussions and rumours. Undoubtedly, the core foundation of health care system has been shattered due to the absence of any specific treatments. Hence, this research study is selected and will be carried out to prevent the pandemic by providing knowledge through video assisted teachings to the antenatal mothers.</p> <p><strong>Aim: </strong>To assess the effectiveness of video assisted teaching programme on knowledge regarding prevention of COVID-19 among antenatal mothers in selected maternity hospitals.</p> <p><strong>Methodology: </strong>This study will be based on a Quantitative research approach along with the use of non-probability convenient sampling technique. The sample population will consist of 400 antenatal mothers from selected maternity hospital. Lesson plan and structured questionnaires will contribute to the context of V.A.T.P.</p> <p><strong>Expected Result: </strong>The study should be able to depict the positive effect of video-assisted teaching programme on prevention of COVID-19 among antenatal mothers from selected maternity hospitals, along with studying the association of their knowledge score to the respective demographic variables.</p> <p><strong>Conclusion: </strong>Video-assisted teaching programme should be effective method for delivering health education at all times and final conclusion will be drawn from the ultimate results of the statistical review.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Cognitive Impairment within Patients of Schizophrenia and Mood Disorder: A Comparative Study 2022-01-20T04:36:44+00:00 Swaroopa V. Lunge Patil Prakash B. Behere <p><strong>Background:</strong> Memory dysfunction, deficits in attention and executive functions as well impairment in cognition is found among patient suffering from Schizophrenia and Mood Disorder throughout the course of illness. All these significantly impact various domains of life in them. It also affects the patient’s insight into the illness and thus impairs therapeutic compliance.</p> <p><strong>Objectives: </strong></p> <ol> <li>To evaluate Cognitive functions in patients with Schizophrenia and Mood Disorder.</li> <li>To compare both groups to see whether cognitive dysfunction varies between them.</li> </ol> <p><strong>Methodology:</strong></p> <p><strong>Study Design</strong><strong>:</strong> Cross-sectional study which is Hospital-based.</p> <p><strong>Study-Setting</strong><strong>:</strong> The IPD and OPD of Psychiatry Department, AVBRH, Sawangi (M), Wardha.</p> <p><strong>Sample Size</strong><strong>:</strong> 240 (120 patients with Schizophrenia and Mood Disorder each).</p> <p>Patients clinically diagnosed having Schizophrenia and Mood disorder using ICD-10 criteria of age group 18-55 years, with at least 8 years of schooling will be included in the study after taking written informed consents. After collecting socio-demographic data and screening the patients with the Brief Psychiatric Rating Scale, the PGI Battery of Brain Dysfunction will be applied to the patients.</p> <p><strong>Results: </strong>This study will assess of impairment of Cognitive functions Schizophrenia as well as Mood Disorder patients would tell whether the cognitive impairment is the same or different in both groups.</p> <p><strong>Conclusion: </strong>Comparison of impairment in cognitive functions in Schizophrenia as well as Mood Disorder patients would be done. Co-relation of Cognitive impairment with Metabolic syndrome in both groups can be established.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Foot Print Analysis and Prevalence of Flat Foot among Children of Rural India – A Study Protocol 2022-01-20T04:41:14+00:00 Suyash Y. Ambatkar Ratnakar Ambade <p><strong>Introduction:</strong> Foot shape and its proportions changes gradually during normal growth of human beings, but the mechanical stresses during bipedal locomotion are a key factor for development of foot. To sustain static position and to arrange for stable base while performing various functional activities, Foot plays major role in it. Deformities in lower extremities of children’s are being very common. As this conditions are physiological, that’s why most of the time this conditions do not require treatment. In an average 90% of patient who are visiting to clinic for foot problem are flat foot. Primary manifestation of flat foot is decreasing in longitudinal arch, which shows that while standing or walking, there is transmission of whole body weight towards the medial side of foot sole. This is the main reason for which flat foot is considered as problem of static alignment of foot and ankle structure.</p> <p><strong>Objective:</strong> To analyze footprint of children and to determine prevalence of flat foot, their anthropometric measurement, Prevalence of structural pathologies of foot and correction of foot prints and radiological evaluation of 8 – 13 years age group of children.</p> <p><strong>Methodology:</strong> All the visiting patients of orthopedic department of AVBRH of age group 8 – 13 year, with sample size. Examination will be done along with radiological examination, radiological assessment and different anthropometric will include Plain X-ray of both feet.</p> <p><strong>Results:</strong> We expect that, anthropometric measurements of rural children may differ from other literatures.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## A Comparative Perspective Study between Intrathecal Midazolam & Nalbuphine as an adjuvant with Hyperbaric Bupivacaine for Post-Operative Analgesia in Total Abdominal Hysterectomy 2022-01-20T05:08:15+00:00 Stuti Dubey Sanjot Ninave Aruna Chandak Vijay Chandak Neeta Verma Nikhil Bhalerao <p><strong>Background:</strong> Subarachnoid block is the preferred form of regional anesthesia for obstetric surgeries. Local anesthetic agents alone are insufficient in providing adequate postoperative analgesia, which is an essential factor for the patients &amp; is the sole essence of anesthesia. Adding adjuvant will result in better quality, the efficacy of SAB &amp; will prolong analgesia postoperatively. Due to minimal hemodynamic &amp; respiratory complications, Nalbuphine, an opioid, can be favored as an adjuvant to subarachnoid block. The addition of Nalbuphine in limiting doses to Hyperbaric Bupivacaine offers improved block quality &amp; adequate pre &amp; post-operative analgesia. Midazolam, an imidazobenzodiazepine given intrathecally, raises the threshold of pain; it also has hypnotic, anticonvulsant, muscle relaxant &amp; amnesic effects of other benzodiazepines.</p> <p><strong>Objectives:</strong> Primarily to compare the duration of pain relief in the postoperative period between administration of Intrathecal Nalbuphine (1mg) &amp; Midazolam(2.5mg) ( Timing of 1<sup>st</sup> rescue analgesia). Secondarily to compare the onset of action &amp; duration of motor &amp; sensory block (Modified Bromage Scale), Effect on Hemodynamic Parameters, 24 hours requirement of analgesic (No. of Injection Paracetamol 15-20mg/kg ), Degree of sedation(Modified Ramsay Sedation Scale) &amp;&nbsp; After-effects(PONV, Pruritis, Shivering &amp; Retention of urine).</p> <p><strong>Methodology:</strong> The study type will be a Comparative Prospective Study on 60 ASA 1 &amp; 2 females in the age group 35-75 years, planned for total abdominal hysterectomy will be separated in two equivalent Group M (n=30) &amp; Group N (n=30). Group M will receive combination Midazolam preservative-free 0.5 ml (2.5 mg) with 0.5% Hyperbaric Bupivacaine 2.5 ml(12.5 mg), &amp; Group N will receive combination Nalbuphine 1 ml (1 mg) with Hyperbaric Bupivacaine (0.5%) 2.5 ml (12.5mg) by Intrathecal Route. Analgesia duration in the postoperative period, the onset of action &amp; duration of motor &amp; sensory block, effect on hemodynamic parameters, 24 hours analgesics requirement, degree of sedation, after-effects, if any, will be studied &amp; compared.</p> <p><strong>Conclusion:</strong> Expected to prove the hypothesis that adding which of the following adjuvant 1mg Nalbuphine or 2.5mg Midazolam with 0.5% Hyperbaric Bupivacaine intrathecally given in SAB prolongs the postoperative analgesia duration more as compared to other.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## A Comparative Evaluation of Intra-Articular Bupivacaine vs Bupivacaine and Dexmedetomidine for Postoperative Analgesia in Arthroscopic Knee Surgeries: A Study Protocol 2022-01-20T05:49:59+00:00 Amreesh Paul Francis Anjali Modak <p><strong>Background:</strong> Various degrees of pain is seen in the post-operative period following almost every arthroscopic knee surgery. The reason behind this pain is due to the irritation that occurs to the nerve endings that are found free in the synovium of the knee. Hence, to make this difficult period pain free various analgesics are given to the patient. They are given through various routes and they may be given as sole analgesics or in combination. One such routes used is the intra-articular route in which analgesics are given intra-articularly for post -operative analgesia. Dexmedetomidine is a drug which can be used the aforementioned route. The main of this study is to evaluate the effectiveness of Intra-articular Dexmedetomidine as an adjuvant to Intra-articular Bupivacaine.</p> <p><strong>Aim:</strong> This study aims to compare Intra-articular Bupivacaine vs Bupivacaine and Dexmedetomidine for prolonging post-operative analgesia following knee arthroscopy surgery.</p> <p><strong>Objectives:</strong> The primary objective is to assess the duration of postoperative analgesia produced by Dexmedetomidine when used as an adjuvant to Intra-articular Bupivacaine after arthroscopic knee surgeries. The secondary objectives are to evaluate Dexmedetomidine as an adjuvant to Intra-articular Bupivacaine, with respect to:</p> <ol> <li>Quality of analgesia,</li> <li>Number of doses of rescue analgesic required during study period,</li> <li>Systemic/Local side effects.</li> </ol> <p><strong>Methods:</strong> 60 patients within the age group 20-60 undergoing arthroscopic knee surgeries will be enrolled for the study. Following the completion of surgery, patients allotted to Group B will receive 19ml of Intra-articular Bupivacaine with 1ml of normal saline and patients allotted to Group D will receive 19 ml of Intra-articular Bupivacaine with 1mcg/kg Dexmedetomidine. Post-operative analgesia will be monitored using VAS and the requirement of rescue analgesics in both groups will be noted down and compared.</p> <p><strong>Expected Outcomes:</strong> The VAS and total requirement of rescue analgesics is expected to be less in Group D with minimal/no side effects.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Efficacy of Modified Putikadi Ointment and Ketoconazole in the Treatment of Dadru (Tinea Corporis) 2022-01-20T06:40:22+00:00 Minakshi A. Urkude Sonali Chalakh Akshay Pargaonkar <p><em>Dadru</em> is one of the most common but miserable <em>Twak Vikar</em> affecting all the ages of population. Increasing urbanization and industrialization have posted greater danger due to pollution and contamination with toxic, allergic and chemicals in our daily life, this fungal infection is commonly found in higher society and also in lower society due to unhygiene. According to Ayurveda, <em>Dadru kushtha</em> is <em>Kapha-pitta</em> predominance disease. It is managed by <em>Shodhana, Shamana</em> and Local application which may be called as <em>Bahiparimarjan chikitsa</em>. In today’s fast life no one has spent so much time, they want quick relief so Local application is the best line of treatment. It works fast due to its physiological effect on external skin in the form of Lepa or ointment.<em> Putikadi Lepa</em> which is mentioned in Sushruta Samhita and Ashtanga Hridaya includes fresh leaves of <em>Karanja (Putik), Arka, Aragwadha, Snuhi and Jati</em> with <em>Gomutra </em>reduces the symptoms of <em>Dadru</em>. All the drugs of <em>Putikadi Lepa</em> are <em>kushtaghna, kandughna, and krimighna</em> type. So it is more effective in <em>Dadru kushta.</em> But it is not possible every time to give fresh <em>Lepa </em>to the patients, so formulation was prepared in the form of ointment for convenience of patients in previous study. When the pilot study was carried out on <em>Putikad</em>i ointment, it was observed that the ointment has pungent smell after application due to <em>Gomutra</em>, so to remove this drawback some drugs should be added like <em>Manjistha</em> and <em>Yashtimadhu</em> to enhance the complexion of skin. This study should be taken to evaluate the efficacy of modified <em>Putikadi</em> ointment in the treatment of <em>Dadru.</em></p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Kidney Function Test for Screening of the Kidney Disease among Hypertensive Patients 2022-01-20T06:42:29+00:00 Reshma Tighare Ranjana Sharma <p><strong>Background</strong><strong>:</strong> Kidney disease results in some loss of renal function and can lead to kidney failure, which is Renal failure is defined as the full loss of kidney function. Renal failure is the last stage of kidney disease, at which point dialysis or a kidney transplant are the only treatments available. The prevalence rate of kidney disease among hypertensive patients in India is 29.8% [1].</p> <p><strong>Objective:</strong> 1. To evaluates the kidney function test by using serum creatinine, blood urea nitrogen and uric acid among hypertensive patients.</p> <ol start="2"> <li>To associate the demographic variables with the selected kidney function test among hypertensive patients.</li> </ol> <p><strong>Methodology:</strong> It is a cross sectional, analytical hospital based study. The patients of hypertension has selected for the study. Patients are chosen based on inclusion criteria, and the nature and aim of the study are explained in detail and the written and informed consent, from the subject will be taken before data collection by the investigator after that the blood and urine samples will be taken from the hypertensive patients for further investigation respectively. The setting of the study is selected hospitals of Vidarbha Region.</p> <p><strong>Expected Results:</strong></p> <ul> <li>There may be a possibility of occurrence of kidney disease among hypertensive patients</li> </ul> <p><strong>Conclusion:</strong> Following the end of data gathering, the statistical analysis will be used to develop conclusions.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Correlation of Salivary Cortisol Levels with Anxiety in Type II Diabetes Mellitus Patients before and after Complete Denture Rehabilitation - An in vivo Study 2022-01-20T06:44:39+00:00 Akansha Vilas Bansod Sweta Kale Pisulkar <p><strong>Background: </strong>Complete edentulism constitutes health care burden, resulting in alterations in physical, psychological and emotional behavior. Also, a reduction in quality of life is expressed by patients, raising their levels of stress and anxiety. Stressful situations cause increased blood pressure and heart rate resulting in the secretion of cortisol hormone, which stimulates gluconeogenesis and glycogenolysis causing hyperglycemia, which may favor the occurrence of Diabetes. As the diabetic’s population is rapidly rising, Prosthodontists are certain to see a greater number of diabetic edentulous patients. Thus, there is a need to assess the relationship of complete denture rehabilitation with the generic health of edentulous patients which can be done by checking the stress levels, and their effects on systemic health.</p> <p><strong>Objectives: </strong>To determine anxiety levels and Salivary Cortisol levels in Type II Diabetes Mellitus patients and compare and correlate them before and after rehabilitation with Complete Dentures.</p> <p><strong>Methodology: </strong>It will be a cross-sectional study, carried out on edentulous diabetic patients aged 50-70 years visiting the Department of Prosthodontics of Sharad Pawar Dental College and Hospital. With consent for participation, Glycated Hemoglobin and anxiety levels will be determined, along with fabrication of complete dentures. Patients will be assessed at two stages; before and 1 month after complete denture rehabilitation.</p> <p><strong>Results: </strong>The research has been approved by the Institutional Ethical Committee. The results expected are the significant reduction in anxiety levels after Complete Denture Rehabilitation and thus, a definitive correlation between anxiety and salivary cortisol levels.</p> <p><strong>Conclusion: </strong>Adaptation of patients to their new set of Complete dentures can be improved by their clinicians by acquisition of the knowledge of relationship of the general health of the patient and correlating it to the dental rehabilitation.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Effect of Benson’s Relaxation Technique on Post-operative Stress and Pain among Women Undergone Abdominal Hysterectomy 2022-01-22T04:16:37+00:00 Vaishnavi Shendre Vaishali Taksande <p><strong>Introduction: </strong>Relaxation programs can be effective in establishing psychological tranquility for patients after surgery [1]. Hysterectomy is the surgical removal of the uterus and its surrounding structures [2]. The vast majority of individuals who undergo surgery endure post-operative pain, which is not only excruciating and distressing, but can also lead to problems and a longer recovery time. Pain worsens stress reactions, resulting in increased tissue breakdown, coagulation, and fluid retention, all of which are detrimental to patient recovery [3].</p> <p><strong>Background:</strong> Women's reproductive health is a worldwide issue with far-reaching impacts for the health, well-being, and development of the entire population [4]. A hysterectomy is performed on about 300 women out of every 100,000 [5]. Younger women may be depressed following a hysterectomy since they have squandered their fertility [6]. Dr. Herbert Benson developed the Benson relaxation technique, which is a type of meditation that focuses on muscle relaxation followed by focused breathing to relieve stress [7].</p> <p><strong>Objective: </strong>1.To assess the stress and pain among women undergone abdominal hysterectomy in experimental group. 2. To assess the stress and pain among women undergone abdominal hysterectomy in control group. 3. To assess the efficacy of benson’s relaxation technique in stress and pain among women undergone abdominal hysterectomy in experimental group. 4. To find out association between stress and pain score with selected demographical variables in experimental group. 5. To find out association between stress and pain score with selected demographical variables in control group.</p> <p><strong>Methodology: </strong>A pretest post-test control group and experimental group research design was adopted to assess the efficacy of benson’s relaxation technique on stress and pain among women undergone abdominal hysterectomy. In this study 100 women who fulfill the inclusion criteria were selected by purposive random sampling technique to collect data from selected hospitals of wardha. Secondary outcome involve evaluation of efficacy of benson’s relaxation technique given to the experimental group.</p> <p><strong>Expected Results:</strong> This study is mainly planned to evaluate efficacy of benson’s relaxation technique on stress and pain among women undergone abdominal hysterectomy. Hence, it is expected that the stress and pain may reduced around 60% after providing benson’s relaxation technique to women undergone abdominal hysterectomy. The conclusion will be drawn from the results and will be published in peer review journal.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Correlation of Gleason Grading System and Nuclear Parameters by Nuclear Morphometry in Patients of Prostatic Adenocarcinoma: A Study Protocol 2022-01-24T07:09:46+00:00 Goyal Aditi Sonkusale Shweta Shukla Samarth Acharya Sourya Vagha Sunita Adnan Asif <p><strong>Background:</strong> Adenocarcinoma prostate is one of the significant causes of death in men.&nbsp; The Gleason Grading System is the most commonly used mortality to assess the degree, yet, identical results among blinded pathologists are challenging to obtain and hence come down to an unobjectionable result.</p> <p><strong>Aim and Objectives: </strong>To evaluate the relationship between histopathologically obtained Gleason’s Grading Score and various nuclear morphometric parameters using a computer-aided system in Prostatic Adenocarcinomas.</p> <p><strong>Methods:</strong> A series of 31 new and histopathologically diagnosed cases of adenocarcinoma prostate will be taken over one year, and the following nuclear morphometric parameters will be studied: mean nuclear area, mean nuclear length, mean nuclear perimeter, mean nuclear roundness factor, mean nuclear area factor and mean nuclear form ellipse. These individual parameters will be correlated with the Gleason Score of the individual cases.</p> <p><strong>Expected Outcome:</strong> The present study expects the nuclear atypia to be more in cases with a higher Gleason Score and avoid the inter-observer contradictions in diagnosis. It can be used as a tool to quantify the aggression of the malignancy and, thus, assess disease progression and prescribe a justifiable management protocol. Nuclear morphometrical analysis can be a more accurate, objective, and effective method in the diagnostic and prognostic significance of prostate adenocarcinoma.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Effect of Radiotherapy on Microhardness and Surface Morphology of Pretreated Primary Teeth with Silver Diamine Fluoride: An In vitro Study 2022-01-21T10:14:14+00:00 Simran Das Nilima Thosar Nilesh Rathi Monika Khubchandani <p><strong>Background: </strong>Radiation therapy has proven to be an effective modality in treating children suffering from cancer. High prevalence of dental caries is seen in children undergoing radiation therapy. This is primarily due to the direct effects of these harmful radiation on the enamel and not as a consequence to the reduced salivary flow. Mechanical properties of the enamel have been seen to be affected by radiation according to various studies conducted.</p> <p><strong>Objectives:</strong> The objective of this study is to evaluate whether radiotherapy causes changes in the microhardness and surface morphology of enamel in primary teeth pretreated with silver diamine fluoride.</p> <p><strong>Methodology: </strong>22 primary teeth samples will be divided into two groups, 11 samples each-study group which will be pretreated with silver diamine fluoride (SDF) and control group. Both groups will be subjected to radiotherapy of 10 Gy radiation for a duration of 6 days. The samples will be tested for Vickers microhardness test and SEM analysis for surface morphological changes post radiotherapy. Statistical analysis will be done using “chi square test, paired and unpaired student t -test”. Surface microhardness and morphological changes of the study and control group compared.</p> <p><strong>Expected Results:</strong> It is expected that SDF application will be effective modality in prevention of caries due to frequent radiation exposure in children suffering from cancer and undergoing radiotherapy.</p> <p><strong>Conclusion:</strong> The study will conclude that SDF will cause a reduction in the microhardness of the surface and lesser morphological changes in the enamel of the primary teeth post radiation therapy in children suffering from cancer.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Impact of Superior and Inferior Approach in Identification and Preservation of Spinal Accessory Nerve during Modified Radical Neck Dissection in Patients with Oral Squamous Cell Carcinoma 2022-01-21T10:27:10+00:00 Naman Pandya Anendd Jadhav Nitin Bhola Naman Khare <p><strong>Background: </strong>During neck dissection, injuries to spinal accessory nerve (SAN) are most common cause of post-operative shoulder morbidity. Which is known as ‘Shoulder Syndrome’. Despite the evolution in neck dissection procedures from radical to super-selective neck dissection, post-operative shoulder dysfunction remains a point of exasperation for head and neck surgeons. It significantly impacts the standard of living for patients with head and neck cancer. According to the anatomic course and branching of SAN, there are various dissection technique for identification and preservation. Our comparison of superior dissection approach with inferior dissection approach for identification, preservation, and complete skeletonization of SAN in posterior neck dissection has not been studied based on its anatomical course.</p> <p><strong>Objective:</strong> To compare Superior Vs. Inferior approach group in regards to safety and superiority of the approach for SAN preservation with minimal or no intraoperative and or post-operative functional complications.</p> <p><strong>Methods:</strong> The patients will be randomly divided into two groups according to the approach used to identify and preserve SAN (superior Vs. inferior approach group). The intraoperative clinical and post-operative data will be collected and evaluated with appropriate statistical analysis.</p> <p><strong>Results:</strong> Collected data from 24 patients will undergo statistical analysis to obtain the results.</p> <p><strong>Conclusion: </strong>This study expects to find a superior modality amongst the Superior dissection approach and inferior dissection approach in terms of identification, preservation, and post-operative functional deficit for spinal accessory nerve.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Comparative Evaluation of Efficacy of Mannitol and Hypertonic Saline (3%) for Treatment of Moderate to Severe Traumatic Brain Injury (TBI) 2022-01-21T12:59:17+00:00 Sakshi Katariya Sandeep Iratwar <p><strong>Background:</strong> Intracranial Pressure of higher than 20 mm of Hg is considered Intracranial Hypertension. For years, Mannitol has been the go-to drug for its cure. However, it has many adverse effects. Therefore, other drugs are being considered for reducing Intracranial Pressure (ICP), and hypertonic saline (HTS) appears to be a good alternative.</p> <p><strong>Methods:</strong> The reason for this study is to report any differences in results after using of mannitol or hypertonic saline for treating Intracranial Hypertension (IH) in patients who were in the tertiary care hospital to be treated of moderate or severe Traumatic Brain Injury (TBI).</p> <p><strong>Methodology:</strong> All patients who had moderate or severe Traumatic Brain Injury (TBI) i.e, were reported at the hospital and had Glasgow Coma Score lesser than 13, were admitted in the hospital over the course of 2 months of the study will be included.&nbsp; Patients will be randomized into 2 statistically comparable groups. Group A and Group B will be given the standard amount of mannitol and hypertonic saline (3%) and clinical result will be noted for both cases.</p> <p><strong>Results:</strong> The results will be calculated by rate of improvement in Glasgow Coma Score (GCS) of both groups and then compared. Primary endpoint will be clinical improvement after 7 days.</p> <p><strong>Conclusion:</strong> The rationale behind which drug of the two - mannitol or hypertonic saline solution (HS) - for treatment of people suffering Traumatic Brain Injury (TBI) to be primary varies considerably and there seems to be no protocol to determine which of these should be preferred. Most of the studies that have been done on the topic conclude that Hypertonic saline (HTS) seems to better suited for lowering Intracranial Pressure (ICP), regardless of its concentration. However, other than its apparent superiority in ICP reduction, it doesn’t seem to have any additional benefits, in relation to mortality.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Association of Depression with Polypharmacy among Diabetic Patients of Geriatric Age Group in Tertiary Care Teaching Hospital 2022-01-24T08:23:06+00:00 Yachika Thakkar Sarju Zilate <p><strong>Background</strong><strong>:</strong> Diabetes mellitus, one of the common serious conditions among the elderly and depression is frequent finding as a Comorbidity. Polypharmacy is common in diabetes and In diabetic senior people, it has been linked to depression. Polypharmacy, especially among the elderly, is a consistent predictor of inappropriate medication. Approaching and analysing the prescription pattern in elderly diabetic patient will rationalize the drug utilization. The current research is to access the co-relation of polypharmacy in geriatric diabetic patient and accompanying depression.</p> <p><strong>Objectives:</strong> To assess depression and polypharmacy and correlate their association in diabetic patients of geriatric age group.</p> <p><strong>Methodology:</strong> This is questionnaire based cross sectional observational study. This shall be conducted in geriatric population attending Medicine department [OPD and IPD] [AVBRH], DMIMS, Sawangi [M], Wardha, Maharashtra, India. The depression will be assessed using Geriatric Depression scale. The Polypharmacy will be assessed using contingency table and odds ratio.</p> <p><strong>Expected outcome</strong><strong>:</strong> It is hypothesized that geriatric diabetic patients with depression [GDS&gt;= 6] are at higher risk of encountering polypharmacy.</p> <p><strong>Conclusion</strong><strong>:</strong> To upgrades standards of life of senior diabetic patients, prescribing procedures should be reviewed.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## An Evaluation of the POSSUM Score's Efficacy in Predicting the Outcome of Patients Undergoing a Laparotomy - A Study Protocol 2022-01-24T10:38:01+00:00 Harsh Bhalsod H. B. Ramteke <p><strong>Background:</strong> POSSUM Score is used to assess the outcome of complication, surgical intervention and the proportion between predicted and observed morbidity and mortality.Such scoring systems have been especially designed to compare patient’s severity of illness, predict mortality, morbidity and to plan an effective treatment protocol.</p> <p><strong>Objectives:</strong></p> <ol> <li>To assess applicability of POSSUM score (morbidity and mortality) in surgical practice in a tertiary care centre in a rural area.</li> <li>To assess utility of POSSUM score in clinical management.</li> </ol> <p><strong>Methodology:</strong> The complications included in the study will be assessed in patients undergoing laparotomy during the hospital stay irrespective of the period of stay. The severity of these complications will be predicted using POSSUM score. The cases developing complications will be randomly selected to make a total participant size of 100.</p> <p><strong>Results:</strong> At the end of the study, we expect easy applicability of POSSUM score in assessment of morbidity and mortality in patients undergoing laparotomy.</p> <p><strong>Conclusion</strong><strong>:</strong> We hope that POSSUM score is an easy tool which can be applied to assess the morbidity and mortality in patients undergoing laparotomy.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Study on the Plasmid and Genomic DNA Stability of DH5α Host System 2022-01-24T07:43:01+00:00 Laxmisai Dixitha Vengili Phavethra Sago Yaswanth Kumar Reddy Kuncha Venkata Suneela Kolli Lasya Sri Varugu Sree Lakshmi Mandadapu Suryanarayana Veeravilli Praveen Kumar Vemuri <p>Plasmids are extremely valuable as a source of DNA and for use in biotechnology. Our research goal was to develop plasmids with extremely high copy numbers for lab-scale plasmid preparations. Using the beverage method simplifies the process of obtaining a large quantity of plasmid DNA for various applications. Diet Coke as a beverage demonstrated that DNA recovery is highly adequate. Diet Sting with EcoRI and BamHI enzymes was used to detect restriction digestion with high sensitivity. However, for lab-scale preparative work, our findings show that plasmid yield can be significantly increased by using standard growth procedures and commonly used growth media.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Relationship between Shukra Sara Purusha with Quality of Semen: A Pilot Study 2022-01-21T12:53:20+00:00 Nikhate Sunil P. Raole Vaidehi P. Karemore Shruti <p><em>Dhatu sarata </em>is an excellent state for any particular<em> dhatu (tissue). Shukra</em> <em>dhatu</em> (Reproductive tissue) is one of the seven <em>dhatu</em> reflects reproductive health. <em>Garbhotpadan</em> (reproduction) is main function of <em>Shukra dhatu (Reproductive tissue). </em>Characteristics future of <em>shukra </em>(Semen) is given by <em>ayurvedacharya</em> and this quality of <em>shukra (Semen) </em>said to be best for fertility. Shukta dhatu (Semen) can be correlated with semen. Its quality and quantity affects reproduction and any deformity is lead to infertility in male. Pilot study was conducted to find out relationship between <em>Shukta</em> <em>dhatu</em> <em>sarata</em> and quality of semen. An observational pilot study conducted on apparently healthy volunteers. 30 male volunteers of age group 25-35 yearr were selected and their <em>Shukra</em> <em>dhatu</em> <em>sarata</em> (Supreme quality of Reproductive tissue) were assessed with standard proforma. Then categorized into <em>Uttam</em> (supreme), <em>Madhayama (Moderate)</em> &amp; <em>Hina (Average)</em> sara on the basis of presence number of characteristics. Semen analysis i.e. semen volume, total sperm count, sperm motility is done in laboratory of same individuals.&nbsp; Higher Sperm count, good Sperm motility and high semen volume are found in <em>Uttam</em> <em>Shukradhatu</em>sara (Supreme quality of Reproductive tissue) individuals as compare to <em>hina</em> <em>shukradhatusara</em> (Average quality of Reproductive tissue) individuals. It is not possible to come to any conclusion as this was pilot study. Further study should be conducted on large sample size.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## A Survey about the Awareness, Knowledge and Attitude towards Intellectual Property Rights (IPR) among the Dental Researchers of SGT University, Gurugram 2022-01-22T16:35:48+00:00 Monika Dhayal Vidushi Sheokand Amit Bhardwaj Chinnu Mary Varghese . Harender Madhur Goyal <p>With the advancements in modern science and technology, Intellectual Property Rights came in to existence to benefit and encourage innovative people for their work. The term intellectual property rights gained his strength from a long time and much expanded since then. These rights are applied to all innovation irrespective of educational qualifications and implies to all subjects. Dentistry in recent years has also developed interest in the field of intellectual property rights (IPR) and Patents due to extensive research in the fraternity. Therefore, it is need of the hour to check out the awareness about intellectual property rights. If people would aware about IPR, then only can proceed for IPRs in future for their research findings. As the universities are the main hub of intellectuals therefore, aim of the present study was to determine the intellectual property rights (IPR) awareness level among the dental scholars of SGT University, Gurugram.&nbsp; Hence, this would be an advantage for dental researchers to explore and expand their scope of activities.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Problems Regarding Polypharmacy in Elderly in Indian Population 2022-01-22T04:41:16+00:00 Anurag Kumar Sunil Kumar <p>Among the general population, various international studies have shown that poly pharmacy is common in the older adults but those adults who were residing in nursing homes took the maximum number of drugs. It has also be shown that nearly half of the older adult population take one or more medications that are not medically necessary as per their conditions. According to various research, it has been clearly established that there is a strong association between multiple drug use and negative clinical consequences. In addition to that, conducting well-designed inter-professional intervention studies, which often include clinical pharmacists, that focus on enrolling high-risk older patients taking multiple medications with mixed results on distal health outcomes can improve the effectiveness of enhancing the overall quality of prescribing medications. It is critical to do research on poly pharmacy in a nation like India or other low to medium income countries. Poly pharmacy is induced by a multitude of variables at the levels of health-seeking, prescription, distribution, and usage. Society-based issues such as a lack of education and access to adequate healthcare in both rural and urban regions, as well as a general lack of health knowledge and passion, further aggravate the situation. Poly pharmacy is a key challenge in senior care. The senior population frequently has several medical diseases and may possibly suffer from cancer, which necessitates the use of multiple drugs for therapy. Multiple drugs used by an aged person can increase the likelihood of drug-drug interactions, noncompliance with the prescription, adverse drug responses, and reduced patient compliance.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Sexual Transmitted Disease among Youth 2022-01-22T17:57:47+00:00 Akash Pathak Anupma Sawal <p>Infections transmitted through sexual contact are known as sexually transmitted infections (STIs). There are ones that can be cured such as syphilis, gonorrhea, and chlamydia infection as well as some that can’t be cured, but are modifiable ones like HIV, herpes simplex, HPV (human papilloma virus), and hepatitis B infections. It is estimated that 20% of individuals living with HIV/AIDS are in their twenties and that almost one out of twenty young adults contract an STI every year. Adolescents are more likely to practice unprotected sex, have more than one sexual partner, and have intergenerational and transactional sex. That’s why, the importance of sexual education should be taught. The cervical lining makes female adolescents and young women more susceptible to STIs. Moreover, they may have difficulties getting the information and services they need to avoid STIs, as well as difficulties locating STI prevention services. In addition, they may have difficulty locating STI prevention services, or they may not have transportation to go to the clinics or they may not be able to afford the treatments. In places that are not youth-friendly, they may feel uncomfortable, even if they can get STI prevention services.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Lights and Shadows of Rituximab in Dermatology 2022-01-18T04:11:50+00:00 Ashok Kumar Geo Danny Sane Roja Renuka Arisha Salam <p>Rituximab is a CD 20 monoclonal antibody drug used in various spectrum of diseases today. It has proven to be a boon, especially in the field of dermatology. Although Rituximab was initially introduced as a novel method to treat B-cell Non Hodgkin Lymphoma, its use has rapidly expanded to include a number of other Lymphomas and Autoimmune diseases.This review is to give a bird’s eye view of updates on rituximab.</p> <p>Conclusion: With its horizons expanding in dermatology, and with better information regarding its efficacy and safety profile, Rituximab has now become an approved first‑line therapy for pemphigus. In conclusion, Rituximab has proven to be a substantial boon for dermatologists in difficult to treat cases.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## COVID-19: Etiology, Transmission, Epidemiology, Treatment and Clinical trials 2022-01-19T09:16:32+00:00 Vinod Kumar Dolly Rani Anuradha Saha Jenifer Robinson Chandra Mohan <p>In 2019, human race again came across a highly transmittable and pathogenic viral infection viz. COVID-19 and along with its pandemic nature, caused severe acute respiratory syndrome (SARS), and owes its emergence from the local seafood market of Wuhan city, China. Corona virus is currently prevalent all over the world wherein it caused infection in more than 29,599,29 individuals worldwide with mortality rate nearby 6.84% in approximately 213 countries within a short span of time and the infection due to this virus is still on a higher verge. The data showed that the transmission rate of COVID-19 is higher than the previous viral infections, particularly because of changes in genetic recombination at S protein in the RBD region. Till now there is no approved treatment available against COVID-19 infection and has been observed for human to human transfer widely. The present review summarizes the etiology, transmission, epidemiology, possible approaches for the treatment of COVID-19 and Clinical trials.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Phytoconstituents and Medicinal Importance of Cannabis sativa 2022-01-24T10:46:06+00:00 Anjali Thakur . Sushma Reena Sharma <p><em>Cannabis sativa</em> has been reported that it is a widely spread species all over the world. It has been receiving more attention due to its therapeutic potential. Popularly, it is also known as marijuana. The phytoconstituents and characteristics of <em>Cannabis sativa</em>, stem, leaves and seeds were provided with more information in feed materials for its utilization and nourishment. Positive biological activities and pharmacological aspects provided from <em>Cannabis sativa</em>. <em>Cannabis</em> played a key role as a medicinal plant in the lives of tribal people mostly living in the Himalaya, providing products for both food as well as their medicinal purposes. The role of <em>cannabis</em> for treating several medicinal conditions increased day by day. The present paper is reviewed on phytoconstituents and medicinal importance of <em>Cannabis sativa</em> which is mainly aimed at researching the state of the art, and enhancing the knowledge of this versatile plant. <em>Cannabis sativa</em> is from the Cannabaceae family, which is mostly able to live in temperate as well as tropical regions. It is the most commonly used psycho-active drug all over the world and the only one most popular illegal drug. This review mainly analyzes the botanical, descriptional and diversity along with the medicinal importance of marijuana among the human being which is found throughout the worldwide.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Spironolactone in Dermatology: A Mini Review 2022-01-24T11:25:12+00:00 Jayakar Thomas S. Soundarya S. Vaishnavi <p>Spironolactone is a drug, similar in structure to aldosterone and acts as an aldosterone receptor antagonist with an anti-androgenic effect.</p> <p>This drug has proven to be useful in several dermatological entities, however its use has not been well explored. Its use in diseases such as acne has opened the door to the possibility of new therapies depending on the clinical manifestations of the patients, as well as its possible to use it as a first line treatment. Other diseases associated with the use of spironolactone where its effects have been shown to be useful are hidradenitis suppurativa, hirsutism and female pattern androgenetic alopecia. In this review we discuss the use of spironolactone in different skin diseases that are common in our environment, dosage according to different studies, treatment recommendations and adverse effects; all of the above mentioned in order to use this drug in a daily clinical practice.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Evaluation of Lung Function Test in Zumba Dancers 2022-01-17T05:36:37+00:00 Prateeksha Moharana Preetha S G. Sridevi Lavanya Prathap <p><strong>Introduction: </strong>Exercise is very important in each and every individual’s life. Zumba exercise is a form of physical exercise that combines all the exercise which is beneficial for the body. The aim of the study is to evaluate the effect of zumba exercise training on pulmonary function tests in individuals.</p> <p><strong>Materials and Methods: </strong>This study was carried out among 60 individuals where 30 people belonged to a normal group and 30 people were zumba dancers. The values were recorded through a computerised spirometer. This study was done among zumba dancers in the Chennai region. The results were analysed using SPSS software. unpaired T test was used to analyse the statistical significance. p&lt;0.05 was considered significant.</p> <p><strong>Results: </strong>The mean values of the lung function test for FVC, FEV1 and FEV1/FVC ratios were 3.73, 2.88 and 82.33% respectively and all the values were statistically not significant.</p> <p><strong>Conclusion: </strong>The study showed that pulmonary function tests in zumba dancers were good when compared to the control group.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## The Use of Ophthalmic and Nasal Naphazoline in the Outpatient Setting 2022-01-17T05:37:54+00:00 Nehad Jaser Ahmed Hasan Soliman Yusufoglu <p><strong>Aim: </strong>The present study aimed to describe the use of ophthalmic and nasal naphazoline in the outpatient setting.</p> <p><strong>Methodology</strong><strong>:</strong> This was a retrospective study that includes reviewing the electronic prescriptions of naphazoline among outpatients in a public hospital in Alkharj.</p> <p><strong>Results: </strong>During the study period of 6 months, 393 patients received naphazoline. Most of them were male patients (77.35%) and the age of 34.35% of them was between 20 and 29 years. The majority of the prsecriptions that contained naphazoline were prescribed by residents (99.75%). Most of the patients received naphazoline as nasal drops either alone (47.84%) or combined with chlorpheniramine (36.13%). The majority of the prescriptions were written by the emergency department (99.24%).</p> <p><strong>Conclusion</strong><strong>:</strong> The present study showed that naphazoline was commonly prescribed in Alkharj. Further studies are needed to explore the frequency and pattern of naphazoline use as well as to explore the frequency of prescribing other sympathomimetic vasoconstrictors in different settings.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Estimation of Knowledge, Attitude and Practices of Tuberculosis Patients in Penang: A Prospective Study 2022-01-17T05:40:34+00:00 Zohra Bhatti Amer Hayat Khan Syed Azhar Syed Sulaiman Madeeha Laghari Irfhan Ali Bin Hyder Ali <p><strong>Background: </strong>A clear understanding of knowledge, attitudes, and practices (KAP) of tuberculosis (TB) patients is important to encourage patients' contribution to TB prevention and control. Appropriate knowledge, positive attitude, preventing transmission and early diagnosis of TB are key factors in improving patient outcomes.</p> <p><strong>Objective: </strong>This study aimed to investigate the knowledge, attitude, and practices about TB and determine related influencing factors among TB patients.</p> <p><strong>Methodology:</strong>&nbsp; A cross-sectional prospective study by using a validated structured tool was conducted among TB patients more than 18 years of age. Descriptive statistics were used to summarize socio-demographic characteristics and TB knowledge, attitude, and practices level. To compare scores of each domain with various demographic factors, the Kruskal Wallis H test was applied.</p> <p><strong>Results</strong>: Total participants in the study were 337. Of these, 231(68.5%) were male and 106(31.5%) were females with a mean age of 46.5±17.1 years. A significant difference was observed between males and females TB knowledge and practices concerning age. Patients with ³ 12 years of educational background profoundly have better knowledge.</p> <p><strong>Conclusion:</strong> Overall, TB patients have shown encouraging results of the study, but poor attitudes and practicing behaviors are observed among TB patients. More extensive strategies should be developed to enhance the campaign of awareness programs among TB patients to improve preventing behavior towards disease.&nbsp;</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Evaluation of the Knowledge of Saudi Women in Childbearing Period towards Toxoplasmosis Induced Teratogenicity – Evidence from A Cross-Sectional Study 2022-01-17T05:43:09+00:00 Wael Mansy Abdulrahman Alwhaibi Ali Mohammad Alqahtani Nasser M. Al-Arifi Abdulaziz N Alotaibi Salmeen D Babelghaith Norah Aljabli Sara Alsubei Raghad Al Fayez Nouf Al Ameel Mohamed N Al-Arifi <p><strong>Background: </strong>Toxoplasmosis is an environmental teratogen that may disrupt fetal development if transferred to the mother during pregnancy, resulting in maldevelopment and newborn mortality.</p> <p><strong>Objective: </strong>To assess knowledge of Saudi women in their childbearing period as regards risk factors of Toxoplasmosis infestation, testing, awareness of disease manifestation and prevention.&nbsp;</p> <p><strong>Methods: </strong>Anonymous online survey was used to examine the knowledge of Saudi women in their childbearing period about Toxoplasmosis induced teratogenicity. The non-probability sampling yields a calculated size of 600 women. The cross-sectional design of the research required categorizing the questions into two significant portions, one for sociodemographic data and the other for assessing Toxoplasmosis awareness. First, a descriptive statistic summarized the demographic characteristics. In categorical data, chi-square tests were employed to compare groups.</p> <p><strong>Results: </strong>A total of 613 women in their childbearing years completed the questionnaire. Most respondents interviewed were 36-40 (46.7%), and Para 1-5 (80%), and 86% were graduates. In addition, 42.2 % had the basic knowledge of Toxoplasmosis, 25.3 % were aware of the manifestations of the disease, and 76.3% correctly identified premature labor or miscarriage as sequelae of the infection. Aside from the frequency of abnormalities and parities and knowledge of toxoplasmosis, no other demographics in our research sample showed a significant association.</p> <p><strong>Conclusion: </strong>The basic knowledge of Toxoplasmosis among Saudi women of childbearing age is unsatisfactory (42.6 %). Age, family income, educational level and the number of abortions were significantly associated with knowledge of Toxoplasmosis among Saudi women in their childbearing age.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## A Survey of Physicians’ Opinion and Treatment Preferences Regarding Febrile Seizures in Children 2022-01-17T05:43:46+00:00 C. Tulasi Priya Chaudhary Devand Gulab <p><strong>Background</strong><strong>:</strong> Fever of either low or high-grade is a big concern when present in the pediatric age group; it is much more worrisome if children are younger than 5 years of age. Fever can subside on its own or with the help of simple remedies and or medications. However, some children will develop seizures when they have a fever. Febrile seizures are one of the most common presenting complaints seen in pediatric patients in emergency room visits and physician consult. Two different types of seizures are seen in children, simple and complex seizures. Simple febrile seizures are non harming and self-limiting, while, complex seizures are prone to have long-term side effects on children. Febrile seizures can occur with or without a source of an underlying cause. In this study, we aimed to identify physicians’ opinions, knowledge, and suggestions to improve guidelines on current treatment trends for fever and fever’s association with febrile seizures in children less than 5 years of age.</p> <p><strong>Objectives</strong><strong>:</strong> To determine physicians’ opinion knowledge, and suggestions to improve guidelines on current treatment trends for fever and fever’s association with febrile seizures in children less than 5 years of age.</p> <p>&nbsp;<strong>Methods</strong><strong>:</strong> A cross-sectional study plan was designed and conducted in June - July 2021 involving general physicians and pediatricians (n = 600). The questionnaire form including 15&nbsp;closed-end&nbsp;questions was distributed to physicians.&nbsp;Descriptive statistics were used to analyse the data.</p> <p>&nbsp;<strong>Results</strong><strong>:</strong> 100% of physicians prescribed antipyretics to control fever and or to prevent complications, especially febrile seizures. All participants were aware that axillary temperature of &gt; 37.2 ° C is defined as fever. All most all, general physicians and most pediatricians used antipyretics to treat other associated symptoms and signs, even when the fever was absent. 76.3% believed that high fever might be an indicator of underlying serious occult bacterial infection. Almost all physicians (91.3%) advised parents to switch to the use of alternate medication when the fevers did not subside after initial treatment with paracetamol; everyone recommended that non-medical supportive treatments like tepid sponging along with antipyretics and ibuprofen to reduce the fever soonest possible. 68% of pediatricians and 90% of general practitioners believe that febrile seizures will cause brain damage. 74% of general practitioners preferred to refer children immediately to specialty centers, for further management of seizures. However, Pediatricians at tertiary care centers, as well as those in private practice used diazepam or lorazepam.&nbsp; &nbsp;</p> <p><strong>Conclusion</strong><strong>:</strong> Differences are negligible between general physicians and pediatricians while managing fever and fever complications including febrile seizures. Irrespective of the knowledge, awareness and the availability of fever guidelines by many national and international organizations, physicians are leaning towards child and parents comfort in treatment fever. The gap is wider in general physicians’ preparedness than pediatricians. A considerable gap exists to improve physicians' approach, diagnosis, and management of fever in the pediatric population.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## A Descriptive Study of Under-five Mortality 2022-01-17T05:44:23+00:00 Mohammad Haroon Rahemi Masihullah Masih <p><strong>Introduction: </strong>The under-five mortality is a global problem, which is an important indicator to, demonstrate the quality of health services in a region or a country. The under-5 mortality rate is the probability of dying before five years of age (per 1,000 live births). In the 1990s under-five mortality rate was 12,7 million, but it decreased to 6,2 million in 2015. In Afghanistan due, to more than forty years of war and internal conflict, low socio-economic status, and high level of illiteracy, the under-five mortality rate is very high.&nbsp;</p> <p><strong>Objective: </strong>This study aimed to determine the mortality rate and it’s causes in children under the age of five in Nangarhar Province.</p> <p><strong>Methods: </strong>This is a descriptive study conducted from 2018-2019 in Nangarhar University Teaching Hospital (NUTH). According to Health Management Information System (HMIS) data reports in the mentioned period, 9164 under five patients were admitted in the different wards of Nangarhar University Teaching Hospital.</p> <p><strong>Results: </strong>The mortality of 824 patients were recorded (824/9164) due to different causes, which contribute 9% of total mortality. Of the 824 deaths, 371 consisted of neonatal deaths, which make 45% of total mortality, the 55% (453/824) deaths have occurred between the age of 28 days and five years. The principal causes of neonatal deaths were 35 percent prematurity, 27 percent birth asphyxia, 24 percent sepsis, 8 percent malformation, and 6 percent was consisting of other diseases such as neonatal jaundice, neonatal tetanus, neonatal diarrhea, birth trauma, etc. In this, study the causes of death occurred in the age of 28 days to five years were 30 percent due to malnutrition, 22 percent pneumonia, 20 percent Diarrhea, 10 percent Measles, 6 percent Malaria, 8 percent Meningo-encephalitis and 4 percent due to other diseases like pertussis, poisoning, trauma, burns, pediatric cardiac disease, neoplastic disease, and others.</p> <p><strong>Conclusion: </strong>The data of our study has taken from the Health Management Information System (HMIS) department of the 2018-2019 years which was collected from different wards of Nangarhar University Teaching Hospital. The rate of under-five mortality was about 8.99 ~ 9%. The result of our study was different from other countries and the mortality rate may be changed from time to time. These changes belong to several factors such as variable definition, promotion of socio-economic status, risk factors, geographical situation, peoples’ education level, availability of health services, and preventive measures.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Controlling Oral Pathogens using Ficus Benghalensis Mediated Silver Nanoparticles 2022-01-17T05:44:57+00:00 K. Thirumagal M. Jeevitha S. Rajeshkumar Selvaraj Jayaraman <p><strong>Aim: </strong>To find antimicrobial property of <em>Ficus benghalensis</em> mediated silver nanoparticles (AgNPs)</p> <p><strong>Introduction: </strong>Nanoparticles have been studied in recent years because of certain properties like physical, chemical, electronic, thermal, magnetic, optical, dielectric and biological. This study was conducted in order to evaluate antimicrobial properties of <em>F. benghalensis</em> mediated &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;AgNPs.</p> <p><strong>Materials and Methods: </strong>In this study, extract of <em>F. benghalensis </em>was used to synthesize silver nanoparticles characterized using UV- visible spectrophotometer, Fresh <em>F. benghalensis</em> mediated AgNPs show excellent antimicrobial activity against oral pathogens, <em>Staphylococcus aureus, Streptococcus mutans, Enterococcus faecalis. and Candida albicans.</em></p> <p><strong>Results:</strong> <em>F. benghalensis </em>mediated AgNPs showed antimicrobial activity against gram positive <em>S. aureus </em>with a zone of inhibition of 16.22 ± 0.31 mm at the concentration of 100 μl. The zone of inhibition against <em>S. mutans </em>was 12.14 ± 0.21 mm followed by zone of inhibition against <em>E. faecalis </em>was 12.12 ± 0.2 mm and antimicrobial activity against <em>C. albicans </em>showed a zone of inhibition of 14.02 ± 0.24 mm at the concentration of 100 μl. The zone of inhibition of the nanoparticles was shown to be increased with increase in concentration against all the pathogens and the maximum inhibition was shown against <em>S. aureus. </em></p> <p><strong>Conclusion:</strong> Overall, antimicrobial activity was seen to be increased with increase in concentration. Thus there was potent antimicrobial activity in <em>F. benghalensis </em>mediated AgNPs which could be beneficial when applied in treatment of infectious oral diseases in future.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Dynamics of Changes in Quality of Life and Local Levels of TNF-α and IL-1β in Patients with Acute Viral Rhinitis 2022-01-17T05:45:26+00:00 Dmytro Grebeniuk Yaroslav Hrytsun Halyna Nazarchuk Oksana Mashevska Lidiia Levytska Liliia Chepel Mykola Melnychenko Iryna Pallii Vitalii Bobyr <p><strong>Introduction:</strong> Acute viral rhinitis is one of the most common pathologies among the population of the globe. Although, at first glance, this pathology seems simple and well-studied, but due to the high incidence, the load it creates on the health care system encourages in-depth study.</p> <p><strong>Aims:</strong> To examine the dynamics of changes in quality of life and local levels of TNF-α and IL-1β in patients with acute viral rhinitis in different treatment regimens.</p> <p><strong>Methodology:</strong> The prospective study included 84 patients with a confirmed diagnosis of acute viral rhinitis. In accordance with the purpose and objectives of the study, all patients on days 1, 5 and 10, in addition to routine studies, were determined by local levels of TNF-α and IL-1β, as well as to determine the quality of life.</p> <p><strong>Results:</strong> In patients of the study group, only partial recovery of local levels of TNF-α and IL-1β and indicators of the physical component of quality of life was observed during 10 days of treatment. The emotional and functional components of quality of life in patients of this study were more correlated than with the physical component and local levels of proinflammatory cytokines, which are objective indicators of the activity of the inflammatory process. Complementing the traditional treatment regimen with 0.25% oxolin in the form of an ointment has reduced the duration of the disease, reduced the incidence of bacterial complications and improved the quality of life of patients with acute viral rhinitis in the short term.</p> <p><strong>Conclusions:</strong> The dynamics of local levels of TNF-α and IL-1β reflects the nature of the inflammatory process in the nasal mucosa and clearly correlates with the physical component of quality of life.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Analytical Method Development and Validation for Estimation of Mifepristone in Pure and Pharmaceutical Dosage Form 2022-01-17T05:46:28+00:00 Sheetal Bastia Vaibhav Gawade Vitthal Chopade Rahul Jagtap Vishal Modi <p>Mifepristone structurally belongs to the class of anti-progesterone steroids, which are used as an oral contraceptive. The reverse phase HPLC method was designed in a simplified and rapid way for the estimation of Mifepristone in bulk as well as tablets. The method was established using a Kromasil C<sub>18 </sub>column of dimensions of 250mm×4.6mm and a particle size of 5m.The used mobile phase was Acetonitrile: Water (70:30, v/v). The pump was pumped at 1 ml/min at a temperature of about 30 ± 2 °C and the eluted analyte was identified at 305 nm. Mifepristone eluted with a mean retention time of 6.27 minutes. The intended method was validated as per ICH (International Council for Harmonisation) guidelines, indicating a high degree of specificity, system suitability, accuracy, precision, and robustness. The LOD (Limit of detection) was found to be 0.7238 ppm and the limit of measurement was 0.9562 ppm. The method linearity was found to be between 1-6µg/ml, with an R<sup>2</sup> of 0.9923. In accuracy studies, the percent recovery was found to be between 99.39% - 100.50%. The method was discovered to be precise as the values of the percent RSD were found to be less than 2.0% for both intraday and interday. The method was discovered to be reliable and robust. Mifepristone in marketed pharmaceutical tablet dosage form was effectively quantified using the established Reverse Phase HPLC method.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Evaluation of Oral Health Condition among the Pregnant Females at Tertiary Care Hospital of Hyderabad, Sindh 2022-01-17T05:47:41+00:00 . Palwasha Yaswant Rai Maria Javaid Nisar Ahmed Khokhar Roohi Nigar <p><strong>Background:</strong> Gestational is special and interesting period for every woman that covers the physiological hormonal changes and leads to the development of new healthy life. Changes in hormones during pregnancy may alter the physiological conditions that impose the bad impact of different body parts including gastric and oral health of the mother. Oral health plays an important role for maintaining normal and healthy life of human being and if any disease or disorder appeared within the oral cavity, it may leads to severity of disease and disturbed normal routine life.</p> <p><strong>Aims and Objectives:</strong> This study aims to evaluate the condition of oral health during gestational period.</p> <p><strong>Materials and Methods:</strong> Descriptive cross sectional study was carried out for the period of six months at Department of Gynecology &amp; Obstetrics ward, Liaquat University of Medical &amp; Health Sciences, Jamshoro and females with positive pregnancy were included in the study and total 146 females were selected, after the signature on informed consent form. Medical history was taken in order to ensure any major disease or medication affecting oral health.</p> <p><strong>Results:</strong> After collection of proper data from all participants, the results were finalized, 19 females were belonging to age group of 18-21years, and 51 females belong to 26-29 years. 47 females had good OHI-S score, 59 had fair OHI-S score. 31 female had 1<sup>st</sup> trimester, 81 females had 2<sup>nd</sup> trimester and 34 had 3<sup>rd</sup> trimester. 19 females had normal PI index, 94 had simple gingivitis and 33 females had periodontitis.</p> <p><strong>Conclusion:</strong> It was important to maintain good oral hygiene before and during pregnancy, so as to prevent the occurrence of periodontal disease and to avert the irreparable damage that may arise during the period of pregnancy.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Emergency Medical Services Challenges Regarding Resource Capacity and Competency during COVID-19 Pandemic 2022-01-17T05:48:22+00:00 Ghaydaa Filimban Khaled Aljasser Loui Alsulimani Asma Altalhi Abdulaziz Alshebili Taha Masri Hattan Bojan Fahad Alhajjaj Mohammad Altuwaijri <p><strong>Objectives: </strong>This study aimed to investigate the availability of resources, personal protective equipment PPE) and beliefs amongst Emergency Medical Services (EMS) professionals in Makkah city. Also, we aimed to assess various aspects of how Emergency Medical Services are handling the COVID-19 pandemic via online self-administrated questionnaire.</p> <p><strong>Methods:</strong> A cross-sectional analysis was conducted on a convenience sample of 276 EMS providers from the city of Makkah in Saudi Arabia during the period from July 2020 to June 2021. SPSS (version 21.0) was used for data entry and data analysis. We approximate a 95% confidence interval (±0.05).</p> <p><strong>Results: </strong>Emergency Medical Technicians (EMTs) and paramedics are representing most of the participants, 44% and 43%, respectively. EMS doctor, EMS registered nurse and others represent the remaining 13%. When the participants assessed their level of satisfaction on how their institutions have handled the pandemic, 34% expressed that they were satisfied, 14% were very satisfied, while 21% and 13% expressed that they were dissatisfied and very dissatisfied. On the availability of resources, 42% had access to N95 masks whenever they needed access to them while 33% did not have access.</p> <p><strong>Conclusion:</strong> As the study demonstrates a relationship between the capability of emergency medical services personnel to handle a pandemic like COVID-19 and institutional preparedness, there are still significant gaps in EMS personnel's PPE training. EMS agencies should be supported in their efforts to effectively prepare their workers while the pandemic continues in our communities. Therefore, institutions should adopt guidelines that stipulate care for patients with COVID-19, provide training to emergency personnel, and properly distribute resources and PPE.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Ocular and Extraocular Symptoms among Medical Undergraduates with Cellphone Addiction, A Cross-sectional Study 2022-01-18T04:07:40+00:00 Kiran Khan Ata ur Rehman Ghazala Nasim Pasha Syeda Laraib Fayyaz Nasima Iqbal Ruqaya Nangrejo <p><strong>Aim: </strong>To find out the frequency of ocular and extraocular symptoms due to cellphone use among the medical students.</p> <p><strong>Study Design: </strong>Cross-sectional study</p> <p><strong>Place and Duration of Study:</strong>&nbsp;Study was conducted in private and public sector medical and dental colleges of Karachi from January 2019 to September 2019.<strong>&nbsp;</strong></p> <p><strong>Methodology:&nbsp;</strong> Self-designed, self-explanatory questionnaire was used to collect data. The setting for the collection of the data has been classrooms, common rooms, cafeteria and open sports areas of the medical and dental colleges which has been surveyed by the different team members of the group. The data was analyzed by using Statistical Package for the Social Sciences (SPSS) version 22.</p> <p><strong>Results: </strong>The mean age of the study participants was 21.2 ±1.82 years, among them majority was female i.e. 60.25%. Participants were having different degrees of blurred vision, eyestrain, dry eyes, eye redness and irritation, difficulty in refocusing the eyes and double vision with frequency of 17.25%, 24.25%, 9.5%, 10.75%, 9% and 5% respectively. Respondents during the survey stated that they were having different physical problems apart from disturbance in eyesight. About 39.75% respondents complained of varying degree of headache and or migraine. 36% were having pain in neck, shoulder or back while 25.25% were having variable degree of fatigue. About 21.5% complained pain in fingers and wrist, 9.5% complained of hand stiffness and their inability to grip or hold any other thing properly.</p> <p><strong>Conclusion: </strong>It has been concluded that cellphone usage has serious ocular and extraocular hazards so there is a need to limit its usage as it is affecting the physical and mental health of the students.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## The Potential Effect of Henna (Stone Dye) Extract Paraphenylenediamine on Human Blood Cells, Liver and Renal Function 2022-01-18T04:16:47+00:00 Umsalma B. Eissa Fathia Khogali Elamin E. Mohamed Elbadri E. Osman Osman Mohammed Elmahi Hisham Ali Waggiallah <p>Some of the dyes that are used for coloring hair and skin contain a chemical compound called paraphenylenediamine (PPD), which is potentially toxic. The study comprised 50 adult Sudanese women who were selected by stratified random sampling and working as henna artist. Urine samples were taken for detection of PPD while blood samples were taken for investigating kidney and liver functions by measuring its relevant hematological indices. In other hand Thin Layer Chromatography (TLC) and High Performance Liquid Chromatography (HPLC) were used to detection of PPD in black henna (stone dye) samples and urine. The PPD was detected in the urine of all women who used the black henna its concentration varied according to duration of exposure being significantly higher in those with &gt;10 years of exposure (p≤0.01). Similarly significant changes in liver function, kidney function and hematological indices were found in the group of women who used natural henna. This study concluded that natural henna is safe to use, while Black dye is potentially hazardous. It contains the high concentration of PPD, is the one most commonly associated with adverse effects.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Streptozotocin-induced Antidiabetic Activity of Vitex negundo, Vitex trifolia and Vitex parviflora Combined Phytosomal Formulation 2022-01-18T04:24:19+00:00 Dharmendra Kumar Ojha Alok Pal Jain <p>Multifactorial metabolic diseases, for instance diabetes develop several complications like hyperlipidemia, hepatic toxicity, immunodeficiency etc., Hence, instead of mono-drug therapy the management of the disease requires the combination of herbs. Marketed herbal drugs comprise of irrational combinations, which makes their quality control more difficult. Phytoconstituents, despite having excellent bioactivity <em>in vitro </em>demonstrate less or no <em>in vivo </em>actions due to their poor lipid solubility, resulting in high therapeutic dose regimen; phospholipids encapsulation can overcome this problem. Hence, present study was designed to develop a phospholipids encapsulated polyherbal antidiabetic formulation. The prepared <em>Vitex negundo,</em> <em>Vitex trifolia</em> and <em>Vitex parviflora</em> leaves extract and phytosomal formulation were studied for the acute oral toxicity and anti-diabetic activity against streptozotocin-induced rat’s model. The antidiabetic activity was compared with control group, the standard drug Glibenclamide (500 mcg/kg /po), leaves extracts and its phytosome formulation (100 and 200 mg/kg/po). Acute toxicity studies show no mortality and morbidity up to the dose 2000mg/kg of body weight. In this study, body weight, serum glucose levels, total cholesterol, triglyceride, HDL, LDL, and total protein were measured. The results showed that there was a significant decrease (P&lt;0.05) in the serum glucose levels, cholesterol, total protein, LDL and triglyceride levels in diabetic rats when compared to the normal (control) rats and increase the level of HDL and body wt. Further the research proves that phytosome formulation is superior in controlling blood sugar than <em>Vitex negundo,</em> <em>Vitex trifolia</em> and <em>Vitex parviflora</em> leaves extract.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Varicose Vien (Risk Factors and Prevalence) in KSA – Questionnaier Study 2022-01-18T04:36:34+00:00 Masoud Ahmad Al-Ghamdi Rakan Abdullah Alghamdi Baiader Saleh Alsheikh Mohammed Abdulaziz Alharthi Abdullah Saad Alqurashi Emad Yousef Alqurashi Ruwaydah Abdulaziz Althunayyan Mishal Mohammed Awaji Abdulaziz Munahi Alanazi Ahmed Mosa Alzahrany Abdulrahman Muwaffaq Khoj Abdullah Ata Abdulqader Alya Faisal Alsharif Amjad Khalid Abumilha Abeer Mousa Alshuqayfi <p>The purpose of this study is to determine the relationship between different variables (namely: age group, gender, risk factors like smoking history, alcohol consumption, long duration of sitting and standing hours, family history of varicosities, history of leg trauma or surgery, frequent constipation, pregnancy more than once, and hormonal therapies including OCPs) and the presence of varicose veins. Also, the purpose is to determine the prevalence of varicose veins among the sample taken in the study, and the prevalence of the different symptoms and complication among this population.</p> <p>A significant relationship was found between the presence of varicose veins and age group, gender, alcohol consumption, long duration of sitting and standing hours, family history of varicosities, history of leg surgery, frequent constipation, pregnancy more than once, and hormonal therapies including OCPs. The results are concordant, in most parts of this study, with the previous studies in different times and regions, done for the nearly similar purposes.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Prevalence of Helicobacter Pylori Infection in Patients with Chronic Dyspeptic Symptoms at Rawal General and Dental Hospital, Islamabad 2022-01-18T04:39:27+00:00 Anwar Hussain Abbasi Hina Andaleeb Beenish Batool Alam Khawaja Ashfaq Ahmed Nadeem Yousuf Subaika Noreen Sajjad <p><strong>Background: </strong>Helicobacter Pylori infection is the most common cause of chronic dyspeptic symptoms all over the world and covers more than 60% of the out-patient department’s (OPD) registry. That is why we aimed to conduct this study to determine the prevalence of helicobacter pylori infection in patients with chronic dyspeptic symptoms visiting at our out-patient department (OPD) of Rawal General and Dental Hospital.</p> <p><strong>Methods: </strong>This was a descriptive cross-sectional hospital based study conducted in the Department of Gastroenterology, Rawal General and Dental Hospital, Islamabad between the periods of two years June 2018 – June 2020 with in patients who presented with a chief complain of dyspepsia through a consecutive sampling technique. Baseline and clinical variables were collected and correlated with the presence and absence of <em>H</em>. pylori infection among 355 finally recruited participants.</p> <p><strong>Results: </strong>The overall prevalence of <em>H</em>. pylori infection was 59.71% (n = 212). Among them, married males were more common. Positive <em>H</em>. pylori patients were younger than negative <em>H</em>. pylori patients, 40.24±6.62 vs. 44.9±8.05 (p 0.04). Participants who had a history of NSAIDS intake for past 7 days were significantly associated with positive <em>H</em>. pylori infection, 54.24% (n = 115), p 0.02. While on the other hands, patients who were receiving proton pump inhibitor for the past 4 weeks were significantly associated with absence of <em>H</em>. pylori infection when they presented with chronic dyspeptic symptoms, 65.03% (n = 93), p 0.01<strong>.</strong></p> <p><strong>Conclusions: </strong>Our study has found that almost two third of the population suffering from chronic dyspeptic symptoms had positive <em>H</em>. pylori infection and these patients are younger than <em>H</em>. pylori negatives. Chronic NSAID users have direct relation in increased prevalence of <em>H.</em> pylori detection while use of PPI plays safety role in prevention and reducing of <em>H</em>. pylori infection.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## A Study of the Attitudes towards Mentally Ill People among a Sample of Primary Health Care Physicians in Saudi Arabia 2022-01-18T04:47:08+00:00 Mohamed Ghowinam Mohamed Lamlom Ahmed Al harthi Ahmed S. Hassan Sarah Ahmed Rayyani Nada Abdulhakim Alghamdi Afnan Samih Felemban Abdulla Abid Jan Salman Anwar Thabet Ragad Abdulaziz Abdulbari Wareef Adnan Rafeea <p><strong>Background: </strong>Psychiatric illnesses are a public health problem worldwide, affecting people of all age. Mental health is an important sector of primary health care services. An increasing number of Saudi citizens and residents utilize primary healthcare services for mental health concerns; hence, there is a need to objectively assess these doctors' attitudes towards people with mental illness.</p> <p><strong>Objectives:</strong> Assessment of the attitudes toward mentally ill people among a sample of primary health care physicians in Saudi Arabia &amp; determination of risk factors associated with bad attitudes.</p> <p><strong>Methods:</strong> A cross-sectional study was conducted over a period of 30 days (1st September 2021 to 30 September 2021). The study has been conducted on Convenient Sample of Arabic speaking physicians working in primary health care centers in Saudi Arabia who accepted to share in research. Demographic Data was gathered using an electronic self‑administered questionnaire and physicians’ attitudes towards mentally ill people have been evaluated by an Arabic previously validated Questionnaire.</p> <p><strong>Results:</strong> This study included 214 physicians, 114 male physicians and 100 females. 72% of participants have a highly positive attitude toward mentally ill patients with a mean score (50±4) and only 28% of participants have a negative attitude with a mean score (38±4). Better attitudes were significantly associated with being female, having (Board, PhD or Fellowship), working for less than a year and having a history of involvement in the care of a mentally ill person. There were no statistically significant differences regarding participants age, nationality, marital status, place and mode of residency, specialty, and having current or past history of mental illness.</p> <p><strong>Conclusions:</strong> Primary health care physicians in Saudi Arabia have positive attitudes toward mentally ill patients, female physicians , having (Board, PhD or Fellowship), working for less than a year and having a history of involvement in the care of a mentally ill person were significantly associated with better attitudes.</p> <p><strong>Recommendations: </strong>Further larger studies are needed on large number of primary health care centers physicians in Saudi Arabia and other Arab countries. Additional research and programmatic work are needed to understand the reasons for negative attitudes. Effective teaching and training programs is necessary to bring in positive attitude change towards mentally ill people among primary health care physicians.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## A Study on Assess the Perceived Image of Nursing and Factors Influencing Them among the Nursing Students 2022-01-18T04:50:40+00:00 Anuj Gavankar Aniket Gavankar Aniket Ghumde Krushna Ghume Seema Singh <p><strong>Introduction: </strong>In a developing country like India, nursing education is difficult to come by. As a result, this research examines nursing experts' beliefs besides expectations, in addition to desired future activities. It is vital to build and sustain a constructive picture of nursing, especially in today's culture, where nurses' achievements are rarely in light of credit, they have earned.</p> <p><strong>Aim: </strong>To assess the perceived image of nursing and factors influencing them among the nursing students.</p> <p><strong>Methodology: </strong>This study was based on a Descriptive evaluative research approach. Non-probability convenient sampling technique was used. The populace were undergraduate students from selected college, consisted of 400 samples. Structured questionnaires were used based on a 5-points Likert scale.</p> <p><strong>Results: </strong>The study shows that 1% of nursing students were strongly disagree, 4.75% were disagree, 7.75% were not sure, 68.75% were agreed and 17.75% were strongly agreed with level of perceived image of nursing whereas level of factors that influenced the perceived image of nursing were poor i.e.,62% had poor, 24.5% had average, 11.25% had good and 2.25% of nursing students had very good level.</p> <p><strong>Conclusion: </strong>The study shows corelation between the perceived image of nursing and factors influencing them among nursing students. Later on, more investigations are expected to investigate students view of the nursing occupation.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Perception of Osteoporosis among General Population in Eastern Province, Saudi Arabia 2022-01-18T04:53:36+00:00 Abdullah Al-Mula Abdul Sattar Khan <p><strong>Background:</strong> Osteoporosis is a progressive bone disease that if not detected and treated early, it can lead to serious complications. It is a silent disease because the patient is usually asymptomatic; therefore, perception of this disease is very important.</p> <p><strong>Objectives:</strong> The aim of the study was to evaluate osteoporosis perception among general population in eastern province, Saudi Arabia.</p> <p><strong>Methods:</strong> A cross-sectional study was conducted through an online self-administered questionnaire. A modified questionnaire was used for data collection. The questionnaire assessed the understanding of symptoms, risk factors, preventive factors, and treatment availability of osteoporosis. The study included all people in eastern province, Saudi Arabia. The sample size was 391. It was conducted from September 2018 to May 2021.</p> <p><strong>Results:</strong> 61.6% of 391 participants questioned did not have a good perception of osteoporosis. There was a variability in the correct response rate, which indicates the presence of gaps in some aspects of osteoporosis perception more than the others do. The cut-off score was 50%.</p> <p><strong>Conclusion: </strong>According to the findings of the study, people in eastern province, Saudi Arabia have poor perception of osteoporosis. Therefore, efforts should be made to establish educational campaigns and use the new technologies in order to raise osteoporosis perception.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Morphological Characteristic and Incidence of Elongate Styloid Process in South Indian Population: A Case Series 2022-01-18T04:55:54+00:00 M. Afrin Nisha Lavanya Prathap Ganesh Lakshmanan <p><strong>Introduction: </strong>Styloid process is a slender osseous projection, cylindrical and sharp projection of the temporal bone, located in front of stylomastoid foramen. Styloid process is from Reichert’s cartilage of the second branchial arch, this is a part of the splanchnocranium. This is Connected to the hyoid bone through the Stylohyoid ligament. The morphology of the Styloid process is due to hormonal and genetic changes. Orthopantomography is a radiographic method used to visualise mandibles. It also provides a rotational view of the jaw. The aim of the study is to analyse the elongation of the Styloid process in the South Indian population.</p> <p><strong>Materials and Methods: </strong>The study was conducted in dental institutions with convenience sampling. The random orthopantomogram sample was collected from a dental institution. Total number of orthopantomogram involved in the study was 80 (40-males and 40-females) that is used to examine elongation of the Styloid process in the South Indian population. The minimised sampling bias is done by stratification according to age and gender.</p> <p><strong>Statistical Analysis: </strong>The data were analysed by using SPSS software. The probability value p&lt; 0.05 is considered as significant and the value p&gt;0.05 was considered as not significant.</p> <p><strong>Results: </strong>This study showed various types of Styloid processes in males and females. However we concluded that there is a difference in shape of Styloid processes. The most common type of the Styloid process found in males is pseudo articulated (32.5%) whereas in females the most common type of Styloid process found is uninterrupted (37.5%)</p> <p><strong>Conclusion: </strong>From the current study we have concluded that the pseudo articulated Styloid process is more in males whereas uninterrupted is more in females. Only retrospective studies were done so far. Therefore in future studies with live models and larger sample size should be conducted.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Factors Associated with Glycaemic Control among Diabetic Subjects in Essaouira Province, Morocco: A Cross-Sectional Study 2022-01-18T04:56:49+00:00 Khaoula Houguig Samia Rkha Mahassine Rayadi Nadia Ouzennou <p><strong>Aims: </strong>The objectives of this study are to determine the frequency of poor glycaemic control, defined by a glycated hemoglobin (HbA1c) rate ≥ 7% in diabetic subjects in the province of Essaouira (Morocco), and to identify the associations between poor glycaemic control and socio-demographic, psychosocial, and pathology-related factors in the diabetic subject.</p> <p><strong>Study Design: </strong>This is a a quantitative analytical cross-sectional study.</p> <p><strong>Methodology </strong>: A face-to-face interview was conducted with 522 diabetic subjects followed at 12 health centers ,4 urban and 8 rural, in the province of Essaouira, between January and December 2020</p> <p><strong>Results: </strong>The mean age of the subjects was 57 years,78% female and 22% male. HbA1c was≥7% in 60% of cases. Rural residence (OR=2.75, 95% CI: 1.86-4.05), poor observance of medication (OR=5.57, 95% CI: 3.07-10.11), poor observance of hygiene and dietary rules (OR=4.1, 95% CI: 2.76-6.11), duration of diabetes more than 8,4 years (OR=1.96, 95% CI: 1.35-2.85), low monthly income (OR=1.96, 95% CI: 1.35-2.85) , were statistically associated with poor glycaemic control. On the other hand, being a member of a diabetes association (OR=2, 95% CI: 1.31-3.06) and having good support from family and friends (OR=1.96, 95% CI: 1.35-2.85) have positively influence glycaemic control.</p> <p><strong>Conclusion:</strong> More than half of the diabetic subjects had a poor glycaemic control, the diabetic subjects living in rural areas, having a poor observance of medication, having a poor observance of hygiene and dietary rules and having a duration of evolution of the disease more than 8,4 years are more susceptible to have glycaemic imbalance.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Comparison of Effect of Phyllanthus emblica (Indian Gooseberry) with and without Honey on Hemoglobin, RBC and PCV among Adolescents 2022-01-18T05:07:42+00:00 M. Kamalli R. Priyadharshini Palati Sinduja <p><strong>Introduction:</strong> <em>Phyllanthus emblica</em> commonly known by names such as Indian gooseberry, amla belongs to the Phyllanthaceae. The plant is used as a medicine and tonic which is highly nutritious and forms an important dietary source of vitamin C and amino acids. Honey is rich in iron which helps in boosting the hemoglobin content in blood by increasing their synthesis. Complete blood count (CBC) is an array of tests to evaluate the cells in the blood which are the red blood cells, white blood cells, platelets.&nbsp;</p> <p><strong>Aim:</strong> The aim of the study is to compare the effect of <em>Phyllanthus emblica</em> (Indian Gooseberry) with and without honey on hemoglobin, RBC (Red Blood Cell) and PCV (Packed cell volume) among adolescents.&nbsp;</p> <p><strong>Materials and Methods:</strong> Ten adolescents including both male and female were selected as subjects for the study. The first group of subjects were categorised to consume gooseberry alone and the second group of subjects were categorised to consume gooseberry along with honey. After 15 days, CBC was taken for the subjects of both groups to analyse the results. Independent ‘t’ test was applied to evaluate the significance of clinical trials performed in two groups.&nbsp;</p> <p><strong>Results and Discussion:</strong> The participant history included fatigueness, pallor, menstrual history, blood pressure, pulse. There is an increase in the mean value of Hb (Hemoglobin), RBC (Red Blood Cell), HCT (Hematocrit), MCV (Mean corpuscular volume), MCH (Mean corpuscular hemoglobin) and RDW (Red cell distribution width). Independent statistical analysis showed that p value is not significant as all the values are not &lt;0.05.</p> <p><strong>Conclusion:</strong> The present study concludes that gooseberry with honey supplementation has shown better results than gooseberry supplementation but it is not statistically significant. It is evident that gooseberry has nutritive and restorative properties. Daily use of gooseberries is safe and can show more significant increase in counts of RBC, Hb in longer duration.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Comparative Clinicopathological Study on pH and Haemoglobin of Blood 2022-01-18T05:11:40+00:00 K. S. Vikraman Palati Sinduja R. Priyadharshini <p><strong>Aim: </strong>Aim of this study to compare the pH and hemoglobin of blood on different genders and different age groups.</p> <p><strong>Introduction: </strong>The full form of pH is the potential of hydrogen, pH is known as the negative logarithm of H+ ion concentration. The pH of any components of body, including blood, is indicated on the pH scale. The value of pH ranges from 0 to 14. A pH value of 7.0 is considered as neutral. Blood is slightly basic; the normal pH level of blood is 7.35 to 7.45. Usually, the body maintains the pH of blood close to 7.40. Hemoglobin is a protein molecule that helps the RBC to transport oxygen. The term heme reforms to the iron-containing porphyrin. This iron-containing hemoglobin is responsible for the red color of the red blood cells.</p> <p><strong>Materials and Methods: </strong>15 blood samples were collected from the lab in Saveetha Dental College and Hospitals. The low sample size is one of the limitations. The pH value is measured by using a multi reagent strip, hemoglobin level was measured by using an automated counter machine, and these values were plotted. The pH value was tabulated and the data were analyzed with SPSS version (23.0).</p> <p><strong>Results: </strong>Mean hemoglobin value was observed different in different age group. In age groups of 21-30 years, the value was 12.95g/dl, in age groups 31-40 years the value was 12.08g/dl, in age groups of 41 to 50 years the value is 13.20g/dl and for age group more than 50 years the value is 14.05g/dl.&nbsp; Mean pH value on comparing with age, the value of pH was 7 for the age group of 21-30 years, 31-40 years was 7, 41 to 50 years was 7.04 and for more than 50 years was 7. Correlation analysis reveals no significant relationship between hemoglobin and pH with increasing age in both males and females.&nbsp;</p> <p><strong>Conclusion: </strong>The value of hemoglobin is increased among different age groups and the pH level remains the same and on comparing with gender the hemoglobin level increases with age group and pH remains the same.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Ex vivo Antimicrobial Evaluation of Different Drugs Using RT-PCR Test 2022-01-18T05:13:00+00:00 Gupta Hitesh Arora Manpreet Puri Abhiney Singla Mamta <p><strong>Introduction:</strong> Various medicaments are used in conjugation with mechanical cleaning and shaping to render root canals free of microbes. The different medicaments used tend to react among themselves sometimes resulting in deleterious products. For this reason use of alternative medicine, therapy is advocated.</p> <p><strong>Aim:</strong> To evaluate the antimicrobial extent of different homeopathic drugs in comparison to the Ayurvedic and Allopathic medicines.</p> <p><strong>Materials and Methods:</strong> A biofilm model of 8 mm dentine discs was prepared from single-rooted teeth, which were inoculated with E. faecalis for 21 days. 100 samples were divided into six groups Group I: Saline (negative Control), Group II: 2% Chlorhexidine Gluconate, Group III: Propolis, Group IV: RHUS Glabra, Group V: Zincum Oxydatum. The infected biofilm was then treated with the medicaments for seven days followed by testing to obtain threshold cycle (Ct) values using the Real-time polymerase chain reaction technique. DNA isolation was carried out and amplification was done using 16S rRNA gene sequence-based nested species-specific primers. DNA denaturation was done using DNA Thermocycler and a threshold cycle was obtained using Real-time Polymerize chain reaction technique.&nbsp;</p> <p><strong>Results:</strong> The threshold cycle (Ct) values obtained were subjected to statistical analysis that revealed a significant difference between the groups and among all 2% Chlorhexidine Gluconate, being the highest (30.3460±0.02505) followed by Propolis (30.1365±0.02621) then RHUS Glabra (30.0865±0.02581) better than Zincum Oxydatum (29.8070±0.02319) and least being Saline (29.6380±0.02505).</p> <p><strong>Conclusion:</strong> All the homeopathic medicines showed antimicrobial properties comparable to the allopathic and ayurvedic drugs. Among RHUS Glabra and Zincum Oxydatum, RHUS Glabra performed significantly better.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Comparison of Haemoglobin, RDW, RBC Values among Diabetes Mellitus and Normal Individuals 2022-01-18T05:25:49+00:00 Sharwini Baskar R. Priyadharshini Palati Sinduja <p><strong>Introduction:</strong> Diabetes mellitus is a disorder characterized by hyperglycemia. It has been reported that 75% of the primary cause for mortality in diabetes mellitus patients is cardiovascular disease which is caused by hyperglycemia. Erythrocytes of diabetes mellitus patients have a shorter life span than normal. Red cell distribution width (RDW) is a measure of the heterogeneity of the volume of red blood cells (Red Blood Cells). High RDW has various adverse outcomes. The study aims to compare Haemoglobin, RDW and RBC values among diabetes mellitus and normal individuals.</p> <p><strong>Materials and Methods: </strong>Blood samples of 20 patients with and without diabetes were collected from outpatients visiting Saveetha dental college and hospitals. The results of the following parameters Haemoglobin, RDW, RBC were analyzed using Independent t Test in SPSS software. The statistical significance (P value) was set at 0.05.</p> <p><strong>Results: </strong>It is evident that there is a higher incidence of diabetes among the male population compared to females which result in higher RBC and Haemoglobin values. The RDW value is also reported to be higher in diabetic patients than non-diabetic patients. For Haemoglobin&nbsp; p value was 0.984 (&gt;0.05), RDW p value was 0.180 (&gt;0.05), RBC p value was 0.680 (&gt;0.05). The p values&nbsp; were &gt;0.05 which is statistically not significant.</p> <p><strong>Conclusion: </strong>The Hemoglobin, RBC and RDW values are higher for diabetic patients than non-diabetic. Higher RDW has various adverse effects such as cardiovascular disease which may cause mortality in diabetes mellitus patients.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Insilco Study on the Structural Characterization and Inhibitor Detection for Super Small Secreted Glycoprotein of Reston ebolavirus 2022-01-18T04:06:44+00:00 Muddapur M. Uday Priya I. Melmalagi Prajwal J. Kamble Nikita M. Ummannanavar Ramya Munavalli Amal Bahafi Aejaz A. Khan S. M. Shakeel Iqubal Tasneem Mohammed Abdul Rahman Ikbal Kayamkani Abedulla Khan Muazzam Sheriff Maqbul Ibrahim Ahmed Shaikh V. G. Shanmuga Priya <p>Super small secreted glycoprotein (ssGP) is a virulent protein that plays a vital role during the <em>Ebola</em> viral infection. This study entails in silico structural and finding inhibitor compound for the secreted glycoprotein of <em>Reston ebola virus</em> (strain Philippines-96). The physical and stereochemical properties and the protein's secondary and tertiary structure were predicted initially. Later, as the predicted model was evaluated to be a reliable structure, binding pockets were predicted, and known binding ligands to similar proteins were identified. Analogue compounds to known ligands were collected and docked against ssGP. The compound with the least binding energy was identified and recommended as a potent inhibitor towards ssGP. From this study, in<em>-vitro </em>and <em>in-vivo</em> analysis was computed for the selected ligand for designing effective drugs against <em>Reston ebolavirus</em>.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Comprehensive Analysis and Assessment on Codon Usage Pattern of Hemolytic Genes from Different Strains of Leptospira interrogans 2022-01-18T07:00:37+00:00 Chandan Dharmashekara Sabhyata M. Gopal Gayatri Vaidya Bhargav Shreevatsa H. H. Bhavana Chandrashekar Srinivasa S. M. Gopinath Shiva Prasad Kollur Sharanagouda S. Patil Kuralayanapalya Puttahonnappa Suresh Raghu Ram Achar Ashwini Prasad Chandan Shivamallu <p><strong>Background</strong>: Leptospirosis is a disease that is zoonotic in nature. It is easily able to survive in the environment and gets transmitted from the reservoir hosts such as rat to humans. Though the cause of <em>Leptospira interrogans</em> virulency is not determined, these studies expresses that the product of a <em>Leptospira interrogans</em> gene sphH is hemolytic in nature and is capable of lysing the erythrocyte cells and also few epithelial cell membranes.</p> <p><strong>Aim:</strong> In this study, we have analyzed the codon usage bias of the gene sphH, taken from 49 strains of <em>Leptospira interrogans</em>.</p> <p><strong>Materials and Methods</strong>: Data Collection: The full CDSs nucleotide of the gene sphH from 49 <em>Leptospira interrogans</em> was downloaded separately in FASTA format from the NCBI nucleotide database. Molecular Evolutionary Genetics Analysis (MEGA) program was used to edit and align the coding sequences. With the help of statistical techniques such as RSCU and ENC we have determined the codons mostly used to express the gene sphH and source of the bias with methods such as parity rule 2, neutrality plots.</p> <p><strong>Result</strong>: The nucleotide content of the , gene across 49 variants of leptospira divulged that the usage of A (36.03% ± 0.74) and T (31.81% ± 0.65) occurred more frequently than the usage of G (17.88% ± 0.57) and C (14.28% ± 0.66) making the gene composition AT more than GC. The composition of bases in the 3<sup>rd</sup> position saw base T most frequent than base A.</p> <p><strong>Conclusion</strong>: The codon and amino acid use patterns reflect this bias in genetic composition. Leptospiral strains have a similar general codon usage pattern and are slightly biassed. The majority of the frequently occurring codons are A- and U-ending, showing that mutational bias is the primary driver determining codon usage in this bacterium. There were significant changes in synonymous codon usage frequencies between <em>Leptospira interrogans</em> and with other virulent strains. Codon use preferences to account for these differences.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Formulation and Evaluation of Microemulsion of Curcumin in Thymol-Menthol Carrier System 2022-01-18T07:06:58+00:00 Meera C. Singh Priyanka Nangre Nikita N. Bagade Rukhsana A. Rub <p><strong>Aim:</strong> To formulate and evaluate the Micro emulsion of curcumin in thymol-menthol carrier system.</p> <p><strong>Study Design:</strong> Curcumin dissolves in mixture of thymol &amp; menthol to reasonable extent.100 mg of curcumin in 1 g of thymol and 0.6 g of menthol mixture was finalized as product mixture. The solution of curcumin in eutectic mixture being oily liquid, it gave the idea for development for the micro emulsion</p> <p><strong>Place and Duration of Study: </strong>Department of Pharmaceutics and Department of Pharmacognosy, STES’s Smt. Kashibai Navale College of Pharmacy, Kondhwa (BK), National Chemical Laboratory, Pune between June 2016 and May 2017.</p> <p><strong>Methodology:</strong> Micro emulsion system with eutectic mixture of thymol and menthol was chosen as oil phase and carrier for curcumin, tween 80 as surfactant and ethanol as co-surfactant. Ternary phase diagrams were constructed to obtain the optimum concentration range of oil phase, surfactant and co-surfactant. The micro emulsion of 100 mg curcumin containing 4.95 % oil phase, 33.39 % surfactant, 11.13% co-surfactant, 50:50% of water was optimum. Micro emulsion of curcumin was prepared by water titration method and evaluated for globule size, drug content, pH, viscosity, conductivity and <em>In</em> vitro drug release study. The <em>ex</em>-vivo permeation study for micro emulsion of curcumin was carried out on excised mice skin using Franz Diffusion apparatus. The cytotoxicity study for thymol, menthol was performed on healthy L929 murine fibroblast cell line. Anticancer activity of thymol-menthol eutectic mixture alone and with curcumin was performed on HeLa cell lines.</p> <p><strong>Results: </strong>The preformulation studies did clearly indicate good compatibility of drug with thymol menthol carrier system. The cytotoxicity study was done on thymol – menthol(TM) as a preformulation aspect to ascertain the toxicity of these two excipients to be tried. It was found that TM was not cytotoxic in 120ug/mL concentration and thus was safe to be used in concentration below 120ug/mL. Batch B1 was optimised. The average globule size of micro emulsion was found to be 131.54 nm, zeta potential was found to be -0.57 mV. The drug content in micro emulsion batch B1 was determined and found to be 74.6%.Permeability study across mice&nbsp; skin <em>ex</em>-vivo model showed 52.38% permeability compared with curcumin alone which was 22.41%. So permeability of curcumin is enhanced substantially with micro emulsion made in thymol and menthol, owing to fact that thymol and menthol act as good permeation enhancers. The <em>In</em> vitro drug release study of micro emulsion was compared with curcumin alone. About 48.75% of curcumin was released from micro emulsion showed increase in release rate.</p> <p><strong>Conclusion:</strong> Eutectic mixture of thymol and menthol showed promising results as penetration and solubility enhancer for curcumin. Solubility of curcumin was improved so as its rate of permeation which was used to develop formulation of micro emulsion with proven anticancer activity. The solubility of curcumin formulated with combination of eutectic mixture was increased up to 50 %.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## The use of Ophthalmic Dorzolamide in Al-Kharj 2022-01-18T07:17:32+00:00 Nehad J. Ahmad Mohamad Ayman Salkini <p><strong>Aim: </strong>The present study was to explore the use of ophthalmic&nbsp;dorzolamide in Al-Kharj.</p> <p><strong>Methodology: </strong>This is a retrospective study that includes reviewing the electronic prescriptions of ophthalmic dorzolamide among outpatients in a public hospital in Alkharj.</p> <p><strong>Results: </strong>Only 24 patients received ophthalmic dorzolamide during the study. The age of more than 54% of the patients was more than 59 years and more than 54% of them were males. More than 54% of the patients received ophthalmic dorzolamide for 2 months and 37.50% of them received ophthalmic dorzolamide for 3 months. All of the prescriptions were prescribed by ophthalmology department and more than 95% of the prescriptions were written by residents.</p> <p><strong>Conclusion: </strong>The present study showed that ophthalmic dorzolamide was uncommonly prescribed in Al-Kharj. Further studies are needed to explore the frequency of using dorzolamide in other settings and to explore the frequency of using other eye drops that are used to decrease intraocular pressure.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Disintegration, Hardness and Dissolution Profiles of Paracetamol Tablets Formulated using Sucrose and Formaldehyde Cross-Linked Starches 2022-01-18T07:23:26+00:00 Ifeanyi Justin Okeke Angus Nnamdi Oli Zwanden Sule Yahaya Thaddeus Harrison Gugu Emmanuel Chinedum Ibezim <p><strong>Background</strong>: Native starches have some limitations such as the inability to withstand some processing conditions, poor flow, packing and compressibility. Cross-linking of starch is one of the methods used to overcome these drawbacks to obtain derivatives with better and desirable properties. This study is aimed at assessing the utilisabilty of sucrose and formaldehyde cross-linked starches obtained from <em>Zea mays, Triticum aestivum<strong>,</strong></em> and<em> Oriza sativa</em> as an excipient for paracetamol tablet formulation. The formulated tablets were evaluated for hardness, disintegration and drug release rate.</p> <p><strong>Results:</strong> The formulated tablets had hardness in the range of 4.35 – 6.37 Kgf. Tablets produced from the native starches had significantly (<em>P &lt; 0.05</em>) lower disintegration time compared to their respective cross-linked starches. The disintegration time of the tablets from the cross-linked starches was in the following order, modified rice starch tablets &gt; modified maize starch tablets &gt; modified wheat starch tablets. The optimal batches containing the modified starches released over 90% of the drug within 40 min.</p> <p><strong>Conclusion</strong>: Sucrose and formaldehyde cross-linked starches obtained from <em>Zea mays, Triticum aestivum<strong>,</strong></em> and<em> Oriza sativa </em>could serve as possible excipients for paracetamol tablets formulation.&nbsp;</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Knowledge of Cleft Lip and Cleft Palate among Medical Students of a Tertiary Care Hospital in South India 2022-01-18T08:04:20+00:00 Sajitha Mohan Surya Rao Rao Venkata Mahipathy Praveen Ganesh Alagar Raja Durairaj Narayanamurthy Sundaramurthy Anand Prasath Jayachandiran Suresh Rajendran <p><strong>Background:</strong> Sufficient knowledge and awareness of cleft lip and palate deformity is required to identify and manage at the condition at the earliest.</p> <p><strong>Objectives:</strong> This study was conducted to assess the awareness and knowledge of medical students on cleft lip and palate. To assess the understanding of the possible causative factors of cleft lip and palate among the same population.</p> <p><strong>Materials and Methods: </strong>A cross sectional study was carried out among 128 medical students attending a tertiary care hospital in south India. This was performed through a researcher administered questionnaire which contained queries regarding risk factors and management.</p> <p><strong>Results: </strong>A total of 89.1% of the subjects were aware of the term cleft lip and palate with the majority being females. Though they were not well informed regarding the treatment procedures, and timings. The results were then interpreted in table formats for better understanding of the level of education on the topic.</p> <p><strong>Conclusion: </strong>There is a general lacking of experience in the diagnosis and management of cleft lip and palate among medical students which should be addressed to ensure timely cure and quality of life of the patients.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Adherence to Pharmacological Treatment and Factors Affecting the Adherence among Hypertensive Patients Attending Primary Health Care Centers in Jazan, Saudi Arabia 2022-01-18T03:51:56+00:00 Husameldin Elsawi Khalafalla Ahmad A. Shugairi Faisal A. Othathi Abdulrahman M. Alhuraysi Abdulaziz Y. Albrraq Ahmad Y. Rayani Mohammed O. Shami Mohammad Jareebi Abrar A. Doweri <p><strong>Background</strong><strong>:</strong> Hypertension (HTN) is a major health problem globally because it can result in significant morbidity and a reduction in life expectancy, HTN is responsible for 9.4 million deaths annually, either due to heart attack or stroke with a contribution of 45% and 51%, respectively</p> <p><strong>Objective</strong>: Evaluate the level of adherence to anti-HTN medications and which factors affect this adherence in the Jazan area</p> <p><strong>Methodology</strong><strong>:</strong> The researcher investigated the adherence to anti-hypertension (anti-HTN) medication of participants aged more than 18 in the Jazan region of Saudi Arabia, they conducted interviews with patients who attend primary health care centers and focused on their socio-demographics, such as age, education, and topographical location of their home. The data from the interviews were analyzed using the Hill-Bone scale to determine perfect and imperfect adherence to anti-HTN medication&nbsp;</p> <p><strong>Resul</strong>ts<strong>:</strong> 82.7% of the participants show imperfect adherence to medication which is a significantly higher percentage than that found in other areas of Saudi Arabia and the Middle East. The researchers further analyzed the data for correlations between sociodemographic characteristics and adherence to anti-HTN medication. This showed that patients living in the mountainous areas of Jazan have a stronger adherence to their medication than those living in the plains or on the coast (OR = 10.77,&nbsp;<em>P&nbsp;</em>value = 0.011). Also, those patients with an income of 5,000 RS or less are more likely to adhere to their medication than those with higher income (OR = 0.18,&nbsp;<em>P&nbsp;</em>value = 0.035). Other socio-demographic characteristics showed no strong correlation with medication adherence.&nbsp;</p> <p><strong>Conclusion</strong><strong>:</strong> Overall, anti-HTN medication adherence in the Jazan region is poor and researchers recommend the implementation of an educational program to highlight the importance of adhering to anti-HTN medication.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Autologous Intrauterine Platelet Rich Plasma Versus G-CSF instillation for Improvement of Endometrial Growth and Vascularity in Recurrent in Vitro Fertilization Failure 2022-01-18T08:06:43+00:00 Asawari Deo Deepti Shrivastava Arzoo Chadha <p><strong>Background:</strong> in vitro fertilization [IVF] is an expensive, cumbersome yet most successful treatment for infertility. Inspite of its success, at the most 40% of the procedure only result in good outcome. Often at times which can be very frustrating and disappointing journey for the couple as well as the clinicians who despite of strict adherence to treatment protocols fail to produce result, it is mostly attributed to implantation failure, which is mostly due to poor receptivity of the endometrium. Several treatments ranging from chinese acupuncture to hormones to endometrial injury all have been treat with not definitive treatment. Autologous platelet rich plasma (PRP) and G-CSF have come up to be exciting new therapy in that aspect. In neutrophilic granulocytes, platelet-rich plasma (PRP) has been shown to increase endometrial development and receptivity, whilst G-CSF has been shown to promote the growth of stem cells and progenitor cells. This study offers an intriguing perspective on the two medications in comparison.</p> <p><strong>Materials and Methods</strong><strong>:</strong> It is a prospective ,cross-sectional, single blind study, conducted over a period of 6 months in 25 women who had failed to conceive after one or more embryo transfers with high-quality embryoswomen having a poor endometrial pattern, as defined by an endometrial thickness of less than 7mm despite conventional treatment with estradiol valerate (up to 12 mg/day), or suboptimal endometrial vascularity, defined as &lt; zone 2 as determined by applebaum's criteria, success of which was measured in number of clinical pregnancies resulted.</p> <p><strong>Results</strong><strong>:</strong> The mean PRP endometrial thickness was 5 mm which significantly increased to 7.34 mm post platelet rich plasma, against post-G-CSF endometrial thickness was 8.02 mm from 6.03mm pre infusion. Out of 10 cases who were infused with PRP,7 of them showed good vascularity (more than or equal to zone 3)out of 10 of those were given G-CSF,5 of them showed good vascularity. Number of clinical pregnancies resulted after instillation of PRP were 4 while 3 in case of G-CSF group.</p> <p><strong>Conclusion: </strong>It can be concluded that although both PRP and G-CSF are equally effective in increasing endometrial thickness but endometrial vascularity is better inproved with platelet rich plasma, clinical pregnancy rates were also better with PRP but being a small sample study it was not significant statistically.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## The Prevalence of Antenatal Depression among Women in Medina, Saudi Arabia 2022-01-18T08:08:56+00:00 Samah Alfahl Alhanouf Dhaifallah Hamad Alharbi Najim Z. Alshahrani <p><strong>Background: </strong>Antenatal depression is a recognized global burden. However, it has remained an ignored part of public health. Most of the maternal depression interventions have been directed towards post-natal depression.</p> <p><strong>Purpose of the Study: </strong>The purpose of this study was to understand the third-trimester antenatal depression risk factors and prevalence among Saudi Arabian women.</p> <p><strong>Method: </strong>This study employed cross-sectional study design from April 2020 to June 2020 and 201 participants were recruited for this study. The study was conducted at Medina in the Maternity and Children's Hospital (MCH) from April 2020 to June 2020. The inclusion criteria were pregnant women who visited the outpatient clinic of antenatal care in MCH. Pregnant women who had a known familial history or already been diagnosed with depression before pregnancy were excluded from this study. The collection of the data was through researcher administered questionnaire to the pregnant women meeting eligibility criteria who were visiting the clinic of antenatal care at the Maternity and Children's Hospital. Data were collected using a structured and validated Patient Health Questionnaire-9 (PHQ-9). All the collected data were analyzed using descriptive statistics, Anova and t-test statistics.&nbsp;</p> <p><strong>Results: </strong>Antenatal depression among participants stands at 35.8% for normal/ minimal depression, 31.3% for mild depression, 3.9% for moderate depression, 5.5% for moderately severe, and 3.5% for severe depression. Antenatal depression was mostly prevalent in the third trimester.</p> <p><strong>Conclusion: </strong>The antenatal depression prevalence among pregnant women in Medina is high. Screening for mental health problems and provision of supportive mental health services as a component of antenatal care services is recommended.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Development and Validation of RP-HPLC Stability Indicating Method for Simultaneous Estimation of Dolutegravir and Lamivudine in Bulk and Pharmaceutical Dosage Form 2022-01-18T08:15:29+00:00 Khushboo Patel Ujashkumar Shah Darshak Patel Jayvadan K. Patel Tejas B. Patel <p><strong>Aims: </strong>Dolutegravir (DVR) and Lamivudine (LMN) is anti-viral drug combination used in treatment of HIV-I infection. FDA approved dosage regime for DVR and LMN is 50mg and 300mg respectively. The aim of present research work is to develop and validate a reverse phase high performance liquid chromatography (RP-HPLC) method for simultaneous estimation of DVR and LMN in bulk and pharmaceutical dosage forms. Further the stability indicating nature of method has been evaluated.</p> <p><strong>Methodology:</strong> A chromatographic separation was achieved on Hypersil BDS C18, 250 × 4.6 mm 3.5 μm particle size, column as stationary phase and mobile phase composed of Phosphate Buffer pH 3.0: Acetonitrile (60:40%V/V) with flow rate of 1.5mL/min with 20µL injection volume. The analytes were estimated at 232nm using PDA detector. The DVR and LMN solutions were exposed to various forced degradation stress conditions to evaluate the stability behavior of the product. The method was also validated as per ICH Guideline (Q2R).</p> <p><strong>Results: </strong>The retention time for DVR and LMN was found 3.94 and 2.62 min, respectively. The developed method was found linear within concentration range of 27.5 to 82.5 μg/ml (50-150%) for DVR and 167.5 to 502.5 μg/ml (50-150%) for LMN. The% recovery (Accuracy) was found between 99.50%-101.23% and 100.09%-101.51% for DVR and LMN respectively in range of 50-150% for both drugs. The%RSD for the accuracy at all levels was less than 2.0%. LOD and LOQ, for DVR were found to 0.669 and 2.028 μg/mL, respectively, and for LMN 0.102 and 0.308 μg/mL, respectively.</p> <p><strong>Conclusion:</strong> The developed RP-HPLC method indicates no interference from the excipients and degradants peaks. All the degradant peaks were having been efficiently resolved through the use of the evolved analytical method with changed retention times. The results obtained were statistically analyzed and meet the acceptance criteria as specified in ICH Q2R1 guideline. Hence, developed method can be successfully applied for the analysis of estimation of DVR and LMN in bulk as well as pharmaceutical dosage form.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Non-reporting of Medication Administration Errors among Nurses in Qatar 2022-01-24T06:51:57+00:00 Nesiya Hassan Rajvir Singh Rinu J. George <p><strong>Background:</strong> Prompt recognition and reporting of Medication Administration Errors (MAE) are paramount in ensuring patient safety in hospitals. The data on under-reporting MAE in Middle East Area is limited.</p> <p><strong>Aim</strong><strong>:</strong> The study intended to estimate the percentage of fear factor and explore the perception of nursing professionals regarding the reason for the occurrence and underreporting of MAE.</p> <p><strong>Design: </strong>A cross-sectional design was utilized to conduct the current study.</p> <p><strong>Place and Duration of Study</strong><strong>:</strong> The study was conducted in eight hospitals working under Public health sector of Qatar between August and September 2016&nbsp;</p> <p><strong>Methodology</strong><strong>:</strong> The data were collected with a purposive sample of 487 clinical nurses employed by the public health sector of Qatar who responded to a pre-designed online questionnaire.</p> <p><strong>Results:</strong> The perceived prevalence of fear factor in non-reporting MAE was 23.45%, 95% confidence interval (C.I).: 16% to 33%. The single factor confirmatory factor analysis (CFA) model explained 65% of the variance in the fear factor of nonreporting of medication administration errors. The highest mean score in the subscale of reasons for non-reporting of MAEs includes fear (mean 0.652±1.671)&nbsp;and administrative responses (mean 0.304±1.466), and reporting processes (mean -0.505±1.669), whereas disagreement over hospital definition (mean -1.158±1.528)&nbsp;of error was the least significant reason for nonreporting of MAE by the clinical nurses.</p> <p><strong>Conclusion:</strong> The study focuses on quantifying the fear factor and underscores the Nurses' fear about the professional consequences of reporting MAE. The findings in this study not only provide evidence concerning the fear of reporting MAE but also shed light on the contributing factors and reasons for the nonreporting of MAE. Nursing leadership needs to concentrate on modifying existing strategies and policies to more comprehensible approaches to reporting errors.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Assessment and Management Pattern of Chemotherapeutic Drug Induced Adverse Effects among Cancer Patients at Tertiary Care Centre 2022-01-18T08:40:22+00:00 Syed Meraj Fatmi Kavita Dhar Jyotsna Sharma Shaktibala Dutta <p><strong>Aim and Objective:</strong> Cancer chemotherapy drugs causes substantial toxicity and produces number of adverse effects which can significantly reduce patient's health related quality of life. The aim of this study was to perform the assessment and explore the management practice of chemotherapy induced side effects among cancer patients.</p> <p><strong>Material and Methods:</strong> Demographic characteristics of patient undergone cancer chemotherapy and adverse drug reactions (ADRs) of chemotherapeutic drugs were noted in patient's case report form. Assessments of ADRs were performed for Severity, Causality and Preventability of each ADR. Association between occurrence of severe ADRs and patient' characteristics were studied using chi square statistics. Frequencies of ameliorative therapy were studied in each patient.</p> <p><strong>Results:</strong> 120 patients were selected and included in the study and a total of 412 ADRs were detected after cancer chemotherapy. Majority (60%) of the participant were female. Most common cancer was found as breast cancer (23%). Commonly used chemotherapy regimens were combination of carboplatin and paclitaxel (14%). Upon severity assessment of ADR, more than one third categorized as "Severe" ADR (36.4%). Majority of the Severe ADR were alopecia and nausea &amp; vomiting. Most of the ADRs (73%) on preventability assessment were found as Not-Preventable. There is a significant association between occurrence of severe ADRs and age, sex &amp; chemotherapy regimen. Combination of palonosetron, dexamethasone and pantoprazole were used as ameliorative therapy (43.3%).</p> <p><strong>Conclusion:</strong> Cancer chemotherapy drugs produce numerous adverse effects. Assessment of severity of ADRs and associated triggering factor may support in management practice of side effects.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Efficacy of Mindfulness Meditation on Emotional Maturity of Mothers of Cerebral Palsy Children 2022-01-18T08:41:55+00:00 Madhuri Wane Priyanka Telang Chaitanya A. Kulkarni <p><strong>Background:&nbsp;</strong>Cerebral palsy (CP) is a&nbsp;disorder&nbsp;of movement that is seen in early childhood. Children with CP sometimes are not able to walk, sit, crawl, or rollover, as early as other kids of their age. This study aims to find the impact of mindfulness meditation on the emotional maturity of mothers of cerebral palsy children<strong>.</strong></p> <p><strong>Methods:&nbsp;</strong>We did this research at Acharya Vinoba BhaveRural Hospital, Sawangi (Meghe), Wardha, we included 50 mothers of children of cerebral palsy visiting at Paediatric therapy unit at Ravi Nair physiotherapy college, Sawangi (Meghe), Wardha. The Purposive Sampling Method was used and the study duration was 6 months. We used variables such as age, educational status, occupational status, income, marital status, region, and emotional maturity scale questionnaire.</p> <p><strong>Results:&nbsp;</strong>The research analysis revealed a high degree of emotional immaturity in the mothers of children with CP from the rural population. 4% of the women were emotionally immature and 96% of them had an extremely immature type of EMS. After giving intervention there was an improvement and the EMS score at 12 weeks was 2% were emotionally immature and 48% were extremely emotionally immature at 24 weeks 0 % were emotionally immature and 24% were extremely emotionally immature.</p> <p><strong>Conclusion:&nbsp;</strong>Education has a marked effect on people. Mental health training is among the most efficient way of controlling emotional debility and making mothers emotionally strong and preventing social harm. This research looked at the impact of mindfulness meditation on the mental health of mothers of cerebral palsy children.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Relationship between Desirable Fetus Gender and Type of Consumed Diet: A Cross-sectional Study 2022-01-18T08:58:38+00:00 Afaf Abdulrahman Yaslam Hoda Jehad Abousada Rubuah Mohammed Ayyashi Rawan Abdulkarim Agala Halah Abdulrahman Hafiz Hanan Misfer Alzahrani Najwan Hassan Abduljabar Lujain Khaled Alhazmi Mohammed Saaduddin Sahibzada Alaa Omar Abusarir Atheer Nasser Alhrany Raibal Adnan Sabbahi Wejdan Ali Alshehri Ghada Meshall Almahyawi Nour Ahmed Naaman <p><strong>Background: </strong>The fetus's development can be influenced by the mother's nutrition in a variety of ways, including the gender of the fetus. However, several research have been published that suggest a link between maternal nutrition and the baby's gender. In other words, the baby's gender can be determined by the mother's nutrition. This study aimed to evaluate the relationship between maternal diet and baby gender.</p> <p><strong>Methods:</strong> This was an analytical cross-sectional study to spot light on the relationship between maternal diet and baby gender. Since the aim of the study was to determine the relationship between maternal diet and baby gender among Saudi, this is the suitable design for this research. The study was carried out among Saudi population. Data were collected from general population using questionnaire during the period from April to October 2021.</p> <p><strong>Results:</strong> The study included the participation of 755 women from different age groups in the Kingdom of Saudi Arabia. The most prevalent age group was 36-40 years (n= 193, 25.6%) followed by the age group more than 40 years (n= 189, 25%) while the least frequent age group was below 22 years (n= 83, 11%). The number of participants who reported having one children were 116 participants. On asking the participants who had male babies whether they craved for special food or not, their answers varied. Salty food, pickles and potato chips were preferred among 298 participants while sweets and chocolate were the favorite food among 155 participants. The special diet is statistically significant with the baby gender at p value of 0.001.</p> <p><strong>Conclusion: </strong>The current study showed that diet preference among mothers affects the gender of the baby as the results showed. Some mothers intentionally reported following special diet in order to have specific gender.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Efficacy of Mobilization with Movement in Patients with Colles’ Fracture: A Randomized Clinical Trial 2022-01-19T09:13:25+00:00 Vishista Biswas Saumya Srivastava Harramb Mittal <p><strong>Background:</strong> Fracture of the distal radius or Colles’ Fracture mainly occurs due to fall on an outstretched hand and Physiotherapy plays an indispensable role in preventing postoperative complication namely hand stiffness. Mulligan concept of mobilization is a specific form of manual therapy technique that embraces skilled movements which is used to mobilize or manipulate soft tissues and joints with the target to improve tissue extensibility, increase in range of motion of joints, foster relaxation and reduce tissue swelling/ inflammation.</p> <p><strong>Objective:</strong> To compare the effectiveness of Mulligan concept of mobilization with movement technique and conventional physiotherapy treatment following postsurgical Colles’ Fracture in terms of range of motion and functional activities.</p> <p><strong>Methods: </strong>A total number of 36 patients were recruited for the study. They were divided into two groups: group I and group II. Group I (n= 18) was given mobilization with movement (MWM) along with wax bath and group II (n=18) was given conventional physiotherapy along with wax bath. The interventions were given for 7 days. The value of goniometer and Michigan hand outcome questionnaire (MHOQ) were taken both at baseline and after 7 days of interventions.</p> <p><strong>Results: </strong>After intervention, there were no significant differences between the groups as the collected information was summarized by using frequency percentage, for qualitative data; and mean, the standard deviation, Median and Inter Quartile Range (IQR) for quantitative data. To compare the difference in proportion Chi square test was used. To compare the ROM and Michigan Hand Outcome Questionnaire between two groups Independent sample t-test was used. Within the group comparison was analysed by using paired t-test. The p-value less than 0.05 was considered significant for the study.</p> <p><strong>Discussion: </strong>This study showed consistent with the previous studies as there was a significant improvement in the range of motion and hand functions between and within the groups.</p> <p><strong>Conclusion: </strong>It can be concluded that both the treatments are equally effective.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Root Canal Morphology of Mandibular First Premolars using Radiography: An in vitro study 2022-01-19T09:14:51+00:00 Irshad Hussain Jakhrani Mahwish Memon Sana Javed Azizullah Muhammad Nawaz Qureshi Aosaf Anwar Memon Munir Ahmed Banglani Salman Shams <p><strong>Objective: </strong>The goal of this study was to document the Root Canal morphology of the first mandibular premolars using radiography.</p> <p><strong>Materials and Methods: </strong>The trial took place at the LUMHS Operative Dentistry Department. Two hundred removed permanent mandibular first premolars that met all of the study's inclusion criteria were gathered from LUMHS Jamshoro/Hyderabad and nearby private dental clinics in Hyderabad. All debris, soft tissues, and calculus were removed from the teeth, which were then preserved in a 10% formalin solution. Each tooth's length was measured from the crown's tip to the root's apex. An removed tooth, on the other hand, was examined from all angles, including buccal, lingual, and proximal. Root concavities and grooves, as well as bifurcation and apical curvature, were found.</p> <p><strong>Results: </strong>Comparison between both views showed 189 teeth have 1 root in and 186 have 1 canal in buccolingual view, while 182 teeth have 1 root and 179 have 1 canal in mesiodistal view. 11 teeth on buccolingual and 18 teeth on mesiodistal view showed 2 roots and 14 teeth on buccolingual and 21 teeth on mesiodistal view showed 2 canals. 110 teetj showed type I canal pattern.</p> <p><strong>Conclusion: </strong>It is concluded that mandibular first premolar teeth have a wide range of radicular traits, with the majority of them having one root and one canal.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Gender Determination using Gonial Angle - A Panoramic Study among South Indian Population 2022-01-19T09:17:52+00:00 Prateeksha Moharana Lavanya Prathap Ganesh Lakshmanan <p><strong>Introduction: </strong>Sex determination is a valuable and important factor in the forensic dentistry. Mandible has several useful traits for sex determination. Forensic practitioners study this by two methods: morphological and metrical analyses. Among various methods, the gonial angle may be used to differentiate male and female strongly to express sexual dimorphism.</p> <p><strong>Aim: </strong>To analyse the gender determination using gonial angle as panoramic study among south indian population.</p> <p><strong>Materials and Methods: </strong>This is a retrospective study conducted among 200 individuals. Gonial angle is a measurement taken by measuring the angle between the 2 tangents from the gonion.As a standard procedure, measurement of right gonial angle and left gonial angle were carried out by Adobe Photoshop and the results were recorded and analysed statistically using SPSS tool.</p> <p><strong>Results: </strong>The mean right gonial angle&nbsp; for males is 95.25 and for females is 95.22 The mean left gonial angle for males is 95.39 and for females is 95.15. The significance of the right gonial angle&nbsp; is P=0.874 and significance of the left gonial angle is P= 0.147. The total mean value for right gonial angle was found to be 95.23 and for left gonial angle is 95.27. Therefore, there was no significant difference found between the right&nbsp; and left gonial angle.&nbsp;&nbsp;</p> <p><strong>Conclusion: </strong>Within the limitations of the study, there is no statistically significant difference observed between males and females in the gonial angle measurements. The Gonial angle measurements can be used to determine the gender and the growth pattern of the mandible. Measurement of gonial angle has its own surgical importance too in the field of orthodontics and therefore future studies should be carried out using larger samples to get reliable results.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Prevalence of Single Umbilical Artery (Isolated and non-isolated) and Its Correlation with Birth Defects and Premature Death 2022-01-19T09:18:34+00:00 Aditi Sandeep Lothe Varsha Pandey <p><strong>Background: </strong>The single umbilical artery (SUA) is linked to congenital abnormalities in almost every organ system, however published findings have been inconsistent. Although It has been proposed that inherited and long-term environmental factors do play a role, there is a need for further investigations on the same. The goal is to look into the possibility of a link between a single umbilical artery (SUA) in the incidence of chromosomal anomalies in the second trimester of pregnancy and their collective occurrence.</p> <p><strong>Methods: </strong>The exclusion of any one of the two umbilical artery and a present umbilical vein was considered as a single umbilical artery for the purpose of this research. A single umbilical artery was established by gross or histologic investigation of the placenta, neonatal evaluation, or autopsy. As a direct consequence, a newborn who did not have a single umbilical artery documented in these records was presumed to have an umbilical cord consisting of three vessels.</p> <p><strong>Results: </strong>SUA was identified in 0.46 percent of our population (4241/918 933). SUA risk factors included pregestational diabetes in the mother, consistently high blood pressure, prior Cesarean delivery.&nbsp; Some other factors include smoking, epilepsy, and conception via assisted reproductive technology. SUA was associated with gastrointestinal atresia or stenosis in the neonate, esophageal and anorectal atresia or stenosis followed renal agenesis. SUA was linked to an elevated risk of congenital cardiac abnormalities by up to 7–8 times. There was a link between microcephaly, congenital hydrocephalus. There was a link established between other congenital brain and spinal cord anomalies as well. SUA displayed a lesser relationship with hernia associated with the diaphragm, limb reduction defect. It also showed a smaller relation to cleft lip or cleft palate. The risks of trisomy 13 and 21 were both increased, while the risk of trisomy 18 was maximum. Fetuses diagnosed with SUA, whether or not accompanied with a deformity, had two times the higher potential possibility of SUA in a future pregnancy.</p> <p><strong>Conclusion: </strong>Single Umbilical Artery is closely linked to gastrointestinal atresia or stenosis, implying the same developmental processes. The higher likelihood of reappearance of Single Umbilical Artery implies that inheritable and/or long-term environmental variables play a role. SUA was shown to have high correlations with trisomies 13 and 18.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Knowledge, Attitude and Practise about Beneficial and Harmful effects of Diet Soda 2022-01-19T09:19:32+00:00 Faaizah Fathima R. Gayatri Devi A. Jothi Priya <p><strong>Background and Aim:</strong> Soda or light drinks are sugar free and don't contain calories. Artificial sweeteners such as aspartame drastically affect our health by causing various diseases like stroke etc. The main aim of this study is to determine the level of knowledge possessed about diet soda and their attitude towards it.</p> <p><strong>Materials and Methods: </strong>A Cross sectional survey was conducted among dental populations with a sample size of 102. A self administered, structured questionnaire was prepared based on knowledge, attitude and practice about diet soda and consisted of 10 questions. It was circulated to the participants through Google forms. The statistics were done using SPSS software, a chi-square test was used to check the association and the ‘p’ value of 0.05 was said to be statistically significant.</p> <p><strong>Results:</strong> From this survey it was inferred that 81.37% people find diet soda unhealthy whereas 18.63% felt it isn't healthy. 56.86% felt it contained calories but 43.14% felt it didn't. Around 61.76% think that artificial sweeteners will lead to more headaches whereas 38.24% felt it won't cause headaches.</p> <p><strong>Conclusion: </strong>This study revealed that many people have little knowledge and are unaware of the consequences of diet soda. Therefore this study may help to gain wide knowledge about diet soda and also help them to change their attitude towards it.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Incidence of Granulomatous Mastitis at Saveetha Medical College and Hospital for the Past Two Years 2022-01-19T09:21:31+00:00 Shruthi Kamal R. Kapila <p><strong>Background: </strong>To find the incidence of Granulomatous mastitis at Saveetha Medical College and Hospital for a period of past two years.</p> <p><strong>Methods: </strong>Retrospective study Incidence of Granulomatous Mastitis at Saveetha Medical College and Hospital for the past two years. The specimens were received from the histopathology section of the pathology department. Detailed gross examination of the specimen was done. This was followed by fixation and staining, done using hematoxylin and eosin stains.</p> <p><strong>Results: </strong>In the period of two years from 2019 to 2020, 10 cases have been reported . Out of which five cases belonged to the reproductive age group, two cases in the post menopausal age group and three cases belonged to peri menopausal age group.</p> <p>All the patients presented with a lump on the breast and abscess. The treatment consists of corticosteroid therapy and minimal surgical intervention.</p> <p><strong>Conclusion: </strong>Granulomatous mastitis is an inflammatory condition that mimics carcinoma of breast. Hence diagnosis is mainly made through exclusion and examination of histopathology slides. Core needle biopsy is the gold standard technique used in the diagnosis of the condition. It’s a self limiting disease, and requires surveillance,corticosteroid therapy and surgical intervention.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Antibacterial and Antifungal Activity of Selected Indian Traditional Medicinal Plants 2022-01-19T09:22:11+00:00 Honnesh N. H. Santanu Saha <p>Antibacterial and antifungal activities are the universal supporting activities for other therapeutic activities like anti-inflammatory, wound healing etc. The traditional medicinal plants <em>Pongamia pinnata</em> and Macaranga peltata selected. The selected plants different extracts (Ethanol, Chloroform, Petroleum ether, Ethyl acetate and Methanol) were prepared and preliminary phytochemical screening was performed. The antibacterial and antifungal activity was performed by Agar well method by using Ciprofloxacin and Erythromycin standards. In this study we come to conclusion that the selected medicinal plants alcohol extract is having significant antibacterial and antifungal activity.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## The Use of Simethicone in a Public Healthcare Organization in Riyadh Region 2022-01-19T09:24:29+00:00 Mohd Faiyaz Khan Nehad J. Ahmed <p><strong>Aim: </strong>Simethicone is anti-flatulence medicine that is used to relieves abdominal pain due to excessive gas in the digestive tract. The present study aimed to describe the use of simethicone in a public healthcare organization in Riyadh Region.</p> <p><strong>Methodology: </strong>This is a retrospective study that includes reviewing the outpatient electronic prescriptions of simethicone in a public healthcare organization in Riyadh Region.</p> <p><strong>Results: </strong>During the study period, 113 patients received simethicone. More than 56 % of them were females and the age of 22.12% of them was between 50 and 59 years. More than 26% of the patients received simethicone for 1 week and 23.90% of them received simethicone for 1 month. Most of the prescriptions were written by residents (90.27%) and more than 57% of the prescriptions were prescribed by emergency department.</p> <p><strong>Conclusion</strong><strong>:</strong> The present study showed that simethicone was prescribed frequently in a public healthcare organization in Riyadh Region.&nbsp; More studies are needed to explore the frequency of use and the appropriateness of prescribing simethicone and other anti-flatulence medicines.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Childhood Asthma and Risk Factors in KSA (Cross Sectional Study) 2022-01-19T09:26:55+00:00 Najya Abdullah Attia Hoda Jehad Abousada Samirah Saeed Almasoudi Abdulaziz Abduallah AlHarbi Omniah Dakiel Alghanmi Abdullah Jamaan Alghamdi Fahad Ahmed Almarshud Reema Khaled Alhazmi Abdulaziz Hisham Haddad Abdullah Saeed Alzahrani Ammar Yasir Aljahdali Shuaa Adel Mahmoud Refal Ghassan Ajjaj Sara Mohammed Mannan Aeshah Ali ALnashri <p>The goal of this study is to see if there's a link between age, gender, and risk factors including having a smoking parent, allergic rhinitis, skin allergies, food allergies, and a family history of atopy with the diagnosis of childhood asthma. The goal is also to evaluate the prevalence of asthma in the study's pediatric sample, as well as the prevalence of other symptoms and complications in this group.</p> <p>A link was discovered between childhood asthma and age, allergic rhinitis, skin allergies, food allergies, and atopy in the family. In most areas of this investigation, the findings are consistent with earlier studies conducted at various periods and in other places for almost identical aims.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Assessment of Complete Blood Count and D-dimer among Patients with Plasmodium falciparum Malaria 2022-01-20T03:56:09+00:00 Mohammed Abdulhafeez Hassan Albara Ahmad Hisham Ali Waggiallah <p><strong>Background: </strong>The most virulent of the human malaria parasites is <em>P. falciparum</em> which is responsible for the bulk of the malaria-related morbidity and mortality. Changes in blood cell parameters are already a well-known feature of malarial infections</p> <p><strong>Aim: </strong>The purpose of this research was to assess the total blood count and D-dimer levels in patients with <em>P. falciparum</em> malaria in Khartoum State, Sudan.</p> <p><strong>Study Design:</strong> It is case- control study was conducted on blood cells prameters and plasma D-dimer for patients infected with Plasmdium falciparum malaria</p> <p><strong>Place and Duration of Study: </strong>study was carried out in Yastabshiroon hospital, Khartoum state, from October 2020 to January 2021.</p> <p><strong>Methodology: </strong>The study comprised fifty people who tested positive for <em>P. falciparum</em> using the National Public Health Laboratory's malaria diagnostic standard. The control group consisted of fifty healthy Khartoum locals with about equal gender and age distribution. To collect data from the study group's personal and medical information, such as name, gender, age, and medical condition, a structured questionnaire was developed.</p> <p><strong>Result:</strong> D-dimer levels were considerably greater in <em>P. falciparum</em> malaria cases compared to non-falciparum malaria cases, neutrophil and lymphocyte counts were significantly lower, although white blood cells (WBCs) count was significantly lower in <em>P. falciparum</em> infection patients compared to non-falciparum (p≤0.05). Hemoglobin concentration and platelet count were similarly significantly lower (p≤0.05). Platelet counts and mean cell hemoglobin concentration (MCHC), on the other hand, were significantly lower in individuals with severe parasitemia compared to those with low and moderate parasitemia.</p> <p><strong>Conclusion:</strong> The study concluded that <em>P. falciparum</em> infection causes considerable hematological alterations. The results of the current investigation revealed a significant increase in the D-dimer mean level, as well as a significant decrease in the count of hemoglobin, total white blood cells (TWBCs), lymphocytes, neutrophils, and platelets. It was also discovered that patients with high parasitemia had considerably lower platelet counts and mean cell hemoglobin concentration (MCHC) levels than those with low and moderate parasitemia.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Determination of Serum Electrolyte and Calcium Abnormalities in Neonates with Birth Asphyxia 2022-01-20T04:01:32+00:00 Gnanavelu Injeti Anjali Kher Amar Taksande Abhilasha Singh Panwar <p><strong>Introduction</strong><strong>:</strong> Birth asphyxia and Hypoxic–ischemic encephalopathy (HIE) are significant causes of neonatal mortality and morbidity. Serum sodium, potassium, and calcium level abnormalities may occur in neonates with birth asphyxia, and their early detection and prompt treatment will improve the outcome of these neonates.</p> <p><strong>Aim</strong><strong>:</strong> To study serum electrolyte and calcium levels and their correlation with birth asphyxia and HIE severity.</p> <p><strong>Methods</strong><strong>:</strong> A prospective cross-sectional study was conducted in full-term neonates diagnosed with birth asphyxia, and their serum sodium, potassium, and calcium estimation were done at birth to 12 hours of birth and repeated at 24 to 48 hours of birth. Serum electrolyte and calcium level abnormalities and short-term outcomes of these neonates were studied.</p> <p><strong>Results</strong><strong>:</strong> It was observed that at Apgar score 1 and 5 minutes, with an increase in severity of birth asphyxia serum sodium and calcium levels decreased while potassium levels increased. A significant positive correlation was observed between serum sodium levels and Apgar score at 1 and 5 minutes. Serum calcium levels showed a significant positive correlation with 5 minutes Apgar score. Serum potassium levels at &lt; 12 hours showed a significant negative correlation with 5 minutes Apgar score.</p> <p><strong>Conclusion</strong><strong>:</strong> With increased severity of HIE and Birth asphyxia, serum sodium levels decreased, and serum potassium levels increased. Serum calcium levels decreased with the severity of birth asphyxia but did not decrease their HIE severity.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Gestational Diabetes as a Risk Factor for Cardiovascular Disorders 2022-01-20T04:05:02+00:00 Riffat Sultana Lalit Maheshwari Imran Ellahi Soomro Iram Jehan Balouch Shazia Tabassum Fazal ur Rehman <p><strong>Background: </strong>Gestational diabetes (GD) is identified as a risk factor for increasing the onset of cardiovascular disorders (CVD). However, it is not clear whether this risk is linked with the intercurrent pathogenesis of type 2 diabetes mellitus. Thus, it is essential to identify markers and risk factors responsible for the pathogenesis of CVD and develop therapeutic strategies to decrease the cardiovascular health burden in affected women.&nbsp;</p> <p><strong>Objective:</strong> The present study aims to evaluate the effect of GD on the future onset of CVD and assess the impact of type 2 diabetes mellitus in this context.</p> <p><strong>Study Design: </strong>A cohort study was conducted in Karachi Institute of Heart Diseases Karachi Pakistan from June 2017 to June 2018. A total of 227 females who give birth to at least one kid were included in this study. Females with previous history of cardiovascular disorders and any other chronic disorders were excluded from this study. Using a biennial questionnaire behavioral, life style characters and health outcomes were evaluated. Multivariable Cox model was used to measure hazardous risk and ratio for cardiovascular disorders with 95 % confidence interval.&nbsp;&nbsp;</p> <p><strong>Results: </strong>In this study, 11.8% of participants were diagnosed with gestational diabetes with a mean age of 31.6 ± 2.6 years. 28% of women with GD were developed hypertension later on compared to the non-GD participants (8%), indicating a positive association between GD and hypertension. A multivariate Cox analysis revealed that women with GD had a 28% increased risk of incidence of hypertension as compared to the non-GD group (HR. 1.24 [95% CI 1.13 – 1.65); P&lt;0.01).</p> <p><strong>Conclusion: </strong>Females with GD are at higher risk for developing CVD later in their life. This association might be due to obesity and sedentary lifestyle.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Ameliorative Effect of Cannabidiol against Gastric Ulcer Induced by Diclofenac in Rats 2022-01-20T04:08:40+00:00 Sara A. Aldossary <p><strong>Purpose:</strong> The aim of his study is to examine the effect of using cannabidiol upon gastric ulcer induced by diclofenac in rats. Method: The experiment was conducted on four groups, with normal rats serving as a control in group one. A single oral dose of diclofenac was administered to Group 2 rats in order to induce a stomach ulcer. The rats in the third group were given a single oral dosage of diclofenac sodium, followed by a 5-day therapy with cannabidiol, which began three days before the diclofenac administration. Drug control on cannabidiol-treated rats in the final group (Group 4). Results: The investigation showed that when cannabidiol was administered, the levels of acidity from diclofenac use decreased, significantly. Conclusion: The investigation resulted in a decrease in overall acidity levels among the rats treated with diclofenac, indicating that cannabidiol was effective in treating the condition.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Effectiveness of Video Assisted Teaching [VAT] in Terms of Knowledge and Self-expressed Stigma Regarding COVID-19 and its Preventive Measures among Housekeeping Staff at Selected Hospital, Gurugram, Haryana: A Pre-experimental Study 2022-01-20T04:14:27+00:00 Khiumajuliu Abonmai Sunil Kumar Dular Rekha Chhillar <p><strong>Background:</strong> The coronavirus disease 2019 (COVID-19) is a contagious disease caused by newly discovered virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The current study is here about Covid-19 and its preventive measures as housekeeping staffs are on the front lines of fighting this global pandemic, as they are responsible for deep cleaning, disinfecting and scrubbing the surfaces and areas that are hosts of potentially dangerous germs and viruses which can widely spread and affect so many lives.</p> <p><strong>Objectives:</strong> The objectives of the study have drawn to fulfill the research reflecting on the effectiveness of Video Assisted Teaching [VAT] regarding COVID-19 and its preventive measures in terms of knowledge and self-expressed stigma among housekeeping staff at selected hospital, Gurugram, Haryana.</p> <p><strong>Materials and methods:</strong> A pre-experimental study with one-group pre-test post-test design was conducted among 100 housekeeping staff by convenient sampling technique in selected hospital, Gurugram, Haryana.</p> <p><strong>Results:</strong> Among 100 housekeeping staff, 91.66% were having previous knowledge regarding COVID-19, 76% were male and mean age was 54 years of age. Overall, 93 (93%), 7 (7%) and 0 (0%) participants had adequate, moderate and inadequate knowledge regarding COVID-19 and its preventive measures and 42 (42%), 58 (58%) and 0 (0%) participants had favorable, moderate and unfavorable stigma related to COVID-19. There was no significant association between the pre-test knowledge and self-expressed stigma regarding COVID-19 and its preventive measures with the demographic variables.</p> <p><strong>Conclusion:</strong> The study found a significant difference in knowledge and self-expressed stigma on COVID-19 and its preventive measures among housekeeping workers in a chosen hospital in Gurugram, Haryana, before and after VAT programme. It was proved that Video Assisted Teaching was effective in teaching COVID-19 and its preventive measures to housekeeping staff in a selected hospital in Gurugram, Haryana. With continuing education, housekeeping staff may become more aware about COVID-19 and reduces the spreading of the diseases.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Comparative Study of Drug Likeness and Pharmacokinetic Properties of Synthetic Antiviral Drugs to that of Remdesivir: In-silico Approach 2022-01-20T04:23:27+00:00 Akshatha C Gayatri Vaidya Chandan Dharmashekara Bhargav Shreevatsa H. S. Vikas H. H. Bhavana Kollur Shiva Prasad Chandrashekar Srinivasa Sharanagouda S. Patil S. Bindya P. Ashwini Pallavi M Chandan Shivamallu Raghu Ram Achar <p>COVID-19's recent appearance in Wuhan, China, has affected more than three million twenty-five million individuals worldwide. It is considered a pandemic disease by WHO. Till now, there is no approved therapeutic for treating COVID-19 infection. The involvement of RNA-dependent RNA polymerase in coronavirus replication is crucial, and it could be a potential therapeutic target. To identify potent inhibitors against coronavirus, we have applied a molecular docking tool targeting RdRp by antiviral synthetic ligands and phytochemical ligands. Auto Dock 4.2.6 was used to do molecular docking in order to predict the most effective drug. In the present study, molecular docking studies of fifty ligands against the protein RNA dependent RNA polymerase. A comparative study was done using standard antiviral ligands Remdesivir. Out of fifty ligands, the top ten compounds were selected, which shows maximum binding affinity.Furthermore, ADME analysis and Lipinski's five rules were investigated to check the drug-likeness and pharmacokinetic properties of the top ten ligands. We observed from the following results that except few, all the ligands showed the best binding energy compared to standard ligands against coronavirus. Depending on the higher docking score, ADMET and drug-likeness prediction top five ligands were selected. This study will provide a lead molecule against RNA-dependent RNA polymerase for further in-vivo and in-vitro of coronavirus.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Morphometric Study of the Mastoid Process and Notch in Dry Human Skulls 2022-01-20T04:42:48+00:00 Sheron Blessy Karthik Ganesh Mohanraj <p><strong>Introduction: </strong>Mastoid process is a pyramidal bony projection . It is located in the posterior inferior region of the temporal bone. Mastoid notch is on the medial side of the mastoid process. Clinical significance causing infection of the middle ear could spread to the mastoid area causing mastoiditis.&nbsp; The aim of the study is to determine the morphometric and morphological analysis of mastoid process and mastoid notch in dry human skull and their clinical implication.</p> <p><strong>Materials and Methods: </strong>The present study was taken from the department of Anatomy in Saveetha Dental College and Hospital by taking 72 dry human skulls. Digital vernier caliper was used to measure the mastoid process and mastoid notch of different parameters. The data was measured and analyzed statistically, using paired sample ‘t’ tests.</p> <p><strong>Results: </strong>The present study shows 0.641 significance in the right and left length of the mastoid process which is not significant. Right breadth and left breadth of the mastoid process of 0.007 and mastoid notch of right and left length 0.00 are significant.</p> <p><strong>Conclusion: </strong>It concludes that the mastoid process and mastoid notch have varied significant differences in the dry human skulls. This study will be helpful in mastoid surgeries.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Computational Quantum Chemical with Biological Studies on Uracil-5-Tertiary Sulfonamides 2022-01-20T05:10:07+00:00 G. V. Gaurav K. Rama Krishna <p><strong>Aims: </strong>To study Computational Quantum Chemical (CQC), Pharmacokinetic and other biological components are listed in pairs of Uracil-5-Tertiary Sulfonamides “5-(4-(2,3-dihydrobenzo [b] [1,4]dioxine-2-carbonyl)piperazin-1-yl)sulfonyl)pyrimidine-2,4(1H, 3H)-dione ” (I) and “N-butyl-N-methyl-2,4-dioxo-1,2,3,4 -tetrahydropyrimidine-5-sulfonamide ” (II).</p> <p><strong>Methodology: </strong>NMR (<sup>1</sup>H, <sup>13</sup>C), FT-Raman, FT-IR, and UV-Vis spectral chemical data were calculated and reported. DFT values ​​for both combinations (I and II) were calculated using B3LYP / 6-31 + G (d, p) and B3LYP / 6-311 + G (2d, p). NMR chemical modification was calculated using the independent atomic orbital measurement method (GIAO). UV-Vis display is also calculated using the same basic sets.</p> <p><strong>Conclusion: </strong>The limits of Hyperpolarizability, HOMO and LUMO are listed. Pharmacokinetic properties (ADMET), drug similarity, bioactivity school, logP, pKa calculated using Molinspiration, pkCSM, Swiss ADME, Chem Axon.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## An Assessment of Knowledge, Attitude and Practices (KAP) towards Diabetes and Diabetic Retinopathy 2022-01-20T05:26:16+00:00 M. Varaprasanna Rao T. Yugaprasanth <p><strong>Introduction: </strong>Diabetes mellitus is an endocrine metabolic disorder whereas Diabetic retinopathy is a major complication of diabetes. Diabetes occurs due to defect in insulin secretion, action, or both which in turn leads to chronic hyperglycemia with disturbances of carbohydrate, fat, and protein metabolism and is associated with long-term damage, dysfunction, and failure of different organs (eyes, kidneys, nerves, heart, and blood vessels). DR is a progressive alteration in the microvasculature that lead to retinal ischemia, altered retinal permeability, neovascularisation, macular edema.</p> <p><strong>Methods and Materials:</strong> It was a prospective cross-sectional study, which was carried out over a period of 6 months (December-2020 to May-2021). The knowledge, attitude and practice were assessed in diabetic patients on diabetes and diabetic retinopathy by using questionnaires. A total of 362 diabetic patients are included in this study. The completed questionnaires were collected and analysed using SPSS software (version 19) and results were expressed in percentages.</p> <p><strong>Results and Discussion:</strong> In the study, majority of the patient were male and in the age group of 46-55 years. Patients had good knowledge on diabetes when compared to diabetic retinopathy, positive attitude was seen towards diabetes than diabetic retinopathy and good practice patterns were observed in diabetes retinopathy than diabetes.</p> <p><strong>Conclusion: </strong>Our study concluded that the patients had good knowledge on about diabetes and a very poor knowledge on diabetic retinopathy. Positive attitude was seen in diabetes than diabetic retinopathy where as good practice patterns was seen in diabetic retinopathy than diabetes patients.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Isolation and Charecterization of Phytoconstituents from Annona reticulata L. Leaf Extracts 2022-01-20T05:42:23+00:00 Sonal D’Souza Nishmitha Gretta D’Souza Jennifer Fernandes Jane Mathew <p><strong>Aims: </strong>The present work was designed to isolate the chemical constituents from the leaf extracts of the plant <em>Annona reticulata</em> L. most commonly known as Ramphal or Bullock’s heart or Custard apple belongs to the family <em>Annonaceae.</em></p> <p><strong>Methods:</strong> The extraction of leaf powder was done using various solvents. The preliminary phytochemical tests were carried out using standard chemical tests. Phytochemical constituents were isolated using column chromatography and characterization of the compounds were carried out using IR, <sup>1</sup>H NMR, and mass spectroscopy data.</p> <p><strong>Results:</strong> The results from the preliminary phytochemical studies showed the presence of alkaloids, triterpenoids, carbohydrates,saponins and flavonoids. Isolation of leaf extracts revealed the presence of a steroid, alkaloid and flavonoid which were confirmed by spectral analysis to be α – amyrin caprylate, xylopine and fisetin.</p> <p><strong>Conclusion:</strong> The study confirmed the presence of α – Amyrin caprylate, Fisetin and Xylopine as its main chemical constituents.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Time Series Models for COVID-19 New Cases in Top Seven Infected African Countries 2022-01-20T06:22:08+00:00 Alemayehu Siffir Argawu <p><strong>Introduction:</strong> In Africa region on the date of December 09, 2021 at 14:46 GMT, the total cumulative cases of COVID-19 was 8,889,437 with total deaths and total recoveries of 224,731 (2.5% of death rate) and 8,185,382 (92% of recovery rate) respectively. Thus, this study aimed modelling and forecasting of COVID-19 new cases in top seven infected African countries using time series models.</p> <p><strong>Methods:</strong> The top seven infected African countries COVID-19 new cases dataset was taken from our World COVID-19 dataset. The study period was from February 14 to September 06, 2020. Different time series models were used for modelling and forecasting of COVID-19 new cases data. Models comparisons were done by normalized BIC, root mean square error (RMSE), mean absolute percentage error (MAPE), and R-squared values.</p> <p><strong>Results:</strong> The COVID-19 new cases data of Algeria, Egypt, Ethiopia, Morocco, and South Africa were fitted by ARIMA (0,1,0), ARIMA (0,1,0), Damped trend, Brown, and ARIMA (0,1,14) models in the study period, respectively. Whereas Ghana, and Nigeria COVID-19 new cases data were followed by simple exponential smoothing models. The 95% confidence levels for lowest to highest forecasted COVID-19 new cases were 258 to 197 with decreasing trend in Algeria, 63 to 933 with increasing trend in Egypt, 636 to 2,141 with increasing trend in Ethiopia, 0 to 1,022 with constant trend in Ghana, 1,900 to 2,807 with increasing trend in Morocco, 0 to 543 with constant trend in Nigeria, and 2,056 to 2,444 with increasing trend in South Africa for the next one month (from September 7 to October 6, 2020).</p> <p><strong>Conclusion:</strong> The findings of the study used for preparedness planning against further spread of the COVID-19 epidemic in African countries. The author recommends that as many countries continue to relax restrictions on movement and mass gatherings, and more are opening their air spaces, and the countries’ other public and private sectors are reopening and then strong appropriate public health and social measures must be instituted on the ground again and again before the virus is distributed and attacked more and more peoples in the region. And, the researcher recommended that risk factors of COVID-19 new cases should be conducted for next time in Africa countries.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Physiological Effects of Cryptic Ancient Religious Chants 2022-01-22T04:12:05+00:00 Abhijit. V. Bodne Varsha Patond <p><strong>Aim:</strong> One of the variables that contributes to higher academic achievement is awareness. In Indian schools, traditional practises are applied to improve mental skills with the purpose of adding value. Prayers and other mantras, for example, can help to regulate and enhance the cardiovascular heart's rhythm while also modifying baroreflex sensitivity.</p> <p><strong>Method:</strong> 50 healthy individuals were selected for the study<strong>.</strong> Comparisons of the effects of reciting Mary's petitions or mantra during voluntary breathing and metronome device control on rate of respiration, spontaneous pulse, blood pressure, and brain circulation in the RR region. The purpose of this study is to compare the impact of singing the Gayatri mantra (GM) on awareness to the function of letter substitution (DLST). Respiratory frequency, normal breathing, baroreflex sensitivity, heart oscillation frequency were recorded. The Bonferroni adjustment was utilised in the frequent measurement analysis of difference.</p> <p><strong>Conclusion:</strong> With the DLST net, both of these times showed complete upgrades in total points. In comparison to PL (3.85 percent), the extent of the development of net points was large after GM (22.67 percent). When repeated seven times per minute, both prayers and mantras generate a noticeable, forceful, and simultaneous rise in present-time cardiovascular system pulsations. The sensitivity of the baroreflex also increases significantly, from 9.2 (SD 4.4) to 11.7 (4.5) ms/mm Hg, P0.06.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Frequency of Hypocalcaemia among Children (Age 2-60 Months) Presenting with First Episode of Afebrile Seizures: A Cross Sectional Study 2022-01-22T04:19:18+00:00 . Asadullah Salma Shaikh Ayesha Farhat . Amanullah Sehrish Memon Muhammad Nadeem Chohan <p><strong>Aim:</strong> To determine the frequency of hypocalcaemia among children aged 2 to 60 months presenting with afebrile seizures.</p> <p><strong>Study Design:</strong> A cross sectional study.</p> <p><strong>Place and Duration:</strong> Department of Pediatrics, Liaquat University of medical and Health Sciences Jamshoro, from February to August-2020.</p> <p><strong>Methodology:</strong> A total of 130 children aged 2 to 60 months, having afebrile fits with birth weight more than 2.5 kg were enrolled. After taking full history, detailed examination was done. Two ml blood sample was taken from each patient and was sent to diagnostic laboratory of the institution to find out calcium levels. In case of proven hypocalcaemia, injection calcium gluconate 100 mg/kg was administered. Mean and standard deviation were calculated for quantitative variables while frequency and percentages were noted for qualitative variables. Frequency of hypocalcaemia was recorded and study variables were compared between children with and without hypocalcaemia.</p> <p><strong>Results:</strong> Majority of the patients, 69 (53.1%) were male, 64 (49.2%) less than or equal to 12 months of age, 28 (21.5%) had maternal educational status as illiterate, 78 (60.0%) belonged to rural areas, 59 (45.4%) belonged to middle socioeconomic status, 69 (53.1%) had poor exposure to sunlight, 80 (61.5%) had malnutrition, 82 (63.1%) had child spacing of less than 2 years, 79 (60.8%) with less than 5 episodes of fits per day and 88 (67.7%) had duration of fits per day as less than 5 minutes. Frequency of hypocalcaemia was noted in 81 (62.3%) cases.</p> <p><strong>Conclusion:</strong> We concluded that hypocalcaemia is the frequent cause of afebrile seizures in children aged 2 to 60 months.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Comparison between Study of Bone Mineral Density in Males and Females of Various Age Groups 2022-01-22T04:20:47+00:00 Anupama Sawal Preeti Thute Deepali Withale Geetanjali Yadgire <p><strong>Background:</strong> Osteoporosis is one of the complex diseases which have multiple etiology. The cause of it is maybe genetic and environmental or nutritional. There are various techniques for the measurement of bone mineral density. The DXA (DUEL ENERGY X-RAY ABSORBTIOMETRY AND BONE DENSITOMETER) is frequently used to measure bone mineral density. The other measures to measure bone mineral density are Quantitative computed</p> <p><strong>Results:</strong> With the increase in negative T tomography and ultrasound tonometry. The WHO standard for distinguishing patients as normal with 1 standard deviation of peak bone mass. Osteopinic 1 to 2.5 below peak bone mass .osteoporotic ;&gt;2.5&nbsp; standard deviation below peak bone mass.</p> <p><strong>Materials and Methods: </strong>The study included 200 Subjects of various age groups of both sexes. The study was carried out in the department of anatomy with the collaboration of the Department Of Orthopedics. The proforma was structured to include the details of the subjects with height, weight, etc.&nbsp; With a score of one, the risk of fracture increased 1.5 to 3 fold.</p> <p><strong>Conclusion: </strong>The study of Bone Mineral Density (BMD) can help in increasing awareness about bone health in growing countries. There is a significant association between various age groups and a non-significant association between genders for BMD evaluation.</p> <p>The current study puts up to our understanding of BMD disparities among people that would suggest the use of local testimonial scales for an authentic explanation of BMD reports.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## To Estimate the Level of Awareness of Contraception amongst the Teenage Girls 2022-01-22T04:29:57+00:00 V. K. Chimurkar Anupama Sawal Darshana Fulmali Vaishnavi V. Chauhan <p><strong>“What is contraception?”</strong></p> <p>Contraception is the method for birth control which helps to prevent unwanted pregnancies. There are so many methods of contraception including long acting reversible methods, barrier methods, hormonal methods, lactational amenorrhea method, fertility awareness based methods, emergency contraceptives, etc.</p> <p>In present decade, the knowledge of contraception in teenage girls is mandatory as the involvement of teenagers in sexual activities is increasing day by day. The reasons can be many such as social media, electronic gadgets, peer pressure, etc. There are so many studies that have shown that knowledge of contraceptives, especially among the teenage girls in universities remains limited and the rate of sexual activity before marriage,&nbsp; and&nbsp; unwanted pregnancies, illegal abortions remains higher among college going&nbsp; students.&nbsp;&nbsp;&nbsp; It leads to various health conditions in girls as well as mental and social disturbances in both girls and boys.&nbsp;&nbsp; There is a need to make them aware about the consequences they have to face after engaging in sexual activities and ending up with teenage pregnancies, unwanted pregnancies and unsafe abortions.</p> <p>Current study aimed to assess the awareness of contraceptives, sexual behavior, and factors associated with contraceptives use among female undergraduate students as well as girls who are illiterate in Wardha region, Maharashtra.</p> <p><strong>Aim: </strong>‘The study was conducted to estimate the level of awareness of contraception amongst the teenage girls’.</p> <p><strong>Objectives:</strong></p> <ul> <li>To provide proper sex education to the teenagers.</li> <li>To aware teenagers about complications of teenage pregnancies.</li> <li>To acknowledge them about sexual activities and their consequences.</li> <li>To acknowledge them about contraceptives and their proper uses.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</li> </ul> <p><strong>Materials and Methods: </strong>Sawangi, Wardha.&nbsp; Total&nbsp;&nbsp; study participants were 140 girls. One group&nbsp; of 70 girls,&nbsp;&nbsp;&nbsp; age&nbsp; between 13 years to 16 years, half of them from school located in Wardha and half of them from rural area around the Wardha.&nbsp; Another group of 70 girls belongs to 17 years to 19 years, half of them from school and half from rural area.&nbsp; The participants were on voluntary basis. The girls belong rural area that had never been to the school.&nbsp; None of them were given questionnaire to fill. Answers were recorded on the questionnaire by the social worker who was assigned the job.&nbsp; Adequate time was given to each adolescent to answer the questions asked. The data thus collected was analyzed. Prior permission and consent were taken from the school Principal and the parents.</p> <p><strong>Conclusion: </strong>The present study concludes that there should be sensitization of teenage girls about contraception and various contraceptive methods. It will help them to prevent the unwanted pregnancies and it adverse outcomes of abortions which is beneficial to maintain their further reproductive life.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Knowledge, Awareness and Practice of Usage of Interdental Aids among Dental Professionals 2022-01-22T04:39:00+00:00 Lasya Genji M. Jeevitha S. Preetha Selvaraj Jayaraman <p><strong>Aim: </strong>To evaluate knowledge, awareness and practice of usage of interdental aids among dental professionals.</p> <p><strong>Introduction: </strong>Dental caries and periodontal diseases, the two most common oral diseases, are mainly avoidable by professional and self-care activities. Dentists’ knowledge and people's attitude on oral hygiene maintenance have a key role in the prevention of oral diseases.</p> <p><strong>Study Design: </strong>This was a survey conducted in an online forum. It was a questionnaire based survey.</p> <p><strong>Methodology: </strong>A set of 10 questions to assess knowledge, awareness and practice of usage of interdental aids was distributed among dental professionals. The data was collected and statistically evaluated using SPSS software.</p> <p><strong>Results: </strong>Majority of the dental professionals are aware of the purpose of interdental cleaning among which 74.5% being MDS and 3.92% being BDS.</p> <p><strong>Conclusion: </strong>Because of the minimal positive reaction to interdental aids among general dentists, educational campaigns offering information on various interdental aids should be conducted.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Awareness of Dry Eyes Disease among Dental Students - A Survey 2022-01-22T04:41:51+00:00 S. Abinaya Palati Sinduja R. Priyadarshini <p><strong>Introduction: </strong>Dry eye is a common condition that affects 85 percent of adult students worldwide, has no effective treatment, and results in significant loss of productivity at work.</p> <p><strong>Aim: </strong>This study aims to assess the knowledge and awareness of dental students about dry eye disease.</p> <p><strong>Materials and Methods:</strong> An online google form was used to distribute a questionnaire based study with 12 questions to 100 people. The study began with the participants being briefed on the trial's details. The study used a 100-person sample size. The information was gathered and statistically examined.</p> <p><strong>Results: </strong>In this study, 96% of the students were aware that lack of sleep causes Dry Eyes Disease and 4% of the students were unaware of it. Around 83% of the students were aware that dry eye is reversible and 17% of the students were not aware of it. The overall result was positive, most of them were aware of the dry eye disease. This proves an outright positive result.</p> <p><strong>Conclusion: </strong>The present study shows that the students under 75% were aware of Dry Eyes Disease but 25% were unaware of dry eye disease. There is no sufficient awareness among dental students. So, by this survey, we create more awareness among dental students.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Knowledge and Awareness on Tendency of Disease in Different Blood Groups among General Population- A Survey 2022-01-22T04:46:23+00:00 M. Vignesh Palati Sinduja R. Priyadharshini <p><strong>Background: </strong>Blood groups are classified into two types ABO system and Rh system and ABO system have the antigen on the RBC and the antibody of the blood and whereas Rh blood system only contain the only antigen called D antigen that is present on the surface of RBC and the criteria to find the Rh+ or Rh- is by presence or absence of D antigen and this is the prime understanding of the blood groups where the antigen, antibody and cellular units together comprise the host response to the antigen or disease and enhance it. Our study is to create the awareness among the people for different blood groups disease-causing tendency</p> <p><strong>Materials And Methods: </strong>The questionnaire was made comprising of 15 questions using google forms and it is circulated among 100 peoples and the data was collected and evaluated by Chi-square test using SPSS VERSION 26. (p&lt;0.005)</p> <p><strong>Results: </strong>The results showed that more than 75% of the study population are unaware of the blood groups associated with systemic illness and further survey is needed to analyze more population.</p> <p><strong>Conclusion: </strong>From the results, we concluded that certain programs and initiatives are needed to overcome the disease caused by the blood groups and our study focuses mainly on improving the knowledge of the individual about the knowledge and awareness of disease in blood groups.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Comparative Anti Inflammatory Activity of Hexane and Aqueous Extract of Mucuna pruriens 2022-01-22T04:50:40+00:00 S. Divyashri R. Priyadharshini S. Rajeshkumar Palati Sinduja <p><strong>Introduction:</strong> <em>Mucuna pruriens </em>is a tropical legume native to Africa and tropical Asia. The plant is an annual climbing shrub with long vines that can reach a height of 15 meters in length. <em>Mucuna pruriens </em>belong to the family legume. It is a herbal drug that is used as a medicine for the treatment of male infertility, nervous disorder, and also as an aphrodisiac. It has been shown that it potentially has more medical importance. It causes orange hair that causes a severe itch when in contact with the skin. It releases a protein called mucanain.</p> <p><strong>Aim:</strong> To determine the anti-inflammatory activity of aqueous and hexane extract of <em>Mucuna pruriens.</em></p> <p><strong>Materials and Methodology:</strong> The extract was prepared and the anti-inflammatory effect was done using a UV-Beckmann spectrometer. The anti-inflammatory activity of nanoparticles prepared using plant extract was investigated by albumin denaturation assay. The results of the test were described as the standard deviation and analyzed using UV-Vis spectroscopy. Correlation and analysis were done in SPSS.</p> <p><strong>Results: </strong>The hexane solution and aqueous solution of <em>Mucuna pruriens </em>have a high percentage of inhibition at the 30 μl, 40 μl and 50 μl concentration when compared with a standard solution. And hexane has a high percentage of inhibition at 50μl when compared with a standard solution. The obtained data were analyzed using spearman correlation analysis and the non-parametric correlation was statistically significant at p value&lt; 0.05.</p> <p><strong>Conclusion: </strong>The aqueous and hexane extract of <em>Mucuna pruriens </em>show good anti- inflammatory activity. In that hexane extract has good anti-inflammatory activity when compared with aqueous extract. And it is used for disease. And further research should be done with the action and mechanism of <em>Mucuna pruriens.</em></p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Determination of Bone Age and its Correlation to the Chronological Age Based on the Greulich and Pyle Method in Saudi Arabia 2022-01-22T04:57:59+00:00 Abdulmalik B. Albaker Asim S. Aldhilan Hamza M. Alrabai Salah AlHumaid Ismail H. AlMogbil Nawaf Fahad A. Alzaidy Saleh Asaad Hamad Alsaadoon Ohud Abdulrahman Alobaid Faisal Hassan Alshammary <p><strong>Introduction:</strong> Many clinical indications need the measurement of bone age, including growth and development abnormalities, the timing of corrective procedures in pediatric patients, and the assessment and treatment of specific endocrine conditions. These evaluations are also useful in forensic science.</p> <p><strong>Aim: </strong>This study aims to compare the bone age of children aged 4 to 18 years old with their chronological age in order to determine whether the Greulich-Pyle (GP) method is trustworthy for Saudi youngsters.</p> <p><strong>Materials &amp; Methods: </strong>Multiple approaches for determining bone age have been published, but Greulich and Pyle's methodology is the most extensively utilized. This method is based on an inspectional evaluation that compares the radiograph to the pattern described in a 1950 atlas using a sample of North American children aged birth to 18 years for the female sex and up to 19 years for the male sex. It is one of the most commonly utilized procedures for assessing the skeletal age of children and adolescents since it is rapid and quick to perform. It is based on the fact that ossification centers in the hand and wrist bones emerge in a predetermined order. For male and female youngsters, the degree of ossification in various hand and wrist bones is compared to the nearest matching plate on the Greulich &amp; Pyle Atlas. This cross-sectional study was performed during April 2021 to September 2021.</p> <p><strong>Results: </strong>Total 216 patients were included or selected in this study among age group 4-18 years, the sex distribution among them were 148 (68.5%) and 68 (31.5%) were male and female respectively. Chronological age and bone age assessment by GP methodamong doctors when chronological age was 135.2 ± 45.0 (range, 45-216 months). Chronological age in male and female were 143.5 ± 44.0 and 116.9 ± 41.8 respectively with p value &lt;0.001 which was statistically significant. The bone age were observed in two reading, first reading and second reading after 15 days by two doctors separately and all the finding were recorded almost similar and significant with p value &lt;0.001. Correlation between Chronological age and Bone age by GP method in both sex observed significant p value &lt;0.001. Linear regression analysis showed that the bone ageand its correlation to the chronological age assessment in first reading in male(r=0.761 and p&lt;0.001) and female(r=0.889 and p&lt;0.001), in reading after 15 days in male(r=0.760 and p&lt;0.001) and female(r=0.868 and p&lt;0.001).</p> <p><strong>Conclusion: </strong>In order to evaluate whether the Greulich-Pyle (GP) technique is accurate for Saudi children, the bone age of children aged 4 to 18 years old should be evaluated to their chronological age, according to this research.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Depression and Its Associated Factors in Hospitalized Patients 2022-01-22T05:00:37+00:00 Iram Shehzadi Naqash Siddique Gorsi Waqas Ahmad Khalid <p><strong>Background and Objectives: </strong>The basic aim of this study was to analyze the prevalence of depression and its associated factors among hospitalized patients in local hospital of Pakistan.</p> <p><strong>Methods: </strong>This Cross sectional study was conducted in Jinnah Hospital Lahore during June 2019 to June 2020.</p> <p><strong>Results: </strong>This study includes 200 patients who were admitted in Jinnah hospital, Lahore. We collect and analyze the data and find the mean values of age, BMI, patient’s income status, economic status and some other socio-demographical values of patients. The data represents that the most frequent reason of admitted in hospital is some kind of gastrointestinal issues. It was also noted that the median length of hospital stay was 7-8 days in 75% of the patients.</p> <p><strong>Conclusion: </strong>It is concluded that depression is a great factor which contribute towards the hospitalized patients suffering. Hospitalized patients were at higher risk for anxiety if they were physically inactive and stayed 8 days or longer in hospital. The risk for depression was higher in patients with a low income and older patients.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Morphometric Analysis and Variation of Pterion, Asterion and Lambda in Dry Human Skulls and Its Sexual Dimorphism 2022-01-24T07:04:20+00:00 Sadhana Karunakaran Karthik Ganesh Mohanraj <p><strong>Introduction:</strong> Pterion is a H- shaped sutural junction of the frontal, parietal, squamous part of the temporal and greater wing of sphenoid bone. Asterion is a sutural junction of lambdoid, parietomastoid and occipitomastoid sutures. Lambda is the junction where lambdoid sutures and sagittal sutures meet. These sutures play an important role in infants' brain development. Flexibility of these allows the bones to overlap and hence it can pass through the brain canal easily without any damage to the brain.</p> <p><strong>Aim:</strong> To analyse pterion asterion and lambda of dry human skulls morphologically and morphometrically and determine its sexual dimorphism.</p> <p><strong>Materials and Methods:</strong> 40 dry human skulls were collected from the department of Anatomy of Saveetha dental college and hospitals. By excluding abnormal and damaged skulls, 20 skulls were studied. Out of 20 skulls, 11 were male skulls and 9 were female skulls. On investigation, Pterion was classified into four types: Sphenoparietal, stellate, Epipteric and Frontotemporal. Asterion was classified into types: Type-1 and Type-2 based on the presence and absence of wormian bones respectively. Lamda was classified into two types: Normal and Abnormal. Statistical analysis was done by SPSS software. Paired Sample T test was used to analyse the data.</p> <p><strong>Results:</strong> Percentage of occurrence of different types of pterion in males and females: Sphenoparietal (59.09 % of males and 59.09 % of females), Stellate (27.7% of males and 22.2% of females), Epipteric (99% of males and 16.6% of females) and Frontotemporal (45.5% of males and 5.5% of females). Different types of Asterion: Type-1 (13.63% of males and 16.66 % of females and Type -2 (86.63% of males and 83.33% of females). Different types of Lambda: Normal (90.9% of males and 94.4% of females), Abnormal (9% of males and 5.55% of females).</p> <p><strong>Conclusion:</strong> In the present study, there was no correlation between the male and female skulls in the presence of Pterion, Asterion and Lambda. Therefore these cannot be used as reliable parameters for determining sexual dimorphism.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Frequency of Pituitary Adenoma among the Patients with Chronic Headache 2022-01-24T07:07:01+00:00 Asadullah Jatoi Asma Jatoi Noman Ahmed Shaikh Ashok Kumar Narsani Mona Liza Mahesar <p><strong>Background:</strong> Antero-superior, Pituitary Gland lies in vicinity of optic chiasm and antero-inferiorly, it is related with posterior wall of sphenoid bone. Pituitary Gland is consisting of three lobes: Anterior, intermediate and posterior and their secretion are regulated by hypothalamus.</p> <p><strong>Aims and Objectives:</strong> To identify pituitary adenoma in the patients coming with complain of chronic headache.</p> <p><strong>Materials and Methods:</strong> Seven hundred sixty-four patients were included in our study. All the patients with chronic headache with/without decreased vision and visual field defects were included our study. Those patients already diagnosed with any other cause of headache such as uncontrolled blood pressure, tumor or diagnosed case of pituitary adenoma and patient with glaucoma were excluded. Detailed history was taken and ocular examination was done. MRI orbit and brain with contrast was done in all patients.</p> <p><strong>Results:</strong> Out of 764 patients, 32 patients were diagnosed as having pituitary adenoma. Macro-adenoma was present in 30 patients and micro-adenoma in 2 patients. On MRI majority of patients had optic chiasm compression with bi-temporal hemianopia.</p> <p><strong>Conclusion: </strong>All the patients with chronic headache with/without visual disturbances and visual field defect must be properly examined and investigated as that will help other researchers to diagnose the Pituitary Adenomas.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Effectiveness of Online Practical Exercises among Third-year Dental Undergraduate Students - A Questionnaire-based Survey 2022-01-24T07:11:50+00:00 S. Amrithaashri Palati Sinduja R. Priyadharshini <p><strong>Introduction:</strong> When teachers and students synthesize knowledge from multiple subjects and experiences, objectively weigh dramatically different viewpoints, and integrate various inquiries, education may become transformative. Online applications have been marketed as effective and well-accepted methods for improving student learning in health professional education, including physiotherapy. This study aimed to evaluate the efficacy of online technology for physiotherapy teaching and learning, as well as user expectations. Educators may create such opportunities by encouraging students to develop their capacities for study, creativity, critical synthesis, creative expression, self-awareness, and intentionality in critical learning spaces.</p> <p><strong>Materials and Methods:</strong> Survey was distributed to third-year undergraduate students. It suggests that most of the students are aware of online practical classes and also they have knowledge about online classes.</p> <p><strong>Results and Discussion:</strong> It is concluded that types of classes students prefer, 69% prefer online classes, 31% prefer offline classes, gaining of knowledge in online classes 91% can gain knowledge, 9% are not able to gain knowledge, Preference in online classes 49% preferred theories, 49% prefer practical classes, 2% prefer none Association between gender and preferences of online practical classes was done using chi-square test p=2, p&gt;0.05 which is found to be statistically not significant.</p> <p><strong>Conclusion:</strong> It is concluded that most of the students are aware, and students also have knowledge about online practical exercises and classes, the results and this study was compared with other studies.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Restless Leg Syndrome in Dormitory and Its Relationship with Sleep Quality 2022-01-24T07:18:12+00:00 Mohammed Abdullah Aljaffer Abdulrahman Mohammed Alrajhi Salem Wadie Basamad Saud Khalaf Alhothaly <p><strong>Introduction:</strong> Restless legs syndrome, is a widespread, chronic, multifactorial movement condition of the limbs in which patients have an insatiable need to move their legs.</p> <p>It was linked to poor quality sleep among students.</p> <p><strong>Objective:</strong> This study aim to explore The Relationship between them among health sciences students who live in dormitory.</p> <p><strong>Methods:</strong> We conducted a Quantitative cross-sectional observation study by using a validated questionnaire targeting Health sciences students and compare to those who live in dormitory Summary statistics for the data are presented in the form of numbers and percentages for categorical variables. A mean score for restless leg symptoms and quality of sleep was calculated. A higher score reflects severe symptoms or poor sleep quality.</p> <p>IBM SPSS 26 for windows software was used for the analysis, and a P-value &lt; 0.05 is considered statistically significant.</p> <p><strong>Results:</strong> A total of 148 students participated in this study. The highest percentage of participants are from the faculty of medicine (58.1%), while participants from other health sciences faculties ranged from 5.4% to 14.2%. 58.1% of the participants are living in the dorms.</p> <p>The relationships between dormitory and restless leg syndrome average score and with sleep quality average score were studied using independent sample t test. The results showed no statistically significant difference between those living in the dorms and those outside the dorms in any of the scores. Even though the results showed no statistically significant difference between students of different faculties in the sleep quality score.</p> <p><strong>Conclusion:</strong> There was no statistically significant difference regarding living in dorms, but there was a statistically significant difference regarding the faculties.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Calculation of the Zone of Inhibition and Sensitivity Pattern of Fenugreek Seeds Extract and Negila sativa Seeds Extract on ESBL E. coli Growth Plates 2022-01-24T07:30:53+00:00 Ata Ur Rehman Kiran Khan Ghazala Nasim Pasha Ulfat Sultana Tajwar Sultana Ruqaya Nangreja <p><strong>Background:</strong> The reason behind the poor outcomes in treating bacterial infections is mainly the limited treatment options. The strains of ESBL are generally resistant to broad-spectrum penicillin, monobactams, and third-generation cephalosporins. Literature is currently highlighting the efficacy of herbs against many resistant organisms. Hence, the study aims to identify the sensitivity pattern and zone of inhibition of <em>Fenugreek</em> seed extract and <em>Nigella sativa</em> Extract against <em>ESBL E. Coli.</em></p> <p><strong>Methodology: </strong>The calculated sample size was n = 40. The <em>ESBL E. coli</em> growth plate samples were recruited from an associated lab which were identified by performing biochemical tests on appropriate media i.e. Mueller-Hinton agar was used.&nbsp; Agar dilution methods were performed to examine the antibacterial effects of fenugreek seed extract (FGSE) and <em>Nigella sativa</em> seed extract (NGSE) against ESBL <em>E. coli.</em> wells of 8mm diameter were punched in the inoculated plates by using sterile cork borer, 100μl of different concentrations of Fenugreek seed extract (30, 40, 50, 60, and 80mg/ml) and <em>Nigella sativa</em> extract (30, 40, 50, 60, and 80mg/ml) were added to wells and the plates and the plates were incubated for 24 to 48 hours at 37°C. After 48 hours presence or absence of zones of inhibition were investigated.</p> <p><strong>Results: </strong>Total 40 samples were calculated for each concentration of the solution of extracts i.e. FGSE group and NGSE group. The effective concentration of FGSE was found to be 40mg/ml and for NGSE was found to be 60mg/ml that showed maximum. Both the extracts showed inhibition of growth of organism at different concentrations table 2 shows the zone of inhibition.</p> <p><strong>Conclusion:</strong> The <em>Fenugreek seed</em> extract at 40mg/ml and <em>Nigella sativa</em> seed extract at 60mg/ml have highest sensitivity and are effective in inhibiting the growth of ESBL <em>E. coli</em> on growth plates.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Trends of Seasonal Influenza Incidence among the Population of Abha, Saudi Arabia During 2019 2022-01-24T07:37:28+00:00 Amal M. Alshahrani Ali Yahya Ali AlHalbub Omar Obaidallah Althobaiti Saud Ghazi Alshumrani Zainah Ghazi Alshumrani Najim Z. Alshahrani Kholoud Ghazi Alshumrani Bayan AlGhamdi Shaima Mohammed Mashhour Al Modeer Omar Alsudairy Alhanouf Dhaifallah Hamad Alharbi Mohammed Alshehri Abdulrahman Ali Alqahtani Abdulbari Ahmed Hanash Nawaf Safaq Alshammari <p><strong>Background: </strong>Influenza is one of the infections in which a specific pattern is observed according to seasons which result in severe forms of disease. By providing regular and extensive quality in epidemiological studies, the surveillance system can help in reducing the threat to public health posed by influenza that eventually minimizes the effect of illness. They also help in reporting the health ministry about the relevant information as an aid to reduce the impact of disease on public health.</p> <p><strong>Objective:</strong> To assess the incidence of seasonal influenza in Abha City, Saudi Arabia.</p> <p><strong>Methods:</strong> This surveillance report conducted among citizens of Abha, Saudi Arabia, 2019. It is based on sentinel surveillance and case-based data collection of laboratory-confirmed cases through electronic health records. All data were obtained from the department of infectious diseases of public health department in Aseer health directorate.</p> <p><strong>Results: </strong>The total reported positive cases for influenza viruses were 808 (22.30%) patients in the city of Abha for the year 2019, among them 435 males and 373 females (F= 9.5149; P=0.002038) which 665 (82.3%) were typed as influenza A and 143 (17.7%) as influenza B. (F= 674.46; P=0.001). The prevalence of the disease is commonly seen in the age group of 5-15 (42.35 %) with a mean age of 15.45±4.50 followed by 16 to 50 years age (37.45%) and 51-65 age group (10%). There was no death registered among these cases. In February maximum cases were found, whereas in June and July minimum cases were recorded. The influenza positivity rate showed one primary peak and three secondary peaks that were recorded in February and January, March and December.</p> <p><strong>Conclusion: </strong>Importance of conducting effective epidemiological surveillance for influenza virus in various regions in Abha specially in winter season with a peak in the month of February.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## A Secure Block Chain Based Contract Manufacturing System for Pharma Industries Using Imperative Ant Loop Optimization Algorithm 2022-01-24T08:01:54+00:00 Neha Saini Arvind P. Bhanu <p>Manufacturers that work under contract for another firm may make their goods under their own brand or label. Using their own or their clients' designs, formulas, and needs as a guide, contract manufacturers perform this service. The pharmaceutical industry relies heavily on contract manufacturing. Due to a lack of capital, some companies are unable to obtain the required equipment for large-scale mass production of certain chemicals. In order to create the final product, they can work with a third-party chemical manufacturer to obtain the necessary chemicals and combine them with their own resources. An organization should carefully assess the benefits and drawbacks of contract manufacturing before committing to this strategy. There may be advantages to contract manufacturing, if the company works with the right service provider capable of delivering high-quality products. The contract manufacturing system proposed in this study is a blockchain-based solution for the pharmaceutical business. Initially, the customer uploads the order details that are preprocessed using normalization method.&nbsp; The preprocessed data is authenticated using the crypto smart contracts before being stored in the blockchain ledger. Then the stored data can be encrypted for security purpose by using the triple MD5 algorithm. Finally, the trust of the order data is evaluated using the proposed Imperative Ant loop optimization algorithm. In order to demonstrate the effectiveness of our system, we use the MATLAB simulation programme to compare it to other approaches.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## The Comparison of Trichoscopic Findings in Female Pattern Hair Loss (FPHL) and Chronic Telogen Effluvium (CTE) in Female Patients 2022-01-24T08:03:55+00:00 Sugat Jawade Bhushan Madke Adarsh Lata Singh Swapna Jawade <p><strong>Background:</strong> Chronic hair loss is a major complaint in middle-aged females. It is sometime difficult to differentiate between female pattern hair loss (FPHL) and chronic telogen effluvium (CTE) in female patients. Trichoscopy is a non-invasive technique that can help to distinguish between FPHL and CTE.</p> <p><strong>Aims:</strong> To compare the trichoscopic findings in female pattern hair loss (FPHL) and chronic telogen effluvium (CTE) in female patients.</p> <p><strong>Materials and Methods:</strong> It is a cross sectional prospective comparative study carried out in the department of dermatology, Acharya Vinoba Bhave Rural Hospital affiliated to Jawaharlal Nehru Medical College, Wardha, Maharashtra. Adult female patients with ages ranging from 30 to 60 years old complaining of diffuse hair loss were included in the study. Patients with scarring alopecia were excluded from the study.&nbsp; Patients were divided into two groups consisting of 20 patients in each group. Group A and B included patients with FPHL and CTE respectively. Trichoscan (SIF hair analysis system) was performed on frontal region of the scalp.</p> <p><strong>Results: </strong>Hair diameter variability was significantly seen in FPHL. &nbsp;Hair diameter was reduced in FPHL (0.045) as compared to chronic telogen effluvium (0.063) with statistical difference between them. Hair density was significantly reduced in FPHL (32 ± 12.24) as compared to CTE (60.66 ± 18.12). Vellus hair density was significantly more in FPHL (22.4 ± 14.3) as compared to chronic telogen effluvium (7.73 ± 6.71). Single hair unit was more in FPHL (65 ± 17.08) as compared to chronic telogen effluvium. Density of yellow dots is more significantly observed in female pattern hair loss as compared to chronic telogen effluvium.</p> <p><strong>Conclusion: </strong>Trichoscopic features based on hair shaft diameter, hair follicular density, vellus hairs, yellow dots and variability in hair shaft diameter can easily help to distinguish female pattern hair loss from chronic telogen effluvium. This differentiation can help dermatologists to plan better and specific management of hair loss in female patients.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Awareness of the General Population about the Causes, Management and Prevention of Peptic Ulcer Disease in Arar City, Northern Saudi Arabia 2022-01-24T04:46:59+00:00 Abdelrahman Mohamed Ahmed Abukanna Basil Falah Ayed Alanazi Talal Atallah Rahil ALRuwaili Essa Abdulrhman Mater AL Harbi Thamer Mohammed Matrud Alanazi <p><strong>Background:</strong> Gastro-dudenal ulcere is a global problem with a lifetime risk of development ranging from 5% to 10%.</p> <p><strong>Objective: </strong>This study aims to determine the public awareness in Arar, Saudi Arabia, regarding the causes, management and prevention of gastro duodenal ulcer.</p> <p><strong>Methods: </strong>A cross-sectional study was conducted in Arar city, Saudi Arabia in the period of 1 September to 30 October 2021 among the general population of Arar, Saudi Arabia.</p> <p><strong>Conclusion:</strong> Almost half of the participants had knowledge about gastric or duodenal ulcers and most of them know the risk factors and possible complications. There is non-significant relationship between gastro-duodenal ulcers awareness and age, gender and educational level while a significant relationship was found between level of awareness and social status, functional status and the average monthly income of the participants.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Relationship between Osteoarthritis and Endocrine Disease in KSA: A Cross-Sectional Study 2022-01-24T04:59:30+00:00 Eman AbdulAziz Balbaid Abdullah Talal Salem Sameer Mari Alqahtani Ziyad Abdulrhman AlOraini Ahmed Saeed Alsaedi Mohammed Abdullah Alghamdi Tameem Abdullah Sabrah Abdalaziz Awad Almarwani Ahmed jaza alreshidi Mohammed Saleh Almarshoud Abdulaziz Yahya Sahhari Abdulhamid Abdulrhman Alfawzan Hanoof Mohammed Alqahtani Athba Mohammad Alkinani Fahad Abdulkarim Alrumayan <p><strong>Background:</strong> Osteoarthritis (OA), the most common kind of arthritis, affects millions of people throughout the world. This problem occurs when the protective cartilage that cushions the ends of the bones wears away over time. The goal of this study was to draw attention to the link between osteoarthritis and a number of endocrine illnesses in the Saudi population.</p> <p><strong>Methods:</strong> This was a cross-sectional research with the goal of shedding light on the link between osteoarthritis and endocrine problems. The research was conducted in Saudi Arabia at colleges, hospitals, and shopping centers. During the months of June to November 2021, data was collected from patients and the general public.</p> <p><strong>Results:</strong> The study included 743 participants. Among them, there were, 519 females (69.9%) and 224 males (30.1%). The most prevalent age group was 20-30 years (n= 354, 47.6%). Majority of study participants were Saudi (n= 713, 96%) and the rest were non-Saudi. The mean body mass index (BMI) among study participants was 29.47 + 7.53 with median BMI of 30 kg/m<sup>2</sup>. It was found that 85 participants took anti-inflammatory drugs for more than twice per week during the last three months (11.4%). It is noticed that the prevalence of autoimmune disease among study participants is low. However, female participants were higher in hypothyroid (P= 0.001).</p> <p><strong>Conclusion:</strong> Finally, it appears that weight, rather than IR, explains the relationship between endocrine disease and knee OA. Individuals with arthritic knee pain may benefit from endocrine disease therapy since the accumulation of endocrine disease components is connected to a higher degree of knee discomfort, independent of age, sex, or weight.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Risk Perception and Hesitancy of Dental Health Professionals towards COVID-19 Vaccine in Riyadh Region, Saudi Arabia-A Web-based Survey 2022-01-24T05:01:25+00:00 Rabiya Basari Uppin Abdullah Maseer Alkhaldi Tareq Matar Al-Shammri Fahad Ebrahim Alnafisah Nasser Nasser Almutairi <p><strong>Background: </strong>Vaccine hesitancy is a common phenomenon due to its unknown long term side effects. Data regarding the sam is scanty in the Saudi Arabia region hence the purpose of this study was to assess the safety concerns and reasons for vaccine hesitancy and acceptance among dental health professionals in Saudi Arabia.&nbsp;</p> <p><strong>Materials and Methods: </strong>A total of 138 dental health professionals serving in a Riyadh region of Saudi Arabia were studied using an online-based structured, close-ended, and self-administered questionnaire developed by Paudel et al consisting of three sections: demographics, experiences, and willingness to get the vaccination, and perception of COVID-19, and COVID-19 vaccine safety. It was a cross sectional study where convienence sampling technique was employed. The total perception score was calculated by adding respondents' agreement with a set of eleven items using a Likert-type scale. Non-parametric tests (Mann– Whitney U and Kruskal–Wallis) were used for analysis (p&lt;0.05).</p> <p><strong>Results: </strong>A total of18.1% of respondents were diagnosed COVID-19 positive beforethe study. Many (71.7%) considered themselves at increased risk of contracting COVID-19. More than half (55.6%) of the participants believed the increased risk is due to their job type. Nevertheless, a considerable proportion of dental health professionals (89.9%) were willing to be vaccinated. The most common reason for hesitancy was the government approval of the safe and effective vaccine. The nationality, marital status, and type of dental professionals showed a statistically significant difference in vaccine safety perception and effectiveness concerns (p&lt;0.05).</p> <p><strong>Conclusion: </strong>The COVID-19 vaccination is well accepted by dental professionals in the Riyadh region of Saudi Arabia. However, vaccine hesitancy is mainly related to the safety and effectiveness of the vaccine and government approval of the vaccine.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Analysis of Pesticide Residues in Water, Rice, Fruits and Vegetables 2022-01-24T05:48:59+00:00 J. Divyashree Sapna Tomar <p>Pesticides have played a major role in increasing agricultural output by pest control and eliminating insect driven illnesses. Kerala’s tragedy on endosulfan exposure made us to study pesticides in water, rice, fruits and vegetables from Thiruvananthapuram location. Rice (the main cereal consumed in Kerala), fruits, and vegetables, as well as water samples from wells and streams in the Thiruvananthapuram districts, were collected for analysis of residue levels in major food items consumed by people in Kerala. The research was carried out to measure the concentration of organochlorine, organophosphorus, and synthetic pyrethroid pesticides using gas chromatography. The water and food samples collected were analysed for pesticide residues and the quantities were estimated using GC-ECD/NPD. A standard mixture containing Pesticides (OCs, OPs, Pyrethroids, and carbamates) was run before the actual samples. The detection was used to estimate the residues of fifteen commonly used pesticides, namely organochlorine pesticides (endosulfan, dieldrin, aldrin, lindane, DDT), organophosphorus pesticides (chlorpyrifos, profenophos, quinalphos, dimethoate, phorate) and synthetic pyrethroid pesticides (cypermethrin, fenvalerate, deltamethrin, carbofuran). &nbsp;The study concluded that food exposure to pesticides would result in unacceptable health hazards and awareness of pesticide residues in foodstuffs, as well as to quantify the possible health. Hence, necessary to maintain the survey of pesticide residues in all food commodities in order to safeguard the consumers.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Sub-foveal Choroidal Thickness in Primary Macular Hole- case Study of Lumhs, Jamshoro 2022-01-24T06:10:18+00:00 Asadullah Jatoi Mona Liza Mahesar Noman Ahmed Shaikh <p><strong>Background:</strong> Primary macular hole is a defect in fovea and is a frequent cause of decrease vision and metamorphopsia. Primary macular Hole (PMH) was first time introduced by Johnson and Gass in 1988.</p> <p><strong>Aims and Objectives:</strong> This study aims to evaluate the sub-foveal choroidal thickness in primary macular hole.</p> <p><strong>Materials and Methods:</strong> This prospective and controlled study was done at Institute of Ophthalmology, Liaquat University of Medical &amp; Health Sciences, Jamshoro for the period one year. Visual acuity was checked with Snellen Chart and ophthalmic examination was done with bio-microscopic slit lamp using 90 diopter (D) lens pre-operatively and post-operatively. Swept Source optical coherence tomography (SS-OCT) was used to confirm the diagnosis, outcome of PMH surgery, to measure choroidal thickness of both eyes preoperatively and postoperatively at the end 2<sup>nd </sup>month.</p> <p><strong>Results:</strong> From the selected patients, the average ages was 63 year, ranging between 46 to 80 years and from them 45 were females and 26 were males. 41 were right eye and 30 were left eye. PMH characteristics was used for the determination of duration of symptoms and minimum hole diameter, In 63 patients hole was closed and in 8 patients the hole was opened. The average duration of symptom was 5 months and Average minimum diameter was 320 μm and range was 139-650 μm among the patients with closed hole.</p> <p><strong>Conclusion:</strong> Sub-foveal CT was thinner in eyes with PMH as compared to fellow normal eye. But it was not related with anatomical results of PMH surgery. The sub-foveal CT reduced thickness is due to longer duration and larger minimum diameter of PMH.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Melissa officinalis L. Essential Oil: Chemical Composition, Antioxidant, Antibacterial and Antifungal Activities- in vitro Study 2022-01-24T06:14:57+00:00 Hafedh Hajlaoui Soumaya Arraouadi Emira Noumi Mejdi Snoussi Adel Kadri <p>The present investigated chemical composition of <em>Melissa officinalis</em> L. essential oil (MOEO) extracted by hydrodistillation. The MOEO was analyzed by gas chromatography-mass spectrometry (GC-MS), revealing the presence of thirty compounds, representing 98.46% of the oil constituents. The predominant components were 1,8-cineole (39.80%) followed by citronellol (16.66%), geraniol (12.25%), myrcene (5.85%) and geranial (5.45%). The antioxidant potential of MOEO has been summarized using DPPH test (IC<sub>50</sub>), superoxide anion (O<sub>2</sub><sup>−<strong>·</strong></sup>) scavenging activity (IC<sub>50</sub>), β-carotene (IC<sub>50</sub>) and reducing power (FRAP) (EC<sub>50</sub>). Results demonstrate strong scavenging superoxide anion capacity and moderate to weaker activity against the other assays. Potent inhibitory effect has been observed towards <em>Micrococcus luteus</em> and <em>Bacillus cereus</em> as well as the <em>Candida albicans</em> ATCC 90028, <em>C. tropicalis</em> (Strain 1) and <em>C. albicans</em> (Strain 8). Our work provides a view for the further studies on the antioxidant and antimicrobial of the MOEO and its main components.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Thymus vulgaris L. Essential Oil: Effect on Fatty Acids and Proteins Oxidation of Little Tuna (Euthynnus alletteratus) Minced during Refrigerated Storage 2022-01-24T06:19:46+00:00 Hafedh Hajlaoui Soumaya Arraouadi Emira Noumi Kaïss Aouadi Mejdi Snoussi Adel Kadri <p>People are uncomfortable having their food chemically treated to boost its shelf life. Thus, Tunisian <em>Thymus vulgaris</em> Essential Oil (TVEO) were investigated in parallel with its capacity to limit fatty acids and proteins oxidation in tuna (<em>Euthynnus alletteratus</em>) minced during refrigeration storage (4°C). Our results revealed that for tuna preservation, the measured concentrations of PV, TBARS and TVB-N during different storage periods showed a good efficiency of this Essential Oil (EO) (3%) in limiting lipids and proteins oxidation of tuna flesh. Moreover, we observed increase in all batches which was significantly different (<em>P</em>&lt; 0.05) with lots treated with TVEO were the most conserved comparing to the BHT. Overall outcomes suggest that TVEO use for tuna conservation could represent a promising strategy to improve the qualitative characteristics as well as the safety of seafood.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Antioxidant and Antimicrobial Activities of Thymus vulgaris L. Essential Oil Growing Wild in Tunisia 2022-01-24T06:25:49+00:00 Hafedh Hajlaoui Soumaya Arraouadi Hedi Mighri Kaïss Aouadi Mejdi Snoussi Emira Noumi Adel Kadri <p>The aim of this work is to investigate the chemical composition, antioxidant, and antimicrobial activities of Tunisian <em>Thymus vulgaris</em> essential oil (TVEO). DPPH, superoxide anion, reducing power, chelating effect on ferrous ions and β-Carotene assays have been employed to determine the antioxidant potential of TVEO. In contrast, 24 reference bacterial strains and 16 fungal strains have been used for the assessment of the antimicrobial activity. Results revealed that TVEO has as carvacrol (67.33%) chemotype, it was equipped with an important antioxidant capacity that is better (<em>P</em>&lt;0.05) than synthetic antioxidants (BHT, BHA, Vitamin C and EDTA) except for superoxide anion test. A higher antimicrobial activity was also observed with IZ, MIC and MBC values of bacterial strains were ranged from 10.33±0.57 to 37.33±0.57mm; 0.019 to 0.078 mg/mL and 0.039 to 0.31 mg/mL respectively. But those of fungal strains were varied between 24.66±1-47.33±1.53 mm; 0.004-0.078 mg/mL and 0.019-0.15 mg/mL respectively. In summary, the obtained data makes TVEO as a good and suitable candidate for its use in food and pharmaceutical purposes.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## GC-MS Profile, α-glucosidase Inhibition Potential, Antibacterial and Antioxidant Evaluation of Peels Citrus aurantium (L), Essential Oil 2022-01-24T06:28:58+00:00 Hafedh Hajlaoui Soumaya Arraouadi Kaïss Aouadi Mejdi Snoussi Emira Noumi Adel Kadri <p>This study was designed to analyze the chemical composition of <em>Citrus aurantium</em> Essential Oil (CAEO) peels and to evaluate α-glucosidase inhibition potential, antioxidant and antibacterial activities. According to GC-MS analyses, 37 compounds were identified with limonene was the most abundant (62.2%). Majority of the identified compounds belong to hydrocarbon monoterpenes fraction (75.7%), followed by oxygenated monoterpenes (19.16%). CAEO α-glucosidase inhibition outlined an important activity with IC<sub>50</sub> = 10±1 mg/mL. Moreover, antioxidant activity revealed that CAEO exhibited a potent scavenging effect through 2,2-diphenyl-1 picrylhydrazyl radical (DPPH<strong><sup>.</sup></strong>) (IC<sub>50</sub>=33.66 µg/mL) and an important ferric ion reducing antioxidant power (FRAP) activity (EC<sub>50</sub>=98.67 µg/mL). Antimicrobial data demonstrate that CAEO was active against a panel of pathogenic bacteria and that CAEO was able to destroy bacterial cells (bactericidal) according to the MBC/MIC ratios towards Gram+ and Gram- tested strains.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## The Association of Anemia with Vitamin D Deficiency among Patients Visiting King Khalid General Hospital in Majmaah, Saudi Arabia 2022-01-24T06:43:15+00:00 Muath Alanazi Raed Alharbi Saleh Aloyuni Ranjay Choudhary Wael Alturaiki Saeed Banawas Bader Alshehri Mohammed A. Alaidarous <p><strong>Aims:</strong> To assess the association between vitamin D deficiency and anemia among patients visiting King Khalid General Hospital in Majmaah City, Saudi Arabia.</p> <p>Methodology: We reviewed the medical records of 120 patients (median age, male 37.44 [±17.86] and female 43.22 [±16.23] years; range 1–96 years) who attended the King Khalid General Hospital laboratory in Majmaah city, Saudi Arabia, between January 2019 and January 2020. The laboratory data included the following parameters: complete blood count (Hb, MCV, MCHC, MCH, Hct, WBC, RBC, and Plt) and vitamin D (25(OH)D) levels.</p> <p><strong>Results:</strong> The chi-squared analysis showed that moderate anemia was highest among the participants who had vitamin D levels &gt;30 ng/ml and less than 20 ng/ml, with a prevalence rate of 5% (n=6) for each category. Mild anemia was prevalent among 4.12% (n=5) of the participants with vitamin D levels &lt;20 ng/ml. Finally, there were significant associations between parameters including age, RBC count, WBC count, platelet count, MCV, MCH, MCHC, hematocrit, vitamin D, and anemia. In addition, the odds ratio results indicated that mild vitamin D deficiency was associated with the degree of anemia, ranging from mild to moderate (OR=1.63 to 1.92). Moderate vitamin D deficiency was associated with the degree of anemia, ranging from mild to moderate (OR=1.76 to 1.97). The results confirmed a negative association between normal vitamin D values and the degree of anemia.</p> <p><strong>Conclusion:</strong> There is a significant association between vitamin D deficiency and anemia among patients visiting King Khalid General Hospital in Majmaah City, Saudi Arabia.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Role of Glucose 6 Phosphate Dehydrogenase (G6PD) in Diabetic Cataract 2022-01-21T04:19:18+00:00 Muhammad Ishaque Bhatti Ali Raza Memon Muhammad Jamil Laghari Rizwan Ahmed Memon Sindhu Laghari Fazeela Rizwan Memon Salman Shams <p><strong>Introduction:</strong> Diabetes mellitus and its complications are spreading with increased rate in Asian population especially in Pakistan. Uncontrolled diabetes can lead to different micro vascular complications. Cataract is one of the complications of diabetes which may lead to lens degenerative changes and visual impairment. G6PD plays a vital role in preventive measurements from cataract development in normal population.</p> <p><strong>Objectives:</strong> This Study was designed to estimate G6PD levels in diabetic without ocular manifestations &amp; diabetic cataract population.</p> <p><strong>Methodology:</strong> This cross sectional comparative study was done at the Department of Biochemistry LUMHS Jamshoro in collaboration with the Diabetic clinic, Institute of Ophthalmology &amp; Diagnostic Research Laboratory LUMHS Jamshoro. 100 diagnosed subjects of diabetes were selected by Non-Probability type of sample technique with consent of subjects and they were divided in to two groups Group A as control 50 diabetic subjects with out ocular manifestation while Group B as case study group contain 50 subjects of diabetes with cataract. The fasting blood glucose level was estimated by Hexokinase Method while G6PD level was measured by kit method on SD Biosensor while HbA1c(% ) was estimated by TTAB methodology. The data was statistically analyzed by SPSS 21.</p> <p><strong>Results:</strong> The mean level of G6PD in Group A was 15.63±2.45 u/Hb while in group B it was 9.01±3.11 u/G HB. This result finally concluded that there was significantly (&lt;0.05) decline of G6PD diabetic cataract as compared with diabetic without cataract.</p> <p><strong>Conclusion:</strong> This study concluded that there was significant decline in G6PD level in diabetic cataract. It is also concluded that the estimation of G6PD level in diabetic population will be beneficial to take early preventive measurements against diabetic vascular complications.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Morphological and Morphometric Analysis of Stylomastoid Foramen in Dry Human Skulls and its Clinical Implications 2022-01-21T04:35:27+00:00 B. Vaishali Karthik Ganesh Mohanraj <p><strong>Introduction: </strong>Stylomastoid foramen present between two processes which are styloid process and mastoid process. Facial nerve and stylomastoid arteries are transmitted through the stylomastoid foramen. Facial canal gets terminated in the stylomastoid foramen. Stylomastoid foramen has a site for facial nerve block. Complications reduced by localization of foramen.</p> <p><strong>Aim:</strong> The aim of this study was to analyse the morphology and morphometry of stylomastoid foramen.</p> <p><strong>Materials and Methods: </strong>Damaged skulls were excluded and 60 dry human skulls without any damage were taken for this study. By using digital vernier caliper length and breath of the stylomastoid foramen was measured. Then the statistical analysis was done using SPSS software and paired t-tests were done for comparison.</p> <p><strong>Results: </strong>The length and breadth of the right stylomastoid foramen was 2.39 ± 0.18 mm and 0.85 ± 0.12 mm and the left stylomastoid foramen was 2.18 ±0.33 mm and 1.13 ± 0.38 mm. From the paired t-tests it was very clear that the difference between the breath of right and left stylomastoid foramen was significant (p&lt;0.05) and difference between the length of right and left stylomastoid foramen was not significant (p&gt; 0.05).</p> <p><strong>Conclusion: </strong>The narrow size of stylomastoid foramen varied from individual skull to other. The accurate value for length and breadth, was measured to determine the variations of facial nerve emerging through it. The change in length and breadth of stylomastoid foramen can be correlated with its clinical aspects with reference to facial nerve.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Consumers’ Level of Awareness and Safety Perceptions of Food Additives 2022-01-21T07:15:54+00:00 Badrah Al-Ghamdi Ghidah Al-Tabsh Alaa Al-Deibani Rahaf Al-Muhanna Shahlaa Gari Nusaiba Khayyat <p><strong>Aims: </strong>We aimed to measure the prevalence of Jeddah residents’ knowledge and their awareness of these ingredients.</p> <p><strong>Study Design:</strong>&nbsp; A cross-sectional study.</p> <p><strong>Place and Duration of Study:</strong> The study conducted in Jeddah, Saudi Arabia, during 2019.</p> <p><strong>Methodology:</strong> This study was cross-sectional via an electronic survey that was handed out, and 676 of 868 respondents fit the inclusion criteria: all individuals were eighteen and above in addition to residing in Jeddah in 2019. Statistical analysis was performed using SPSS version 21. Pearson's chi-square was used to test association.</p> <p><strong>Results:</strong> The results showed that 63.5% of consumers needed more information about food additives. About 80.5% were familiar with preservatives which, in their opinion, were the most disconcerting food additives. Moreover, 37.2% desired easier and accurate labels to gain a better understanding of this topic, while 43.6% said that the most acceptable idea for disseminating information about food additives to the public was by animation in independent display areas.</p> <p><strong>Conclusion:</strong> The study’s findings are examined in terms of the implications for future research and for the development of concrete communication materials to improve food additive awareness in Jeddah, Saudi Arabia. The level of knowledge was low. Further studies are needed to be done in Saudi Arabia about this topic.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Outcome of Deliberate Paraphenyline Di-Amine Ingestion among Young Women 2022-01-21T08:14:10+00:00 Odho Lutuf Ali Imtiaz Begum Ali Raza Aatir Hanif Farhat Minhas Khalil Ahmed <p><strong>Background: </strong>Para phenylene diamine (PPD) or black stone, a common hair-dye ingredient in South Asia, has recently emerged as a new means of suicidal attempts in developing countries especially in Asia.</p> <p><strong>Objective: </strong>To determine the outcome of deliberate Para phenylene di-amine ingestion among young women.</p> <p><strong>Methodology: </strong>This descriptive analysis was conducted upon a sample of 400, young women (aged 18 to 35 years) presenting to the emergency department from June 2019 to December 2021, with deliberate Para phenylene di-amine ingestion. After taking written informed consent, the data was recorded onto a structured questionnaire containing inquiries pertaining to basic biodata, socioeconomic details, time elapsed since ingestion, clinical signs and symptoms and the outcome (within 24 hours).</p> <p><strong>Results: </strong>The mean age of the sample stood at 23 (SD ± 2) years. Out of the total 400 cases of deliberate ingestion reporting to the study setting, 19 were asymptomatic and were discharged after initial care. Among the symptomatic patients, 212 (53%) recovered within 12 hours without need for intensive care, while 139 (34.75%) needed admission to intensive care unit, following which a full recovery was achieved within 24 hours (98 patients) or more (31 patients), while the remaining 10 patients succumbed to the poisoning. 30 patients reached the hospital in critical state and died in the emergency department.</p> <p><strong>Conclusions: </strong>The cumulative mortality rate recorded in the research was 10%. Factors such as time between ingestion and presentation to the hospital, the quantity of ingestion and the general health status, affected the outcome of the patient.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Satisfaction Levels of Remote Healthcare Simulation amongst EMS Professionals in Pune, India 2022-01-21T09:33:15+00:00 Parag Rishipathak Monesh Bhandari Anand Hinduja <p><strong>Aim: </strong>Healthcare education comprises of various components including theory, practicals, clinical and cognitive skills. The teaching andragogy has evolved from classroom sessions and laboratory experiments to clinical rotation duties. Simulation has played a significant role as a new revolutionary tool in andragogy as it involves self-reflective and immersive learning. The COVID-19 pandemic and social distancing rules necessitated the suspension of all in-person learning activities at workplaces, public places and all educational institutes. Consequently, distance learning became essential. As a result, the classroom sessions were replaced by online mode sessions and the teaching faculties had no option but to adapt to the new technology in a short period of time. It is crucial to gauge the satisfaction levels amongst Emergency Medical Professionals (EMP’s) attending remote simulation sessions to devise more user friendly programs for the future. The aim of the study is to assess the satisfaction level of the Emergency Medical Professionals exposed to remote simulation</p> <p><strong>Study Design</strong><strong>:</strong> Quantitative Study.</p> <p><strong>Place and Duration of Study</strong><strong>:</strong> Symbiosis Centre for Health Skills, Pune in October 2021.</p> <p><strong>Materials and Methods: </strong>A quantitative study on satisfaction level was conducted in October 2021, amongst 200 Emergency Medical Professionals (EMP’s) in the city of Pune, India. Simulated Clinical Experiences (SCE’s) on various cardiac emergencies were designed by Simulation Educators. The participants attended the session via virtual platform Microsoft Teams for a period of 2 hours. A 19-item student satisfaction survey, was used to determine the participant’s satisfaction with the remote simulation session.</p> <p><strong>Results and Discussion: </strong>The study was conducted with the aim to adjudge the level of satisfaction amongst EMS professionals with the remote simulation mode of teaching. In the post Covid era, remote learning has become a norm and cannot be ignored. The session successfully recreated a real patient care setting and the participants enjoyed the immersive learning experience. Although limited number of participants could actively engage in the patient care during the session, the debriefing ensured that all participants were involved in the session.</p> <p><strong>Conclusion: </strong>The unanimity in the satisfaction scores is very encouraging for facilitators to devise interesting SCE’s and teach in the remote simulation mode. This shall ensure that the continued medical education does not suffer as a result of the pandemic.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Evaluation of Antioxidant and Xanthine Oxidase Inhibitory Potential of Methanolic Root Extract of Acorus calamus- an In vitro Study 2022-01-21T09:50:23+00:00 Ashfaaq Ahmed R. Gayathri V. Vishnu Priya J. Selvaraj S. Kavitha <p><strong>Background: </strong>Gout is an inflammatory joint disease that elevates the uric acid levels in blood that triggers the formation of urate crystals in the joint,especially since the past 50 years. Xanthine oxidase catalyses oxidative hydroxylation of hypoxanthine to Xanthine to uric acid. show it's higher in men aged above 50 years. <em>Acorus calamus</em> is a mid term, perennial, fragrant herb. Therefore, the main approach for the treatment of gout is reducing uric acid.</p> <p><strong>Aim:</strong> To analyze the antioxidant and Xanthine Oxidase inhibitory potential of methanolic root extract of <em>Acorus calamus.</em></p> <p><strong>Materials and Methods: </strong>Preparation of methanolic root extract of <em>Acorus calamus </em>was done by hot percolation method. Phytochemical screening test was done. The antioxidant activity was carried out by DPPH radical scavenging assay. Anti gout potential of the herbal extract was analysed by the evaluation of Xanthine oxidase inhibitory potential. The data were analyzed statistically by a one-way analysis of variance (ANOVA) followed by Duncan’s multiple range test to see the statistical significance among the groups. The results with p&lt;0.05 level were considered to be statistically significant.</p> <p><strong>Results: </strong>Methanolic root extract of <em>Acorus calamus </em>shows a strong presence of phytochemicals such as alkaloids ,terpenoids, steroids, saponins, flavonoids.IC<sub>50</sub> of antioxidant potential of Methanolic root extract of<em> Acorus calamus</em> was found to be 210 µg/ml.Ic 50 of xanthine oxidase inhibitory potential of methanolic root extract of <em>Acorus calamus</em> was found to be 310 µg/ml.</p> <p><strong>Conclusion:</strong> Methanolic root extract of <em>Acorus calamus </em>exhibited significant antioxidant and anti gout potential. Further research on the natural Xanthine oxidase inhibitors especially <em>in vivo</em> studies and investigation of active compounds and its pharmacokinetics to be elucidated.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Synthesis, Anti Cancer and Anti Fungal Studies of New Phenyl Ethylene Derivatives 2022-01-21T10:20:01+00:00 V. S. R. N. Phanikumar M. Kiranmai Reddy G. Veera Raghava Sharma <p>Synthesis of Phenyl ethylene derivatives (4a-4f ) are reported in this communication. Products were characterized by<sup>1</sup>HNMR, Carbon (<sup>13</sup>C) NMR&nbsp; and Mass spectral data. Synthesized compounds of 4a-4f were screened for anti cancer and anti fungal activities and their results are presented. The main intermediate (3) was prepared from 4-methoxy phenyl acetone (1) reacted with aqueous ethylamine and NaBH<sub>4 </sub>&nbsp;to get the compound (2).Further dehydrohalogenation of (2) with 4-bromobutanol and potassium carbonate at 80°C&nbsp; resultedin compound (3)which on&nbsp; further dehydration with p-toluene sulfonic acid under reflux conditionsgave 4a to 4f.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Patient’s Satisfaction about Dental Services during Pandemic COVID-19 at Riyadh Elm University: A Questionnaire Study 2022-01-21T10:42:42+00:00 Sarah Abu-Raisi Atheer Al-Baqami Razan Al-Ruwaili Sarah Al-Qahtani Lama Al-Julayfi Bushra Al-Ghanoom <p><strong>Background: </strong>Health-care organizations all throughout the world are concerned about quality. Patients' satisfaction has been studied at a number of dental clinics throughout the globe. Patient satisfaction is an important factor in assessing the relationship between the quality of health-care services delivered and the patients' confidence. During the COVID-19 epidemic, the study's goal was to find out how satisfied patients were with the quality of dental treatment, as well as the preventative measures and precautions offered at Riyadh Elm University's dentistry clinics.</p> <p><strong>Materials and Methods:</strong> During the COVID-19 epidemic, a pre-validated questionnaire was issued to patients visiting Riyadh Elm University clinics. The research took place from March to September 2020. The questionnaire included questions about consultation provision, gratification with the receptionist's performance, satisfaction with your treating healthcare professional, treatment expenses, satisfaction with the level of housekeeping prevention strategies and preemptive provided, and eventually an overall assessment of the clinic's services.</p> <p><strong>Results: </strong>During the COVID-19 pandemic, 1313 questions were gathered from the Riyadh Elm University dentistry clinic's electronic system. During the pandemic COVID-19, (92%) of the participants agreed that getting an appointment at the dental clinics was straightforward, (88.9%) were satisfied with treatments received at Riyadh Elm University's Dental Clinic during the COVID-19 epidemic, and (66 percent) with treatment costs. During the pandemic COVID-19, the vast majority of participants (91 percent) were satisfied with their treatment provider, and the vast majority of participants were satisfied with the services offered by Riyadh Elm University's dentistry clinic.</p> <p><strong>Conclusions: </strong>Riyadh Elm University's dentistry clinics were successful in achieving participant satisfaction with services, staff, treatment, and fees during the COVID-19 outbreak.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## A Study Design for Awareness Regarding Appropriate Antimicrobial use and Antimicrobial Resistance among Health Care Professionals and Lay Persons 2022-01-21T10:52:07+00:00 Tileshkumar Turankar Shilpa Gaidhane Sonali G. Choudhari Abhay Gaidhane Shantanu Raju Sawale <p><strong>Aim: </strong>This study is designed to determine the awareness of anti-microbial resistance and appropriate antimicrobials use among health care professionals (intern, junior residents and nurses) and lay persons.</p> <p><strong>Methods:</strong> The study will be held at rural tertiary care hospital in central India including junior resident, Interns and nurses, patient and their relatives. Survey tool and data questionnaire will be provided to participants in English and Marathi.</p> <p><strong>Results:</strong> Comparison of knowledge of antimicrobial resistance among hospital staff, patient and their relatives will be done.</p> <p><strong>Conclusion:</strong> There is a need to frame policies to prevent excessive use of Antimicrobials and to increase awareness about the knowledge of proper usage antimicrobial and antimicrobial resistance among lay person.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Assessment of Cytotoxic, Antioxidant, Thrombolytic, Anti Inflammatory and Antimicrobial Activity of Curcuma longa Linn, Cissus quadrangularis and Boerhaavia diffusa Herbal Mixture - An In vitro Study 2022-01-21T10:59:07+00:00 Y. Dinesh R. Abilasha Pratibha Ramani S. Rajeshkumar <p><strong>Background and Aim: </strong>Plants play an important role in drug research, and the pharmaceutical industry is heavily reliant on natural products for new drug development. Curcumin, a natural compound contained in the rhizomes of the plant <em>Curcuma longa Linn</em>., has been shown to have anti-inflammatory properties in scientific studies. <em>Cissus quadrangularis L.</em> is a fleshy plant that can be found all over the world, especially in Asia, Africa, and a few other warm tropical areas. <em>Boerhaavia diffusa L. </em>(Nyctaginaceae) is present in the tropical regions of India, South America, and Africa. B. diffusa roots are commonly used in Ayurveda to treat various ailments. The aim of the study is to assess the cytotoxic, antioxidant and thrombolytic, antiinflammatory and antimicrobial properties of the aqua-alcoholic extract of the herbal mixture (<em>Curcuma longa Linn</em> +<em>Cissus quadrangularis </em>+<em>Boerhaavia diffusa )</em></p> <p><strong>Methods: </strong>Aqua-alcoholic extract of mixture of <em>Curcuma longa Linn</em>, <em>Cissus quadrangularis and Boerhaavia diffusa </em>was prepared. Phytochemical in-vitro studies were done using the CCB mixture cytotoxicity by brine shrimp lethality assay, antioxidant activity by DPPH assay, anti inflammatory activity by albumin denaturation assay, antimicrobial activity against Staphylococcus aureus, Streptococcus mutans, Escherichia coli and Candida albicans by agar well diffusion method, thrombolytic activity by clot lysis assay.</p> <p><strong>Results: </strong>The CCB mixture showed good cytotoxic activity at varying concentration in brine shrimp lethality assay, increasing antioxidant activity with DPPH assay, increasing thrombolytic activity, increasing anti inflammatory activity with increasing concentration, the anti microbial activity was not efficient as positive controls.</p> <p><strong>Conclusion: </strong>In this in-vitro study the CCB mixture shows improved cytotoxic, antioxidant, thrombolytic, anti-inflammatory and antimicrobial activity. Further studies on invivo animal and human clinical trials needs to be done.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Morphological and Morphometrical Analysis of Dry Human Scaphoid Bone in South Indian Population and Its Clinical Implications 2022-01-21T12:29:49+00:00 K. Uma Maheswari Karthik Ganesh Mohanraj <p><strong>Introduction: </strong>Scaphoid is the second largest among all the carpal bones, which is present on the radial side of the proximal row of carpal bones. Scaphoid Fractures are the most common of the carpal bone injuries. Scaphoid Fractures heal slowly due to thelimited blood circulation of the bone</p> <p><strong>Materials and Methods: </strong>The study was performed on 20 Scaphoid Bones,which were collected from the Department of Anatomy,Saveetha dental college. By using digital vernier callipers,morphological and morphometrical parameters (length and breadth)of scaphoid bones were measured,tabulated and statistically analysed.</p> <p><strong>Results: </strong>All the 20 scaphoids showed the presence of tubercle. Double foramina in the main dorsal sulcus were seen in 7 right and 6 left specimens. No significant differences were found in lengths and breadths of the bone.In the present study, at least one foramen is found in all the main dorsal sulcus and the number of specimens showing presence of double foramen in the main dorsal sulcus are 7 right and 6 left specimens.</p> <p><strong>Conclusion: </strong>This study showed that no significant morphological and morphometric differences were found between right and left sides. The data obtained in the present study will be helpful for the hand surgeons, radiologists and clinical anatomists for surgical reduction to follow up the reunion of fractured scaphoid bones.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Accuracy in the Dimension of Extracted Tooth with Intraoral Periapical Radiograph: A Comparative Study 2022-01-22T06:42:22+00:00 Akshay Nambiar Joyce P. Sequeira <p><strong>Introduction:</strong> Because of its simplicity, cheaper cost, lower radiation exposure, and easy availability in a dental clinical setting, intraoral periapical radiographs (IOPAR) are frequently utilised for preoperative planning and evaluation for most minor oral surgical procedures.</p> <p><strong>Aim:</strong> The Aim of this study is to Assess the Accuracy and Reliability of Intraoral Periapical Radiograph with the extracted teeth.</p> <p><strong>Methodology:</strong> The study is comprised of 54 patients. For each extracted tooth, the actual measurements for tooth length will be measured with a Vernier caliper with a least count of 0.01mm. After obtaining the actual length of the tooth with the Vernier Caliper, the Length of the tooth will be measured from the Intraoral Periapical Radiograph using a Vernier caliper.</p> <p><strong>Results:</strong> By comparing the length of the actual tooth with that of an IOPAR, it was found out that the difference that was obtained is statistically significant.</p> <p><strong>Conclusion:</strong> There is significant overestimation in the dimension of the tooth.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Dextromethorphan Use in the Outpatient Department 2022-01-22T07:51:26+00:00 Menshawy A. Menshawy Nehad J. Ahmed Abdullah A. Alrizqi Bander A. Alhuthali Ibrahim A. Alghamdi Saleh Alghamdi <p><strong>Aim: </strong>The present study was conducted to describe the use of dextromethorphan in the outpatient department.<strong>&nbsp; </strong></p> <p><strong>Methodology: </strong>This is a retrospective study that involves evaluating electronic prescriptions for dextromethorphan among outpatients in a public hospital in Alkharj.</p> <p><strong>Results: </strong>During the study period, 348 patients received dextromethorphan. Most of them were females and the age of more than half of them was between 20 and 39 years. Most of the patients used dextromethorphan for 5 days (63.51%) and about 30% of patients used it for 7 days. Most of the prescriptions were written by emergency department (93.97%).</p> <p><strong>Conclusion: </strong>The present study showed that dextromethorphan was commonly prescribed in the outpatient setting in Al-Kharj. Furthermore, more studies are needed to explore the appropriateness of its use.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Role of Neoadjuvant Chemotherapy in Locoregionally Advanced Oral Cancers 2022-01-24T06:01:24+00:00 Vinay Nandlal Baretha M. B. Bagawan Ashok Kshirsagar <p><strong>Background and Aim: </strong>Oral-carcinoma is one of the most common cancer world-wide. Its treatment in advanced conditions to increase the survival rate is a major concern. This study was aimed at assessing the use of neoadjuvant cancer therapy (NACT) for improving the operability in non-operable patients with advanced oral carcinoma (T4b and N3 disease) and to observe easier resection in T4a disease.</p> <p><strong>Methodology: </strong>This prospective study included total 40 patients with advanced oral carcinoma (T4a, T4b, and N3 stages), who were administered with NACT- Cisplatin (80 mg/m<sup>2</sup>) over 2 days and 5-fluorouracil (750 mg/m<sup>2</sup>) for 4 days along with hydration and antiemetics (3 cycles for every 4 weeks) and later, if resectable, will be taken for the surgery . Follow up of patients (6 months) was advised to assess recurrence if any. Chi-square test was performed to analyze the association of NACT with resectability and operability in patients. Histopathological examination was done to see for extent and margns status post surgery. Non operable cases were given palliative radiotherapy and symptomatic treatment.</p> <p><strong>Results: </strong>Patients displayed T4a<strong> (</strong>70%), T4b (30%), and N3 (15%)stages of oral cancer. Stable disease was observed in 57.5% of patients, indicating its importance in cancer treatment. Easier resection was observed in 67.85% i.e. 19 patients. Significant association of locoregionally advanced oral cancer (T4a, T4b and N3 disease) with respectability (<em>P=</em>0.012) and operability (<em>P=</em>0.001) after NACT was observed. The most common adverse events observed during NACT were nausea/vomiting (28.3%), neutropenia (11.66%), diarrhea (8.33%), and anemia (3.33%).</p> <p><strong>Conclusion: </strong>Easier resection in 67.85% cases among operable group seen and 50% of cases among non operable group became operable. Further studies on its profound use in oral squamous cell carcinoma can help reduce morbidity and increase the survival rate.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Evaluation of Anti Cholesterol and Antioxidant Potentiality of Aqueous Extracts of Citrus aurantifolia, Zingiber officinale and its Formulation - a Comparative In vitro Study 2022-01-22T10:48:34+00:00 Priyanka Sivasubramanian R. Gayathri V. Vishnu Priya J. Selvaraj S. Kavitha <p><strong>Background: </strong>Several plant extracts and herbs have been used for treating and prevention of cardiovascular diseases hypertension, angina pectoris, congestive heart failure, atherosclerosis, cerebral and venous insufficiency and arrhythmia. Similarly, aqueous extracts of <em>Citrus aurantifolia </em>and <em>Zingiber officinale</em> which is commonly called as lemon and ginger respectively and its formulation were analysed for its antioxidant and anti cholesterol activity.</p> <p><strong>Objective: </strong>This research has been performed in order to evaluate the anti cholesterol and antioxidant potentiality of aqueous extracts of <em>Citrus aurantifolia</em>, <em>Zingiber officinale</em> and its formulation respectively.</p> <p><strong>Methods: </strong>The study setting carried out for this research was in vitro, hence the work was performed outside the living organism.<em> Citrus aurantifolia </em>and <em>Zingiber officinale</em> were purchased from a farm in chennai. The experiment began starting from the preparation of aqueous extract of lemon and ginger. A formulation was made combining equal amounts of the two extracts followed by this, a phytochemical screening test was conducted. Antioxidant and anti cholesterol potential of the extracts and its formulation were also analysed. The data was statistically examined by one-way analysis of variance (ANOVA) continued by Duncan’s multiple range test, it was compiled to see the statistical significance among the groups present. The results carrying p&lt;0.05 level were contemplated to be statistically significant.</p> <p><strong>Result: </strong>From the study, though both the extracts possessed a good antioxidant and anti cholesterol potential, comparatively the formulation exhibited an increased antioxidant and anti cholesterol potential respectively (IC₅₀ = 250 µg/ml) and (IC₅₀= 375µg per ml). Here, the formulation exhibited significantly more activity than the individual extracts.</p> <p><strong>Conclusion: </strong>Even though there is sufficient knowledge among citizens about the nutritional value present in herbal formulations, there isn’t enough in-depth study conducted on the formulation of these two extracts based on their cholesterol inhibitory activity. From this particular study it was proven that the formulation showed synergism. Hence the formulation of these extracts could be preferred over other synthetic drugs since it is natural, cost effective and easily accessible.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## The Prescribing of Glucosamine Supplements in the Outpatient Setting in Alkharj 2022-01-22T11:15:52+00:00 Nehad J. Ahmad Mohamad Ayman Salkini <p><strong>Aim:</strong> This study aimed to describe the prescribing and use of glucosamine supplements in Alkharj.</p> <p><strong>Methodology: </strong>This is a retrospective study that includes reviewing the electronic prescriptions of glucosamine supplements among outpatients in Alkharj.</p> <p><strong>Results:</strong> During the study period of 6 months, only 36 patients received glucosamine supplements from the outpatient department in a public hospital Alkharj. The age of more than 63% of the patients was more than 49 years. Most of the patients who received glucosamine supplements were females (75%). All of the glucosamine supplements prescriptions contained capsules for 30 days. More than 52% of the prescriptions were prescribed by specialists. More than 80% of the prescriptions were prescribed by orthopedic department and 8.3% were prescribed by rheumatology.</p> <p><strong>Conclusion:</strong> The present study showed that the use of glucosamine was uncommon in Al-Kharj. Further studies are needed to explore the frequency of using glucosamine in different settings in Alkharj.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Awareness of Blood Pressure Changes during Menstrual Cycle 2022-01-22T11:29:06+00:00 . Joshitha A. Jothi Priya R. Gayatri Devi <p><strong>Introduction: </strong>Blood pressure is not constant at different days of the month and even throughout the day. Variation in BP during different phases in the menstrual cycle can also be attributed to the effect of the female hormones on cardiovascular systems. The purpose of the study was to evaluate the awareness of blood pressure changes during the menstrual cycle.</p> <p><strong>Aim: </strong>To Assess the Awareness of Blood Pressure Changes during Menstrual Cycle.</p> <p><strong>Materials and Methods: </strong>The sample size used for the study is 100. A self structured questionnaire was prepared and uploaded on google forms. This standard questionnaire in google forms was circulated. After which all the data was collected and the data was analysed using Chi square analysis. The Chi square analysis was done using SPSS software.</p> <p><strong>Result:</strong> We were able to establish a fair awareness about blood pressure changes during the menstrual cycle among our study population. It was statistically significant with p value of 0.037 (P&lt;0.05).</p> <p><strong>Discussion: </strong>Variation in BP during different phases of the menstrual cycle can also be attributed to the effect of ovarian hormones on cardiovascular function. Since hormonal changes follow a non-linear trend throughout the menstrual cycle, it may have an unpredictable effect on BP regulation</p> <p><strong>Conclusion: </strong>There is a fair amount of awareness about blood pressure changes during menstruation among both women and men but women have more awareness.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Prevalence of Anxiety Disorder among MBBS under Graduate Students during COVID-19 Pandemic, Tamilnadu 2022-01-22T11:43:22+00:00 Ardhanaari Manickavasagam . Premasubathira M. Pavanasaravanan S. Sumitra Vijay Chathoth Ramarao Mannam <p>Anxiety disorder is one of the most common psychiatric co-morbidity found to be prevalent in many pandemic situations or while experiencing a delimiting illness to self or community. This study aimed at screening undergraduate students pursuing MBBS for anxiety disorder. It was focused on early diagnosis, intervention and creating awareness among themselves and their community. The&nbsp; study was done among 272 undergarduate medical students from Tamil nadu during the period when COVID- 19 infection was prevalent in the community. They were requested to fill a proforma and questionnaire and were screened with Hamilton Anxiety scale. Study reported 80.9% mild, 11.8% moderate and 5.1 % severe levels of anxiety in study population.</p> <p><strong>Aim: </strong>To study the prevalence of anxiety among MBBS under graduates during COVID pandemic in Tamilnadu.</p> <p><strong>Study Design: </strong>Cross sectional online screening and assessment study.</p> <p><strong>Place and Duration of Study:</strong> The study was done online from Meenakshi Medical college and Research Institute, Enathur, Kanchipuram, Tamilnadu, from December 2020 to January 2021.</p> <p><strong>Methodology:</strong> The study included 272 MBBS undergraduate students of Tamilnadu (180 female and 92 male participants; age range 18-24 years All the participants were asked to fill an online proforma questionnaire following an online consent form and were screened and assessed for anxiety disorder using Hamilton Anxiety scale. Students who had severe COVID-19 infection or non consenting individuals were excluded from the study.</p> <p><strong>Results: </strong>80% of the study population belong to age group between 19-21 years of age.&nbsp; This study had more female (66.2%) participants when compared to male (33.8%). Majority of the study population belong to Hindu religion (89%) followed by Christians (5.9%) and Muslims (5.1%). Majority of the study population belong to upper socio-economic status (76.5%). Most of the study population were not infected by COVID-19 disease 76.8%) followed by 14.7% with past history of COVID -19 infection and 8.5% were actively infected during the study period. Most of the study population reported on anxious mood (85.3%) with various severities ranging from mild (32.7%), moderate (34.9%), severe (13.6%), very severe (4%) while only 14.7% had no anxious mood. 67.6% of the study population reported of anxious mood from mild to moderate in severity. 84.2% of study population reported on tension with various severities ranging from mild (30.5%), moderate (31.3%), severe (16.2%), very severe (6.3%), whereas 15.8% reported on absence of tension. 62.1% of the study population reported of having fearfulness with varying severities mild (27.2%), moderate (25%), severe (6.6%) and very severe (3.3%) while 37.9% did not report of fear. Majority of the study population reported of insomnia (63.6%) with varying severities of mild (26.5%), moderate (16.9%), severe (13.2%) and very severe (7%) while 36.4% did not report of insomnia.71% of the study population reported of impaired attention and concentration. 71% of the study population reported of depressed mood, mild (29.8%) , moderate (19.1%), severe (16.2%)and very severe (5.9%) while 29% had no mood symptoms. Hamilton – Anxiety scale revealed that 80.9% had mild, 11.8% moderate, 2.2% severe and 5.1% had very severe anxiety levels.</p> <p><strong>Conclusion: </strong>Majority of the study population had anxiety symptom severity ranging from mild to very severe. Pandemic situation had led to an increase in the incidence of anxiety disorder even among medical students. Early screening and management of symptoms might lead to better prognosis.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Complimentary Food Practices in Rural Areas (6 Months to 1 Year) 2022-01-22T11:51:15+00:00 Samidha Borkar Jayant Vagha <p><strong>Background:</strong> Diet is defined as nutritionally adequate &amp; appropriate intake of food items that also provide the required energy &amp; protein intake by ensuring proper growth and development. Adequate nutrition of the infants &amp; child is essential. Complementary needed practices are included apart from breast milk to meet one's needs. A balanced diet is defined as nutritionally adequate &amp; appropriate intake of food items that also provide energy and protein.</p> <p><strong>Methods:</strong> A cross-sectional/observational study is to be conducted by taking approval to meet one’s need; complimentary food practices are included apart from breast milk, from the ethical committee which includes multigravida women as study participants PNC, PEDS ward, AVBRH. The data of sample size is recorded, tabulated analyzed.</p> <p><strong>Results:</strong> As many as 43.33% of the mother from the study group has started weaning practices before six months of age. Whereas the standard complementary feeding practices is Dal pain (66.66%) followed by mashed roti/bread (60%) furthermore Dalia (53.33%). The no meals per day were three meals by 36.66% of participants. The typical food being Dal pani, a thin gruel, with most of the participants starting weaning</p> <p><strong>Conclusion:</strong> Poor complementary feeding practices are observed in a rural typica e comisfood is Dal pani, a thin gruel, with most participants starting weaning before 6 months of age.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## The Perception of Attitude as a Factor that Affect Professionalism among General Physicians of Primary Health Care Centers in Saudi Arabia 2022-01-22T12:11:13+00:00 Fatimah Ibrahim Tahtouh Abdulbari Ahmed Hanash Mohammed Ibrahim Tahtouh Esmahan Ibrahim Tahtouh Razia Aftab Ahmad <p><strong>Background: </strong>Medical professionalism is considered, in modern clinical practice as the basis of the social contract between physicians and their society. It encompasses a wide range of values such as altruism, accountability, excellence, duty, service, honor, integrity, and respect for others. It has been researched extensively in the Western world, but only a dearth of studies exist in Saudi Arabia and the Middle East.</p> <p><strong>Methods:</strong> A cross-sectional study was conducted on 157 physicians working in primary health care centers in Abha and Khamis-Mushayt cities of Saudi Arabia. The study tool was a self-addressed validated questionnaire.</p> <p><strong>Results: </strong>Participants in the study were 157 general physicians, of whom 63.7% were males. The Saudis were 84.1%. The mean of experience of work in years was 3.5 years. Only, 50.3% had training in medical professionalism training, whereas 49.7% did not receive any training in professionalism (the mean number of training sessions was 3.1). The mean score of professionalism was 109.1 (out of a potential total of 130 points). Participants with High professionalism were 49%, while 49.7% were found to have moderate professionalism, and only 1.3%, was with poor professionalism. Factors related to a significantly positive association with professional behavior were; higher age, being married, being non-Saudi, higher qualifications (like Diploma/MSc), increased practice experience, and professional training one is involved in.</p> <p><strong>Conclusion: </strong>The participant physicians reported high levels of professional behavior. However, there is a need to focus on addressing job satisfaction factors to improve participants’ practice attitude and subsequently increase professionalism.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## The Use of Topical Chloramphenicol for Eye Diseases in the Outpatient Setting 2022-01-22T12:24:24+00:00 Nehad J. Ahmad Abdullah I. Hamdi Nawaf Binduhaim Hesham A. Alkhulifi Menshawy A. Menshawy <p><strong>Aim</strong><strong>:</strong> The present study was conducted to evaluate the outpatient prescribing pattern of ophthalmic chloramphenicol in a public hospital in Alkharj.</p> <p><strong>Methodology</strong><strong>:</strong> This is a retrospective study that includes reviewing the electronic prescriptions of ophthalmic chloramphenicol among outpatients in a public hospital in Alkharj.</p> <p><strong>Results</strong><strong>:</strong> During the study period from 1<sup>st</sup> of January 2018 to the end of June 2018, 168 patients received ophthalmic chloramphenicol. More than 50 % of them were males and the age of 55.95% of them was less than 20 years. More than 46% of the ophthalmic chloramphenicol prescriptions were prescribed for 7 Days and 39.29% were prescribed for 5 days. More than 83% of the prescriptions were prescribed by emergency department.</p> <p><strong>Conclusion: </strong>The present study showed that ophthalmic chloramphenicol <em>was uncommonly prescribed in Al-Kharj.</em> Further studies are needed to explore the appropriateness of its prescribing and its use in order to decrease the bacterial resistance and to increase its efficacy.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Role of Yogurt in Children having Diarrhea and Severe Acute Malnutrition at Nutrition Stabilization Center Hyderabad 2022-01-22T17:25:59+00:00 Aqsa Abbasi Farzana Shaikh Muhammad Nadeem Chohan Khuda Bux Khoso Zamir Ahmed Abdul Hameed Radhan <p><strong>Aim: </strong>The aim of conducting this study is to evaluate the role of yogurt in the dietary management of diarrhea in the severe malnutriated children.</p> <p><strong>Study Design:</strong> Observational prospective study.</p> <p><strong>Place and Duration:</strong> Nutrition Stabilization Center, Department of Pediatrics Civil Hospital Hyderabad from 1st July 2018 to 31st December 2018.</p> <p><strong>Methodology:</strong> A total of 100 children with severe acute malnutrition and Diarrhea, age 6 months to 5 years were enrolled. After admitting children were treated with yogurt instead of fluids, f-75 and ORS. Within 7 days of admission we observed and recorded that children tolerated the breast milk and yogurt, clinically improvement, General condition, Edema, Sunken eyes, Thirst, Skin pinch, Weight gain and Social response of baby. Chi-square test was also applied to observe the difference efficacy of yogurt in diarrhea in children suffering from malnutrition. P-value ≤0.05 was considered as significant.</p> <p><strong>Results:</strong> Most of the children were 13 to 48 months of age. The average age and weight of the children was 32.04±13.53 months and 5.23±1.39kg respectively. Average number of stool was significantly reduced at day 1 and day 5. Overall it was observed that efficacy of yogurt in diarrhea in children suffering from malnutrition was 69%.</p> <p><strong>Conclusion:</strong> This study suggest that yogurt-based diet is effective in treating diarrhea in severely acute malnourished children. It should be granted priority in the nutritional management of severe malnutriated children affected by diarrhea.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Topical Hydrocortisone Use in the Outpatient Department 2022-01-22T17:48:54+00:00 Nehad J. Ahmed Mohamed R. Alsubaie Abdullah T. Almutairi <p><strong>Aim:</strong> This study aimed to describe the use of topical hydrocortisone in the outpatient department in Alkharj.</p> <p><strong>Methodology: </strong>This was a retrospective study that included reviewing the electronic prescriptions of topical hydrocortisone among outpatients in Alkharj. The inclusion criteria included all of the outpatient prescriptions that contained topical hydrocortisone in the study period.</p> <p><strong>Results: </strong>During the study period between January 2018 to June 2018, 196 patients received topical hydrocortisone. More than 52% of the patients were males and the age of 31.63% of them was less than 10 years. Most of the patients received topical hydrocortisone as a cream (87.76%). Most of the prescriptions that contained topical hydrocortisone were written by residents (98.98%) and most of the prescriptions that contained topical hydrocortisone were written by emergency department (70.41%).</p> <p><strong>Conclusion:</strong> The present study showed that topical hydrocortisone was prescribed commonly in the outpatient setting. More studies are needed to explore the frequency of topical hydrocortisone prescribing in other settings and to explore the frequency of using other topical medications in different settings.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Psychological Status of Healthcare Workers during COVID-19 Pandemic in Saudi Arabia 2022-01-23T07:39:31+00:00 Feras Abdullah Al-Awad Hawraa Mohammed Aldhamen Abdullah Ali Alghamdi Abdulaziz Abdulkhaliq Alwakeel Kawthar Mohammed Aldhamen Lina Adel Alafghani Khames T. Alzahrani Abdulmajeed Alwabel Samaher Barabie Ahames Alharthi Baraa Omar <p><strong>Background:</strong> The 2019 Corona Virus Disease (COVID-19) is a global pandemic affecting the lower respiratory tract that is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov2). It has caused psychological stress on people around the world, particularly those in the medical field. The purpose of this study is to determine the levels of anxiety, depression, burnout, and the sources of anxiety among healthcare workers (HCW) in Saudi Arabia during the COVID-19 pandemic. To determine the coping strategies of HCWs in dealing with mental health issues that may affect them during the pandemic.</p> <p><strong>Methodology:</strong> An observational cross-sectional study was carried out between May 2020 to November 2021 in Saudi Arabia. A Total of 260 HCW of both genders who are working in private and governmental hospitals were selected. However, non-healthcare workers such as technicians, administrators, clerical staff and maintenance workers were excluded.</p> <p><strong>Results:</strong> A total of 260 HCWs 98 (37.7%) doctors, 27 (10.4%) nurses, 6 (2.3%) pharmacists, 5(1.9%) physiotherapists, 113(43.5%) interns and 11 (4.2%) others, of whom 127 (48.8%) were male and 133 (51.2%) were female. The majority of participants aged from 20-29 years old 205 (78.5%), followed by 30-39 years old 26 (10%), 40-49 years old 18(6.9%), and 50-59 years old 10(3.8%), and 70-79 years old 1(0.4%). Around 42(16.2%) HCWs were working in ER, 82(31.5%) in wards, 83(31.9%) in outpatient clinics, 15(5.8%) were working in both wards and outpatient clinics, 6 (2.3%) in ICU and around 32(12.3%) in all demographics.</p> <p><strong>Conclusion:</strong> The results of this study illustrated the burden of psychological problems among different healthcare workers during the COVID-19 pandemic. The findings suggest that all health care workers (HCWs) were affected by varying degrees severity of anxiety and depression, insomnia and complaining from cardiovascular symptoms.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Frequency of Complementary Feeding, Top Feeding and Exclusive Breast Feeding among Infants at Tertiary Care Unit: A Retrospective Cross Sectional Study 2022-01-24T07:18:39+00:00 Sehrish Memon Ayesha Farhat Asadullah Memon Iqra Khokhar Hina Naqvi Muhammad Nadeem Chohan <p><strong>Ai</strong><strong>m:</strong> To determine the frequency of complementary feeding, top feeding and exclusive breast feeding among infants at tertiary care unit</p> <p><strong>Study Design: </strong>Retrospective cross sectional study</p> <p><strong>Place and Duration:</strong> Pediatric Out Patient Department (OPD) of Sheikh Zayed Hospital, Lahore from November 2017 to May 2018</p> <p><strong>Methodology:</strong> Three hundred children were enrolled. The mothers of the children were asked about the feeding practices (i.e. exclusive breast feeding, top feeding, complementary feeding) which were described as frequency distribution table</p> <p><strong>Results:</strong> Exclusive breast feeding was found in 54 (18%) children, complementary feeding started at 6 months of age in 102 (34%) children, while the top feeding was given in 144 (48%) children.</p> <p><strong>Conclusion:</strong> At the age of 6 months, complimentary feeding was practiced most frequently. Exclusive breast feeding was not very common. So, mothers should be encouraged to promote breast feeding among their children.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Gingival Recession among the Patients Wearing Fixed Braces Visiting Dental College of Larkana 2022-01-24T07:59:46+00:00 Mor Khan Shar Amna Nisar Aalishan Ali Raza Sarang Sohoo Zahra Batool Abdul Bari Memon Mehran Mazhar Abro <p><strong>Aim: </strong>To evaluate gingival recession among the patients wearing fixed braces visiting dental college of Larkana.</p> <p><strong>Study Design: </strong>Descriptive Cross-Sectional</p> <p><strong>Place and Duration of Study: </strong>Department of Orthodontics, Bibi Aseefa Dental College (BADC) Larkana December 2018 to February 2020.</p> <p><strong>Methodology: </strong>This study was carried out at Bibi Aseefa Dental College Larkana. The patients were recruited with consecutive sampling technique. The gingival recession was evaluated clinically using Miller`s classification. A structured questionnaire was used for the information relevant to oral hygiene status. Data was analyzed using SPSS version-23.0.Chi-square test was applied between the gender and gingival recession at 95% confidence interval.</p> <p><strong>Results:</strong> Males were 23% and females were 77%. The mean age was 21.03±4.684.The class-I recession was observed in 6% patients and Class-II was in 2% patients. The gingival recession was observed in 8.5% patients. There was significant relationship between gingival recession and gender (p-value-0.018).</p> <p><strong>Conclusion:</strong> It is concluded that there were many patients facing the problem of gingival recession during treatment. There was significant association of gender and gingival recession.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## A Study of Carotid Doppler and Highly Specific C Reactive Protein in Type II Diabetes Mellitus and Its Correlation with Macrovascular Complications 2022-01-24T08:15:10+00:00 Vijayashree S. Gokhale Rupesh S. Parati Ponvijaya Yadav Keyuri Mehta <p><strong>Background:</strong> Diabetes has a multitude of macrovascular complications, one of them being Carotid artery Atherosclerosis leading to stenosis and predisposing patient to Stroke. A hypothesis put forward is the presence of low-grade inflammation in Diabetic patients, which may enhance atherosclerosis. A study was planned to assess Carotid artery stenosis and HsCRP levels in Diabetic patients, so as to identify at risk group and take measures to prevent complications such as stroke and ischemic heart disease.</p> <p><strong>Aim:</strong> To study the patients by clinical parameters, ultrasound carotid doppler study, and estimation of HsCRP with patients of type II DM.</p> <p><strong>Study Design:</strong> Cross sectional observational study.</p> <p><strong>Place and Duration of Study:</strong> Study was conducted at Department of General Medicine, Dr D Y Patil Medical College, Pune from July 2019 – September 2021.</p> <p><strong>Methodology:</strong> The study included 50 subjects with type 2 DM (as per inclusion and exclusion criterion). All participants were explained the nature of the study and after informed consent all subjects were clinically examined and were subjected to carotid artery doppler and HsCRP levels.</p> <p><strong>Results:</strong> In our study 16% had carotid stenosis of &lt;50% while 8% had &gt;50%. However, 42% had increased intima-media thickness. On the other hand, 52% subjects had raised HsCRP levels.</p> <p><strong>Conclusion:</strong> In our study, Carotid Stenosis and impending stenosis was seen in significant number of Diabetic patients of more than 5 years duration, who also had higher HsCRP levels.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Comparative Evaluation of the Influence of Single Preoperative Antibiotic Dose of Amoxicillin (1gm) and Postoperative Antibiotic Dose of Amoxicillin Drug (500mg) Regimen on Postoperative Outcome and Implant Stability in Single Tooth Dental Implant Surgery: Randomized Controlled Trial 2022-01-24T09:59:53+00:00 Soumya Dudhani Shwetha Shetty Amit Jagtap <p><strong>Aims: </strong>A single blinded randomized controlled trial was conducted to test the efficiency of two antibiotic regimens on post operative outcome and implant stability in single tooth dental implant to overcome the increasing drug resistance due to over prescription of medicines and side effects of the same.</p> <p><strong>Methodology:</strong> 20 participants needing single tooth dental implant were enrolled based on inclusion and exclusion criteria. The participants were randomly assigned into groups. 10 participants in group 1 received only a single preoperative dosage of amoxicillin 1gm which was followed by paracetamol. In group 2, 500mg amoxicillin was given postoperatively followed by a three times a day for 3 days regimen. The postoperative outcome was evaluated based on swelling, post-operative bruising, suppuration and wound dehiscence noticed on 2<sup>nd</sup> and 7<sup>th</sup> day postoperatively. ISQ (implant stability quotient) was checked 3 months post implant placement as osseointergration is the main goal of implant placement.</p> <p><strong>Results:</strong> Post-operative bruising, suppuration and wound dehiscence were not noticed in the entire study due to sterile environment during implant placement. When swelling was compared between group 1 and 2 it was statistically insignificant on day 2 (Mann Whitney u=40.00, p=0.383) and day 7 (Mann Whitney u=50.00, p=01.00). ISQ (IMPLANT STABILITY QUOTIENT) score in group 1&amp;2 also showed statistically insignificant results (t=0.00, p=1.00) Which states that there was no significant difference in the stability of implants when single preoperative antibiotic dose of amoxicillin(1gm) and postoperative antibiotic dose of amoxicillin drug(500mg) regimen 3 times a day for 3 days was given.</p> <p><strong>Conclusion:</strong> this study shows that in healthy individual, when single implant is placed in proper sterile environment with routine dental hygiene such as brushing and chlorhexidine mouthwash use by patient, single preoperative dose of amoxicillin 1gm is sufficient for the success of implant. However, considering the limitations of the study, further work is necessary to validate reliability.</p> <p>No adverse effects were observed in the study</p> <p>Funding: NIL</p> <p>Reg no:DYPDCH/EC/648/12/2021</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Factors Associated with Delayed Presentation among Women with Breast Cancer 2022-01-24T10:10:11+00:00 Munawar Hussain Mangi Rubina Bashir Seema Rahim . Paras <p><strong>Purpose: </strong>Breast cancer in women is one of the most common tumors in women worldwide. Throughout Pakistan, there have been multiple reasons that cause a delay in the presentation of breast cancer and many reasons are neither reported nor studied. The objective of our study is to provide detailed estimates on the prevalence and causes of delays in order to plan targets for intervention<strong>.</strong></p> <p><strong>Materials Methods:</strong> This is a Quasi-Experimental study done at Department of General surgery, Shaheed Benazir Bhutto Medical College, Lyari Karachi from September 2018 to August 2020. We recorded the histories of 200 women by conducting structured interviews after their written consent and noted their mean age, standard deviation, early symptoms, and reasons for delayed presentation. Only patients who discovered their symptoms are included in the study.We then conducted the analysis on early and advanced stage patients using SPSS Version 20.</p> <p><strong>Results: </strong>The mean patient's age was 44.2 ± 4.13years, where 200 females were observed with a maximum age of 70 years and minimum age of 20 years in our data. Approximately 49% of breast cancers were advanced stage and about 69% had a rural residence, while painless bump was observed in 91% of women,hospital distance was less and more than 60 minutes and that’s has hindered presentation too. Similarly, about 71.2% of breast cancer patients presented with advanced-stage disease. We observed the most common factor to be a painless lump and misdiagnosed first visit.</p> <p><strong>Conclusion: </strong>Our study concludes that distance, rural residence, painless breast lump, and misdiagnosis are the most common reason of delay presentation by the patients and should be intervened.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Knowledge, Attitude and Awareness about the Benefits of Indoor Plants: Reduction in Stress Level and Mental Health Satisfaction 2022-01-24T10:30:17+00:00 M. K. Arun Ganesh R. Gayatri Devi A. Jothi Priya <p><strong>Background:</strong> Environmental pollution is a serious threat to living beings and global warming. Indoor pollution also comes under environmental pollution. One of the sustainable but underexploited solutions is the indoor plants which are of much significance and importance. The indoor air quality is improved by indoor plants, which benefits humans by improving their physical and mental health.</p> <p><strong>Aim:</strong> The aim of this study is to analyze and gain knowledge on the awareness people of age 25-35 have on the benefits of indoor plants.</p> <p><strong>Materials and Methods:</strong> The self-administered questionnaire was designed based on awareness. The questionnaire was distributed through Google forms linked to 110 numbers of the study population of age between 25 and 35. Methods of representation of each output variable were represented in the pie chart form. The measure that was taken to minimize the sampling bias was that the validity was checked both internally and externally. The statistics were done using SPSS software, chi square test was used to check the association and P value of 0.05 was said to be statistically significant.</p> <p><strong>Results:</strong> From this study, 83.6% of the participants’ have indoor plants at their homes or workplaces. 82% people felt that indoor plants help to reduce stress levels which was not statistically significant (p: 0.07) and 89% of them felt indoor plants helping to promote healing of injuries faster which was statistically significant (p: 0.02).</p> <p><strong>Conclusion:</strong> Indoor plants were beneficial to the majority of the population in different ways. Populations between the age 25 and 35 were aware about indoor plants and awareness camps, social media, seminars and workshops can be conducted among the people to promote knowledge on indoor plants.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Effects of Light-Curing Techniques on Dental Resins - A Cross-Sectional Study 2022-01-24T12:17:27+00:00 Saeed Awod Bin Hassan Ayman Mousa A. Alfaifi Abdulrahman Mohammed Nasser Otudi <p><strong>Background:</strong> Commonly used dental resin composites are used as dental filling materials with the help of light induced polymerization reaction. The purpose of this cross-sectional research was to compare the results of different light intensities on the hardness of different dental composites. Following light treatment units were used.</p> <ul> <li>QTH also called Quartz Tungsten Halogen</li> <li>LED also called Light Emitting Diodes</li> </ul> <p><strong>Methods: </strong>&nbsp;This one-month cross-sectional, in-vitro study was carried out in the Dental Materials Laboratory in Saudi Arabia. Using non-probability, convenient sampling, a single trained operator prepared 60 dental restorative composites (DRC) samples in steel molds with a diameter of 10mm and each mold was 2mm thick. During the polymerization of DRCs, the effects of light intensities, sorption and solubility, and microhardness were all measured. SPSS was used for statistical analysis and a p-value of &lt;0.05 was declared striking.</p> <p><strong>Results: </strong>&nbsp;When QTH and LED lamps were used, the average micro hardness of DRC was estimated to be 15.480.46 and 18.260.53, respectively. The mean light intensity of QTH was 434 mW/cm2 and for LED lights it was 925mW/cm2. There was no notable difference in DRC sorption and solubility capability (p=0.001) during the polymerization reaction (p=0.128).</p> <p><strong>Conclusion: </strong>&nbsp;When it came to increasing the surface micro hardness of DRC, LED light was found to be more effective than QTH light.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Effect of Methotrexate and Linoleic Acid on BAX/BCL2 Ratio in Human Hepatocyte Cell 2022-01-24T12:59:44+00:00 Ayse Gül Kabakci Halil Mahir Kaplan Ergin Şingirik Memduha Gülhal Bozkır <p><strong>Aims: </strong>To investigate the effect of methotrexate and linoleic acid on BAX/BCL 2 ratio in human hepatocyte cell.</p> <p><strong>Study Design: </strong>Original Research Article.</p> <p><strong>Place and Duration of Study:</strong> The study was carried out in partnership with the Department of Anatomy and Department of Medical Pharmacology of Çukurova University Faculty of Medicine, using the laboratory facilities of the Department of Medical Pharmacology.</p> <p><strong>Methodology:</strong> Human hepatocyte cell line (CRL-11233) cells obtained from the American Type Culture Collection Organization (ATCC) were used. Expressions of apoptotic pathway markers, apoptosis inducing factor&nbsp; BAX, BCL2 and BAX/BCL2 were evaluated. All analyzes were examined in four groups (Group 1; control, Group 2; linoleic acid given, Group 3; methotrexate given and Group 4; linoleic acid and methotrexate given).</p> <p><strong>Results:</strong> The mean ± standard error values of the obtained results as nanogram / milliliter (ng / ml) are in Group I, Group II, Group III and Group IV, respectively; BAX values, 0.900 ± 0.1864, 1.002 ± 0.2098, 8.352 ± 1.467 and 4.295 ± 1.522, BCL 2 values, 13.93 ± 1.198, 13.92 ± 1.739, 2.938 ± 1.059 and 9.250 ± 1.492 and BAX/BCL2 values 0.065, 0.072, 2.843 and 0.464.</p> <p><strong>Conclusion:</strong> While BAX/BCL2 level increased in the group given methotrexate, it decreased in the group given linoleic acid and methotrexate.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Preliminarily Phytochemical Screening, Anti Inflammatory and Antimicrobial Activity of Macrotyloma Uniflorum (Horse Gram) Leaf Ethanolic Extract on Selected Oral Pathogens 2022-01-24T13:18:01+00:00 P. A. Vasishta R. Gayathri V. Vishnu Priya <p><strong>Aim:</strong> To know the Preliminary phytochemical screening, Anti Inflammatory activity and antimicrobial activity Macrotyloma uniflorum (<em>Horse gram</em>) leaf ethanolic extract on selected oral pathogens.</p> <p><strong>Introduction:</strong> Macrotyloma uniflorum also known as <em>horse gram</em> is a plant grown for feeding horses, rarely by humans and also in Ayurvedic cuisine. This plant is a legume from tropical southern Asia which belongs to the family of Fabaceae and the kingdom of Plantae.</p> <p><strong>Materials and Methods:</strong> Macrotyloma uniflorum ethanolic plant extract was made and statistical analysis was done using various methods in order to know the anti inflammatory and antioxidant properties by preliminary phytochemical screening.</p> <p><strong>Results and Discussion:</strong> The polyphenolic compounds flavonoids and tannins appear to be the most promising in Macrotyloma uniflorum ethanolic plant extract.</p> <p><strong>Conclusion:</strong> The study demonstrated in vitro antioxidants and anti- inflammatory activities of Macrotyloma uniflorum leaf extract through scavenging, chelating and reducing&nbsp;&nbsp; activity.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## A Review on Mucormycosis Disease & Its Treatment 2022-01-17T05:40:00+00:00 Akshay Kumar Waster Pradeep Sune <p>Mucormycosis is an angio-intrusive disease brought about by the Mucorales organism. Even though it is an uncommon condition, it is turning out to be more normal among immunocompromised patients. Rhino-orbitocerebral, cutaneous, dispersed, gastrointestinal, and pneumonic structures would all be able to be found. Notwithstanding the lively treatment, there is a generally speaking expanded passing rate. The audit's significant objective and objective are as follows: Mucormycosis Overview and Etiopathogenesis, Fatality of Rhino cerebral Mucormycosis Strategies for determination and treatment have as of late progressed. Mucormycosis is more typical in seriously neutropenia patients and people who need phagocytic action. Notwithstanding, this isn’t true on account of Patients with AIDS19. It suggests that T lymphocytes are involved. They are insufficient in forestalling parasitic expansion. Just the neutrophils are impacted. Voriconazole treatment for quite a while, essentially among the People with malignant growths of the blood and bone marrow Transfers of undifferentiated hematopoietic cells are more regular. Besides, Mucormycosis can likewise be found in individuals who don’t have any manifestations Rhino-orbitocerebral, cutaneous, dispersed, gastrointestinal, and pneumonic structures would all be found. Notwithstanding the lively treatment, there is a generally speaking expanded passing rate. Mucormycosis results from various fungi that may be innocuous and primarily affect immunocompromised patients. For this reason, the clinician must have a high index of suspicion to diagnose this disease in any of its forms when it presents in a patient with these risk factors. Starting with the host’s features and the fungus’s tropism once it invades the host, this activity discusses the manifestations of Disease, appropriate evaluation/management of mucormycosis, and highlights the role of the interprofessional team in evaluating and treating patients with this condition.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Endogenous Endophthalmitis in COVID-19 Patients 2022-01-17T05:41:09+00:00 . Manilika Swapneel Maruthkar Sachin Daigavane Nachiket Rahate Prayas Sarda Samarth Shukla Sourya Acharya Aditi Goyal <p>Intrinsic endophthalmitis is indeed behavior that causes eye disease that spreads into the bloodstream from a distant primary site. The intraocular disease caused by hematogenous microbial proliferation is known as indigenous endophthalmitis. Extrinsic and intrinsic endophthalmitis are the two types of endophthalmitis that exist.&nbsp; The presence of an external point of entry is linked to extrinsic endophthalmitis. Intrinsic endophthalmitis is a kind of septicemia caused by a blood-borne infection. Endophthalmitis is a disease of all the inner coating of the eyeball except the sclera and cornea, which is accompanied by substantial, increasing vitreous swelling. Endophthalmitis is a severe ocular crisis with severe visual and general consequences. An exterior injury of the entrance, such as injury, operation, or an inflamed cornea, is the most prevalent route of entry for potential pathogens. Endophthalmitis has a complex etiology, with many pathogenic species and substantial regional heterogeneity. The treatment of endophthalmitis has evolved dramatically during the last century. Endophthalmitis induced by direct inoculation dissemination of pathogenic microbes is a rare occurrence that occurs most commonly in sick or disadvantaged people. Intravenous medication usage, diabetes mellitus, immunological impairment, cancer, prolonged hospitalization, or systemic antibiotic therapy have all been linked to a 0.04 percent incidence rate. Haden described metastatic endophthalmitis in a seriously sick patient with pneumococcal cerebrospinal encephalopathy treated with intravenously anti-meningococcal serum in the 1918 volume of the Journal Ophthalmology. Endogenous endophthalmitis, unlike extrinsic endophthalmitis, needs comprehensive systemic&nbsp;antibiotic treatment. In indigenous endophthalmitis, the illness originates not in the eye but elsewhere in the body. As a result, it is necessary to obtain comprehensive cultures. Patients are sometimes unable to carry out their functions in society or household. As a rest, the person cannot cope financially and socially in his environment. Many social and influential factors are disturbed, and the patients are often depressed. Cosmetically the surgeries are not satisfying. Artificial prosthetics can be used, but they're seldom of minimum functional importance. Such interventions can be helpful for the patient. The focus should be made to deliberately save the patients and not just the cosmetic value of the surgery. Persons with chronic endophthalmitis had more excellent eyesight than people with symptomatic or subacute endophthalmitis. Improvements in eyesight were observed in individuals with persistent or subacute keratitis several months after the surgery more frequently than in people with symptomatic endophthalmitis. Nevertheless, in 40 percent of the overall all instances with an abrupt start, there have been no improvements or even decrease in visual acuity.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## A Review on Syphilis: Clinical Manifestation and Epidemiology 2022-01-17T05:42:31+00:00 Akshaya Rana Mrinangka Deb <p>Syphilis is a persistent infection caused by the bacteria Treponema pallidum prevalent in low-income countries but rare in middle- and high-income countries. T. pallidum is known for its invasiveness and immune evasion; its clinical symptoms are produced by local inflammatory responses to replicating spirochetes and are often confused with other diseases. The spirochete has a prolonged latent phase in which people might be infected even if they don't display any symptoms. Individuals, as well as the entire population, are affected by the sickness. Only one drug, penicillin, is recommended for the treatment of syphilis, and response to therapy is evaluated by changes in serological test titers over months. Despite the availability of simple diagnostic tests and the effectiveness of treatment with a single dose of long-acting penicillin, syphilis is emerging as a global public health problem. This is especially true among guys in high- and middle-income countries who have sex with men. Even though syphilis is a long-standing disease with well-established treatment ideas, diagnosis and therapy can be difficult due to the wide variety of symptoms and the difficulty of interpreting serological tests. The World Health Organization (WHO) has set a target of lowering syphilis incidence by 90% by 2030, but progress is slow. Countries can reduce the prevalence of syphilis by ensuring detection, treatment, and referral of infections by partners.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## An Algorithmic Approach of Evidence-based Dentistry-review 2022-01-18T04:06:12+00:00 M. I. Sheefaa Palati Sinduja R. Priyadharshini <p>Evidence-based practice is mainly based on scientific evidence, nowadays there is an increasing approach towards research-based studies, there are various steps in choosing the criteria, steps in writing, level of grading, and various search engines have been mentioned, such as google scholar, PubMed, etc. finally we have various other criteria for selecting and writing the final article, it is very important to choose a proper website for publishing our article. In recent years, practice of dentistry has become more complex and challenging, because of its advancement on a daily basis, so it is very important to analyse and update the current. iSeek is also a particular type of search engine for students, teachers, and administrators alike. The main aim is to provide a balanced mix of knowledge with science for the clinical expertise, and at same time which helps to know the needs of the patient so that optimizing patient care in a practice would not be underestimated.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Assessing the Roadblocks to Organ Donation 2022-01-18T04:10:52+00:00 Tithi Sherawat Nikhil Dhande <p>There has been a significant propulsion in the growth rate of organ failure across the globe in the recent times and major contributor for the same is rising graph of non-communicable diseases, especially diabetes and hypertension in developing countries like India. For patients with end- stage organ disease, organ transplantation is the most desired therapeutic option but according to the current estimates, there is a substantial discrepancy between the organ supply and demand ratio as organ transplantation serves only to less than 10% of the global need of organ donations. These figures thereby necessitates the action towards the promotion of organ donation at various levels. Despite massive advancements in the intricate procedure that occurs between organ donor identification and transplantation and overcoming challenges such as a lack of knowledge, financial restraints, and insufficient transplant facilities, there is still a perennial inability to meet the needs of donors across the country. Varying beliefs and cultures reflect different regulations and donation practices among different groups, posing a challenge to the standardized processes. The purpose of this article is to set out the close link between shortage of organ supply, its relation to the various factors contributing to it along with the certain suggestions in which we can counter these challenges. This article also provides a brief overview of the origin and evolution of India's Transplantation of Human Organ Act, in the hope that our experience in drafting legislation governing organ transplantation may be useful to ones who are considering or overseeing this life-saving procedure.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Medicinal Plants Exhibiting Antifertility Activity: A Review 2022-01-18T04:32:35+00:00 Priyanka Goswami Mrinmoy Basak <p>This review reveals that some plants and their part used having anti-fertility action, which are helpful for researcher to develop new herbal anti-fertility formulations. In the recent years, interest in drugs of plant origin has been progressively increased. The aim of this review is to highlight the work on anti-fertility of plant origin. We undertook an extensive bibliographic review by analysing peer reviewed papers, and further consulting well accepted worldwide scientific databases. Peer reviewed articles were gathered consulting the databases NISCAIR, SCOPUS, PUBMED and Google scholar using terms such as “antifertility”, “anti-implantation”, and “antispermatogenic” activity of plants. Plants, including their parts and extracts, that have traditionally been used to facilitate antifertility have been considered as antifertility agents. In this paper, various medicinal plants have been reviewed for thorough studies such as <em>Aegle marmelos</em>, <em>Chenopodium ambrosioides, Jatropha gossypifolia, Leonotis ocymifolia. </em>For women who can't use modern forms of contraception due to adverse effect or other reasons, therefore herbs can offer alternatives and reducing fertility would be better than other contraceptives. This review creates a solid foundation upon which to further study the efficacy of plants that are both currently used by women as traditional antifertility medicines, but also could be efficacious as an antifertility agent with additional research and study.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Ocular Manifestation of COVID-19: A Review 2022-01-18T05:02:18+00:00 Tanmay Tarang Pranaykumar Shinde Praveena kher <p>In December month of 2019, a few pneumonia cases of mysterious origin were discovered in a city in China. Later it was found to be coronavirus which caused mild to moderate upper respiratory tract infections in patients. WHO designated it a pandemic in March 2020. The virus belongs to the coronaviridae family. The clinical symptoms that are seen in covid-19 are fever, cough, fatigue, shortness of breath, etc. ocular manifestations of covid are rare, but some of them include dryness of the eye, pain, discharge, itching, etc. the most common and essential manifestation is conjunctivitis. It is spread through droplets. Proper protection and hygiene can minimize the spread of this infection.</p> <p>Other than the very much known respiratory illnesses such as cough, cold, loss of taste, smell, etc., the covid 19 was also seen to have some ocular manifestations. Studies showed 1 out of 10 patients to have some visual change during the illness period. The most common ocular manifestation is that of conjunctivitis. Although, conjunctivitis must be differentiated from other causes of eye redness. There are many different kinds of conjunctivitis of different etiologies; it is essential to know the exact etiological factor for providing the patient with definitive treatment. As covid is very contagious, ocular examination and management are also challenging since it can spread from the doctor to the ophthalmologist attending them. So, prevention is possible to deal with this ongoing pandemic and its ophthalmic complications.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Hepatitis B Viral Infection Associated with Cirrhosis and Hepatocellular Carcinoma 2022-01-18T05:12:19+00:00 Simran Tawde Anup Kediya <p>In humans, the hepatitis B virus causes a persistent infection in the liver. Recently, 3.5 percent of the worldwide been infected with HBV on a long-term basis. It is a chronic, dynamic disease that can be managed with medication but not cured. With continuous inflammation and viremia, the risk of final liver disease and hepatocellular cancer rises. Out of the 24 million people afflicted, 15% to 40% develop cirrhosis, leading to a failing liver or carcinoma. Chronic HBV infection usually progresses through several clinical phases, each of which might continue for decades. vaccination and, less by the use of antivirals to lower the viral burden of individuals are reducing the incidence of HBV infections. Serum and liver demonstrations diagnostic markers that are well defined and verified allow for assessing disease worsening, virus increase status, patient risk stratification, and therapy options. Novel chemicals are being tested to achieve HBV surface antigen clearing, a serological state linked to a better probability of remission after treatment termination, and a decreased risk of cirrhosis and hepatcellularcacer. Hepatcellularcarcinma (HCC) is the most frequent type of first seen liver cancer and a leading cause of cancer-related death globally. HCC is the ninth most significant cause of cancer death in the United States. Advancingstrat, screens, and new techno in diagnosis and treatment, the incidence and death of cancer continues to climb. Regardless of the cause, cirrhosis remains the most critical risk factor for the development of HCC.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Role of Tocolytics in Preterm 2022-01-18T05:26:55+00:00 Samriddhi Sharma Sandhya Pajai Shubhada Jajoo <p>Tocolytics are the drugs that are used to prolong the time of child birth, for a short period - up to 2 days. If the labour starts too early during pregnancy also termed as preterm birth, which is supposed to be one of the major cause of neonatal mortality and&nbsp; morbidity, all over the world. Administration of tocolytic agents can help in preterm labour to delay the preterm labour by 48 hours. Tocolytics temporarily slow the contractions and hence it is possible to transport the patient to a hospital, where specialized care can be provided to premature baby and also corticosteroids can be administered, which&nbsp; help mature the baby’s lungs. Different class of drugs are studied as tocolytics. Beta-Adrenergic receptor agonists like Terbutaline, Ritodrine, Fenoterol, Metaproterenol, Hexoprenaline, Albuterol, Orciprenaline, Nylidrin. Calcium channel blockers like Nicardipine and Nifedipine. Magnesium Sulfate. Nonsteroidal anti-inflammatories or prostaglandin inhibitors like Indomethacin, and Oxytocin inhibitors like Atosiban were found effective in different studies with some side effects, are discussed here briefly. Some Nitrates, alcohol, Progesterone have also been tried with not much significant effect. Calcium channel blocker specially Nifedipine is most studied and found to be safer and effective for tocolysis. Individual uterine relaxant therapy should take into account&nbsp; individual&nbsp; differences in&nbsp; metabolism and response to drugs.. Short term use of tocolytics has been proven more effective and safer than longer use of it for pre-term labour.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Assess the Psychological Resilience on Academic Stress and Social Support among Nursing Students 2022-01-18T05:27:37+00:00 Neha Lacharwar Nikita Mahadule Sarika Maishkar Manisha Mandaokar Ruchira Ankar Pranali Wagh <p><strong>Background of Study: </strong>Because of staffing shortages and other issues related with nursing practice. Nursing is progressively more intensive &amp;&nbsp;is considered a difficult profession. Nursing students face more educational stress than students in other disciplines since they must modify to varied hospital environments for practice and are vulnerable to a wide range of while emplacement, clients' health, along with ageing &amp; deaths, were discussed. They must deal with the emotional and educational pressures that come with patient care. All of these precursors have the potential to promote pressure and mental problems, just like fear, and concern, and depression. 1) To assess nursing students' mental resiliency. 2) To assess the educational pressure and the social support. 3) To assess the correlation between demographic variable in nursing students.</p> <p><strong>Methodology</strong><strong>:</strong> A descriptive research design was used in this study. 300 nursing students were studied for mental strength, educational pressure, and social support using a probability sample technique.</p> <p><strong>Conclusion: </strong>As a result, it is critical that nursing students, in particular, can handle pressure because it will effect educational progress and, as a result, student skills in the field of clinical nursing. And this has an impact on patient treatment.</p> 2021-12-21T00:00:00+00:00 ##submission.copyrightStatement## Factors Affecting Uptake of Vitamin D in Gastro-Intestinal Tract 2022-01-18T06:59:01+00:00 Abhishek Kumar Swati Garg Samarth Shukla Sourya Acharya Sunita Vagha <p>Vitamin D deficiency affects about 50% of entire people. Vitamin D deficiency affects an estimated 100 million individuals worldwide, spanning all cultures and age groups. This catastrophic situation of vitamin D deficiency can mainly be attributed to lifestyle and the average impact that cuts down exposure to rays from the sun. It is required for the epithelium to produce vitamin D with the help of ultraviolet B (UVB). In comparison to fair-skinned people, dark-skinned people absorb a larger quantity of UVB in their epidermal melanin. Fairer folks require more solar exposition to get the same amount.</p> <p>The increased cases of vitamin D deficiency is a significant prevalent ailment caused by vitamin D deficiency. It is a self-governing, deadly cause of widespread mortality worldwide. New research supports hypovitaminosis D as a cause of neoplastic, cardiac, orthopedic, immunological, NIDDM, and mental disorders. Vitamin D doses are usually compounded to a minimum of 1000 IU by physicians. According to a 2007 study, a high vitamin D intake decreases mortality risk. We've focused on vitamin D research and abstracted the mechanisms that have been linked to vitamin D and its therapeutic implications.</p> <p>Vitamin D is unique in that it may be produced from the epidermis in reaction to UV radiation. AFTER IRRADIATING THE ERGOSTEROL TO UV LIGHT, Vitamin D2 is produced in sun-irradiated fungus. When UVB sunlight strikes the epidermis, vitamin D3 is produced. It's the most "natural" recipe possible. Humans produce vitamin D2. Vitamin D3 is produced mainly by oil-rich fish. Chylomicrons are generated when vitamin D is taken orally.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Advancements in Diagnostics and Treatments of Helicobacter Pylori 2022-01-18T07:08:32+00:00 Aditi Singh Shital Mahajan <p>Helicobacter pylori is the first officially known recognized bacterial carcinogen with more than half the world's population colonized by the gram-negative bacterium. However, more often complications are seen in adults than in children.</p> <p>Decreased Helicobacter pylori can be a two-edged sword, reducing the incidence of stomach ailments while increasing the risk of allergies and constipation. Helicobacter pylori causes various diseases ranging from gastritis to gastric lymphoma.</p> <p>A number of research have been done on H. pylori which play a crucial role in their diagnosis and in finding an appropriate treatment against specific diseases caused by them. The choice of diagnostic method is based on relevance of cost, effectiveness against antimicrobial resistance and less side effects of the drugs used un the treatment. If the disease is not treated properly, the colonization can persist for a lifetime. Recently, an increase in drug resistance has been observed worldwide. Therefore, the rapid and accurate determination of any type of Helicobacter pylori antibiotic resistance before the administration of detoxification is particularly important.</p> <p>Initially the article introduced the pathogenesis and microbiology of Helicobacter pylori. Later there is a complete overview of the diagnostic methods currently available for the detection of the infectious agent. The review also focuses on using next generation sequencing in the detection of the bacterium. To date, advanced sequencing technologies and their applications within the lab settings are in line with Helicobacter pylori management guidelines thereby helping in early diagnosis and treatment of the underlying disease.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## The Hypoglycemic Activity of Lactic Acid Bacteria Isolated From Medicinal Plants of Uzbekistan and Their Probiotic Potential 2022-01-18T07:12:56+00:00 D. I. Amirsaidova G. A. Bekmurodova Sh. M. Miralimova B. A. Imamaliev <p>The study aimed to evaluate the hypoglycemic activity of lactic acid bacteria isolated from the medicinal plants possessing antioxidant and hypoglycemic properties growing in Uzbekistan and analyze their prоbiotic properties.</p> <p>Four plant isolates of lactic acid bacteria (LAB) and three commercial strains were used in the study. Alimentary hyperglycemia was induced in white outbred rats, and glucose level was measured before and after treatment with lactic acid bacteria according to the experiment scheme using an intraperitoneal glucose tolerance test.</p> <p>The investigation was shown that strains of <em>Lactobacillus kunkeei 1, L. рlantarum TK1, L. рlantarum KA3, Enterococcus faecium</em> effectively reduce postprandial hyperglycemia in rats. Moreover, evaluation of their probiotic properties: sensitivity to antibiotics, simulated gastric juice, simulated juice of small intestine, bile, and elevated concentration of sodium chloride, demonstrated that the strains <em>Enterococcus faecium 1, Lactobacillus kunkeei 1, L. рlantarum TK1, L. рlantarum KA3</em> meet the criteria for probiotics.</p> <p>These strains could be considered promising candidates for the preparation of probiotic preparations intended not only to correct gut microbiota but also to maintain normal blood glucose levels.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Obesity in Children: Symptoms and Complications 2022-01-18T07:15:26+00:00 Tanya Agrawal Keshav Hiwale <p>We aim to review the causes, symptoms, and treatment for obese children. And what does an obese children problems the effect and problem? We can say complicated condition in which our body weight is more than desired weight according to height, weight, and age. Obesity is characterized differently for children and teenagers than it is for adults. Male child and Female children develop at various rates, and children are still growing. This condition leads to a a higher risk of getting other dangerous diseases like DM, HTN, etc. Childhood is the right time to pay attention; otherwise it will lead to obese adolescents and adults. Facts from different articles was amalgamated and shown in a simplified fashion, with the year of publication, the age of the children, sample size, study design, and study conclusions all taken into account. The key finding of this review was obesity is a major topic of concern today, especially in childhood. The lifestyle we have adapted in the present generation is more luxurious and physically less active. Obesity is the primary cause of a lot of diseases like diabetes mellitus, hypertension, thyroidism, even in younger children</p> <p>This review article thoroughly covers a lot of ground, with references provided. It is a collection of various case studies that have been completed. As a result, this essay will only include essential information if anyone reads it. Childhood Obesity is a word used to describe a youngster who is considerably overweight for their age and height. Childhood obesity can lead to diabetes, high blood pressure, and high cholesterol.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## A review on Ocular Tuberculosis: Epidemiology, Clinical Features and Treatment 2022-01-18T07:21:38+00:00 Rakshit Kumar Singh Chehak Bewtra Praveena Kher <p><strong>Background:</strong> globalization and migration movements are intimately linked to the expansion of tuberculosis. Tuberculosis has also been the primary cause of death in patients with HIV infection and the leading cause of death related to antibiotic resistance. Tuberculosis may affect any part of the uveal tract. T cell activity is of significance in Tuberculous infection. The phagocytosis of bazillion by macrophage is a significant factor in limiting the spread of infection. However, in patients who have had a previous tuberculous infection, the cell-mediated response is also associated with tissue damage due to the direct effect of sensitized T lymphocytes on the cell containing the ingested bacilli. Ocular tuberculosis is extrapulmonary tuberculosis with a wide range of symptoms. Tuberculosis is considered to infect the lungs of the patients in 80% of cases, and 20% of cases affect other organs like the eye. Ocular tuberculosis is an infectious disease with bacterial etiology that has a chronic case with a poor prognosis. Even the most effective treatment can cause vision loss, and clinical recovery is not always permanent. Ocular tuberculosis frequently results in permanent impairment, lowering patients' quality of life.</p> <p><strong>Objective: </strong>This article reports the various known presentations of ocular TB and reviews essential epidemiology, diagnosis, and treatment elements.</p> <p><strong>Methodology: </strong>The present study is a systematic review of literature searched from electronic databases and highly reputed websites like PubMed, researchgate, Elsevier, etc. Medical Subject Headings (MeSH) and the trial registry in the English language.</p> <p><strong>Conclusion:</strong> Ocular tuberculosis (OTB) diagnosis and treatment are difficult to come by. The disease's current uncertainty is due to mixed ocular tissue involvement, a lack of consensus on best practice diagnostic tests, and global variations in medical management. The present evaluation intends to provide an update on OTB's recent progress.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Meibomian Gland Dysfunction Causing Dry Eye Syndrome in Computer Users 2022-01-18T07:25:52+00:00 Rashmi Shukla Archana Thool <p><strong>Background:</strong> Meibomian glands are follicular glands that release lipid that shapes the tear film's superficial layer. A persistent, extensive terminal duct blockage and descriptive alterations in the secretory output indicate meibomian gland dysfunction. Digital eye strain is characterized by changes in ocular surface integrity, tear film function, blinking patterns, accommodation disorders, differences in fixation, dryness, weariness and discomfort while using digital gadgets. The COVID 19 pandemic have resulted in almost everything to be on digital platform.</p> <p><strong>Objective:</strong> To conclude after reviewing various studies (between Jan 2016- Dec 2020) which were focused on how digital eye strain adversely affects the function of meibomian glands and adds to symptoms of dry eye in computer users.</p> <p><strong>Study Design:</strong> Narrative review article</p> <p><strong>Methodology:</strong> Various articles were reviewed which got published in between 2014-2020 in indexed journals. Meibomian gland dysfunction significantly affects the factors such as blink rate, tear break-up time (TBUT), tear evaporation rate, tear film composition as well as corneal staining, we will find its significant effect and relation to digital eye strain.</p> <p><strong>Expected Results:</strong> Based on previous articles.</p> <p><strong>Results:</strong> Digital eye strain significantly affects the function of meibomian gland, thus results in altered and poor tear film that finally results in dryness of eyes.</p> <p><strong>Conclusion:</strong> Eyes with meibomian gland dysfunction, develop changes such as, reduced blink rate, shorter tear breakup time; altered tear film composition and disturbed ocular surface which adds on to symptoms of dry eye especially in chronic computer users.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Evaluation and Management of Cerebral Vasospasm after Subarachnoid Hemorrhage 2022-01-18T07:26:31+00:00 Hani Mohammed Alabdaly Othman Mohammad Alassaf Danah Kamal Kabrah Khaled Bassam Almadi Renda Ali Alhabib Rakan M. Alotaibi Abdullah Salem Almalki Fahad Azib Alghamdi Reema Abdullah H Albalawi Laila Hamad Hakami Moudhi Mohammed Alajmi <p>Constriction of the large and medium-sized cerebral arteries following an aneurysmal subarachnoid haemorrhage (aSAH) is a well-known condition that primarily affects the anterior circulation supplied by the internal carotid arteries. SAH is a rare but potentially fatal type of stroke. Across the literature, authors have defined vasospasm using terms such as "symptomatic vasospasm," "delayed cerebral ischemia" (DCI), "transcranial Doppler vasospasm," and "angiographic vasospasm." Because posthemorrhagic vasospasm causes significant neurologic morbidity and death, there has been a great deal of interest and research into its physiologic basis and developing effective preventative and treatment strategies. The triple-H therapy hemodynamic augmentation technique, which includes hypertension, hemodilution, and hypervolemia, has been an important part of the treatment. In this article, we'll look at cerebral vasospasm following subarachnoid haemorrhage, including its causes, epidemiology, evaluation, and, most importantly, management.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Comparative Investigation of Spot Kit Versus RTPCR in COVID Active Patients 2022-01-18T07:27:33+00:00 Lavanya Sehrawat Kishor M. Hiwale <p>On 31 December 2019, numerous pneumonitis occurrences of pneumonitis of uncertain origin, in Wuhan city, People’s Republic of China. The previously unknown origin was identified and designated the 2019 new Coronavirus in January 2020. WHO eventually dubbed it Coronavirus disease 2019 (COVID-19). The infection has been identified as Coronavirus-2, which causes severe acute respiratory illness (SARS-CoV-2). It was crucial to control the rapid evolving SARS-CoV-2-associated Coronavirus disease 2019 pandemic. In order to do so, highly sensitive and specific lab diagnostic assessments like RTPCR and Genome sequencing helped in identifying the cases at an early stage which further helped increasing the rate of survival. With time multiple tests were formulated which aided us but a need for the best and more accurate one was still needed. Some of these tests were quick but had a lower level efficacy while the old tests were accurate but are really slow. In this review article, we have formulated a comparative investigation of spot kit versus RTPCR in COVID active Patients from case reports, original investigation articles published by PubMed and Google scholar. With the help of these articles we have come a the best possible conclusion. The conclusion came out as COVID-19 patients found positive by RTPCR but negative by spot kit are uncommon to be infectious.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Determining the Role of Minerals and Trace Elements in Diabetes and Insulin Resistance 2022-01-18T08:06:02+00:00 Shivam Wankhede Jayshri Jankar <p>Minerals and trace elements are micronutrients that are required for human health but are only available in trace amounts. Regardless, their organic chemistry roles are well established. Micronutrient deficiencies have been connected to a number of human health issues. This critique focuses on a handful of these mineral and chemical element shortages, as well as their effects on polygenic illness and internal secretion resistance. The degree of trace components varies substantially across entirely different populations depending on the food composition. Trace elements play a major role in many boy processes. Trace elements and minerals are required for a scope of natural synthetic responses, just as working as chemical and protein stabilizers and cofactors. Certain elements control fundamental organic cycles by restricting to the receptor locales of the semipermeable film or changing the state of the receptor to keep specific particles from entering the cell. Micronutrients have a dual role: they keep cell structures stable at ideal levels, however their inadequacy prompts different courses, which can prompt illness. These imperative micronutrients assume a significant part in human wellbeing and have an immediate relationship with Diabetes Mellitus. Here we have reviewed the role of&nbsp; copper [Cu], selenium [Se], and Zinc [Zn].</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Overview on Small Intestinal Diverticulosis 2022-01-18T08:16:42+00:00 Mohammed Salah Hussein M. Alqahtani, Yazeed Saeed J. Al Mutibah, Salma Muidh N. Alomrani, Nawaf Farag O. Alshammari, Nasser Mohammed Ba Nafea, Bushra Abdulrahman Obaid H. Alaenzi, Yousef Ali M. Halawani, Omar Mansour A. Alzahib, Ibrahim Hussain D. Almalki, Musab Abdulrahman F. Albalawi, Faisal Saad T. Alqahtani, Turki Mushabab S. Alshehri, Mohammed Ali R. Al Sharif, Abdullah Owaidh Hadeel Majed A. Matbouli <p>Diverticulosis is a digestive system condition in which numerous sac-like protrusions form (diverticula). Diverticula in the small intestine are significantly less prevalent than diverticula in the colon. The aetiology of this illness is unknown. Peristalsis anomalies, intestinal dyskinesis, and high segmental intraluminal pressures are thought to cause it to develop. Small intestinal diverticula (SID) are incident is very low and rare, also they are usually asymptomatic.&nbsp; A nonspecific inflammatory condition might be the reason for the person's visit to the emergency room. In order to restrict the differential diagnosis and reveal a localized inflammatory lesion, ultrasound and computed tomography are frequently used. The objective of therapy is to reduce intestinal spasms, and the best way to do so is to consume a fiber-rich diet (vegetables, fruits, and cereals). Surgical treatment for diverticulosis is not required. Giant diverticula, on the other hand, need surgery since they are more prone to get infected and perforated. This review aims to overview the disease etiology, epidemiology, evaluation, and management.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## A Review on Gene Therapy 2022-01-18T08:48:56+00:00 Kumar Akarshan Nilay Smita Damke <p>Gene therapy is an emerging concept that gives hope to people with highly fatal conditions. It’s almost three decades since the emergence of the idea of gene therapy. Since then, hundreds of medical trials have been conducted worldwide from which we not only have gained enough knowledge but have experienced the need for it in society. Even though the concept of gene therapy has experienced setbacks, success stories are increasing exponentially, proof of which are recommendations and approvals of gene therapy from various medical associations worldwide. Our knowledge has grown over the years, and during this period, we have come across various safety datahelp help us develop better gene therapy approaches. The chief concept of this procedure is to revamp the vehicles for delivery which typically are nanostructures, plasmids, and viruses. The USA and Europe have been pioneers in gene therapy for a very long period; various reports have come from Asian countries, including India, in recent times. Our knowledge of the concept of gene therapy is increasing day by day. New information and data are being analyzed regularly to help provide gene therapies for different diseases. New research has led to various new drug applications for approval at the FDA. In this review, various points, from the history of gene therapy and its requirement in today’s society to the most recent advances in gene therapy, have been discussed. It also covers the works and advances of gene therapy in India.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Miracle of Gastroretentive Drug Delivery Systems: Approaches for Treatment of Gastric Disorders and their Future Perspectives 2022-01-18T08:52:04+00:00 Jitendra Gupta Pawan Pandey Reena Gupta <p>Nearly half of the world’s population suffers from <em>Helicobacter pylori</em> (H. pylori) and gastric disorders. It is the most common pathogenic bacteria that cause gastritis, gastroduodenal ulcer disease, and gastric cancer. Because short residence period, a narrow absorption window in the upper small intestine results in poor bioavailability with standard dosage forms. In addition, combination therapies develop antibiotics, undesirable responses, and poor patient compliance. Therefore, these drawbacks may overcome by Gastro-retentive drug delivery systems (GRDDs). A site-specific drug delivery system comes into force for boosting the therapeutic oral bioavailability, prolonging the residence site, effective medication through a small absorption window of GIT, and stimulating local effect in the stomach and duodenum. This review highlighted anatomy and physiology of gastric barrier, various GRDDS approach, merits, demerits for improving drug delivery, and future perspectives. Finally, this review may benefit researchers and industrialists working in this field.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Relationship between Anorexia Nervosa and Less Weight: A Medication Treatment Analysis 2022-01-19T09:14:09+00:00 Akshita Sharma Samruddhi Borse Ashish Anjankar <p>Anorexia nervosa is an eating disorder causing people to obsess about weight and what they eat. It is a characterized by a distorted body image with a fear of overweight. This causes abnormally low body weight. People with anorexia has an intense fear of gaining weight and distorted perception of weight. It mainly of two types-</p> <ol> <li>I) RESTRICTING- where person loses weight by severe limitation of food intake.</li> <li>ii) BEINGE/PURINGING- in which there are periods of food intake that are compensated by self induced vomiting, laxative or diuretic abuse or excessive exercise.</li> </ol> <p>Signs maybe behavioral or physical like obsessing about weight, weight gain fears, eating only low calorie food, bloated, constipated, irritable, distracted and not able to concentrate.</p> <p>It is prevalent in young women and teenage girls. People consider anorexia nervosa in connection with females but it can affect people of any sex or gender. Master agreement is for intricate, broad, long haul medicines that utilization a comprehension of the brain Physiology, precise standards and methods acquired from persuasive support treatment and argumentative conduct treatment. These therapies ought to be acted in various settings that meet the degree of power and level of management and clinical consideration required. There is a need to arrange crafted by a wide scope of clinical and mental administrations which frequently don’t cooperate. Due to the age bunch included and the also time span included, patient consideration frequently goes through many changes. This is the pinnacle of backslide and decompensation.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## A Review of Diabetic Retinopathy-Pathophysiology, Clinical Presentation, and Management 2022-01-19T09:15:40+00:00 Dipanshu Kesharwani Shreya Parashar Jerin Varghese Pradeep Sune <p><strong>Introduction: </strong>Diabetes is a metabolic disease that can lead to DR. So DR is nothing but a complication of diabetes mellitus which is characterized by gradual progressive loss of vision, macular oedema, blurred vision, floaters, etc. It is crucial to understand the severity of the disease and the risk factors associated with the disease to prevent the disease and reduce the incidence and prevalence of the disease. Also, there is a need for the screening of the disease to facilitate early detection of the disease and prevent the population from blindness. The aim of the review is to understand the disease according to its clinical features, grading and to learn more about the development in medicine for the management of the disease.</p> <p><strong>Methodology: </strong>Various literature search was performed up to November 2021 to understand the disease and its presentation in different stages. Various sources used are Pubmed, Mayo clinic, Google scholar. And then all research articles were thoroughly analyzed and combined to understand the pathophysiology, clinical presentation, and management of DR in different stages.</p> <p><strong>Result: </strong>DR is a microvascular disease and a complication of diabetes mellitus. There are various risk factors, hypothesis for the pathophysiology of the disease. All the information was summarized and presented in this review article</p> <p><strong>Conclusion: </strong>DR is a manageable disease and the best way to manage DR is by controlling blood sugar level, changing lifestyle and preventing the modifiable risk factors to prevent the progression of the disease.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## A Systematic Review of Auditory Loss and Its Management 2022-01-19T09:20:18+00:00 Shrawani Kulkarni Mansi Totey Shivi Agarwal Sagar Gaurkar <p>Auditory loss is a highly under recognised undermined issue which needs to be studied in extensive detail, as according to World Health Organisation, more than 45% of the global population has loss of auditory. The high percentage can be lowered if auditory enhancement techniques such as auditory aids or implants of cochlea were not underused. In order to increase the usage of these devices we must first understand the inner workings of the ear and the pathologies that may cause it to malfunction and then move on to proper management. Auditory loss as defined by WHO as the inability to hear as well as someone with normal auditory, these are persons having auditory thresholds of 20 dB or better than 20 dB in both ears. Auditory loss is often classified into two types, conductive auditory loss and sensorineural auditory loss which is a broad classification into which we can separate the various pathologies which bring about same outcomes. In conductive auditory loss, there is often involvement of external or middle ear where there is obstruction in relay of sound waves, hence, quite literally a problem with the conduction. Conductive auditory loss can be both congenital or acquired but most often can be resolved in a manner which will result in recovery of auditory. Sensorineural auditory loss occurs when there is dysfunction in the inner ear which often leads to progressive and permanent auditory loss. Though it can be congenital, it is most often acquired, especially when it is age related more commonly known as presbycusis which affects a large amount of the aging population. The management can be done through various processes including oral medications, surgical interventions and other manual procedures. Various assistive technologies like auditory aids and cochlear implants are also vital in preservation of auditory.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Determination of Risk Factors for DCIS Ductal in-situ Carcinoma of Mammary Gland 2022-01-19T09:23:18+00:00 Aneesh Bang Shailesh Nagpure <p>Mammary gland is altered gland present in skin whose main function in females is that it acts as a lactating gland while in males it is non-functional. When the sample of tissue of mammary gland is observed under microscope it was found that there are 2 major types of tissues which are present. These tissues are epithelial and stromal tissues. The epithelial component of the breast consists of 2 major parts: terminal duct-lobular unit (TDLU) which performs the main secretory function during lactation, and large duct system which performs the function of collection and drainage of secretions; both are interconnected to each other. During the menstrual age of a female patient there are different number of tissues (connective and adipose) is present in the mammary gland these tissues mainly perform as the support system for the mammary gland. Acini, ducts, and lobule are enclosed in intralobular stroma and is mainly formed of connective tissue(loose) myxomatous stroma and some dispersed lymphocyte. The ductal carcinoma is very serious Pathology of breast which is now a major concern in developed country and to a certain extent in developing countries also. There are many major risk factors which are responsible for the same. Some may be of lifestyle based or of genetic based. The treatment for the disease is now possible with advancement in the medical science.</p> <p><strong>Purpose for this review article is: </strong>Determine the cause affecting factors influencing factors and pathos physiological background of development of DCIS also to describe the gene involved in alteration of cell to enhance tumorous growth and the treatment therapy involved alongside the disease.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## Blunt Trauma Associated with Scleral and Retinal Injury 2022-01-19T09:29:01+00:00 Kushagra Khanna Swapneel Maruthkar Samarth Shukla Sourya Acharya Sunita Vagha Aditi Goyal <p>Ruptures of the eye normally occur at the point of impact, called a direct rupture, with a strongly focused blow. Because the force is dispersed according to hydraulic law, if the force is more diffuse, the rupture will be indirect and occur in the tunic of sclera of&nbsp; weak location . The Physical examination commonly reveals the presence of a scleral hole of the globe following ocular trauma, however hidden perforations are common. The limbus, the area right below the ocular muscles, and the area around the optic nerve are all vulnerable locations in the sclera. A number of posterior segment abnormalities which are&nbsp; caused by blunt trauma,&nbsp; trauma to the orbit , and due to trauma related to other systemic causes. There can be several type of&nbsp; injuries to retina which include (commotio retinae), injury choroid, retinal pigment epithelial oedema, retinal pigment epithelial oedema (choroidal rupture), and optic nerve (evulsion of optic fibres ) which can also&nbsp; occur due to blunt ocular trauma. After this kind of&nbsp; ocular trauma, retinal detachment, traumatic macular holes may be seen. Concussive forces also lead to&nbsp; damage to the orbital tissues near to the globe, which can also&nbsp; result in injury to various structures inside the eye like&nbsp; (chorioretinitis sclopetaria). other types of retinal injury include Diffuse retinopathy (Putcher’s retinopathy) can be caused by systemic trauma. They tend to be circumferential rather than radial, although if the hit is powerful enough, they may spread radially. The ones near the limbus are difficult to tell apart from lacerations, while the ones further back are easy to spot.</p> 2021-12-22T00:00:00+00:00 ##submission.copyrightStatement## A Review of Challenges in Performing RT- PCR for COVID-19 in Rural Healthcare Settings 2022-01-20T04:11:31+00:00 Priti Karadbhajane Aatmika Chauhan Shilpa Gaidhane Manoj Patil Zahiruddin Quazi Syed Anil Tambekar Abhay Gaidhane <p>COVID-19 pandemic has thoroughly shaken the community globally, including remote rural areas of all countries. Testing for SARS Cov-2 and clinical laboratory became the priority in hospital and healthcare settings during this pandemic. WHO confirmed the specificity and sensitivity of RT-PCR and announced the RT-PCR as the confirmatory test for the Covid-19 investigation. Governments mobilized all their vital resources towards establishing laboratories and enhancing the number of diagnostic tests to curb the spread of pandemics. In India's resource-limited limited settings, a molecular technique like RT-PCR faced several problems like improper laboratory setup, deficiency of trained health professionals, and many setbacks. This review reflects on challenges experienced in rural and resource-limited settings during the Covid-19 pandemic.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Utilization and Limitations of the Shock Index in the Emergency Settings 2022-01-20T04:38:54+00:00 Amal Saleh Akeel Awad Hassan Alamri Nada Ayed Alayed Abdulkarim Hamzah Alraddadi Yasser Mansour Aljufan Mohammed Yousef Alnazzal Nidal Abdullah Al Mutaileq Saba Saeed Baskran Hadeel Mohammed Alrowaily Abdulrhman Ebrahim Mughallis Mohammed Saeed Alamri <p>It is widely known that evaluation and prediction tools play an essential role in diagnosing and managing patients admitted to the emergency department. For example, evaluating patients by shock index can diagnose an underlying shock, indicating the need for resuscitation. Evidence shows that the shock index has been used in the emergency department to evaluate different cases. Due to various conditions, it can predict different clinical outcomes and mortality among patients presenting to the emergency department. In the present literature review, we have discussed the utilization and limitations of the modality in these settings. Our findings indicate that the shock index is a valuable tool that can effectively predict the need for blood transfusion and mortality among patients with traumatic injuries and other conditions, including sepsis and cardiovascular diseases. However, many factors can limit the efficacy of this tool in these settings. For instance, age, some conditions, and specific medication use might reduce the sensitivity of shock index in predicting mortality. In addition, some studies reported that the SIPA score could be better used for pediatric patients. Besides, most of the current studies are retrospective, limiting the quality of evidence in these studies. Accordingly, further studies are needed.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Role of Orth Biologics in Core Decompression for Femoral Head Preservation in Early Avascular Necrosis of Hip 2022-01-20T05:22:02+00:00 Mohit Dadlani <p>Head preserving procedures for Early Avasculathe Necrosis of hip are invariably effective in early stage. Core decompression (CD) is mostly performed modality for early stages of AVN having different success rates. Current review aims at determining efficiency of Bone marrow aspirate concentrate, Platelet rich Plasma, Bone morphogenic proteins and combining it with Core Decompression for early AVN stage, before femoral head collapse. To preserve a femur head damaged by osteonecrosis, treatment options should be applied early in the disease process for best results. When the articular cartilage becomes deficient to nutrients, it become more difficult to save a particular femur head, and eventually bone destruction occur, affecting hip biomechanics; articular changes eventually develop, necessitating arthroplasty or arthrodesis. Other early treatment techniques has been identified &amp; improved to improve femur head survival &amp; delay replacement.&nbsp; Analysis of 20 studies published between 2011 and 2020 was done of which 6 were retrospective &amp; 14 were prospective. PRP showed better survival and functional outcome, however 3 studies showed inconclusive evidence for its regular usage. BMAC enhanced efficiency of CD &amp; cell increment or combination of PRP for growth stimulation. Concluding, CD and BMAC worked effectively that CD only before femoral head collapse. But, PRP need more evidences for extensive utilization. Adding PRP to BMAC or culturing it would increase potency of CD with BMAC. Less data is available to assess efficiency of BMP-7 &amp; role of Intraosseous bisphosphonate therapy could be studied for inexpensive &amp; better alternate.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Variations of Influenza: A Review 2022-01-20T05:43:52+00:00 Aditi Ashokrao Kale Shital Mahajan <p>The seasonal influenza or flu remains a major cause of illness and death all over the world. It is the transmissible viral disease that affects whole of the respiratory tract and its severity ranges from mild to severe. The activity of influenza virus shows great periodic rhythm in different areas of the globe where neither hot nor cold and it is very uncertain in equatorial region where temperature is high throughout the year indicating that climatic components can drives periodic rhythm. Seasonal variability in infectious disease conditions is one of the ancient studies in human bioscience, dating from at least archaic Greece. Each year around the globe despite decade of research and drug development, annual flu viruses constantly cause outbreaks of influenza. Albeit we are starting to recognize the mechanisms that support the emergence of annual flu microorganisms, the onset and character of the evolving recent viruses remains unexpected. The flu pandemic is an important cause of the sickness and death of the elderly. Decreased immune function plays an important role in the worst outcome.&nbsp; Several factors which impact on the severity of annual influenza includes characteristics of the specific virus, use of antiviral drugs, and vaccination of influenza. The population which has high chances of getting this serious illness are: gravid mother, kids below the 5 years of age, the older age group, people with persistent cases (such as long-standing heart disease, lung disease, kidney, digestive, neuropsychiatric, hepatic disease or blood related disorder) with people with low immune status (such as HIV / AIDS, taking chemotherapy or steroids.&nbsp; In cooler climates, occasional outbreaks take place predominantly in the cold climate, while in hot climates, colds can occur year-round, originates the unusual epidemic.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Causes and Management of Tooth Discoloration: A Review 2022-01-20T05:48:00+00:00 Ashwag Siddik Noorsaeed Saba Abdulelah M Lanqa Rahaf Abdulrhman Alshehri Sara Abdulelah M Linga Reem Ahmed J. Alzahrani Yusuf Khalaf M. Al Ghamdi Aljawharah Aidh Alghamdi Shaima Fahad Alamri Rzan Abbas T Zaatari Amjad Alhassan Fathi Mohammed Abdulrahman Al bi habib Azza Anas Abu Dawood Maram Bakr Ibrahim <p>Tooth discoloration is a common dental occurrence that is linked to both clinical and aesthetic issues. The treatment of tooth discoloration has grown into highly complex, scientific, and therapeutic field by the twenty-first century. Dental surgeons must understand the etiology of tooth staining in order to provide an accurate diagnosis and thus management. Extrinsic causes produce tooth darkening, whereas intrinsic congenital or systemic influences cause tooth discoloration. Tooth bleaching is a safe and effective way to lighten the color of the teeth. Today, the physician has a number of options, including at-home tray-based bleaching treatments with low hydrogen peroxide or carbamide peroxide concentrations. Surgical options include dental restorations which is may be indicated for some cases. This review aims to summarize current evidence regarding causes, classification and management of tooth discoloration. Medline and PubMed public database searches were carried out for papers written all over the world on tooth discoloration. No predictive analytics technology was used.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Causes and Management of Esophageal Hematoma: A Review 2022-01-20T06:47:08+00:00 Mohammed Salah Hussei Fahad Ayed Alharbi Moath Saleh S. Alzahrani R. Alyami,Atheer Mohammed Seham Salem Almohammadi Emad Bani Alharbi Khalid Saad Alrashdi Linah saleh Abbas Feras Hassan A. Alshehri Hind Bandar H. Alrashedi Sarah Salem Almohammadi Reem Mussaed Aladwani Majed abdulaziz Almajdui Saud Saad Alradadi D. Almadani, Bassam Mowafak <p>Intramural hematoma of the esophagus (IHE) or dissecting intramural hematoma is a relatively unusual complication of acute mucosal and submucosal lesions that results in a blood accumulation between the layers of the esophagus. Esophageal hematoma is a rare condition that can develop spontaneously or as a result of trauma, poisoning, or medical intervention. Mallory-Weiss syndrome, Boerhaave syndrome, and IHE are all forms of acute mucosal damage of the esophagus, with IHE being the rarest of the three. In general, esophageal traumatic damage, including traumatic penetration and perforation, is uncommon, making IHE incidence and prevalence difficult to measure. Although most esophageal hematomas are asymptomatic, they can cause significant chest discomfort, dysphagia, and hematemesis. Esophageal hematomas should be distinguished from Mallory-Weiss tear and Boorhaave's syndrome, which they may closely resemble in such cases. Moreover, cardiovascular and respiratory diseases should be ruled out, therefore further tests such as an electrocardiogram, chest X-ray, and laboratory testing can be useful. The majority of cases resolve with conservative treatments, with symptoms disappearing in 1-2 weeks. NPO, IV fluids, acid suppression, and treatment of coagulopathy are all conservative procedures. This review aims to summarize current evidence on etiology, epidemiology, diagnosis and management of esophageal hematoma.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## A Review on Biofilms 2022-01-20T06:56:27+00:00 Dishika Dewanad Katre Mrinangka Deb <p>Formation of biofilm is the unusual way of survival for microbes forming the biofilm; pathogenic microbes increase their survival rate by showing resistance to the various antimicrobial therapy as well to other destroying agent. Establishment of biofilm vary from living to non-living surface that also includes the medical device and health care setting. Majority of the hospital born infection are due to the biofilm this occur due persistence of the biofilm on the medical device that lead to the spread of the infection among the patients. The biofilm also try to destroy the innate immunity of the host to which it cause infection. This review article describes the process of formation and the composition of biofilm. In most bacteria, formation of biofilm seems to happen in response to specific environmental stimulus and results in, formation or termination of biofilm matrix via the secondary messenger molecule c-di-GMP.</p> <p>In between formation and termination of biofilm development we have determined biofilm stages, but the currently available data seems to indicate that these transformations are usually monitored not by specific genetic machinery but by adaptive responses. The formation of biofilm can occur by multiple pathways. The structure of the biofilms is specific to a particular species as well as dependent on environmental and physiological conditions. Various subgroups of bacteria e.g., motile and non-motile bacteria can interact during biofilm formation, and this type of interactions during the formation can affect biofilm constitution.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Indications, Contraindications, and Clinical Significance of Holter Monitoring Device 2022-01-20T07:03:37+00:00 Marwah Yakoop Abdullah Traad Louai Zarei Mubarak Mohamed Althaidy Ibrahim Ahmed Alghamdi Abdulrhman Shamsuddin Alkindy Ibrahim Hassan Almalki Jomannah Fahad Barnawi Eman Hassan Alfayez Amjad Saad Alali Saleh Fouad Merza Fatema Shaker Hasan Saad Khalid Almaghrabi <p>Holter electrocardiogram monitoring devices are mainly indicated to assess the 24-hour heart rate and rhythm, enabling clinicians and physicians to evaluate the underlying disorders, possibly arrhythmias. The clinical significance of these modalities was apparent in different clinical events, including cardiac and non-cardiac ones. Many applications and clinical advantages were reported since the device was first reported, which changed the way how healthcare settings deal with and monitor cardiac rhythm and associated abnormalities. Evidence shows that Holter monitoring devices are useful in the appropriate patient populace and are very efficacious in diagnosing and following cardiac arrhythmias and other different cardiac conditions, which can significantly enhance the prognosis and management of cardiovascular patients. In this context, it has been shown that primary healthcare physicians should always be aware that many patients might be present with asymptomatic cardiac arrhythmias. However, not many studies have adequately assessed them in the non-cardiac population, which calls for conducting more future investigations. In the present literature review study, we aim to discuss the indications, contraindications, and clinical significance of using the Holter monitoring device based on data from the relevant studies in the literature.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Updates in Diagnosis and Management of Neonatal Cholestasis 2022-01-22T04:22:45+00:00 Nazim Faisal Hamed Alaa Saud M. Alyasi Abdulaziz Abdulrahman Abdulqader Bedaiwi Turki Saleh Alshehri A. Asseri Muhand Ali Amer Faisal Alqaishesh Alenaze Ihtifal Salamh Albanaqi Almhnd Talal F. Alenezi Khaled Abdulaziz Alanazi Zaid Ibrahim Z. Al Kharaan Kawthar Fawaz Mansor Alhamwan Mohammed Salem Slman Alshahrani Ahmed Basheer Ahmed Al Obaid <p>Neonatal jaundice refers to the yellow coloration of the skin and sclera of newborn babies that results from hyperbilirubinemia. About 50% of term and 80% of preterm babies develop jaundice in the first week of life. Jaundice is also a common cause of readmission to hospital after early discharge of newborn babies. Jaundice mainly develop due to two factors—the cessation of fetal hemoglobin as it is substituted with adult hemoglobin and the comparatively immature metabolic trails of the liver, which are incapable to conjugate and so expel bilirubin as quickly as an adult. This grounds an accretion of bilirubin in the blood (hyperbilirubinemia), causes the symptoms of jaundice. The typical results in an infant who has cholestasis are prolonged jaundice, scleral icterus, acholic stools, dark yellow urine, and hepatomegaly. Trying of diagnosis of children with jaundice must begin with the classification of serum bilirubin into total bilirubin and direct (or combined) bilirubin. Phototherapy is introduced based on risk influences in the nomogram and&nbsp; serum bilirubin levels. IV immunoglobulin is suggested for cumulative bilirubin levels from isoimmune hemolysis regardless of phototherapyand exchange transfusion is designated if there is a risk of neurologic dysfunction regardless beginning of phototherapy. This review aims to summarize current evidence regarding epidemiology, etiology, diagnosis and management of neonatal cholestasis.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Overview on Disorders of Oral Pigmentation 2022-01-22T04:32:24+00:00 Rakan Saifuddin Shaheen Abdulrahman Kamal Habash Firas Walid Basoudan Hassan Adnan Alwayel Bassam Walid Alarfaj Ali Naji Alwayel Jafar Ali Alaithan Abdullah Hamoud Al Gharbi Abdulrahman Aldayel Mohammed Jawad albaqshi <p>Oral pigmentation is a very frequent disorder that can affect any area of the mouth. Oral pigmentation can be a symptom of a physiologic or pathologic condition. There are a variety of reasons, ranging from basic iatrogenic processes like dental amalgam implantation to sophisticated medical illnesses like Peutz-Jeghers syndrome (PJS) and Addison disease. pathologic pigmentation can be classed as exogenous or endogenous. Drugs, tobacco/smoking, amalgam tattoos, or heavy metals can all cause exogenous pigmentation. Endogenous pigmentation is linked to endocrine abnormalities, syndromes, infections, chronic irritation, and reactive or neoplastic conditions. For any oral pigmented lesion that is not easily identified, clinicians must physically evaluate the oral cavity, gather clinical histories, and be willing to do a biopsy. Management depends on the causing factor of the oral pigmentation disorder and thus multiple approaches can be considered. The decisive therapy for early-stage melanoma is surgery, such as broad local excision with sentinel lymph node biopsies, elective node dissection, or both.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Opportunistic Infections Due to Overuse of Steroids 2022-01-22T04:45:42+00:00 Ovais Khan Ulhas Jadhav <p><strong>Background:</strong> Case reviews of rhino-orbital mucormycosis in sufferers with coronavirus sickness 2019 (COVID-19) are at the rise, specifically in India. Diabetes mellitus (DM) is a chance aspect for excessive COVID-19 and mucormycosis on its own. The purpose of this is to carry out a scientific review of the literature to decide the capabilities of Opportunistic Infections due to overuse of steroid.</p> <p><strong>Methods:</strong> Using key phrases like COVID 19, Mucormycosis, Mucor, Novel corona virus, and SARS CoV-2, a scientific review was carried out on the subsequent databases: PubMed, Google Scholar, and Cochrane Library.</p> <p><strong>Results: </strong>Increased mucormycosis in India seems to be the end result of an unholy trinity of diabetes (excessive genetic occurrence), immoderate corticosteroid utilization (will increase blood glucose and results in opportunistic fungal contamination), and COVID-19 (cytokine storm, lymphopenia, endothelial damage). To lower the prevalence of lethal mucormycosis, all efforts must be taken to keep ideal hyperglycaemia, and best careful evidence-primarily based totally use of corticosteroids in sufferers with COVID-19 is suggested. Glucocorticosteroids (GC) play an critical position withinside the remedy of neuro-oncologic patients. GC are used for the control of malignant mind tumour’s, both number one of secondary, neoplastic epidural spinal wire compression (NESC), as adjuvant chemotherapy of a few relevant worried device tumours and perioperatively in mind surgery. GC are believed to exert their effect on mind tumours especially through decreasing the tumor-related vasogenic edema, in all likelihood through lowering the extended capillary permeability of the blood-mind barrier (BBB),</p> <p><strong>Conclusion:</strong> Diabetes mellitus seems to result in a vicious cycle of hyperglycaemia and immunosuppression while coupled with the SARS COV 2 Virus and steroid treatment, which could cause excessive fungal colonization like mucormycosis.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Non-alcoholic Fatty Liver Disease and Cholesterol: The Lesser-known Links 2022-01-22T04:47:20+00:00 Anshool Kumbhare Sanket Bakshi Aman Agrawal Anand Bakre <p>Non Alcoholic Fatty Liver Disease&nbsp;refers to a group of hepatic histological abnormalities that ranges from noninflammatory intra-cellular lipid collection to NASH develop, fibrosis, or hepato-cellular carcinoma, which results from a mismatch between lipid supply and lipid clearance, is a characteristic of Non Alcoholic Fatty Liver Disease. Recent buildup aetiology. Hepatic FC build up in Non Alcoholic Fatty Liver Disease&nbsp; is caused by changes in intracellular cholesterol transport as well as a poorly balanced cellular cholesterol equilibrium characterized by an increased, and amplification of routes. With the induction of intra-cellular signalling pathway in stellate cells, Kupffer cells, including hepatocyte, FC build up causes liver damage. Inflammation and fibrogenesis are aided by the activation of Kupffer cells and stellate cells.. These episodes feed a never-ending cycle, which helps in forming steatosis while also promoting liver cells mortality, and hepatic injury, that can lead to disease progression. In this review, we highlight what we know about NAFLD's dysfunctional cholesterol homeostasis and look at the liver pathophysiologies and how they contribute to the disease's continuous liver injury. This knowledge's treatment implications are also highlighted. Inflammation and fibrogenesis are aided by the activation of KCs and HSCs. Furthermore, FC buildup in liver mitochondria causes mitochondrial malfunction, which leads to an increase in reactive oxygen species generation, as well as the unsettled response of proteins in the ER (endoplasmic reticulum), which leads to endoplasmic reticulum death.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Angiotensin Receptor Neprilysin Inhibitor [ARNI] and Its Implications Ejection Fraction Preserved Heart Failure: A Recent Review 2022-01-22T04:51:47+00:00 Alokita Trivedi Ajinkya Punpale Swarali Kale Sunil Kumar <p>This review article discusses the Angiotensin Receptor-Neprilysin Inhibitor which is remedy made up of two anti-hypertensive pharmaceuticals (sacubitril and valsartan). These medications may prolong life expectancy more than ACE inhibitors, which have been routinely used to treat heart failure. ARNi is now being used to treat individuals with heart failure those who have a low ejection fraction, which means their basic pumping chamber isn't working properly. Patients must be symptomatic despite receiving effective medical treatment for heart failure or be unable to tolerate a sufficient dose of ACE inhibitors to be eligible. Sacubitril and/or Valsartan are the debut members of a latest class of drugs described as angiotensin receptor neprilysin inhibitors to receive FDA approval (ARNI). The FDA has approved the medicine for the management of chronic heart failure sufferers with a lower ejection fraction and NYHA classifications II, III, or IV.</p> <p>Before commencing sacubitril and/or valsartan, patients must have to be able to accommodate ACEI or ARB. This intervention covers the instances, mode of action, approaches of administration, significant toxic reactions, risks and benefits, bioactivity, and surveilling of sacubitril &amp; valsartan so as to the practitioners can control patients under therapy in settings into which it implies as a part of the effective interprofessional.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## An Association between Diabetes and COVID-19 Patients: A Brief Overview 2022-01-22T04:55:43+00:00 Pragyna Parmita Reema Ghodmare <p>Coronavirus disease, a pandemic (COVID19), an illness caused by the severe acute respiratory syndrome Coronavirus 2 (SARSCoV2), is triggering significant illness and death. The current coronavirus disease SARSCoV2 2019 (COVID19) pandemic is a certain challenge for patients with diabetes. Advanced phase and the occurrence of diabetes mellitus, high blood pressure, and obesity rise the threat of hospitalization and contribute to the sternness and death of patients with COVID19.&nbsp; Furthermore, it further exacerbate the clinical consequences for those patients with diabetes who often suffer from comorbidities. In infectious diseases blood sugar control is often suboptimal, and Insulin therapy and Anti-diabetic drugs must be adjusted consequently. On the other hand, diabetic patient’s accessibility to the outpatient clinics is limited during the current season in order to advise on unconventional treatment options, in particular to the implementation of new telemedical strategies.&nbsp; Therefore, the COVID-19 disaster should be used as an opportunity to take a remarkable step in the care of patients with diabetes. COVID19 patients suffering from diabetes are related with a two bend upsurge in death and cruelty of COVID19 matched to people who don’t have diabetes additionally, data suggests that high blood &nbsp;pressure, diabetes and cardiovascular disease are peril factors important for progression and unfavourable of COVID 19 patients. It was a critical obstacle to conduct an examination that should contain numerous intriguing features, like a progressive age, addicted to smoking, and obesity that could possibly alter the deduction depending on the limited number of victims.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Retinal Detachment Following Cataract Surgery 2022-01-24T06:59:48+00:00 Pranav Pathak Pravin Tidake <p><strong>Introduction:</strong> The most frequently executed operating technique for cataract worldwide is the extraction of cataract. Development of pseudophakic retinal detachment (PPRD) following surgical extraction of cataract forms a major and growing quantity of rhegmatogenous retinal detachment (RRD) cases. PPRD is one of the severe, vision-related event and hence there is a need to find out the correlation between PPRD and cataract removal surgeries.</p> <p><strong>Objectives:</strong> There is a different risk of developing PPRD with different methods of cataract extraction. Attempts are made to find the consequence of the new cataract surgery on the danger of retinal detachment and additional factors that modify this risk by collectively drawing the findings of clinical trials investigations in this review. Also, the comparison is made among different cataract surgeries for incidence of PPRD development.</p> <p><strong>Conclusion:</strong> PPRD is an uncommon but significant adverse consequence. According to more recent research, phacoemulsification has a comparable or higher success rate in centers that are experienced with the process. While the exact risk of PPRD related to phacoemulsification is becoming apparent, the specific risk of PPRD attributable to phacoemulsification remains unknown.</p> <p><strong>Limitations:</strong> Small population numbers restrict the available literature. The number of PPRDs that occur is minimal due to their rarity; hence just four of our 16 studies had more than 50 PPRDs. Patients with a past history of RRD were commonly omitted from the available research, and several studies had extremely short follow-up periods. Due to the methodological inconsistencies between the numerous studies evaluated there was restricted assessment of the literature, making direct comparisons more difficult.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Bronchial Asthma in the Era of COVID-19 2022-01-24T07:03:37+00:00 Sameer Dhabalia Sourya Acharya <p>Coronavirus disease also (COVID 19) a worldwide pandemic contagious infection produced through the Coronavirus SAR.S-CoV2, and aberrant, overactive immunity and "chemokines" have been hypothesized as possible pathogenic reasons for rapid COVID 19 development. Because of a poor viral immunogenic reaction with a potential for aggravation evoked by groups of similar respiratory virus, asthmatic patients have increased susceptibility to and severe forms of covid infection. Existing research, however, has not found an anticipated proportion of patients with asthma between COVID patient. Features of the immune responses of type2 nature, such as type2 cytokines such as IL-4, IL-13 and eosinophil buildup, may give protection against the Corona virus. Furthermore, traditional asthma treatments like as inhalation of corticosteroid, AIT (allergens immunotherapy), and monoclonal antibodies (anti-IgE) may minimize the chance for disease by the causative agent in asthmatics by reducing inflammation and strengthening antiviral defense. The connections between COVID along asthma need to be researched upon more. Infection with a respiratory virus causes up to eighty percent&nbsp;of acute asthma attacks in kids and 50% of similar instances in adults, with Rhinovirus (RV) being the most common cause. (1) CoVs are also seen in asthma exacerbations, with an 8.4 % frequency. Surprisingly, no cases of asthma attacks&nbsp;have been reported as a result of COVID-19. As a result, during the SARS and MERS outbreaks, there seem to be minimal reports of asthma attacks. Such specific events still have to be thoroughly documented. The study's main goal was to find out how common asthma was among COVID-19 participants. COVID-19 was used to examine asthmatic and nonasthmatic patients' clinical features and comorbidities. We also looked at the possibility of being admitted to the hospital as a result of asthma and/or the usage of inhaled corticosteroids.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Multiple Sclerosis: Diagnosis and Treatment Management in Allopathy 2022-01-24T07:05:28+00:00 Vanee Meghrajani Anand Bakre Sourya Acharya Sunil Kumar <p>This article summarizes the literature related to the pathogenic mechanisms and treatment options for multiple sclerosis, an autoimmune, demyelinating disorder of the central nervous system. The etiology of MS is not known, both genetic and environmental factors are known to play a role. The risk factor that is strongly associated with MS Epstein-Barr infection. Other factors subjected to modification are childhood obesity, smoking and vitamin deficient individuals. Vitamin D deficiency as a risk factor has been proposed to explain the increase in prevalence of MS with increase in the latitude. The pathogenesis involves a response which is mediated by T-cell directed against myelin and other similar proteins. The function of B-cells in the disease process is not known. Recent advancements in the understanding of multiple sclerosis has led to development of disease modifying therapies, which in turn has led to a decrease in severity of the disease and relapse rates. Disease modifying therapies act by modulating or suppressing the immune system. Moreover, several drugs have shown effectiveness in certain studies. A number of treatment options have now become available making treatment of MS possible. The management of MS is divided into 3 categories:</p> <ol> <li>Treatment of Exacerbations</li> <li>Slowing disease progression with Disease modifying therapies</li> <li>Symptomatic treatment</li> </ol> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Laparoscopic Versus Open Mesh Repair in Treatment of Inguinal Hernia 2022-01-24T07:14:21+00:00 Vinay Narladkar Pankaj Gharde <p>Hernia, in the definition means to actually protrude. Inguinal Hernia is more common among all the hernias. Hernia repair is the most common surgery performed in all medical institutions. Inguinal Hernia (repair) is the most common performed surgery operatio. The contents of Ithe nguinal canal are, Spermatic cord and Ilioinguinal nerve Inguinaln Hernia presents in two types Indirect and direct hernia. Indirect type is the most common. The prevalence of Inguinal Hernia specifically is more common in males which is 25% and in females is 2%. As known till date, Treatment of hernia is a definitive surgery. 10-15% of hernias are direct. 50% of direct hernias that occur are of bilateral origin. And 35% of Inguinal hernias are direct. Etiology of hernia is-Chronic cough Smoking Straining Constipation Heavy work and Previous appendicectomy When in late 1984, Author Lichtenstein coined the term Tension-free hernioplasty, it changed the conventional surgrical technique by making mesh hernia repair more common. When in 1990 laparoscopic tension free technique which was introduced it was being promoted that it causes less pain shorter recovery period. There are multiple repair techniques for Inguinal hernia. This is a most common occurrence in men which does not have a particular effective surgical technique. This study is to determine wheather which technique is comparitivly more effective and useful in the future which will be effective as well as economical. This specific study required a meta analysis of randomised control trials. There are multifactorial reasons for deciding which srugical technique is best.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Covid-19 – Resurgence and Vaccination 2022-01-24T07:27:02+00:00 Sadhana Mishra Swaroopa Chakole <p>COVID-19 is raging through different countries in what is popularly known as second wave. Parallels can be drawn between second waves of COVID-19 and Spanish flu considering massive infectivity and case fatalities. Coronavirus 2019 is the disease that has become more ferocious day by day. As it was thought after lowering in infection cases, it is not over yet. Viruses, especially coronaviruses, are notorious for mutations The novel coronavirus has presented its notoriety by mutating into double mutant strain, which is wreaking havoc in the second most populous country, India. The health care infrastructure is almost collapsed and cannot cater such huge demand. Vaccinations must be the utmost priority as they have been effective in severe cases. Mutations needs to be monitored closely. Ramping up of health care infrastructure through public as well as private efforts can help a lot. Spreading authentic information can be the antidote for vaccine hesitancy. The herculean task of containing the deadly virus is not only on hospital care facilities but also on people.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Meditations on Relieving Alcohol Addiction 2022-01-24T07:33:59+00:00 Suraj Behere Ajay Meshram <p>Although prenatal alcohol causes growth retardation, mood disorders, adverse outcomes, and congenital disabilities, fetal alcohol spectrum disorders are not well diagnosed. In the world of alcohol spectrum disorders, 0.77, in Europe and North America, a high increase of 2-5%, which highlights the need for increased diagnostics and treatment. However, the history of self-reported breastfeeding has been weakened by fidelity, the absence of physical symptoms, and disorders of the fetus alcohol spectrum—There are various diagnostic differences in the system and ways to slow progress in diagnosing and controlling the disease. Neuroimaging brain structure, cortical Development, White Matter microstructure, and fetal alcohol spectrum disorders show abnormalities in functional connections in human beings. These approaches to disability development change as well as integration, high performance, memory, hearing, vision, behavior, ability to move. Promising trials of nutritional interventions and psychiatric medications continue with the goal of treatment. With 6,837 participants from the United States, the Netherlands, Italy, and Australia in 27 research projects, this book review evaluates the effectiveness of this process, which includes mindfulness, vipassana, and meditation. Meditation practitioners were able to reduce the reasons for drinking and get rid of alcohol cravings by strengthening awareness and self-control, which led to increased alcohol-related self-control, reduced stress, and eventually stopped drinking excessively. These results support the use of meditation in alcohol treatment programs. In addition, suggestions are being made to improve this strategy to effectively address alcohol abuse. -Meditation is a promising cure for alcoholism. This series of 16-week cases was designed to gather initial data on the effectiveness of meditation and evaluate the feasibility of research methods. Nineteen adults who relied on alcohol were enrolled in a hospital stay. Patients were randomized to either a standard course of chlordiazepoxide four times daily with additional medication as needed (fixed-schedule therapy) or to a treatment regimen that provided chlordiazepoxide only in response to the development of the signs and symptoms of alcohol withdrawal (symptom-triggered therapy). The need for administration of “as-needed” medication was determined using a validated measure of the severity of alcohol withdrawal.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Effects of Hypothyroidism on Women 2022-01-24T07:38:52+00:00 Aditi Shinde Vaishali Paunikar <p><strong>Background:</strong>&nbsp;To determine the impact of treating clinical hypothyroidism during gestation on maternal depressive symptoms.</p> <p><strong>Methods:</strong> Females with singleton pregnancies identified clinical hypothyroidism were randomised to prenatal thyroxine medication or sample in an auxiliary study to a multicenter trial. At the end of the pregnancy, the treatment was stopped. Females with overt thyroid disorder, diabetes, autoimmune disorder, or depression were excluded from the study. Before taking the survey medicine (between 3-4 months of pregnancy), between 32 and 38 weeks of pregnancy, and at one year post-delivery, contestants were examined for forbidding symptoms with the help of the Center for Epidemiological Studies-Anxiety zone(CES-D). The primary result was a score on the CES-D for mother depressive symptoms.</p> <p><strong>Results:</strong>&nbsp;In individuals with schizophrenia spectrum disorders, imbalanced thyroid hormonal state in general, as well as hypothyroidism and hyperthyroidism, were found in 29.3, 25.17, and 4.08 percent, respectively. These figures were similar to those seen in patients with mental abnormalities (23.24, 21.62 and 1.62 percent, respectively). Anti TPO positivity was found in 11 of the 18 patients with schizophrenia scale illness. There were no distinctions based on gender.</p> <p><strong>Conclusions:</strong>&nbsp;Patients with schizophrenia-spectrum disease and mood swings both had thyroid abnormalities. Patients with schizophrenia-spectrum abnormalities were more probably to have autoimmune thyroid disease than those with mood swings. The results highlight the importance of evaluating individuals with schizophrenia-scale abnormalities for thyroid hormone abnormalities and how it affects hypothyroidism.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Effect of COVID-19 on Mental Health of Health Workers 2022-01-24T07:44:02+00:00 Aarav Vats Pramita Muntode <p>Healthcare personnel have been put in an unusual scenario from the effect of COVID-19 epidemic, which had increased their psychological and mental health anguish. Anxiety, sadness, and stress among healthcare workers have been the subject of several studies. Increased psychological stress has been shown to have negative consequences for a person's physical health. Psychological pressures may increase the present health problems of the healthcare workers having pre-existing co morbidities. Frontline COVID-19 healthcare personnel are being pushed to their breaking points, leading to suicidal ideation. Furthermore, the stress of a having heavy workload and burnout may present itself in very serious ways in family relationships and a desire to leave their occupations. Future study should focus on the aforementioned negative consequences in order to aid in the development of mental healthcare approaches to manage COVID's psychologic impact on healthcare workers in an outbreak. for care&nbsp; and sustain the psychological well-being of healthcare workers, it is necessary to employ techniques and policies.&nbsp;&nbsp;&nbsp;&nbsp;</p> <p>The COVID-19 has been shown to have a negative influence on the mental health of healthcare professionals&nbsp; who work in disaster response. A large number of Health workers (PTSS) have been connected to posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms. As risk and resilience factors, exposure level, job title, year of experience, social and work support, workplace organization, quarantine, ages, gender, marital status, and copying style were all found to be significant. These characteristics must be considered when developing effective intervention planning for HCWs facing with the current COVID-19 outbreak in order to improve their condition and limit the risk of unfavorable outcomes [1].</p> <p>The objective of this article is to provide a brief review on the Effect of Covid-19 on mental health of health workers.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Epidemiology and Management of Unconjugated Hyperbilirubinemia 2022-01-24T07:54:27+00:00 Mohammed Salah Hussein Walid Hajaj AlOrainy Abdullah Mohammed Daghriri Khalid Mohammed Alotaibi Afnan Hamdan Owayn Alanazi Husam Abdulaziz Alkhathlan Raghad Abdullah Alsaaedi Najd Adnan Alamoudi Faisal Abdulmohsen Bin Talib Muzaynah Abdullah Al Ali Mohammed Abdullatif Alowaidi Naif salem H Alshammari Laila Mohammed Mujarribi Rayan Saad Ahmed Almalki Afnan Abdullah Ahmed Oraijah <p>Unconjugated hyperbilirubinemia is characterised by increased serum or plasma bilirubin (unconjugated) levels that exceed the laboratory's reference range. Unconjugated hyperbilirubinemia, is the most common cause of jaundice in newborns. Unconjugated hyperbilirubinemia is caused by bilirubin metabolism dysregulation, which includes increased synthesis, reduced hepatic absorption, and decreased bilirubin conjugation. Gilbert syndrome (type 1 and 2), Crigler-Najjar syndromes (type 1 and 2), and hereditary illnesses producing hemolytic anaemia are all examples of inherited conditions that can cause unconjugated hyperbilirubinemia. Crigler-Najjar syndrome is a sporadic condition, Gilbert syndrome is more common yet less dangerous symptom. Using phototherapy and plasmapheresis, the major goal of treatment is to lower the amount of unconjugated bilirubin. Intensive phototherapy is the basis of management of Crigler-Najjar syndrome type 1. Combined with plasmapheresis and in some cases liver transplantation may be required.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Role of Diet, Exercise for Improvement of Immunity 2022-01-24T04:15:49+00:00 Rushikesh Mawale Archana Dhok <p><strong>Background:</strong> Survival needs a healthy immune system. The immune gadget ought to be continuously on the lookout for indicators of invasion or hazard. Immune cells have to be able to differentiate between self and non-self-molecules and between probably dangerous non-self-molecules (which include those produced by using infections) and non-destructive non-self-molecules (e.g., from meals). The hyperlink between nutrients and vitamins and immune function is explored in this Special Issue of Nutrients.</p> <p><strong>Summary:</strong> We summarise the immune system's essential sports and how they interact with nutrition during existence on this prologue, highlighting the topics on this Special Issue. Macronutrients, micronutrients, and the microbiota within the gut all have a position in immune response modulation. Nutritional immune system law can help wholesome folks keep away from or postpone the emergence of immunological-mediated persistent diseases.</p> <p><strong>Conclusion:</strong> Continued looking at this discipline will subsequently result in a greater understanding of the position of meals and vitamins in immune features, making individualized vitamins a more viable alternative for enhancing human health.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Review on Moderate to Severe Asthma in Primary Care 2022-01-24T04:29:49+00:00 Faisal Suliman Algaows Abdulaziz Fahhad Alanazi Gheed Khalid Bamousa Areej Hassan Alatawi Bassam Ghazi Ahmed Khlood Awad Alshammari Hashim Mohammed Albuhayri A. Bahadi Omnia Abdullah Mohammed Saleh Safar Almalki Hanouf Abdullah Alhusayni Mohammed Ibrahim Saleh Alsaeed Abdullah Suwaymil Alrashdi Meshari Nada S Alotaibi Sajjad Ahmed Mohammed Alabbad Osama Alsallum Alanazi <p>Asthma is a chronic condition characterized by wheezing, coughing, and shortness of breath due to airway inflammation and hyper-responsiveness. Severe asthma accounts for a considerable amount of asthma-related costs, although being less common than milder asthma.&nbsp; According to a review of US studies, the expenses for people with severe asthma are roughly 1.7- to 5-fold higher than for people with mild asthma. A subspecialized severe asthma services provides the benefit of an organized, variety of approaches to validate the diagnosis, asthma severity and phenotype, and risk factors and comorbidities management. This multimodal approach frequently comprises a team of respiratory physicians, nurses, and support health specialists, such as physiotherapists, speech therapists, nutritionists, and clinical psychologists. In addition to evaluation and monitoring for common comorbidities, they provide physician review, lung function testing, blood tests, inhaler optimization, and general illness awareness. This review aims to overview approach to diagnosis and management of moderate to severe asthma in primary care settings.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Review on Surgical Management of Esophageal Rupture Saudi Arabia, Review Article 2022-01-24T04:18:22+00:00 Hashem Bark Awadh Abood Fatmah Khalid Aljudaibi Zainab Ali Alarayedh D. Alazmi, Dalal Ali Y. Arishi, Dekra Yousef A. Alomair, Abdulrahman Mohammed Zarbah, Jaber Mohammed J. Zarbah Suhair Mohammed Alhawkash Nedal Hatem Abada Sarah Fahad Alshammari Aseel Adel Shams Rahaf Ahmed Alamer E. Alotaibi, Hamoud Shaya Hazem Khairan Althobaiti Noor Ameen Al Abbad <p>Esophageal rupture presents a significant interprofessional challenge to the entire therapeutic team. The majority of symptoms are non-specific, which can significantly delay the time between perforation and final diagnosis. An esophageal rupture can be caused by a variety of pathophysiological factors.&nbsp; Instruments such as endoscope causes an elevation in the wall tension, particularly iatrogenic interventions, or a massive rise in intraluminal pressure caused by throwing up, chest injury, or abdominal injuries are the main stressors.&nbsp; The choice of the management plan and its outcome depends mainly on the site of the rupture.&nbsp; Although the perforation can occur at any site of the esophagus, there is a tendency to main areas that correspond to natural points of narrowing of the lumen. If esophageal rupture requires surgery, patients should be transported to the operating room as soon as feasible. Minor delays in surgical therapy can lead to higher rates of morbidity and fatality. This review aims to summarize current evidence on etiology, epidemiology, diagnosis, and surgical management of esophageal rupture.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Antibiotic Resistance in Clostridium Difficile: A Rapidly Evolving Threat 2022-01-24T04:40:52+00:00 Saumya Singh Gargi Mudey <p>The bacteria, <em>Clostridium difficile</em> the main pathogen associated with nosocomial infections is a gram positive, anaerobic and forms spores. The host and pathogen reaction results in a wide array of manifestation of the disease which ranges at one end as asymptomatic carriage to the other end as severe; toxic megacolon and thus making the treatment with antibiotic a challenge. To add upon the <em>Clostridium difficile</em> shows antibiotic resistance making its eradication almost impossible. This antibiotic resistance of <em>Clostridium difficile</em> has made it a global challenge over the decades, making it impossible for us to come to a conventional antibiotic to treat infections by <em>Clostridium difficile</em>. Several new strains of <em>Clostridium</em><em> difficile</em> have emerged following the unscrupulous use of antimicrobial agents and subsequent transfer of resistance-causing genes between virulent strains the subsequent generations. The resistance to antibiotics is still rampant and not in control, rather it is on rise as the bacteria has greater access to new host due to its mobility and very infectious nature. With the use of extended antimicrobial therapy, an acute danger of creating and spreading new resistant and multi-drug resistant strains always looms.<em> Clostridium difficile,</em> during its life cycle, produces spores, which give the organism the capacity to resist extremes of change in the environment. In a country such as India, with a high population density and thus forming a high potential platform for the spread of multidrug-resistant strains of <em>Clostridium difficile</em> isusually addressed. An understanding of the emergence of antibiotic resistance in <em>Clostridium difficile,</em> the mechanisms by which the <em>Clostridium difficile </em>acquires it and sensitivity to antibiotics becomes very important. Therefore, we present a review of the antibiotic resistance seen in <em>Clostridium difficile. </em>RT027 has emerged as the most virulent strain all the strain of <em>Clostridium difficile.</em> Drug resistance is via multiple pathways, including <em>erm, cfr, tet, </em>and <em>rpo B</em> genes, as well as <em>Gyr A</em> and <em>Gyr B</em>. Of these, tet is transferable to non-resistant strains. Thus, indiscriminate use of antibiotics has created multiple antibiotic resistant strains of <em>Clostridium difficile.</em> Judicious and planned antibiotic treatment is advisable.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## An Audit on HIV Infection 2022-01-24T07:58:40+00:00 Anmol Kamble <p>The human immunodeficiency virus (HIV) is a retrovirus which stores its genetic information in single-stranded RNA and which causes AIDS and HIV Infection. In Acquired Immunodeficiency syndrome the patient's immune system collapses, and the patient may be prone to infecting bacteria, viruses, and fungi. HIV may be transmitted through body fluids of infected patient body fluids including blood, seminal fluid, vaginal fluid, and breast milk. CD4 Cells, T-cells, and macrophages get infected by the human immunodeficiency virus HIV. This Infection results in low levels of T cells by programmed cell death of T cells which is associated with antimicrobial response during inflammation.</p> <p>The manifestations of Acquired immunodeficiency syndrome are due to opportunistic infection caused by other microorganisms naturally managed by person immune systems damaged by HIV infection. The rate of HIV transmission decreases with the condoms; it gives a comparable level of assurance. Human Immunodeficiency Virus transmission can be prevented among health care workers by wearing necessary personal protective equipment. The universal body fluid and blood precautions should be followed for all such invasive procedures. Face shields, gloves, and gowns are meant to be worn whenever performing invasive procedures. Laboratory workers should use safety cabins for handling specimens or doing lab procedures. Mouth pipetting should be avoided, and Automatic pipetting tools should be used. The work surfaces of the Laboratory ought to be cleaned with suitable disinfectant after spilling of sample. If the laboratory machine or devices are ,infected, they should be sterilized or cleaned with Disinfect before to fixing. After finishing laboratory testing or work, the laboratory workers should remove their protective equipment, wash their hands, and leave their protective equipment in the Laboratory.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## A Brief Study on Trichomonas Vaginalis 2022-01-24T08:00:21+00:00 R. Vijay Mrinangka Deb <p>In today's modern world women face too many challenges in front of them and in an country like India. There is still old system in which women can’t work. They are kept at home and indulged in household activities and their dreams don’t matter. they are not aware of the changes in their own body due to complete negligence or illiteracy. India is still one of the most illiterate countries in the world and its economy is still very low and beyond advancement.&nbsp; India is a developing country and nowadays people are starting to get aware about problems of women. Now in today's society women are allowed to work and they are not kept at their household but are given an opportunity as equals. But still there are many places in India which are not aware about problems faced by women and they don’t know how to help them and we have to provide them education about their own healthy bodily practices. Women in the modern and ancient world were affected by many such diseases which causes harm not only to them but also to their young ones if untreated. In the modern culture, now a days a new trend of having multiple sexual partners have become common and therefore, due to unsafe and unprotected sex practices and poor awareness, a lot of diseases has been transmitted worldwide to both genders. Trichomoniasis vaginalis is one of the most common sexually transmitted disease in women caused by a parasite which transmitted during unsafe and unprotected during sexual practices.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Epidemiology, Evaluation and Management of Anti-Phospholipid Syndrome 2022-01-24T04:43:58+00:00 Mohammed Salah Hussein Ali Ahmed Alsharif Yazeed Ibrahim H. Alhofair Abdulrahman Mohammed S. Alhuraysi Mohamed Fouad Alabsi Ibrahim Ahmed Kattan Khalid Anwar A. Abo Alela Mohammed Fawzi Mujallid Ferass Zeyad Timraz Zahra Ahmed Alhababi Tayil Mutiq Alrashidi Hazem Khairan Althobaiti Malak Abdulrahman Rajeh Ahmed Sadaka Kadi Amal Ahmad mobarki <p>Antiphospholipid syndrome is defined as the presence of antiphospholipid antibodies in the setting of thrombosis and/or pregnancy loss (APLS).Antiphospholipid syndrome (APS) is an autoimmune thromboinflammatory condition that affects individuals and their families in a negative and often fatal way. There are the two types of APS: Primary APS, which develops on its own, and secondary APS, which is linked to another autoimmune disorder, most often systemic lupus erythematosus (SLE). The HLA-DR7, DR4, DRw53, DQw7, and C4 null alleles have all been linked to APLS. APS is frequently misdiagnosed due to clinical diversity and a lack of diagnostic test consistency. The classification criteria were created to categorise APS patients for research reasons, but they can also be used by professionals to establish diagnoses. Unprovoked thrombosis is currently treated with long-term warfarin or another vitamin K antagonist drug. To avoid obstetric complications, low-dose aspirin and prophylactic heparin, primarily low-molecular-weight heparin, are utilised.In this article we’ll be looking at Anti-phospholipid Syndrome, it’s etiology, epidemiology, evaluation and management.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## A Literature Review on Prevalence and Causes of Childhood Blindness in India 2022-01-24T06:12:14+00:00 Prachi Gupta Vishal Kalode <p>Target of vision 2020- right to sight is to control blindness. Blindness in children affects their psychological and social growth. Various research were done on community and in blind school to know about the prevalence and causes of blindness in children. Total five- community based studies were done for knowing about the prevalence of blindness that also includes two refractive error studies for the children below 16 years of age in India. Result of data collected from blind school showed that blindness in children shifted from corneal causes to whole globe abnormalities.</p> <p>Blindness in children has different impact in different region based upon the socioeconomic development of that region, primary health care centre present in that region and also the eye care services provided to the people. The strategies to control blindness should be region specific. Solution has to be drafted based on regional challenges, in such a way that it helps to cure the blindness and also help to reduce the chances of blindness in future. Prevention strategies is targeted towards proper and timely immunization, control of Vit A deficiency by providing healthy and balanced diet and to educate people about the outcome of blindness and also providing tertiary level care to treat the causes. No available data is present to know about the causes and incidence of blindness in children. Rehabilitation programme done on community level help to identify the incidence and causes of blindness in children present in India.</p> <p>In this article we have discussed about childhood blindness, prevalence of childhood blindness, causes of childhood blindness, prevention of childhood blindness, control of childhood blindness, programmes running for childhood blindness. Refractive error such as myopia leads to blindness in children. School going children are at increase risk for developing blindness due to refractive error that is not corrected. Control of blindness in children is very important because a child suffer more years from blindness than adults. Around 1.4 million are affected by childhood blindness globally. Per year approx 500000 children are affected and became blind. The cause that is most common and in fact single for childhood blindness worldwide is vit A deficiency. By the year 2020, WHO has took the initiative to eliminate blindness. Some of the factors that can help are good nutrition to child, taking proper care of mother and child, proper immunization of mother and child, health education etc.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Brief Review on Shatavari (Asparagus racemosus) and Its Medicinal Uses 2022-01-24T06:22:51+00:00 Adish Kurdukar Sangita Jogdand <p>Asparagus racemosus is another name for shatavari. It belongs to the family asparagaceae. It is an adaptable plant as well. The adaptation of human body to mental and physical stress is said to be achieved by the help of adaptogenic herbs like these.</p> <p>Shatavari is an ayurvedic medicine staple that is made available in the form of analeptic for the wellbeing and vitality of person.</p> <p>It is popular among all therapeutic plants due to various active biochemicals present in it such as steroidal glycosides, saponins (Shatavarins I, II, III, and IV), flavonoids, polyphenols, vitamins and alkaloids (racemosol). Shatavari extracts from its different parts like roots, flowers, leaves and stems are effective in treating female organs which are involved in reproduction.</p> <p>For centuries, ayurvedic medicine has employed shatavari. However, there haven't been enough human trials to recommend it for any medical problem. It is, however, safe to consume it in modest doses, and doing so will allow you to benefit from its antioxidant and immune-boosting properties.</p> <p>Except for being an indigenous medicinal plant which known to be important for its sapogenin content which is the precursor of many active pharmacological steroids, it also has many medicinal uses like antioxytoxic (shatavarin four),spasmodic to uterus, hypertensive as well as hypoglycemic activity, anticoagulant activity, antiviral activity, anticancer and antidysentric activity. In ayurvedic medicine asparagus racemosus is considered as tonic specific to females .Despite of being a herb which is rejuvenating it is used in infertility cases of females, increases libido , enhances ovulation as well as folliculogenesis, also increases lactation.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## A Brief Study about Proteins: Organic Molecules in Biological Systems 2022-01-24T06:27:03+00:00 Aayush Chauhan Anupama Sawal <p>In addition to becoming increasingly common as the population becomes older, nutritional therapies that promote health and independence later in life are becoming more significant as a consequence. When people age, their physical size and strength may be maintained, which may contribute in the fulfilment of this goal to a certain degree, but not completely. Following the findings of new research, people may benefit from increasing the frequency with which they eat protein in their diet. According to the results, existing protein intake guidelines may be insufficient to help people in attaining their goals in this area. It is vital to identify alternate, more ecologically friendly sources of protein to replace animal protein since animal protein production has a detrimental impact on the environment. The impact of plant-based protein-rich diets, which should be followed by individuals at risk of malnutrition, on appetite in older persons is still up in the air at this point. But according to the findings of the study, they do. Protein is an excellent source of energy since it has been shown in tests to be more satiating than other equivalent macronutrients. It is also a good source of protein. According to the researchers, they are investigating the protein needs of an ageing population [those over the age of 40], as well as sustainable protein sources, the appetite-related implications of a plant-based diet, and future research aims. The findings will be published in the journal Nutrition soon after they are made public, according to the publication schedule.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Pathogenesis and Virulence of Chlamydia Trachomatis 2022-01-24T06:33:24+00:00 Aastha Parashar Mrinangka Deb <p>The pathogenesis of C. trachomatis disease is a multi-step process that includes: (1) infectivity and exposure to the organism (2) Susceptibility to infection and sickness related to the host's genetic makeup. Recurrence and chronic infections are also common in at-risk teenage and young adult groups. Antibiotic resistance to the primary medications used to treat C. trachomatis is becoming increasingly widespread, even with the correct diagnosis. Chlamydial infection can prevent tumor necrosis factor (TNF)-an-induced physiological apoptosis. Failure to adequately prevent, identify, treat, and remove infection increases the risk of pathogenicity and illness. The plasmid glycoproteins 1–8 (pGP1–8) encode eight open reading frames and most Chlamydia species. In the United Kingdom, there has been a recent increase in the prevalence of such illnesses, whereas, in the Scandinavian nations, there has been a drop, albeit there has been a minor increase in recent years (owing to the development of nucleic acid testing technologies, to some extent). However, it should be noted that reliable monitoring systems and population-based data are Chlamydia trachomatis 4 gitis. Chlamydia trachomatis is made plasma or accessible; moreover, it’s weakened in the vaginal canal of the mouse and nonhuman primate ocular tissue. The plasmid-free organisms ‘in vivo but not in vitro traits were completely mimeographs when pGP3 was inadequate, demonstrating that plasmid-encoded pGP3 is a critical virulence factor in vivo. Moreover, leading to a shortage of cost-effective moment in time tests, including methodologies consistent with strain typing during therapeutic, and the overall degree underlying therapeutic failure is foreign. Those disadvantages were exacerbated because the rest of the genders’ infestations were undiagnosed, allowing continuous silence propagation and developmental defects. The popular medications C. tachometers are becoming more prevalent with proper identification.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Role of Primary Care Physician in Management of Generalized Anxiety Disorder 2022-01-24T06:38:33+00:00 Faisal Suliman Algaows Hajar Saleh Alnajdi Khalifah Sulaiman Alsuqayh Basel Ali S. Alqahtani Arishi, M. Khaled Yahya N. Alomrani, Nawaf Farag Sarh Sami Abdulghani Farah Najeh ALShammari Khalid Ali Alsaykhan Hozan Mohammed Ali Sakinah Jawad Al Kuwaiti S. Alsanna, Haytham Bager E. Alhazmi, Essa Ibrahim Abdulelah Abdulrhman Najmi Yassir Mohammed Darwish <p>Individual survival would be impossible without anxiety, which is a natural and important emotion. Anxiety is considered a disease that requires treatment when it occurs in the absence of a threat, or in a disproportionate proportion to a threat, as well as when it&nbsp;prevents the affected individual from leading a normal life. Generalized Anxiety Disorder (GAD) is a widespread mental disorder characterized by excessive and difficult-to-control anxiety and concerns. as well as a variety of psychological and physical symptoms. Patients with GAD frequently visit primary care, and it is widely acknowledged that the majority of patients should be treated in this environment. Clinical practice guidelines advocate pharmacological (e.g., SSRIs and venlafaxine) or cognitive behavior therapy as first-line therapies for GAD. There are several proposed etiological explanations for GAD, including Freud's psychoanalytic theory, Stack's interpersonal theory, and the Stress Diathesis Model. The exact pathophysiological process of the disease is not fully understood. Patients with GAD frequently visit primary care, and it is widely acknowledged that the majority of patients should be treated in this environment. Clinical practice guidelines advocate pharmacological (e.g., SSRIs and venlafaxine) or cognitive behavior therapy as first-line therapies for GAD. In this article, we’ll be discussing GAD epidemiology, etiology, evaluation, and treatment.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Predominance of Inadequate Extent of Vitamin D Amid COVID 19 Patients and Related Threat in India 2022-01-24T06:41:22+00:00 Vaishnavi Uttam Goradwar Alka Rawekar <p>In 21 st century the COVID-19 pandemic is a serious global health threat. There is no substantiate therapy alternatives accessible hence both the advanced and emerging nations are struggling the load equitably. Contemporary studies indicate the creditability of treatment of Vitamin D also protrusion for COVID-19, in ambience having insufficiency more predominant. Although estimation of Vitamin D isn’t conventional in India, the current analysis aims over the extent of Vitamin D amid coronavirus infection sufferers <sub>.</sub></p> <p><sup>&nbsp;</sup>Extent of Vitamin D perhaps appraised in order to diagnose COVID-19 sufferers also assist to alter therapy concordat, relevant pre-emptive&nbsp; intercession of Vitamin D can change seriousness also course course of COVID-19.<sup>2</sup>Vitamin D inadequacy is more predominance amid COVID-19 patients. Its vital function in COVID-19 sufferers are not obliged to be disesteemed and Vitamin D supplementation&nbsp; amid sufferers can put a stop to exacerbating seriousness of ailment.</p> <p>Predominance of insufficiency Vitamin D amid COVID-19 sufferers also to arbitrate in case an inadequate extent of Vitamin D is notable threat to COVID-19 has been employed by this cross-sectional study.</p> <p>Contemporary medicinal cases too revealed appurtenance Vitamin D could lessen the occurrence of short term pulmonary affliction also seriousness of pulmonary tract ailments in grown-up kids. In accordance with thesis exploration , there aren’t alike discovery of medicinal case that has released by 1/7/20, respecting appurtenance of Vitamin D in capability of anticipation ,therapy of coronavirus infection. Over the appraisal , it is sum up that crucial and capable function of Vitamin D metabolic function out of kidney in anticipation also therapy of severe acute respiratory syndrome coronavirus 2, assisting to usher moderately nearer to executing that aim. The focusing points present over are: Vitamin D :may serve a role in forbidding severe acute respiratory syndrome coronavirus 2 affliction, evaluation of nephritic, metabolic processes outside kidney(extra nephritic) also synchronization, evaluation bimolecular procedure also multidimensional purposes afar skeletal stability, evaluation of confined modification of the immune response in human contagious ailments.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Review of Role of Telomerase in the Management of Age-related Macular Degeneration 2022-01-24T06:55:22+00:00 Anisha Ranjan Pravin Tidake <p>Age related macular degeneration is degenerative disorder, which is more prevalent in the Western, developed countries but can become a major threat in India as well. It affects the macula and leads to the senescence of retinal pigment epithelium. Most commonly affected is the central vision as macula is involved in central vision. On Optical Coherence Tomography (OCT) reduction in retinal epithelium can be seen along with accumulation of blood in the sub retinal space due to haemorrhage in the wet type of ARMD. It is a multifactorial disease and some of the major risk factors of this disease include sunlight exposure i.e. production of large amounts of reactive oxygen species (ROS), smoking, blue iris etc. It is more commonly seen in females and in Caucasians. It is of two major types which include the dry type (85%) and the remaining wet type. Wet type is characterised by neovascularisation whereas the dry type shown the presence of drusens and hyperpigmentation of the retina on examination. Clinical features of this disease include gradual loss of vision, but in wet type due to fragile vessels there occurs haemorrhage which can lead to sudden loss of vision. ARMD can be prevented by introduction of telomerase in the treatment line. Telomerases help in increasing the life span of RPE, thereby delaying the senescence of the retinal cells. Other treatment modalities also include the administration of lutein, xeathanthine, various antioxidants and anti-VEGF (vascular endothelium growth factor) medication. All these measures together can help in reducing the number of cases of ARMD and providing a better vision to the older population to increase the quality of life.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## A Comprehensive Review on – Acalypha indica Linn. 2022-01-24T06:56:29+00:00 M. Surendra Kumar S. Bhuvaneshwari M. Santhoshkumar A. Arunnesh M. Mohamed Ameen K. Sathiyapriya N. Astalakshmi <p>Medicinal plants possess high therapeutic values. It can act as remedies for various human diseases and ailments. <em>Acalypha indica</em> is an herbaceous annual plant which belongs to the family euphorbiaceae. Euphorbiaceae is a large family of&nbsp;flowering plants. The&nbsp;Euphorbiaceae&nbsp;consist of monoecious or dioecious, herbs, shrubs, vines, or trees. Latex is present in some major groups. <em>Acalypha indica</em> commonly called as kuppaimeni. It is mostly found in the backyards of houses and waste places throughout the India. This herb has wide range of therapeutic purposes and have nutritional properties. The plant widely used to treat various diseases like antibacterial, antifungal, acaricidal effects etc. This review article provides an insight into wide-range of information on the phytochemistry and pharmacological aspects of this species.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## A Retrospective Study on Agrocultural Poisoning: Causes and Effects 2022-01-21T04:11:39+00:00 Aditya Gupta Sudhir Ninave <p>A rise in the usage of pesticides in agriculture has coincided with an increase in the number of people who have been poisoned by them. Herbicides greater part are incessant agrochemical poisons, trailed by organophosphates. Numerous horticultural toxins, such as ethyl parathion and defoliant, have been banned in recent years. To discourage illicit use, they are combined with a coloring agent such as indigo carmine. Additionally, parquet has a "stanching" ingredient. Organochlorines work through a completely different process. Whereas Organophosphates are anti-cholinesterase, while organochlorines are anti-cholinesterase. Meddling with the transmission of driving forces through nerve cells. Organochlorines give out a kerosene-like odor when people die. The presence of organochloride in the gut contents or offal is used to make the diagnosis. Organochlorines are resistant to putrefaction and can be identified long after a person has died. Suicidal, accidental, and homicidal poisonings have all been linked to paraquat. This poisoning is moderately caustic, and ulcers around the lips and mouth is frequent. The severe alterations in the lungs, especially after the sufferer has lived a few days, are the hallmark of paraquat poisoning. Algicides, aphicides, herbicide safeners, fertilisers, and other agrochemicals are less often seen. Most governments have enacted regulations to avoid unintentional poisonings from these substances. The Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) was passed by the US government in 1962, while the Indian sovereignty proceeded The Insecticides Act in 1968. These laws, in addition via other things compel pesticide producers to include signal phrases on their labels to alert the public to their toxicity and associated dangers.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## COVID-19 in Diabetes Patients 2022-01-21T08:24:35+00:00 Padigela Rugvedh Akshad Wadbudhe Smita Damke <p>The 2019 coronavirus pandemic (COVID19) infected more than twenty-two point seven million human and resulted in the causalities of seven lakh ninety-five thousand people throughout the world. Diabetics are more prone to hitches and side effects caused by COVID19. The COVID19 pandemic overlaps with the already present high blood glucose pandemic that will produce bulky and suggestively more prone residents with high blood sugar levels and COVID19. This article will provide an outlook of the irrefutable suggestion for subordinate experimental products of COVID19 disease in diabetics compared to healthy individuals, including in specific group of individuals, such as broods, pregnant women, cultural minorities and folkloric. It also discusses similarities connecting COVID19 and it suggests that difficulty or pre-existing conditions in diabetics may exacerbate the infection process. Finally, this paper describes the outlook for chronic sequelae after COVID19 for more prone groups of diabetic individuals.</p> <p>The year 2019 was hit by a very miserable disease which turned into,&nbsp; a contagion known as COVID19 caused by SARSCOV2 it is a ribonucleic B infective particle. The infected people have self-limiting symptoms, mature publics and the people with other related health disorders were under high hazard, also the impermanence rate was high among them. There were many and some were asymptomatic, the medical professionals advised them to isolate themselves and monitor the clinical symptoms.</p> <p>The insignificant warning sign affected role were given supportive care and isolation in ambulatory setting Mature patient role those with other health disorders were closely scrutinized until clinical recovery was achieved. The COVID19 pandemic was terminal.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Psychological and Neuropsychiatric Long-Term Effects of COVID-19 2022-01-24T07:15:12+00:00 Mustafa Elsaied Esmail Mohamad Abdulrahman Alhazouri Nourah Abdulaziz Al Modahka Haidar Nasser Alhassan Arwa Abdullah Zabran Ali Jafar Almutawah Bandar Badar Almutairi Ali Shaker AlQadhib Hamad Abdulaziz Alshuaib Safaa Khalid Dhafar Amr Jumah Alalwani <p>Viruses are abundant, and several have been found to infect the CNS, resulting in neuropsychiatric disorders affecting the cognitive, emotional, behavioural, and perceptual domains. As the pandemic of the disease now known as COVID-19 has progressed, the psychological ramifications of the sickness have become more widely recognized. The present COVID-19 pandemic could have psychological effects for numerous causes. Certain situations, such as pervasive anxiety, social isolation, stress in health-care employees and other social workers, unemployment, and financial troubles, may make both infected and non-infected people vulnerable. Furthermore, psychological distress was found to be adversely linked with suggested health behaviours to reduce infection risk and favourably associated with non-recommended behaviours in quarantine conditions. The purpose of this research is to review the available information about the psychological and neuropsychiatric long-term effects of COVID-19. According to the existing literature, the COVID-19 pandemic has a significant negative influence on mental health, particularly in older persons with and without dementia. Viral infection, as well as the social isolation that follows in order to prevent it from spreading, has a variety of neuropsychiatric repercussions. To clarify such impacts and assess the long-term ramifications for the mental health of older persons, as well as explore alternative mitigating techniques, larger and more robustly designed research studies are needed.</p> 2022-01-15T00:00:00+00:00 ##submission.copyrightStatement## Pharmacology of Cisatracurium Besylate 2022-01-21T09:25:59+00:00 Vasam Rajesh Kumar Sanjot Ninave Vivek Chakole <p><strong>Background:</strong> In routine anesthesia practice, a variety of neuromuscular blocking agents are used. Cisatracurium besylate is a nondepolarizing neuromuscular blocking agent with an intermediate duration of action. Because of the high molecular weight and polarity, the volume of distribution is small. Cisatracurium besylate undergoes Hofmann elimination, making it an excellent choice for patients suffering from organ failure.</p> <p><strong>Methodology:</strong>&nbsp; This review article was prepared after a thorough study of the literature using data search engines such as Scopus, Pubmed, Web of Science, and Google Scholar. This article referred to prior Cisatracurium observational studies and case reports.</p> <p><strong>Review Findings:</strong>&nbsp; After learning pharmacology, uses, contraindications of Cisatracurium and reviewing the previous observational studies and case reports about Cisatracurium, this drug is used as a muscle relaxant during general anesthesia for tracheal intubation. It has been used successfully in critical care settings where patients were placed on mechanical ventilation and required complete skeletal muscle paralysis. Systemic or cutaneous release of histamine is not caused by cisatracurium.</p> <p><strong>Conclusion: </strong>Cisatracurium is a relatively new intermediate-onset, long-lasting skeletal muscle relaxant. This medication can be used safely in patients with hepatorenal impairment. It, like other muscle relaxants, can be used during elective surgical repair under general anaesthesia as well as in patients undergoing prolonged controlled mechanical ventilation. The only concern could be the cost effectiveness in comparison to other skeletal muscle relaxants on the market.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Impact of COVID-19 on the Management of Diabetic Retinopathy 2022-01-21T09:40:43+00:00 Pranav Gupta Pranaykumar Shinde Praveena Kher <p>Diabetic retinopathy (DR) is one of the most common causes of vision loss in people across the world. COVID- Despite the fact that early diagnosis and management guidelines for DR have considerably lowered burden of disease, 19 disease outbreak limitations have had an impact on actual world clinical management in the care of DR patients. This research includes the most latest treatment guidelines and outcomes for DR in the context of the outbreak.</p> <p>When contrasted to equivalent instants of time in 2019, intravitreal doses for DR have declined dramatically globally during the outbreak, spanning from around 30 percent to around 100percent reduction. After a substantial amount of time, several research on operational findings demonstrate a loss in visual acuity.</p> <p>In the treatment of DR, changing practice methods have led to lower intravitreal doses and cumulative loss of vision acuity during follow-up. It will be vital to continue reviewing practise guidelines as more COVID mutations arise.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## The Uses and Application of Platelet Rich Fibrin in Clinical Practice 2022-01-21T11:09:23+00:00 Kapil D. Bhangdiya Deepankar Shukla <p>Platelet derivatives are commonly used in wound healing and tissue regeneration. Different procedures of platelet preparation may differentially affect growth factor release and cell growth. Preparation of platelet-rich fibrin (PRF) is accompanied by release of growth factors, including platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF) and transforming growth factor b1 (TGFb1), and several cytokines. When compared with the standard procedure for platelet-rich plasma (PRP), PRF released 2-fold less PDGF, but 415-fold and 42-fold VEGF and TGF b1, respectively.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## A Review on: Smart Polymers used in Novel Ophthalmic Drug Delivery System 2022-01-21T12:17:29+00:00 Amol Tagalpallewar Shivani Chakankar Kalpesh Patil Akshay Baheti Manish Wani Satish Polshettiwar <p>Loss of sight or vision loss are utmost concerned worldwide health problems resulting in significant financial and public loss. Eyesight helps one to capture signals from the surrounding environment and depict clear visual images. Drug delivery to the eyes has been seen as a significant task for the reason that an eye has different defensive boundaries and drug clearance system resulting from an exceptional structural and functional nature of eyes. Formulation administered into the eye in the form of regular ophthalmic formulations leads to less absorption of drug. Therefore, approaches have been carried out to advance a novel, nontoxic and effective ophthalmic drug delivery system to control the difficulties occurring by the regular formulations. Latest innovation in pharmaceutical drug design has produced stimuli responsive in-situ gel system providing continuous release action and increased ocular drug bioavailability. They act by undergoing phase conversion from solution to gel owing to the variation in ocular temperature, ions and pH in the ocular environment. Stimuli transformed gel is formed in the region of cul de sac thus combating the limitations of regular ophthalmic formulations such as less retention time and fast nasolacrimal drainage within the eyes<strong>.</strong></p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Cutaneous Manifestations of COVID-19 2022-01-21T12:23:54+00:00 Vartika Dube Adarshlata Singh Vineet Dube <p>Although the pathogenesis of the newly discovered 2019 coronavirus disease is still unknown, it has several extrapulmonary manifestations, such as cutaneous lesions. Among those who took Covid, the American Academy of Dermatology reports that 22.2% of patients had morbilliform or pernio-like rashes; 17.8% had papulosquamous purpura; 16.8% had macular erythema, and 7.8% had retiform purpura. According to the available information, around 450 patients with (COVID-19) infectious disease have developed a variety of skin lesions. While it's understandable that dermatology consultations have been scarce during this pandemic and that the primary focus has been on systemic manifestations of covid, it's also far from surprising that cutaneous lesions have gone undiagnosed. The patient's ages ranged from 2 months to 75 years (The condition is most commonly encountered in elderly persons).</p> <p>&nbsp;Cutaneous symptoms are less common in India. According to reports compiled from various sources, skin lesions are more common in Albinos, Scandinavians, and Caucasians than in Indians, Mongolians, and Africans. On the other hand, skin lesions were more prevalent during India's second COVID-19 wave (most likely due to an increment in the number of people affected). Patients with a mild form of the disease were more likely to have pernio-like lesions, while critically ill patients only had retiform-purpura (those who required ventilator support and were on the verge of organ failure). Individuals with COVID-19 have been found to have urticarial rash, erythematous/morbilliform rash, papulovesicular exanthem, chilblain-like patterns, livedo reticularis, and purpuric-vasculitic patterns, among other dermatological issues. Chilblains and the Multisystem Inflammatory Syndrome (MIS) in children (2-15 years) are also skin manifestations of (COVID-19), which are more commonly seen in the UK and Western Europe. During the second wave, there were two cases of a multisystem inflammatory syndrome associated with chilblains in India.&nbsp; Covid-19 cutaneous presentations occur in 0.2% to 19.4% of people, but the frequency and timing are difficult to pin down. There is also a variable degree of association between the severity of the illness and specific skin manifestations.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## A Brief Overview of Diabetic Retinopathy 2022-01-21T12:35:36+00:00 Aditi Rajput Sejal Mankar Shashank Banait <p>Diabetic Retinopathy (DR) and diabetic macular oedema are caused by multiple &nbsp;retina's&nbsp;capillary changes and increased retinal blood vessels permeability, which contributes to the emergence These treatments aren't always beneficial in all patients, and possible adverse effects can linger in a considerable number of people. One of the mechanisms that is found is the plasma&nbsp; kallikrein-kinin system (KKS). The formation of intraocular KKS causes retina’s capillary permeability, vascular dilation, and retinal thickening in preclinical investigations. possibly distinct physiologic pathways, according to proteomic study from the vitreous of eyes with DME. Furthermore, proteins linked to substantially more closely linked to the KKS route than&nbsp; discovered to be an effective way to reduce diabetic mice in preclinical investigations. An early phase I human study of a new plasma KKS inhibitor for the management of DME is now underway to assess the approach's safety and serve as a first step in translating basic science discoveries into a novel therapeutic involvement. Many years of study of the etiology plus treatment has transformed our understanding of the condition. Because neurodegenerative illness precedes and coexists with microvascular alterations, diabetic retinopathy is&nbsp; characterised as a neurovascular disease rather than a capillary disease. The intricacies of the pathways implicated in various phases of disease severity, on the other hand, continue to be a difficult challenge for drug development. Laser photocoagulation is now one of the best investigation&nbsp; for treating proliferative diabetic retinopathy, however it is rapidly being phased out for diabetic macular oedema. Inhibitors of vascular endothelial growth factor, which were recently discovered, are changing the treatment of diabetic retinopathy, particularly diabetic macular edema . Anyhow, anti-vascular endothelial growth factor medicines do not work in all individuals, highlighting the reality that diabetic retinopathy is a complex illness. To improve our perceptive of how retinal anatomy affects visual function, more research is needed. This is expected to contribute to a greater knowledge of the disease phenotype based on therapy reactions to specific drugs, and also the creation of a strategy to improve the company of different phases of seriousness. In the Diabetes control and complications trial (DCCT) main preventive and secondary intervention cohorts were found to be older at baseline than the WESDR groups, with an elderly&nbsp; age of finding, a lower haemoglobin A1c (HbA1c) level, and more recurrent injections and monitor, but there were few other significant changes.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Obesity Related Cardiovascular Diseases and Diagnosis 2022-01-22T06:32:20+00:00 Avinash Padale Aditi Mishra Tamana Manwani Anil Wanjari Sourya Acharya <p>Obesity is defined as a condition in which the amount of adipose tissue in the body is excessive and there has been many researches proving a strong correlation between cardiovascular diseases in obese individuals. The elevated incidence of many identified risk factors including hypertension (HTN) ,diabetes mellitus (DM), and hyperlipidaemia, it could be single and as disease is transmitted to a degree that is indirect great degree for higher incidence of cardiovascular disease in obese people. Obesity, on the other hand, has numerous direct effects on the cardiovascular system, which will be explored in depth. We also look at how to overcome the numerous problems that obesity poses in the performance and interpretation of cardiac tests. Adiposity raises danger of unfavourable cardiovascular system (CVS) problems in a variety of ways. These effects may be mediated indirectly by metabolic syndrome danger elements such as hyperlipidemia, HTN, and dysglycemia, or by the impact of adiposity-related sleep disturbances. Dysmetabolic syndrome are linked to truncal adiposity, associated fat spread mostly part of the abdomen as compared to periphery. The circumference of waist are effective measures of adipose spread and higher amount indicate a higher danger of cardiovascular disease. However, there are several direct consequences of adiposity on CVS that aren’t influenced by metabolic syndrome factors or related effects of sleep disturbances. This essay will mostly focus on these topics. Because of restrictions in physical examination as well as different tests such as electrocardiograms (EKGs), imaging examinations, and cardiac catheterization, obesity also makes it difficult to make an accurate cardiovascular diagnosis. We'll talk about these restrictions and offer suggestions for how to overcome them.</p> 2021-12-23T00:00:00+00:00 ##submission.copyrightStatement## Endometriosis in Postmenopausal Women 2022-01-22T06:55:46+00:00 Anjali Chimegave Kalyani Mahajan <p>There is functional endometrial tissue anywhere other than the uterine cavity and uterine mucosa with a penchant for infiltration and invasion. It is labeled as endometriosis. It is a chronic inflammatory condition. It can occur anywhere, but the most common site is the ovary. It is also labeled as endometrioma or Chocolate cyst. Other common sites for endometriosis are the pouch of Douglas (POD), posterior leaf of the broad ligament, uterosacral ligament, fallopian tube. Barin is the least common site for Endometriosis. Endometriosis is never seen in the spleen. This condition, which impacts 10–15 percent of women of childbearing age, is characterized by pelvic pain and infertility. Dysmenorrhoea, adnexal mass, and infertility are the classical triad of clinical features. This classical triad is mainly seen in the women of childbearing age but can also be seen in the women after menopause. Endometriosis is an estrogen-dependent condition that tends to go away on its own or after surgery.&nbsp; It tends to regress after menopause because it is an estrogen-dependent condition. Endometriosis is associated with cellular and humoral immunity also. Impaired immune function may contribute to the development of endometriosis. Despite this, up to 2.2 percent of women after menopause are affected. Endometriosis in postmenopausal women is seen mainly after elevated systemic estrogen concentrations or excess exogenous estrogen intake. In most women, symptomatic endometriosis after menopause begins more than ten years after menopause in the absence of elevated systemic estrogen concentrations or exogenous estrogen intake. This is necessary to understand the pathophysiology and management of endometriosis after menopause.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Management of Obstetrics and Gynecological Patients with COVID-19 2022-01-22T08:08:01+00:00 Arjun Heda Sapna Sharma Arpita Jaiswal Singam Neema Achary Shaina Dutta <p>Since December 2019, the Coronavirus illness, commonly known as COVID19, has quickly spread from Wuhan, China. The first COVID-19 patient was identified in Italy on February 20, 2020, and developed respiratory failure, prompting hospitalization to the critical care unit (ICU). For more than a year, the highly contagious and lethal coronavirus illness has been causing havoc on the earth. It has progressed to a pandemic level affecting the lives of millions around the globe. The condition can afflict anybody, and there is currently no definitive treatment. Pregnant women do not appear to be more susceptible to infection than the general population. On the other hand, pregnant women have a different immune system and a stronger overall response to viral infections, which could lead to more severe symptoms in some cases, such as COVID-19. COVID-19 presents a minimal overall risk to expecting moms. On the other hand, pregnancy increases the chance of COVID-19-related severe illness and fatality. On the other hand, pregnant women may be more susceptible to serious, potentially fatal respiratory illnesses. Furthermore, research shows that maternal-fetal transfer occurs via contact with respiratory secretions, excluding transmission in the womb. As a result, the best way to manage breastfeeding is uncertain, and the infant may need to be isolated from the mother for a short time. Finally, because healthcare providers are at a higher risk of infection during birth, further measures must be followed along with a proper management and care plan of both the mother and the health care provider.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Age Wise Social Impact of COVID-19: Covering All Aspects of Life 2022-01-22T10:21:07+00:00 Dhruv Jindal Shreyash Bhole <p>The Coronavirus infection has drastically modified and converted the lives of innumerable members of the general population and has affected every aspect of life in significant way.&nbsp; Worldwide closure and precautionary procedure and actions have separated the humans, counterfeit the world wealth, and restricted access to physical and psychological medical management.&nbsp; These precautions may be compulsory to keep down the unroll of the infection, the gloomy effects of physical, mental, and communal aspects are noticeable. The COVID19 infection has dramatically modified the lives of countless members of&nbsp;the overall&nbsp;population, significantly affecting all aspects of life. This study aims to analyse existing research on&nbsp;the consequences&nbsp;of the COVID19 pandemic&nbsp;and canopy&nbsp;the wide-ranging effects of the pandemic on one platform. This study aims to review the existing research on the wide-ranging impact of pandemic onto one platform under four categories- children, youth, adults and older people for the future uses. Issues covered under these categories are given below:-&nbsp;&nbsp;&nbsp;</p> <ul> <li>Impact on children- This study will cover matters such as child sexual abuse, effect on people with disability, effect on routine immunizations and a child’s perspective towards illness.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</li> <li>Impact on youth- This study will cover matters like online learning difficulties and learning loss, effect on sports, and technological impact.</li> <li>Impact on adults- This study will cover issues such as increased rate of unemployment, divorce, Effect on sexual life and parenting difficulties.</li> <li>Impact on older people- This study will cover concerns like loneliness, age discrimination, decreased social life and social interactions, difficulties in accessing technological services, sleep disturbances, decreased exercise, and fear of death.</li> </ul> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Psychological Impact on Post-COVID Patients 2022-01-22T10:55:45+00:00 Bramhni Bongirwar Anjali Vagga <p>The most significant thing in a mental health disorder is its prevalence. Here we compare the consequences of pandemics on people’s mental health with the recordings of ASD &amp; PTSD in the last forty years; we will prove that they are primarily different. The symptoms of mental disorders differ; therefore, the chances of good treatment differ are significantly less. We tend to cancel some chances of a new mental disorder, considering a new one can emerge from this pandemic. We have to determine the extent of what pandemics are doing to one’s mental state. The author planned medical care for immediate support.</p> <p><strong><em>&nbsp;"Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." Thus mental health is more than just the absence of mental disorders.</em></strong></p> <p>Mental health is a state of mind in which he can realize his capacities and abilities, cope with stress, and have optimal productivity.</p> <p>Mental health is essential for a person for his own sake and the collective good of society; for good mental health, a person should be content with his life. Thus the prevention and restoration of mental health are essential for individuals and society. Multiple social, psychological, and biological factors are responsible for knowing a person's mental health.</p> <p>Social factors, stressful conditions in the workplace, gender discrimination, and unhealthy lifestyle are also responsible for the detoriation of mental health. There are specific psychological and personality factors that make people vulnerable to mental health problems. Biological risks include genetic factor.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Review on Targeted Drug Delivery in Pancreatic Cancer 2022-01-22T11:02:11+00:00 Chinnarao Pinisetti Vimal Arora <p>Targeted delivery systems are the advanced systems where the active pharmaceutical ingredient is delivered accurately to the specific site for the necessary pharmacological action and better therapeutic Index. The main motto of these transport systems is to increase the drug activity at specific target sites with a low amount of drug as compared to high doses of conventional dosage forms. This helps to reduce the side effects of medication, as the drug acts directly at the specific tissues or cells and shows its intended action at the given concentration without getting dissipated in the other areas of the body or the surrounding environment. The evolution of these new approaches plays a vital role in the treatment of chronic diseases like diabetes, tumors, and cancer, etc. This context mainly talks about the delivery agents for the treatment of pancreatic cancer, delivery agents, and the recent advancements made in this area.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Psoriasis and Cardiovascular Risk Profile: A Comprehensive Review 2022-01-22T11:09:50+00:00 Deema Devi Laishram Ulhas Jadhav <p>Psoriasis is an inflammatory immune-mediated, chronic skin disease with many co-morbidities involving complex pathogenic interactions between the innate and adaptive immune systems. In people living with psoriasis, there is an increased probability of having other health conditions such as cardiovascular illnesses. A growing number of studies show that classic risk factors which lead to cardiovascular diseases and metabolic syndromes are common in psoriasis patients, leading to a more significant cardiovascular burden. The present article aims to synthesize what is known in the literature concerning the epidemiological and clinical data relating to cardiovascular risk factors and psoriasis. The many pathophysiological mechanisms which justify this association for stratification of the risk profile in psoriatic patients are also reviewed, along with the implementation of different cardiovascular prevention strategies. The benefits and drawbacks of the numerous therapies frequently used to prevent cardiovascular diseases and analyze specific psoriasis medications that impact risk factors of cardiovascular illnesses or the significant arterial events in psoriasis patients. The detailed assessment of the various cardiovascular risk profiles in psoriasis patients has been discussed profoundly. Also, the several mechanisms involving the inflammatory cytokines released from the cells during inflammation, especially in dyslipidemia, atherogenic process resulting in plaque formation, hypertension, diabetes, obesity, and even the efficacy of statins, have been reviewed from the sources of different articles published in different parts of the world.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Effects of Coronavirus on Human Cardiovascular System 2022-01-22T11:22:27+00:00 Bhagyesh Puri Smita Damke <p>SARS-CoV-2 has many biological traits, the pathogenic virus that caused the acute respiratory syndrome (SARS) epidemic in 2002. Clinical investigations have also discovered a link between CORONAVIRUS and cardiovascular illness. The coronavirus disease is caused by binding the viral spike protein to angiotensin-converting enzyme 2. It has spread around the world, affecting millions and millions of people. CORONAVIRUS looks to be connected to even worse results and an elevated risk of mortality in individuals before cardiovascular illness, even though CORONAVIRUS can cause myocardial damage, arrhythmia, acute coronary syndrome, and venous thromboembolism. Possible drug-disease interactions are becoming more concern for individuals with CORONAVIRUS and associated cardiac and vascular esses. By integrating our expertise of the virus's genetic makeups with clinical findings, we can better grasp the possible processes causing CO VID-19. This might pave the door for creating medicinal and pharmaceutical products. Pulmonary embolism is one of the most common acquired conditions in generalized hospitalized patients but an uncommon finding in patients with Covid. It has a penchant for thrombosis fueled by at least two separate yet interconnected processes i)A state of hypercoagulability and is Large vessel thrombosis and thromboembolism. ii)Direct vascular and endovascular damage. In situ microvascular thrombosis is caused by endothelial damage.PE can be presented in patients admitted to the ICU despite standard prophylactic anticoagulation. Deep vein thrombosis is present in significant cases of PE.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## A Brief Review on Dementia 2022-01-22T11:35:28+00:00 Amisha Nayudu Avinash Taksande <p>Dementia is a cognition decline that interferes with daily life functions. It is a syndrome cause of dementia is neurological and some medical conditions. Sometimes other diseases can contribute to dementia. Dementias of the neurodegenerative kind are common in adults, while injury to brain and brain tumors are common in students. In recent years, there have been advancements in neuroimaging and the correlation of clinics with pathology, and in the development of biomarkers, doctors still await modifying therapies for neurodegenerative dichasia.</p> <p>There have been only a few articles on dementia within the IJP.</p> <p>Most of the patients found are above the age of 60. Therefore, community-based interventions for the management of diseases like dementia are essential. The effectiveness of those resolves must be acknowledged. Also, the danger factors for dementia should be identified.</p> <p>It is statically proved that folks will suffer from dementia more within the near future. Thus research during this field is significant for developing service and training. This paper aims to review research published on dementia in people above 40 years.</p> <p>The cases of dementia increase with the increase in age of the person. Dementia makes people more and more dependent on others. Dementia is increasing challenges to our society and healthcare system. Clinical and pathological criteria for the significant dementia-causing diseases overlap significantly. The emergence of symptoms decades into the pathophysiological process hamper targeted disease therapy. A significant number of research initiatives are underway to identify potential biomarkers of disease processes earlier. The association of both overt cognitive decline and underlying pathophysiological processes with normal aging complicates identifying disease processes early within the spectrum of normal aging.</p> <p>Once the diagnosis is established, prognostic measures are required and are still lacking, as disease trajectories between individuals can vary greatly. Globally, governments recognize these challenges. Investment and research infrastructure are beginning to reflect the scale of the need. Drugs conferring symptomatic benefit are available, and memory service structures exist to diagnose dementias and guide management. The personal impact of dementia on patients and families is also increasingly recognized, with discussion in the media surrounding famous sufferers and dramatizations in literature and film. Herein we attempt to describe the current landscape of dementia.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Blood Coagulation: A Potentially Lethal Manifestation in COVID-19 Patients 2022-01-22T12:17:33+00:00 Varun Tiwari Abhishek Ingole <p>Blood clotting is a well-known phenomenon which is intended to provide protection in case of any external cellular/ tissue injury. However, this phenomenon in COVID-19 patients is leading to unusual thrombotic presentations. Since the emergence of novel coronavirus, World has come across various benign as well as lethal manifestations in COVID-19 patients and one such life-threatening manifestation which needs rigorous attention is the genesis of strange blood clots that can travel and get logged into several parts of the COVID-19 patients leading to various clinical presentations. COVID-19 infection is caused due to interaction of spike glycoproteins of coronavirus &nbsp;with ACE 2 receptors on the host &nbsp;cell surface. This interaction in the arteries, veins or capillaries could lead to injury in the vascular &nbsp;wall of blood vessels that can directly/Indirectly lead to coagulation and clotting cascades activation and subsequent formation of internal blood clots. However, it is undesirable to have the presence of these clots as they could lead to certain fatal complications that need emergency medical intervention or else, they may lead to the death of a patient. Due to the severity of this manifestation, early detection of these blood clots in covid-19 patients become very important intervention which could be done by observing certain specific signs and symptoms and/or with the help of various laboratory biomarkers like D-dimer, platelet count, erythrocyte sedimentation rate (ESR), ferritin, fibrinogen, etc. Once the early diagnosis is made, the patient can be treated appropriately with the help of anticoagulant therapy, which includes use of oral and parenteral anticoagulant drugs. This way the complications of blood coagulation like thrombo-embolism, could be prevented.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Percussion in Cardiovascular Examination of a Tombstone 2022-01-22T12:34:39+00:00 Abhinav Malvi Sourya Acharya <p>The growing abundance of technology in the medical field has led to doctors' sensory de-skilling. Technology is seen replacing the clinical diagnosis based on sensory perception. Percussion as a skill has been lost from clinical practice. Though percussion disappeared from wards, it is still taught in medical colleges. Percussion is a very vital component in the bedside examination of the patient. Auenbrugger first thought of tapping the chest of patients to determine the cardiac size, borders, and presence of pericardial fluid, its extent, and related pathologies. Percussion used to be a critical component of clinical heart disease evaluation. There was rapid advancement of technology in the last century. With the introduction of technology in the medical field, diagnosing and treating disorders and diseases have significantly improved. Percussion can be a valuable bedside aid in determining the cardiac size, borders and to find the presence and extent of pericardial fluid. Cardiac percussion is not just tapping the chest and hearing the sound produced, it is also feeling the touch and observing the vibrations produced noting the tone, thus percussion takes a considerable amount of time, practice and a mindset to master as a clinical skill. Thus teaching the correct way to percuss right from the initial years in the medical school is extremely necessary. With proper knowledge and experience cardiac percussion can prove to be a beneficial tool in specific cardiac pathologies.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Effect of Vitamin-D on COVID-19: A Review 2022-01-22T13:00:26+00:00 Aditi Padode Harsha Keche <p>Vitamin-D deficiency is a common yet understated problem. A number of people are at a risk of its deficiency while many others go undetected with the deficiency. The novel corona virus, an RNA virus, has run its rampant course across the globe affecting millions for the worse. COVID-19, a disease caused as a result of the infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has shown to produce severe lower respiratory symptoms. This has so far resulted into a reported death count of more than 4.9 million worldwide. More than 4.5 lacs were affected in India. COVID-19 affects numerous other organs such as the liver, brain, kidney and heart. Dosage of Vitamin-D regularly, during the treatment and as a pre-emptive measure have all shown to reduce respiratory tract inflammation. Low plasma 25(OH)D levels appear to be an independent risk factor for COVID‐19 infection and hospitalization. Administration of a large dose of Calcifediol or what is also known as 25-hydroxyVitamin-D , a main metabolite of the Vitamin-D&nbsp; endocrine system, noticeably lessened the need for ICU treatment of patients requiring hospitalization after being tested positive for COVID-19. Elevated levels of Vitamin-D in body could decrease the length of hospital stays and reduce the intensity of the COVID 19 infection.&nbsp; In many COVID-19 patients the T regulatory lymphocytes (Tregs) levels are found to be low. These low levels&nbsp; can be elevated by Vitamin-D&nbsp; supplementation. Low levels of Vitamin-D&nbsp; have also been associated with increased inflammatory cytokines and a noticeably increased risk of pneumonia and viral upper respiratory tract infections. While further large-scale studies are required to provide concrete answers, the severity of the disease has been shown to be reduced and Vitamin-D&nbsp; can potentially be used as a supplementary treatment against Covid-19 and also as a precaution against the same. These results are significant and should not be ignored.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Impact of Social Media on the Health of Individuals during the COVID-19 Pandemic: A Systemic Review 2022-01-22T17:08:32+00:00 Aryaki Wanjari Nikhil Dhande <p>Utilization of online media in the hours of Covid-19 pandemic contrarily affects the soundness of people. Patients had the option to take treatment for minor sicknesses through media transmission administrations. After the ascent in the number of instances of Coronavirus, a couple of patients were treated for Covid through telecom administrations given by specialists. Online media helped in conveying data about the pandemic. It has helped in proceeding with the academic year on the web. Individuals living at various places had the option to interface with one another as a result of web-based media. Then again there were many symptoms of utilizing online media like conveyance of falsehood, visual illnesses, uneasiness issues, sorrow, stationary way of life, weight and other pressure disorders. Although school terminations might be impermanent, further developed admittance to and utilization of such stages might rush the all inclusive acknowledgment of advanced devices over the long haul. Conduct changes brought about by expanding dependence on computerized contraptions might bear even after the COVID-19 pandemic. This danger should not be disregarded using social media like distribution of misinformation, ocular diseases, anxiety disorders, depression, sedentary lifestyle, obesity, and other stress disorders. In spite of the fact that school terminations might be impermanent, further developed admittance to and utilization of such stages might hurry the all-inclusive acknowledgment of computerized apparatuses over the long haul. Social changes brought about by expanding dependence on computerized contraptions might persevere through even after the COVID-19 pandemic, and this is a danger that ought not be overlooked. This article aims to analyze and review the use and side effects of social media and health awareness during COVID-19 period. This study drew on data from various research articles on the relationship between social media's effects and side effects. Social media and health awareness have exhibited recent trends. Discussion of potential approaches to meeting the growing demand for social media and management of health has further increased concerns about the ocular diseases, obesity, mental health and telemedicine.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Vestibular Migraine in Adolescents 2022-01-22T17:38:05+00:00 Anisha Vyawahare Swarupa Chakole <p>Migraine is a recurrent throbbing headache that affects one side of the head and is usually related to nausea and decreased vision. Migraine is typically seen in adolescents due to increased use of electronic devices and computers. It is a non communicable disease.10 percent patients with migraine suffer from vestibular migraine. Vertigo in children can lead to migraine and continue in adults too. Preventing the vertigo attacks in children and adolescents can help in the treatment of migraine. Behavioural therapy is an important factor in treatment of migraine in this age. 40% of migraine patients have some associated vestibular symptoms which includes dizziness and disturbed balance. An elevated comorbidity of migraine and vertigo was discovered in several patient categories and later verified at the community level, far exceeding what random chance would predict. Vertigo is substantially more commonly seen in migraine sufferers, particularly those with aura, than in headache-free controls. Migraine is one of the most disturbing diseases in USA, is nearly as common as hypertension and more common than asthma and diabetes. Migraine and vestibular symptoms can coexist with inner ear disorders. It is a difficult condition to diagnose and treat. Multiple temporal patterns are responsible for this. The most common cause of vertigo in children is vestibular migraine (VM). Clinical findings and laboratory test results have been found in a sample of children and adolescents suffering from Vestibular migraine. Recent classification criteria for dizzy children are discussed and their limitations. Migraine is typically seen in adolescents due to increased use of electronic devices and computers. It is a non-communicable disease. 10 percent patients with migraine suffer from vestibular migraine.</p> 2021-12-24T00:00:00+00:00 ##submission.copyrightStatement## Black Pepper: Its Health Benefits 2022-01-24T06:33:15+00:00 Sangita Jogdand Sejal Singh <p>Black pepper has a scientific name of‘<em>piper nigrum’</em>is an unripe fruit of peppercorn which is dried, it is a flavor enhancer in food, besides also has health benefits, it contains bioactive compound piperine which adds a spicy taste to it being an antioxidant it reduces risk of various life-threatening illnesses (atherosclerosis, cardiovascular disease and neurological conditions) and also increases bioavailability of various nutrients, piperine at any given dose weakens memory impairment, in low dose piperine potentially&nbsp; increases neuronal density in hippocampus. Black pepper boosts HCL in stomach and has antispasmodic properties. Active compounds present play a significance in stimulating leucocytes increasing immunity against various pathogens. It is given along with iron supplements to improve its bioavailability without any adverse reaction. Piper Nigrum given in significant amount enhances learning and memory inadequacy related to AlCl, also exhibits anticholinesterase activity preventing nerve degeneration. In the ongoing COVID scenario biologically active compounds in piper nigrum:&nbsp; piperdardiine and piperanine are markedly effective against COVID‐19, hence is preferred as a medication. Black pepper rectifies the lipid profile, along with degree of total cholesterol, LDL and triglyceride in patients with cardiovascular diseases, piper nigrum being prosperous in having constituents of vanadium in it contributes in boosting and recovering fron cardiac function after a myocardial infarction and dealing with pressure overload–induced hypertrophy by inhibiting protein tyrosine phosphatases. Piper nigrum can boost melanocyte proliferation and bring back pigmentation to depigmented skin, therefore this could possibly be the treatment for vitiligo. Alkaloid constituent of black pepper, bring to bear anticancer properties in a wide range of malignancies.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Use of Tracheostomy in COVID-19 Patients and it’s Effects on Healthcare Workers 2022-01-24T07:28:08+00:00 Kriti Dixit Chandra Veer Singh <p>Tracheostomy in COVID-19 patients needs important decision making and surgical planning, especially since it’s an aerosol-generating procedure and poses a threat to the health care personnel involved. Various public health agencies have recognized that some particular health care procedures considerably increase the risk of transmission of respiratory pathogens because they produce aerosols.</p> <p>Severe infection with SARS-CoV-2 [COVID-19] causes respiratory illness resulting in Acute Respiratory Distress Syndrome (ARDS) and respiratory failure that put patients in need of intrusive mechanical ventilation. Because it is linked to longer use of sedatives, narcotics, muscle palsy leading to a longing desire for invasive central catheters, and the patient's stationary position inflicting line infection and pressure injuries to the skin, prolonged invasive mechanical ventilation usually results in ventilator-associated pneumonia and other complications.</p> <p>If patients are projected to be ventilator-dependent for a lengthy period of time, surgical treatment is considered once every 7–10 days for automatically ventilated patients. However, due to the risk faced by the health care workers, it has been recommended by organizations such as WHO, that health personnel must take appropriate measures so as to minimize the risk of contracting the deadly virus. This includes wearing personal protective equipment [PPE] while performing the procedure. An N-95[or above] face mask, face shield, latex gloves, full-body disposable cover, foot covers are some of the contents of personal protective equipment [PPE].</p> <p>Our goal is to provide authoritative guidance to healthcare providers and healthcare systems and to highlight the possible effects of the accumulating experiences, currently available evidence, and historical lessons, tracheostomy decisions during the current COVID19 epidemic. Because incubated patients have a poor prognosis and there is a danger of transfer to providers through this highly aerosolizing procedure, the pathway of tracheostomy placement has changed.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Study on Post Liver Transplant Diabetes Mellitus (PLTDM): Pathogenesis and Risk Factors 2022-01-24T07:51:43+00:00 Ganesh Lothe Vrushabh Gomase Sandip Mohale <p>Post-liver transplantation Diabetes Mellitus (DM) or PLTDM, affects 30 % of liver transplant patients and is linked to an elevated risk of death &amp; a variety of adverse consequences. PLTDM is a multi-cause disease, however, the use of immunosuppressive drugs from the calcineurin inhibitor (CNI) family is the primary risk factor (tacrolimus and cyclosporine). Other variables, including before-transplant obesity, alcoholic independent steatohepatitis, &amp; hepatitis C virus infection, can enhance the incidence of Post Liver Transplant DM. Only when the dosages of Calcineurin inhibitor &amp; steroids have been stabilized &amp; the stress after the operation has been alleviated should a diagnosis of PLTDM be made. Insulin secretory dysfunction is the most common complication caused by CNI. To enhance long-term success for both the patient and the transplant, plasma glucose management must begin soon after the surgery. Metformin and DPP-4 inhibitors, among the more well-known antidiabetics, have a notably non-malignant profile into the setting of Post Liver Transplant DM &amp; are recommended oral medicines for large duration treatment. Insulin treatment is another viable treatment option for the disorder's underlying pathophysiological problem. There is yet little information on the effects of newer antidiabetic families on Post Liver Transplant DM. With immunosuppressant medicines, the physician managing diabetes, dyslipidemia, and hypertension following transplant must be aware of the increased risk of drug-drug interactions and infections. The increased risk of fluctuating and decreased renal function, which can lead to hypoglycemia, must be included in treatment goals and treatments. While research is underway to develop ways to prevent PTDM, it is critical that immunosuppressive regimes be chosen based on their ability to prolong graft survival rather than to avoid PTDM.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Pleural Biopsy in Evaluation of Malignant Pleural Effusion- A Review 2022-01-24T08:07:41+00:00 Reshma Babu Ulhas Jadhav Pankaj Wagh Mona Vohra <p>Malignant pleural effusion (MPE) is one of the common presentation of many carcinoma including lung, breast and lymphomas. It is very important to make an etiological diagnosis of the MPE cases without any delay as treatment depends on its cause. Cytopathological examination of fluid for malignant cells is the easiest and most sensitive method for detecting malignant pleural effusion (MPE). Despite cytology being a sensitive test, many patients remain undiagnosed, then there is a need of histopathological examination of pleura. Invasive procedures like Closed pleura biopsy (CPB) or thoracoscopy was recommended. CPB was earlier considered an investigation of choice in cases of undiagnosed pleural effusion with good efficacy Since the emergence of medical thoracoscopy (MT), use of CPB in the diagnosis of cytology negative MPE is gradually declining. However, due to the high cost and challenges associated with the surgery, thoracoscopy is only used in a restricted number of cases. CPB is less reliable than cytopathological testing of fluid or MT in determining MPE. Yet, it is a simple procedure with little procedure -related complication. The purpose of this article is to assess the clinical presentation and approach to MPE, as well as the role of CPB in diagnosing MPE and to investigate the benefits and drawbacks of CPB.”</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Tongue Reconstruction by Nasolabial Flap 2022-01-24T10:17:48+00:00 Saurabh Shelke Chandra Veer Singh <p><strong>Background: </strong>The nasolabial flap is an easy, however untrained, modest tissue reconstruction process with an honest delivery of blood that may be utilized to restore minor tissue defects within the hollow mouth region. The study's intention turned into to peer how a success inferiorly primarily based completely nasolabial flaps had been for restore in sufferers with early mouth maximal cancer.&nbsp;</p> <p><strong>Methods:</strong>&nbsp; A total of twenty-eight sufferers with T- or T2 malignant mass of the tongue which had reconstructions, the use of the inferiorly primarily based nasolabial flap was investigated retrospectively. All of the sufferers blanketed with inside the studies had their flap viability, wound issues, infections, function, scar, and recurrence mentioned post-operatively. After the manner, all sufferers had been monitored for at least six months.</p> <p><strong>Results:</strong> The nasolabial flap is used to restore abnormalities withinside the buccal mucosa, oral commissure, decreased lip, lateral border of the tongue, demanding palate, and mouth floor. The flap becomes a success in all sufferers without a recurrence. The beauty and purposeful results have been each satisfactory. Minor complications include postoperative trismus, immoderate wound contracture, ectropion, infection, and wound dehiscence passed off in a few sufferers. One of the maximum not unusual place issues in most male sufferers becomes intraoral hair boom over the flap employed.</p> <p><strong>Conclusions:</strong> The NLF is a feasible and adaptable choice for restoring small to intermediate deficits of the oral hole area due to ablation of early tumors of the oral hole area if proper interest is paid to flap design, operational approach, and postoperative treatment.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## The Ayurvedic Concept of Kshavathu as Related with Western Concept of Allergic Rhinitis – A Review 2022-01-24T10:53:26+00:00 K. Sivabalaji Roshna Bhutada Shraddha Jain <p>Individuals with Kshavathu for chronic periods develop long-standing complications which affect the immune system manifested as respiratory diseases. Poor life style habituates such as physical inactivity, exposure to mist, wind, dust, sleep disruption increase are the factors responsible for nasal disorder symptoms and their severity. As allergic rhinitis may results from an IgE mediated or a non- IgEmediated immune response, it is also important to have an anti-allergic strategy&nbsp; to make the patient symptom- free for a longer period. The attempt is made to minimize the allergic rhinitis features&nbsp;&nbsp; related to kshavathu such as paroxysmal sneezing, its crucial feature.&nbsp; Kshavathu not only indicates simple sneezing but a vast pathology exists behind this clinical condition. Kshavathualso is associated with several conditions that affects the patients day- to-day life pressuring the need to understand and identify the interventions that could help in managing the risk factors, especially with healthy individuals who are at risk of immune impairment. The Ayurveda protocol includes Nasya (nasal drops) and internal medication as possible interventions to reduce the risk of complications and improve immune response. Treatment modality emphasis the tolerance of nasal mucosa to the aerial allergens to keep the patient symptom - free. Nasya with Vata Kapha Hara medication and internal medicine which addresses both the factors Agni and elimination of the Doshas should be administered. Therefore, this review paper attempts to explain various consequences of Kshavathu mentioned in classic texts and also enlists the management ofits complications.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Inevitable Impact of Steroids and Mucormycosis – A Review 2022-01-24T11:06:33+00:00 Nirbhay Kumar Mishra Sanjesh Kumar Mansi Singh Siva Prasad Panda <p>The human population remains in the threat of the Pandemic of COVID 19 till date with one another faces of it. The second wave of the pandemic led population into vain again with yet another danger of the third wave. The use of the steroids for controlling and treatment of the upsurge during the second wave remained a trend. The uncontrolled use of steroids invites the secondary infection mucormycosis also called black fungus which affected the population badly. Mucormycosis is opportunistic infection that acquired immune compromised patients with COVID 19 and steroids in treatment paradigm. Most of the patients with high blood glucose levels and diabetes faced this threat and created pandemic in pandemic again. The reviews focus on the positive and negative both prospects of the steroidal use and how steroids were the leading cause of the blowout of the Black fungus infection.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## A Critical Review on Concept of Adjuvant 2022-01-24T11:18:25+00:00 Jaydeep Kumar Sahu Renu Bharat Rathi Rajkumar Gupta Bharat Rathi <p><strong>Introduction:</strong> The concepts of <em>Ayurveda</em> are unique when considered it in terms of treatment of diseases as well as preventive care in healthy persons. ‘<em>Anupana</em>’ is one among them, which is practiced with medicine and food. It helps in fast spreading, quick absorbing of medicine and food in the body. By changing the <em>Anupana</em> of one drug, it can be used in different diseases, which makes it unique. In order to drag attention of researchers to this unexplored topic, critical review has been prepared to highlight it in different features.</p> <p><strong>Methods: </strong>References were sought in Pub Med, AYUSH research portal, DHARA online and Google Scholar by utilizing all key words and MeSh terminologies along with <em>Ayurveda</em> textbooks. Based on PRISMA guideline, 06 full text articles were included in this study. Clinical studies were also found where <em>Anupana</em> was used as modality for management.</p> <p><strong>Discussion:</strong> Present systematic review put the light on the different aspects of <em>Anupana</em> as a theoretically and clinically proven novel concept to enhance the efficacy of formulation or drug quickly. <em>Anupana</em> facilitates the action of pharmacokinetics as well as pharmacodynamics.&nbsp;</p> <p><strong>Conclusion: </strong><em>Anupana </em>has multi-dimensional benefits, including nutritional, stimulating, preventative, and curative properties. An appropriate <em>Anupana</em> should be chosen that is suitable for us in order to receive all of the benefits from its intake. Hence it can be concluded that <em>Anupana</em> concept is an integral aspect of Ayurveda and a blessing to human beings in terms of health.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## A Review on Role of Shaman Chikitsa in the Medoroga w.s.r to Dyslipidemia 2022-01-24T11:55:02+00:00 Praveen Nandal Sadhana Misar Wajpeyi Khushhali Balpande <p><strong>Background: </strong><em>Medoroga</em> is a condition in which there is an excessive accumulation of <em>Meda&nbsp; Dhatu</em> in the body. Accumulation of <em>Medo Dhatu</em> in different parts of the body causes blockage of <em>Strotsa</em> which ultimately leads to poor nourishment of other <em>Dhathus</em>. Lack of exercise and <em>Kaphavardhak Ahar Viharar</em> are the two main causes of <em>Medoroga</em>. In modern times, the way of life has changed drastically to quick nourishments and inactive tendencies throughout the world. Because of these factors, the accumulation of <em>Meda Dhatu</em> happens immensely. In Ayurveda, dyslipidemia is considered under <em>Medoroga</em>. Dyslipidemia is an emerging serious health abnormality associated with co-morbidities including CVD that continues to be the leading cause of death worldwide. It is characterized by an increase in cholesterol, triglycerides, LDL levels, and a decrease in HDL levels.</p> <p><strong>Aim and Objectives: </strong>This review are conducted with the aim to study the various formulations and drugs described for <em>Medoroga</em> (Dyslipidemia) as <em>Shaman Chikitsa</em> in Ayurveda.</p> <p><strong>Materials and Methods:</strong> The classical texts of Ayurveda and modern medicine, Journals, and Research articles from Google Scholar, Pubmed, etc were selected for the study.</p> <p><strong>Observations and Discussion</strong><strong>:</strong> The research studies conducted on guggul formulations, <em>Arogyavardhinivati</em>, <em>Triphala</em>, <em>Trikatu</em>, <em>Arjun</em>, and <em>Yava </em>showed significant improvement in lipid levels which may be due to their <em>Katu</em>, <em>Kashaya Rasa</em>, <em>Ushna</em>, <em>Teekshna Guna</em> and <em>Lekhana</em>, <em>Deepana</em>, <em>Pachana</em> properties that help in reducing aggravated <em>Kapha</em> and <em>Meda</em>.</p> <p><strong>Conclusion: </strong>Dyslipidemia can be effectively managed with various formulations given in Ayurveda.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## A Review on Vocal Cord Palsy: Complications and Management 2022-01-24T12:29:28+00:00 Shivi Agarwal Mansi Totey Shrawani Kulkarni Sagar Gaurkar <p>Vocal cord paralysis is a multifaceted problem that affects people of all ages and is initially diagnosed by various healthcare providers. It is a common condition that occurs due to the obstruction of nerve impulses from the brain to the voice box. It ranges from slight hoarseness to fatal, life-threatening complications. To get to the exact diagnosis, determining the etiology of paralysis is essential. For restoration of normal function, accurate diagnosis has proven to be helpful. Vocal cord paralysis (VCP) is a. reasonably common condition caused by a vagus nerve or its recurrent laryngeal nerve branch disease process. The nerve’s longer length causes increased vulnerability. Peripheral lesions to the vagus are responsible for 90% of VCP (Vocal cord paralysis). Etiology includes scarring due to intubation or inflammatory disorders, iatrogenic causes like surgical traumas, malignancy, CNS pathologies like stroke, CNS tumors, and systemic diseases like ALS, Guillain barre syndrome. Vocal cord paralysis can cause consequences such as a weak cough, trouble swallowing, dysphagia, stridor, hoarseness, aspiration risk, granuloma formation, airway blockage, and a lower quality of life. Various treatment modalities like tracheostomy, usage of botulinum toxin, adenoidectomy, cordotomy, reinnervation, and gene therapy are used. For this narrative review, a literature search was undertaken using "unilateral and bilateral vocal cord palsy" and "dysphagia" in the Pubmed, Medline, and Embase databases. Bilateral vocal cord paralysis is a problematic and distressing condition that affects both adults and children. Surgical procedures such as tracheostomy, adenoidectomy, cordotomy, and laryngeal reinnervation have been used to treat this condition successfully. Treatment modalities should be individualized according to the patient's clinical features and physician's expertise.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement## Review of Different Vaccines and Vaccination Campaings against Covid around the Globe and India 2022-01-24T13:07:41+00:00 Jahanvi Goyal Swaroopa Chakole <p><strong>Background: </strong>Coronavirus is caused by beta variant of coronavirus, occurred as an unexpected breakout from the city of Wuhan in China, spreading across borders in no time. A large number of measures like imposing strict curfews, lockdowns, avoidance of public gatherings, home isolation, quarantine etc. have been imposed in the nation to curb the disease transmission, but none of the measures were enough to stop the viral transmission. The only efficient measure to stop the transmission of virus is developing herd immunity by the use of vaccines. As known from the past experiences vaccines take a long time to get approval, but many COVID vaccines have received emergency approval for public use. Vaccines, by creating herd immunity in the population, are the most efficient strategy of limiting the epidemic. Vaccines are the most cost-effective method of preventing infection transmission. Vaccine development typically takes several years, however due to significant mortality; numerous vaccines against COVID-19 have obtained emergency approval<strong>. </strong>Most of the vaccines developed today or in trial aim at targeting the S protein or the RBD region. There has been remarkable success in development of COVID-19 vaccine since the registration of first case on January 10-2020.Mortality and morbidity associated with the disease are increasing day by day and hence temporary measures like lockdown and stay-at-home strategy would not suffice for long. A large number of vaccination campaigns have been launched around the globe. They aim at reducing the incidence of the disease and henceforth the associated mortality.</p> 2021-12-25T00:00:00+00:00 ##submission.copyrightStatement##