Online ISSN: 2515-8260

Current Issue
Volume 10, Issue 2

Volume 10, Issue 2, Winter 2023


Catheter-Associated Urinary Tract Infection: Incidence Rate And Antibiotic Sensitivity Pattern Of Bacterial Isolates In Patients Admitted In I.C.U Of Tertiary Health Care Hospital Of Jammu Province

Rajni Bharti, Priyanka Sharma, Neeru Rajput, Shashi Sudhan Sharma .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1-7

Health care-associated infections (HCAIs) are infections that occur while receiving health care developed in a hospital or other health care facility1. HAIs are associated with increase in the cost of treatment, adverse patient outcomes, social impact, morbidity and mortality. DAIs continues to be one of the major threats to the patient safety, particularly in m of low-and middle-income countries2,3,4,5. There are four major types of healthcare associated infections which were commonly encountered. Catheter associated urinary tract infections (CAUTI), Central line associated blood stream infections (CLABSI), Ventilator associated pneumonia (VAP) and surgical site infection. Among these first three are known as device associated infections (DAIs). Around, 15-25% of hospitalized patients require urinary catheterization. The risk of developing CA-bacteriuria increases with time; with an average risk of 3-10% per catheter days to 25% at the end of one week and to nearly all cases in one month6.
For the diagnosis of CAUTI, a patient with a urinary catheter in place must meet one of two criteria: one or more of the given signs and symptoms with no other recognized causes; such as fever (temperature ≥ 38 degree Celsius), urgency, suprapubic tenderness, and urine culture positive for ≥105 cfu/mL, with no more than two microorganisms isolated; and positive dipstick analysis for leukocyte esterase or nitrate and pyuria (≥10 leukocytes/mL) with no other recognized cause. Catheter-associated urinary tract infections (CAUTIs) have accounted for as much as 40% of all nosocomial infections in the United States, affecting an estimated 800,000 patients per year. The incidence of nosocomial UTI among the 25% of hospitalized patients, who have a urinary catheter, is approximately 5% per day, with virtually all patients developing bacteriuria by 30 days of catheterization7. One of the recent study found that most catheter-associated bacteriuria was asymptomatic8. But silent catheter-associated UTIs may represent a large pool of antibiotic-resistant pathogens9 and drive a great deal of generally unnecessary antibiotic therapy. These infections increase the length of stay, hospital cost, and mortality.10According to Centre for disease control and prevention-National Healthcare Safety Network-2013 report, the mean incidence of CAUTI per 1000 catheterized days was 0-5.3% in critical care units and 0-3.1% in inpatient wards11. In India the incidence of CAUTI is 1.63-2.1 per 1000 catheter days12, 13. Broad range of bacteria can cause CAUTI. In short term catheterized patients it is monomicrobial such as gram negative bacilli like Escherichia coli, Klebsiella, Serratia, Citrobacter, and Enterobacter, Pseudomonas and Acinetobacter and gram positive cocci like Coagulase negative staphylococcus and Enterococcus. In long term catheterized patients it is polymicrobial. In addition to the pathogens of short term catheterization, it is caused by Proteus, Providencia and Morganella.6The significant risk factors for CAUTI include age, uncontrolled diabetes and long hospital stay14. Other risk factors are female gender, impaired immunity and length of duration ofcatheterization15.

Efficacy Of Methotrexate And Acitretin In Cases Of Psoriasis

Dr. Rajeev Kumar, Dr. Praveen Kumar Singh .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 8-12

Background: Psoriasis is a systemic immune-mediated disease accompanied by arthritis in a significant percentage of patients called psoriatic arthritis. The present study was conducted to compare methotrexate and acitretin in cases of psoriasis.
Materials & Methods: 80 patients of palmoplantar psoriasis of both genderswere divided into 2 groups of 40 each. Group I patients were given oral acitretin 0.5mg/kg daily for 3 months and group II were given oral methotrexate15mg/week for 3 months. Modified psoriasis area severity index (MPASI)score was recorded. Improvement was graded as: no change, slight improvement, moderate, marked and almost cleared.
Results: There were 15 males and 25 females in group I and 20 males and 20 females in group II. The mean MASI score at baseline, 1 month, 2 months and 3 months was in group I was 61.2, 41.4, 31.2 and 21.6 and in group II was 58.4, 39.2, 24.5 and 15.4. The difference was significant (P< 0.05).
Conclusion: Both oral methotrexate and acitretin were highly effective in treating palmoplantar psoriasis. The reduction of Psoriasis lesions with Oral methotrexate was faster than acitretin.

Reconstructions Of Length Of Ulna From Its Fragments-A Pilot Study In Eastern Indian Population

Srimoyee Mukherjee, Partha Sarathi Hembram, Achintya Biswas, Aniruddha Das, Nabanita Juin, Gowtham .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 13-30

Background: In a densely populate, demographically diverse and vast country like India, the identity establishment of a dead person assumes great medico-legal importance. It also poses a true challenge to the forensic pathologist working in an environment where decomposition and taphonomic process are highly rapid and variable. One of the important pillars for identification is the stature. The estimation of age, sex and stature are vital for skeletal samples, when found from sites in mixed lot. So, a technique is urgently needed for reconstruction of total length of long bones from their fragments. This investigation was designed to estimate the total length of ulnas using its fragmentary bone length in a population specific study. In addition to this, the goal was to deploy them in stature formulae for population specific cases and lastly to estimate the stature of the individual.
Materials and Methods: After getting institutional ethical committee clearance, the study over 50 Ulna Bone revealed linear equation where total length of ulna was used as dependent variable and the different fragmentary length being the independent variables.
Results: The measurements of both sides (left and right) were grouped and noted separately but the results were pooled to obtain the regression equation. This was done because no significant difference in measurement between the left and right side in the sample of 50 ulna bones. The following Regression Equation was obtained:-
TOTAL LENGTH OF ULNA = 3.85+ 4.53QR +0.71ST +1.81PQ+0.32 TU
R SQUARED VALUE = 0.97.
Conclusion: This study was a preliminary work and a pilot project for estimating the regression equation to reconstruct the total length of ulna from its fragmentary lengths in a population specific sample (Eastern Indian population). Being population specific, it can be applied in disputed cases of identification of mutilated and fragmentary human remains of that geographic region and can be of immense help in future, especially for the law enforcement agencies in the case of mass disasters.

A STUDY ON DIGITAL MARKETING AND ITS IMPACT ON CONSUMER

Manali Parmar, Dinki Sahu, Monika Sahu, Swati Parida, Dr. R Shridhar .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 31-40

With consistently expanding advancement  in  innovation, utilization about Computerized Advertising, Online Entertainment Promoting, & Web search tool Showcasing is additionally expanding. Advanced Advertising is utilized by advertisers to advance labor & products to commercial center. Computerized Promoting places   significant job  in  expanding deals about labor & products. motivation behind this exploration is to concentrate on  effect about Computerized Promoting, how it's   significant device as two advertisers & buyers. We have additionally concentrated on  effect about Computerized Showcasing & its impact on  shopper purchasing conduct. This exploration was finished on  base about an organized poll as essential information & example size is 100 respondents

AN ANALYSIS ON HOW DEMAND AND SUPPLY AFFECTS THE EQUILIBRIUM OF MARKET OF THE MUTUAL FUND

animesh Panda, prem Kandra, ayush Kumar Choubey, trupti Ranjan Sahu, Ms. Jasmine Joshi .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 41-48

Shared Assets is an arising speculation vehicle that is covered with   pool about assets assembled from numerous financial backers. Common assets are assuming part about monetary go-betweens between banks and financial backers who needs to put resources into an offer market. fundamental point about shared reserves is to broaden gamble about financial backers. Larger part about businesses putting their sum current common assets for dealing with gamble about their monetary resources. There is   gathering about protections which is known as   portfolio that assists with choosing security current view about presentation. These colossal measures about cash current shared assets are worked by venture proficient called an asset supervisor or cash chief or portfolio director. This asset chief's responsibility is to put asset's resources current various protections like gold, stock, and different resources for make expected capital additions or pay. Shared reserves give open doors perpetually little and individual financial backers to get to expertly kept up with arrangement about protections like bonds, values, and different protections. Thusly, addition or misfortune emerging from such speculation can be shared aggregately among financial backers with respect to their commitment to asset.   shared asset's scope about speculation is organized and worked to satisfy venture targets.

COMPARATIVE STUDY OF FINANICIAL REPORT OF BANKING AND AUTOMOBILE SECTOR

Nayenika Solanky, Mahalakshmi.J, Santoshi Kumari, Shamma Parveen, Robert Frank, Ms. Jasmine Joshi .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 49-63

Most budget summary examinations center around firms having a place with ventures that either contribute essentially to monetary figures or set in a profoundly serious business climate. target  about this paper is an investigation done to see degree to which an organization has executed utilizing rules monetary execution is great also right. This study researches execution  about business banking area for time  about April-2011 to Spring - 2014. Budget summaries  about Pivot bank, ICICI bank, Government bank also HDFC bank for demonstrated periods were gotten from data set, for example, CMIE, Ability, cash control also hurray finance. outcomes have impacted their monetary execution, also thus, point  about this proposition is to show impacts  about outflow outrage to Volkswagen's fiscal summaries, contrast distinctions with BMW's presentation during concentrated on time  about 2012-2016, also propose suggestion that would their proficiency in a consistently creating climate. exact piece  about this proposal was done, by utilizing near budget summary examination, to find contrasts in organizations' resource also capital designs, development, resource also work utilization effectiveness, liquidity, productivity, benefit per representative also relative power. As a general rule, it was established that, BMW was more beneficial for most part because  about more proficient administration  about money change cycle, as well as higher working benefit per representative, return on deals also work efficiency. They likewise had better also manageable resource also capital design, contrasted with Volkswagen. Important data got from these budget reports were summed up also used to process monetary proportions for four-year time frame. Monetary proportions are devices used to gauge productivity, liquidity also dissolvability execution  about four significant Indian business banks. This examination is to investigate fiscal reports  about these banks utilizing liquidity proportions, movement proportions, influence proportions, benefit proportions, a nd market esteem proportions. For liquidity, accompanying proportions were utilized: current proportion, fast or basic analysis proportion. For movement, Stock turnover proportion, debt holder turnover proportion also working capital turnover proportions were utilized. For influence, accompanying proportions were utilized for example obligation proportion, value proportion, also interest inclusion proportion. For productivity, overall revenue, net revenue, return on resources, return on investor's value, also income per share were utilized. For market esteem, cost profit proportion also procuring per share proportions were utilized.

Comparison of renal functions amongst obese and non-obese adults of rural population area of Northern India

Dr. Prerna Panjeta, Dr. Piyush Bansal, Ashutosh Kumar, Komal Saini, Dr. Vikram Kala .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 64-69

Introduction: Obesity has become the leading global health problem. In numerous large population-based studies-Higher BMI associated with presence and development of low estimated GFR and many other renal diseases.
Objective: To study the renal functions in obese adults of rural area.
To do comparative analysis of renal functions with age and sex matched non obese adults.
Material and Methods: The present cross-sectional study was carried out in the General Medicine OPD of BPS GMC for Women, Khanpur Kalan, Sonipat, Haryana. A sample of convenient 100 obese patients were taken. A total of 200 patients attending General Medicine OPD were taken, out of which 100 were obese and 100 were non obese.
Results: Statistically significant P values were obtained for Blood Urea, Serum Creatinine, Serum Calcium, Serum Phosphorus, and urine albumin among obese and non-obese adults. Study shows no significant gender differences between obese and non-obese. Statistical analysis shows some age-related differences among obese and non-obese large population studies-showing positive association of BMI with chronic kidney disease.

A Case Report on Eosinophilic Cholecystitis with Frozen Calot’s Triangle – A Rare Inflammatory Etiology Affecting Gallbladder

Dr. Sreedevi B.V .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 70-73

Eosinophilic cholecystitis is regarded as ther are presentation of gallbladder infection that has similar presentation as acute cholecystitis. It presents with symptoms similar to that of cholecystitis with infiltration of excessive esnophils within the gallbladder. Eosinophilic cholecystitis can occur alone or most of the times in combination with eosinophilic inflammation gastrointestinal tract and rarely associated with inflammation of airway

Evaluation of the Single Path Versus Double Path PECS I and II Blocks as an Efficient Analgesic Choice in Female Breast Surgeries

Dr. Rajeev Kumar, Dr. Praveen Kumar Singh .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 74-78

Background: Excruciating pain is a common consequence following breast surgery and can be efficiently managed with double path PECS I and II blocks. Pectoral plane blocks (PECs) are being utilised more frequently in analgesia for patients undergoing breast surgery.
Methods: Sixty patients undergoing breast surgery were randomly assigned into two groups: Single path and double path. Performance time of technique, the onset and length of the sensory block, visual analogue pain ratings (VAS), postoperative analgesic requirements and success rate were the outcomes.
Results: A single-path block performed more quickly. With the exception of 10 hours postoperatively, where the double-path group had lower pain scores, other time points saw equal pain scores. The sensory block lasted longer and started sooner in the double path block.
Conclusions: The use of double-path pectoral blocks was a beneficial approach, as it was associated with a faster onset, and a longer duration of analgesia.

A Study to Observe the Cases of Abdominal Wound Dehiscence in Patients Undergoing Emergency Laparotomy with Midline Incision

Dr. Amuleek Kaur, Dr. Karaninder Singh Wilku,Dr. Gopal Swaroop Bhargava,Dr. Ajaypal Singh Sandhu .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 79-86

Aim: A study to observe the cases of abdominal wound dehiscence in patients undergoing emergency laparotomy with midline incision.
Objectives: To calculate the frequency of abdominal wound dehiscence in patients undergoing emergency laparotomies subjected to midline incision and to determine hypoproteinemia, anemia and surgical site infection as contributing factors for abdominal wound dehiscence in emergency laparotomies with midline incision.
Materials and Methods: Observational cohort study carried out in the department of General Surgery at Sri Guru Ram Das University of Health Sciences, Vallah, Sri Amritsar on 60 patients who underwent emergency laparotomy with midline incision.
Results: In our study, patients belonging to various kinds of age group and socio economic background were included in the study irrespective of the gender. Amongst the 60 patients included, abdominal wound dehiscence was seen in 36 patients corresponding to 60% of the sample size. This study was endeavoured to delineate the role of anemia, hypoalbuminaemia and SSI (surgical site infection) in the dehiscence seen in these patients and it was observed that majority of the patients undergoing abdominal wound dehiscence had hypoalbuminaemia thus, making it the most significant risk factor followed by anemia and surgical site infection.
Conclusion: In this study we concluded that Abdominal wound dehiscence is a serious sequel of impaired wound healing. Many factors can predispose to this grave complication of which anemia, hypoproteinaemia and surgical site infection carry enormous significance. Patients with these risk factors require more attention and special care to minimize the risk of occurrence. Postoperative abdominal wound dehiscence can be prevented by improving the nutritional status of the patient, strict aseptic precautions, optimization of patient's hemodynamic losses and by proper surgical technique. Early diagnosis of burst abdomen and aggressive treatment helps in reducing morbidity and mortality. Some of the major factors like the ones mentioned in this study must be vigilantly looked for and treated to prevent this catastrophic complication.

Clinical And Radiological Outcome Of Minimally Invasive Unilateral Pedicle Screw Stabilization Versus Minimally Invasive Bilateral Pedicle Screw Stabilization For TLIF Procedures In Degenerative Single Level Lumbar Spine Diseases: A Randomized Controlled Trial

Mohan NS, Siddesh Patil, Akshay BG, Basanagoud Nagaral, Arjun kumar,Shravan M Kaginele .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 87-96

Objectives: To compare Clinical outcome of degenerative lumbar single level spine diseases treated by minimally invasive unilateral pedicle screw stabilization versus minimally invasive bilateral pedicle screws stabilization for TLIF procedures assessed by VAS, ODI SCORE AND SF 36 and to compare the radiological outcome by Beck index, fusion index, vertebral alignment, proper placement of cage. To compare intraoperative blood loss, duration of surgery, length of hospital stays between the mentioned two groups.
Materials and Methods: A total of 30 patients were randomized into two groups. Group 1 underwent minimally invasive unilateral pedicle screw stabilization -TLIF (15patients) and group 2 underwent minimally invasive bilateral pedicle stabilization -TLIF (15 patients) from the period between July 2020 to July 2022 and were followed up for mean duration of 18 months. Degenerative lumbar single level involvement with spinal canal stenosis grade 2, 3 and spondylolisthesis grade 1, 2 were involved. Clinical assessment was measured with visual analogue score (VAS score), Oswestry disability index (ODI) Score and Short form health survey -36 (SF36). Radiological assessment was done with Briedwell interbody fusion index, placement of cage. And were followed up at 3 months,6 months, 12 months and 18 months after surgery.
Results: The mean Age (Years) was 52.73 ± 11.92. Out of 30 participants 15 (50.0%) had Group: MISS- U/L instrumentation –TLIF. 15 (50.0%) of the participants had Group: MISS -B/L instrumentation TLIF. Majority of them were l4-l5 involvement. There was a significant difference between the 2 groups in terms of Duration of Surgery (Minutes) (W = 0.000, p = <0.001) and intraoperative blood loss (W = 3.500, p = <0.001), with the median Duration of Surgery (Minutes) being highest in the Group: B/L TLIF group. With the median Blood Loss (mL) being highest in the Group: B/L TLIF group. There was statistically significant improvement in the trend of VAS Score, ODI score, SF-36 over time in each group after surgery but there were no statistically significant changes between these 2 groups. There were no statistically significant changes in terms of fusion and cobbs’ angle between these 2 groups.
Conclusion: MISS TLIF with unilateral pedicle screw fixation in a single level degenerative disc diseases is similar to bilateral pedicle screw fixation with added advantages of shorter operative time, lesser intraoperative blood loss, similar days of hospital stay, no statistical significant difference in post operative changes in VAS score, ODI score, SF 36 score, briedwell fusion index, cobbs angle when compared to bilateral pedicle screw instrumentation leading to early mobilization, easy rehabilitation and return to activities of daily living.

A Prospective Study To Evaluate The Effect Of Subacromial Triamcinolone Injection In Cases Of Subacromial Impingement Syndrome

Dr. Jaskirat Singh,Dr. Rohit Sharma, Dr. Rajan Sharma, Dr. Arshpreet Singh, Dr. Paramveer Panesar, Dr. Harmeet Singh Gill .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 97-108

Background: Subacromial Impingement Syndrome is the common cause for shoulder pain caused due to pathology in one or more of the structures present in the Subacromial area. The discomfort is linked to a loss of shoulder function and difficulty performing regular everyday activities. The pathophysiology is not entirely understood. The Subacromial injection was developed to reach a high drug concentration at the site of pathology while using a less overall drug to avoid systemic side effects. Triamcinolone Acetonide produces both anti-inflammatory and direct analgesic benefits in the shoulder.
Material and Methods: This study included 55 patients with Age more than 20 and Pain during Shoulder Arc of Motion, Positive Neer’s Sign and Hawkin’s Test. Pain during Shoulder Arc of motion, Visual Analogue Scale Score and Shoulder Pain and Disability Index was calculated pre injection and post injection at 2,6 and 12 weeks. Data was collected and analyzed statistically.
Results: 55 cases were worked up on OPD Basis. Mean age was 50.69, Male dominance. Pain during Shoulder Arc of Motion which was initially present in all 55 patients decreased over the follow-ups and at the end of 12 weeks only 3 patients had persistent pain. Visual Analogue Scale Median at 0 weeks was 9 which decreased to 0 at 12 weeks, Shoulder Pain and Disability Index Median at 0 weeks was 82.3 which decreased to 3.07 at 12 weeks. All these changes were significant with p value < 0.001.
Conclusion: We conclude that in our patients suffering from Subacromial Impingement Syndrome post subacromial injection under C-ARM guidance with Triamcinolone Acetonide, the results measured by Pain during Shoulder Arc of Motion, VAS Score and SPADI showed significant improvement. Thus, We support that Subacromial injection of Triamcinolone Acetonide is safe, economical and effective in the treatment of patients suffering from Subacromial Impingement Syndrome

The Impact Of Diabetes On Sputum Conversion In Treatment Of Pulmonary Tuberculosis

Prabhat Singh, Tanu Manhas, J.B Singh .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 109-114

Background: India is the world's largest TB epidemic country, with approximately 2-3 million new cases of TB. Diabetes mellitus (DM) is an emerging chronic health condition of developed and developing countries. It increases the risk of developing active TB by a factor of 2–3 compared with normal population. Materials And Methods: Patients with sputum smear positive pulmonary tuberculosis with diabetes mellitus were enrolled for a prospective observational study at GMC Jammu in India. Diagnosis of Diabetes Mellitus was based on the following criteria: Blood Sugar Fasting > 126 mg/dl, Blood Sugar (after 2 hrs during OGTT) > 200mg/dl and HbA1C > 6.5%. Results: Persons with diabetes mellitus (DM) have a 3-fold increased risk of developing tuberculosis. The median age of the Diabetic patients was significantly higher than the non-diabetics. Magee et al reported that TB–DM patients were significantly more likely to be older. After 2 months of treatment, the sputum positivity decreased in both the groups. There were significantly more Diabetics (28%) as compared to non- diabetics for AFB (P<0.05).  Conclusion: After anti-TB treatment, the sputum positivity decreased in both the diabetics and non-diabetics. However, decrease was less in diabetic patients at 2 months of treatment. Increasing age was an independent risk factor of increased risk of symptoms. Patients having both tuberculosis and DM should be screened for TB in early stages.

Comparative Study Of Intravenous Paracetamol Versus Intravenous Diclofenac For Postoperative Pain Relief In Elective Laparoscopic Cholecystectomy

Sanjay Gadre, Manasi Panat, Pravin Dhakite .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 121-127

Background: Laparoscopic cholecystectomy is the preferred surgical technique for uncomplicated cholecystectomy. Recommended approach for post operative pain management is to initiate the treatment with analgesics such as paracetamol, NSAIDS followed by adjunctive use of opioids to treat more acute pain symptoms. Present study was aimed to compare intravenous paracetamol versus intravenous diclofenac for postoperative pain relief in elective laparoscopic cholecystectomy.
Material and Methods: Present study was prospective double blinded Randomised controlled study, conducted patients between 18 - 65 years, ASA physical status I/II, posted for laparoscopic cholecystectomy. 80 cases were randomly divided as Group A (75 mg Diclofenac: 40 cases) & Group B (1 gm Paracetamol: 40 cases).
Results: In present study difference in VAS score in group A & group B at all points was statistically not significant except at 6 Hours where difference in VAS score in both group was statistically significant (P value 0.02). After comparing the Visual Rating Scale (VRS) scores of both groups to assess postoperative pain, it was found that VRS score in group A was higher than group B at 15 minutes, 30 minutes & 6 hours and was statistically significant. It was found that 26 (65%) of patients in group A required rescue analgesic whereas 18(45%) in group B required rescue analgesic. However, the difference observed was statistically not significant (P= 0.072). It was found that 3 (7.5%) of patients in group B experienced an adverse effect whereas 6 (15%) in group A had an adverse effect. The difference was statistically not significant. (P=0.061).
Conclusion: Paracetamol is considered superior to diclofenac in laparoscopic cholecystectomy as paracetamol gives better & prolonged analgesia than Diclofenac as evidenced low VAS & VRS score and also lesser requirement of rescue analgesia.

Outcomes Of Intralesional Bleomycin For The Management Of Cutaneous Low Flow Venous Malformations

Babar Zargar, Heena Masrat, Aaliya Tabasum .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 128-132

Background: Venous malformations are a type of vascular malformation with abnormally developed vein, venules and venous capillaries bunching together to produce soft cystic reducible masses containing venous blood. They account for about two third of vascular malformations. It may involve skin, mucosa or any other part of the body. The aim of this study was to evaluate the efficacy and safety of intralesional bleomycin sclerotherapy in low flow venous malformations.
Materials and Methods: During 2019- 2022, 213 patients with cutaneous venous malformations were treated with bleomycin sclerotherapy at a tertiary care hospital. The diagnosis of venous malformation was made on the basis of clinical history and physical examination and confirmed by doppler ultrasonographic examination Only patients with low flow venous malformations were treated with intralesional bleomycin sclerotherapy.
Results: All were treated with intralesional bleomycin (0.1 I.U/ kg body weight) on an outpatient basis. Complete resolution (grade 4) was observed in 76(35.6%) patients and almost complete resolution (grade 3) with very minimal residual lesion or pigmentation was seen in 89(41.7%) patients thus producing a complete or near complete response in 77.3% patients.
Conclusion: Intralesional bleomycin sclerotherapy is an excellent treatment modality for the management of low flow venous malformations with very low procedural morbidity.

Comparison Of Absorbable With Non- Absorbable Sutures In Closure Of Laparotomy Incisions

Barinder Kumar, Ruhi Khan, Irfan Malik, Mushtaq Ahmed .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 133-136

Background: To compare absorbable with non- absorbable sutures in closure of laparotomy incisions.
Materials and Methods: Sixty patients of both genders were divided into 2 groups of 30 each. In group I, fascia was closed with Prolene and in group II, fascia was closed with Vicryl. Using continuous suturing technique, fascia was closed with same size suture in both groups. Length of suture in both groups was constant 4:1. Post-operative infection at 3rd, 5th, 7th and 9th days was recorded.
Results: Group I had 15 males and 15 females and group II had 16 males and 14 females. Procedure was elective performed in 17 in group I and 18 in group II and emergency 13 in group I and 12 in group II. Diagnosis was hemoperitoneum 11 in group I and 12 in group II, blunt trauma abdomen 6 in group I and 3 in group II, gut gangrene 3 in group I and 2 in group II, mass abdomen 2 in group I and 3 in group II, intestinal perforation seen in 5 in group I and 6 in group II and intestinal obstruction 3 in group I and 4 in group II. The difference was significant (P< 0.05). Wound dehiscence was seen in 7 in group I and 12 in group II. The difference was significant (P< 0.05).
Conclusion: Prolene as compared to absorbable Vicryl suture had less wound dehiscence and better outcome.

Relation Of Weights Of The Internal Thoracic Organs With Age And Sex – An Autopsy Based Study Done In Medical College Of West Bengal

Subrata Biswas, Deepmalya Sengupta, Sanjib Bandyopadhyay, Aniruddha Das, Sanchita Das Kundu, Gowtham .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 137-149

Background: Autopsy (necropsy, post mortem examination, thanatopsy) is the examination of a person’s body after death. An autopsy is of different types. But among them Medicolegal autopsy is the concern of the forensic pathologist in India. Study of weight of human body organs plays a significant role in almost all the branches of medical sciences including forensic medicine, as any deviation in weight from the normal range suggests some pathological change in the organ. Recording of organ weights is one of regular criteria by the forensic experts during an autopsy. The findings were compared to what is standard or average of a specific organ for a specific age range and particular sex. The determination of weights of abdominal organs in particular has significant clinical value.
Materials and Methods: After getting institutional ethical committee clearance, the study done over the body of the 570 deceased came for medicolegal autopsy fulfilling the inclusion and exclusion criteria.
Results: Total 570 cases were selected after following the inclusion and exclusion criteria out of which 362 were males and 208 were females. Among the studied 570 cases, 362 (63.5 %) were male and 208 (36.5 %) were female. In this study the discussion was mainly on relation of age, sex, body weight, and body length upon the weights of thoracic viscera.
Conclusion: A database can be formed from this study regarding normal range of the weight of various organs and their relation with external parameters of the subjects which can be applicable on the population of this region for future reference. In severely mutilated bodies found in mass disasters or in homicidal killing, weights of isolated organs may give an idea about the stature, built and age of the victims helping in identification.

Rockwood Pins And Dynamic Compression Plating In Management Of Clavicular Fractures

Irfan Malik, Mushtaq Ahmed, Barinder Kumar, Ruhi Khan .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 150-153

Background: To compare Rockwood pins and dynamic compression plating in management of displaced and shortened mid-clavicle fractures.
Materials and Methods: Clavicular fractures patients were divided into two groups of 35 each. Group I patients were treated with Rockwood clavicle pins and group II patients were treated with dynamic compression plate. Parameters such as mode of injury, and the functional outcome was evaluated using the American Shoulder and Elbow Surgeons (ASES) score and Constant score.
Results: There were 20 male and 15 females in group I and 22 male and 13 females in group II. The mode of injury was fall seen in 7 in group I and 5 in group II followed by road traffic accident seen in 20 in group I and 21 in group II and physical violence in 8 in group I and 9 in group II. A significant difference in both groups was observed (P< 0.05). ASES score subjective pain value was 9.7 in group I and 8.7 in group II, activity score was 28.4 in group I and 27.3 in group II. A significant difference was seen in both groups (P< 0.05). ASES score objective range of motion was 41.9 degree in group I and 40.2 degree in group II, strength was 20.9 in group I and 20.1 in group II. A significant difference was seen in both groups (P< 0.05).
Conclusion: Rockwood clavicle pins were superior as compared to dynamic compression plate in patients with displaced and shortened mid-clavicle fractures.

Assessment Of Type Of Headache In Children

Ruhi Khan, Irfan Malik, Mushtaq Ahmed, Barinder Kumar .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 154-157

Background: To assess type of headache in children.
Materials and Methods: One hundred ten children age ranged 4 years to 10 years of both genders were selected. A thorough clinical examination and type of headache was recorded in case history proforma. A detailed neurological examination including ophthalmoscopy was performed on children with headache.
Results: Out of 110 patients, boys were 50 (45.4%) and girls were 60 (54.6%). Age group 4-6 years had 38, 6-8 years had 32 and 8-10 years had 40 patients. The difference was significant (P< 0.05). Type of headache was tension headache in 10, migraine in 46, migraine-like headache in 42, and non-specific headache in 12 patients. The difference was significant (P< 0.05).
Conclusion: The most common type of headache was migraine. Maximum number of pediatric headache was seen in 8-10 years of age.

Randomized study of functional outcome of microdiscectomy versus endoscopic lumbar discectomy in lumbar disc herniations

Mohan NS, Siddesh Patil, Dr.Basanagoud Nagaral,Dr. Akshay BG, Varun KO

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 158-168

To evaluate and compare the functional outcome of Lumbar disc herniations treated by open microscopic discectomy and endoscopic lumbar discectomy assesed by VAS AND ODI AND SF-36 score.To compare intraoperative blood loss, duration of surgery, length of hospital stays between the mentioned two groups.
Methods: Our study consists of 30 cases of lumbar disc herniations operated with microdiscectomy / endoscopic lumbar discectomy at Sanjay Gandhi institute of trauma and orthopaedics Bengalore. from december 2020 to december 2022 with follow up period of 12months for each patient after the surgery. Functional outcome was assessed through VAS AND ODI AND SF-36 score in every visit.
Results: The mean Age (Years) was 35.67 ± 6.36. out of 30 patients 15 (50.0%) of the participants had Group: OLM. 15 (50.0%) of the participants had Group: ELD. (46.7%) of the betweenthe2groupsintermsofDurationofSurgery (Minutes)(W=212.000,p=<0.001),with the median Duration Of Surgery (Minutes) being highest in the Group: OLM group.There was a significant difference between the 2 groups in terms of Blood Loss (mL) (W = 222.500, p = <0.001), with the median Blood Loss (mL) being highest in the Group: OLM group. there was a significant difference between the 2 groups in terms of improvement in VAS,ODI, and SF-36 score during the first 3 months of postoperative follow up. But after 3 months there Were no statistically significant changes between these 2 groups.
Interpretation and conclusion: The clinical results of endoscopic discectomy are similar to those of microdiscectomy in regard to improvement in radiated pain and disability but offer an advantage in relationit causes lesser soft tissue dissection, preservation of bony structures and allows early recovary of the patients,and it could lead to less surgical time, and blood loss. Endoscopic discectomy is a safe and effective technique,representing an alternative to the gold standard microdiscectomy.

Household smoke exposure: Its effects and prevention

Dr. M RajendraPrasad, Dr. Ramkumar Boopathirajan, Dr. Nishitha G, Dr. Sai Sravan Kumar R Dr. SaiSravan Kumar R

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 169-172

Smoke inhaled from factories, wildfires, factories, motorbikes, and wood stoves has an impact on household pollution and its effects. The effects of smoke pollution have been studied.
Method: From December 2021 to November 2022, a thorough assessment of papers and reports conducted utilising the accessible resources to identify possible health concerns associated with smoke pollution in homes by Department of Community Medicine, TRR Institute of Medical Sciences, Warangal, India. Researchers gathered 125 publications and reports, 15 investigations were chosen.
Result: Lower respiratory ailments, heart disease, liver and kidney damage, pneumonia, asthma, and harm to the brain have all been linked to smoke pollution. Homelessness may worsen due to the increased burden of illnesses brought on by harmful pollutants in the atmosphere from smoke pollution, including dwarfed crops, water shortages, and water running dry. In many countries, it may also become impossible to pay for the costs of collective medication. The hazards are partially attributed to the combustion of biofuels like wood, manure, or coal, which affects the mechanisms that influence the accumulation of greenhouse gas emissions, particularly carbon dioxide, and the associated changing weather.
Conclusion: Our study suggests enduring new policies that advance public health and quality of life all throughout the globe.

Effect of cholecystectomy on lipid profile and common bile duct

Dr. Chaitanyakumar Reddy P, Dr. Amarnath Reddy P, Dr. Menta Venkata Sandeep, Dr. Sheik Rehman

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 173-176

Gallstones represent a significant public health problem in
modern societies, affecting 10% to 15% of the adult population. The types of gallstones
include mixed, cholesterol and pigment stones. This study was aimed to evaluate the serum
lipid profile and common bile duct diameter in patients with gallstones pre-operatively and
post operatively and to establish the effect of cholecystectomy on lipid profile and common
bile duct dimensions.
Materials and Methods: The study was conducted in Narayana Medical College and
Hospital, Nellore, Andhra Pradesh, India. This was a prospective observational study carried
out from August 2019 to March 2020.
Results: Out of total 50 cases, 29 cases (58%) were female and remaining 21cases (42%)
were male.Highest number of cases were in the age group 30-40 years (38%) followed by
30% between 40 to 50 years of age.In the present study, there was decrease in Total
Cholesterol levels, Low density lipoprotein (LDL) and Very low density lipoprotein (VLDL)
levels 1 week after surgery, 1 and 3 months after surgery. Triglycerides (TG) levels initially
increased after 1 week and decreased significantly 1 and 3 months after surgery. Significant
increase in HDL levels are seen after 1week which continued till 3months after surgery.
The current study showed an significant increase in CBD diameter of 0.53, 0.76 and 1.07 mm
in 1week, 1month and 3 months respectively after surgery.
Conclusion: It can be concluded from this study that cholecystectomy results in
normalization of lipid levels.And also increases the diameter of Common bile duct but within
physiological limits of that age and sex group

Agriculture Irrigation System Using Wireless Sensor Network

Dr.M.Rajaiah, Mr.S.M.Rafi,Mr.K.Kartheek, Mr.N.Venkatesh, Ms.M.Praveena,Ms.P.Chandini .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 177-183

IoT based advanced solution for monitoring the soil conditions and atmosphere for efficient crop growth is presented. It also capable of monitoring temperature, humidity, soil moisture level using NodeMCU and several sensors connected to it. The system uses sensors which gives the amount of moisture in the soil, the humidity and temperature of the region, and a rain detecting sensor which and PIR sensor is using for motion activity can be used in deciding whether the crop is suitable for growing. All these sensors along with Arduino UNO are connected to the internet and a smartphone.

AN EFFICIENT APPROACH FOR AGRICULTURE MANAGEMENT USING ARTIFICIAL INTELLIGENCE

Dr.M.Rajaiah, Dr.P.Chandrakanth, G.IndhuA.Vijay reddy,B.kamalnadh, G.pavan sai .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 184-194

The United Nations Food and Agriculture Organization asserts that the whole world’s population would rise by an additional 2 billion in 2050, whereas at that time, the increased land area for farming will solely account for 4%. In the aforementioned situation, more coherent cultivation practices need to be accomplished by utilizing modern technological advancements and unravel the ongoing barriers in farming. An undeviating use of Artificial Intelligence and its subsets in agriculture can serve to be an embodiment of a shift in the way that farming is exercised during the present time. The agricultural domain faces countless obstacles for instance disease, improper soil analysis, pest infestation, irrigation, and inadequate drainage, and a lot more. These challenges lead to dangerous environmental hazards and intense crop loss as a result of using redundant chemicals. The realm of Artificial Intelligence along with its meticulous learning abilities has evolved to form akey approach for dealing with diverse
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farming-related issues. This paper emphasizes the applications of Artificial Intelligence practices in different domains of agricultural science, the industry insights, and the challenges to adopting AI in agriculture.

An Algorithm for Extraction of Decision Trees from Artificial Neural Networks

Dr.M.Rajaiah, Dr.N.Krishna Kumar,Mr. Akula Sujan Kumar,Mr. Amruthala Anil Kumar,Mr. Kamineni Venkat Chowdary,Ms. Addam Vennela .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 195-207

Although artificial neural networks can represent a variety of complex systems with a high degree of accuracy, these connectionist models are difficult to interpret. This significantly limits the applicability of neural networks in practice, especially where a premium is placed on the comprehensibility or reliability of systems. A novel artificial neural-network decision tree algorithm (ANN-DT) is therefore proposed, which extracts binary decision trees from a trained neural network. The ANN-DT algorithm uses the neural network to generate outputs for samples interpolated from the training data set. In contrast to existing techniques, ANN-DT can extract rules from feedforward neural networks with continuous outputs. These rules are extracted from the neural network without making assumptions about the internal structure of the neural network or the features of the data. A novel attribute selection criterion based on a significance analysis of the variables on the neural-network output is examined. It is shown to have significant benefits in certain cases when compared.

Image Restoration using Beyond Deep Residual Learning

Dr.M.Rajaiah, Prof.V.SreenathaSarma, Mr.P.Sumohith, Ms.M.Pravallika, Ms.M.Surekha, Ms.N.Lavanya .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 208-218

Modern deep learning techniques outperform cutting-edge signal processing techniques in image restoration applications. However, these CNNS still perform poorly if a picture has a lot of patterns and structures. Here, we offer a unique feature space deep residuary learning technique that outperforms the current residual learning method to handle this problem. The main concept is derived from the finding that a learning algorithm performs better if the input and/or label manifolds may be topologically simplified by an analytical planning to a feature space. Our in-depth numerical analyses utilizing denoising tests and the single-image super-resolution (SISR) rivalry show that proposed space residual learning surpasses the present atatus of the workmanship methods. Furthermore, our algorithm placed third in the NTIRE competition with a computational time that was 5–10 times quicker than that of the top-placed teams.

KIDNEY DISEASE PREDICTION USING SVM AND ANN ALGORITHMS

Dr.M.Rajaiah, Ms.EswararajuHemasri, Ms. Damai Venkamma,Mr. Annapureddy Teja,Mr. Bulagakula Gowtham .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 219-232

Huge volumes of healthcare data are gathered by the industry, but regrettably they are not "mined" to reveal hidden information for efficient analysis, diagnosis, and decision-making. Finding hidden patterns and linkages frequently involves idle. Advanced data mining methods can assist and offer a solution to deal with this scenario. The technique of extracting hidden information from a large dataset is known as data mining. Clustering, classification, association analysis, regression, and other data mining techniques summarization, analysis of time series and sequences, etc. Data mining methods are important a crucial part in several fields including text mining, graph mining, medical mining, Web mining and mining of multimedia. The goal of this research project is to forecast renal Utilizing Artificial Neural Networks (ANN) and Support Vector Machine (SVM). This study compares the accuracy and execution times of these two algorithms in order to assess how well they function. According to the experimental findings, the ANN performs better than the alternative approach.

MULTI-DISEASE PREDICTION MODEL USING IMPROVED SVM-RADIAL BIAS TECHNIQUE IN HEALTHCARE MONITORING SYSTEM

Dr.M.Rajaiah,Dr.U.Thirupalu, Mr.Kakavakam Sandeep,Ms.Gogula Prameela,Mr.BollineniJayanth Krishna .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 233-245

Data is a valuable resource in this digital age, and there was a tonne of data being generated across all fields. Health care industry data comprises contains information about the patient as well as information on the ailment. The use of machine learning and medical data will assist us in doing data analysis to uncover hidden illness patterns and develop individualized treatments for the patient and utilized to forecast the illness. A generic architecture for illness prediction has been presented in this work in the field of medicine. Using an improved SVM-Radial bias kernel method, this system was tested using a smaller set of features from the Chronic Kidney Disease, Diabetes, and Heart Disease dataset. It was also compared to other machine learning methods such as SVM-
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Linear, SVMPolynomial, Random forest, and Decision tree in R studio. All of these machine learning algorithms have been assessed based on their performance

An Empirical Study of Machine Learning Algorithms forCancer Identification

Dr.M.Rajaiah,, Mr.Venkataradhakrishnamurty, Ms.K.Lavanya,, Mr.A.Mohansai,Ms.G.V.Kumari, Ms.K.Amitha .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 246-251

A major challenge in the search for a cure for cancer is predicting the illness status of the disease. For instance, distinguishing between benign and malignant tumours helps doctors diagnose cancer more accurately. Although technology advancements produced data on patients with various illness stages, it would be crucial to assess how well machine learning algorithms accomplish predictions. In this article, we suggest employing machine learning algorithms such a variation of AdaBoost, deepboost, xgboost, and support vector machines. We then analyse them using area under curve and accuracyon actual clinical data linked to thyroid cancer, colon cancer, and liver cancer. Results from experiments demonstrate the SVM's strong performance.

Retrieving Sales Records by Using POWER BI

Dr.M.Rajaiah,Mrs.B.Sravani,Mr.N.DeepakReddy, Mr.M.VenkatAkhil, Mr.P.Kasiviswanath, Ms.A.PalaniSai, .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 252-263

This graphic was published by Gartner, Inc. as part of a larger research document and should be evaluated in the context of the entire document. TheGartner document is available upon request from Microsoft. 2022 Gartner Magic Quadrant for Analytics and Business Intelligence Platforms, Austin Kronz, Kurt Schlegel, Julian Sun, David Pidsley, AnirudhGaneshan, 22 March 2022. Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Gartner’s research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.Turn your data into a competitive advantage by using Power BI and Azure together to connect, combine, and analyse your entire data estate. Enable business analysts, IT professionals, and data scientists to collaborate seamlessly, providing a single version of data truth that delivers insights across your organization. "Nowwe have a single consolidated source of truth that everyone uses, and we can increasingly automate our analysis for a deeper diveinto the intricacies of the data."

STROKE PREDICTION USING ML CLASSIFICATION ALGORITHMS

Dr.M.Rajaiah, Mr.K.Rahul, Ms.N.Mounika, Mr.N.Nitish .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 264-273

Stroke is a medical disorder that harms the brain by rupturing the blood vessels there. It can also happen when the passage of blood and other nutrients to the brain is interrupted The World Health Organization (WHO) claims that stroke is the main global cause of mortality and disability. The prediction of heart attacks has been studied, however likelihood of a brain stroke is depicted in very few works. Due to this evertheless, numerous machine learning models are created to forecast the potential for a brain stroke. This essay contains a variety of physiological variables with machine learning techniques, such as Decision Tree Classification, Random Forest, and Logistic Regression K-Nearest Neighbors, support vector machines, and classification likewise Naive Bayes.

DIAGNOSIS OF SPORTS INJURIES WITH AI MACHINE LEARNING: EXPLANATION OF INDUCED DECISIONS

Dr. S.Naveen Kumar, K.Nandhini, K.Thanmayi, G.subramanyam, CH.Siva kumar. .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 274-278

Medical database data can be mined for knowledge using machine learning techniques. Various machine learning methods were employed in our application to extract diagnostic information to support judgments regarding the diagnosis of sports injuries.

Survey on Human Behaviour Recognition Using CNN

Dr. M. Rajaiah,Mr. Syed Akhtar basha, Mr. M. Naveen, Mr. M. Muni Sundaram, Ms. P. Ruchitha .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 279-284

In the field of computer vision, human behaviour identification is a vital area of research with important applications in several fields, including as intelligent surveillance, smart homes, and virtual reality. The requirements for high recognition accuracy and applicability in the modern complex environment are difficult for traditional manual procedures to achieve. The advent of deep learning has created new opportunities for behaviour recognition research. The primary goal of this paper is behaviour recognition using convolutional neural networks (CNN). The study context and significance of behaviour recognition are initially discussed before delving into and examining the classical learning methods and deep learning methods of behaviour recognition. We build a convolution neural network-based algorithm based on the distinctive human behaviour in public spaces.

SYSTEM SECURITY BASED ON ANDROID

Dr.M.Rajaiah, Mr.A.Hemanth Kumar, Ms.M.Sowjanya, Ms.M.Revathi, Mr.N.Srikanth, Ms.P.Tejaswini .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 285-288

Android is a savvy versatile terminal working stage center on Linux. Be that as it may, because of its open-source programming and programmable structure character, it drives the Android framework helpless against get infection assaults. This paper has profoundly inquired about from the Linux framework security system, Android explicit security instruments and other assurance components. Also, on this premise, Android gadgets have accomplished firmly watched on ordinary state. With the goal that aggressors cannot utilize the portion module or center library to get most elevated access consent and be assaulted. In the mean time, to additionally reinforce the security of Android gadgets, it empowers them to appropriately deal with the high-hazard danger. This paper likewise fortified interruption identification framework (HIDS) in light of the host so as to identify noxious programming and reinforce the Android framework level access control.

Academic Stress and Academic Self-Efficacy among Medical and Nursing Students in Post-COVID-19 Pandemic Era, in Erode, Tamilnadu: A Cross-Sectional Study

Nithya.M,Sivakumar.R,Muthukumar.D Nandakumar.S, Vajiravelu Suganthi, Panneerselvam Periasamy, Sasikala Gunasekaran .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 289-304

Background:After Covid-19 Pandemic, there are many elements including academic stress that contribute to psychological problems among medical students. Most importantly, these psychological elements may have an impact on how satisfied they are with their academic success.Aim and Objectives:To study the association between academic stress and academic self-efficacy on academic performance among MBBS and nursing students in the post-COVID-19 pandemic.Methodology:This is a cross‑sectional study and it was conducted via Google Form survey completed by students studying MBBS and nursing students in Erode district.A self-report format was used to collect data from students regarding academic stress, academic self-efficacy, and academic performance.Results:A total of 295 students(33.9% male, 66.1% female) had completed survey. MBBS and nursing students had a moderate level of academic self-efficacy (69.9%), a high level of academic stress.Students' academic stress, self-efficacy, and academic performance were found to be positively correlated (p < .05). The results show that significantly MBBS students’ academic self-efficacy mean score significantly higher than Nursing students (P <0.05). Conclusion:There is a significant association was observed on the levels of Academic Self efficacy versus MBBS and Nursing course students (P<0.05).

Assessment of Cases of Tympanic Membrane Perforation

Mohini Tyagi .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 305-308

Background: To assess cases of tympanic membrane perforation.
Materials and Methods: One hundred ten patients with dry perforations of tympanic membrane with no history of active middle ear disease were enrolled and the type, degree and frequency of hearing loss was determined by tuning fork test and pure tone audiometry. Clinical parameters such as cause of injury, side, site, complaints and type was recorded. The duration of disease was also recorded.
Results: Out of 110 patients, males were 65 (59.0%) and females were 45 (41%). Cause of perforation was RTA in 52, domestic assault in 38 and armed robbery in 20. Type was penetrating in 66 and non- penetrating in 44. The difference was significant (P< 0.05). Side involved was left in 46 and right side in 64. Site was anterior in 53, posterior in 41 and undefined in 16. Complaint was otalgia in 62, otorrhoea in 75, vertigo in 27 and tinnitus in 27. The difference was non- significant (P> 0.05). The mean hearing loss in 0-9 mm3 perforation was 24.1 dB, in 9-30 mm3was 36.7 dB and >30 mm3was 47.5 mm3. The difference was significant (P< 0.05).
Conclusion: Commoncause of perforation was RTA, domestic assault and armed robbery. Type was penetrating and non- penetrating. Complaint was otalgia, otorrhoea, vertigo and tinnitus.

Assessment of Cases of Biliary Leakage after Cholecystectomy

Mushtaq Ahmed, Barinder Kumar, Ruhi Khan, Irfan Malik .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 309-312

Background: To assess cases of biliary leakage after cholecystectomy.
Materials and Methods: We selected 1000 cases in four years from 2019- 2022 of laparoscopic cholecystectomy of both genders. 20 patients of biliary leakage after cholecystectomy of both genders were enrolled and site of bile leak and management were recorded.
Results: Out of 1000 patients of laparoscopic cholecystectomy, males were 450 (45.0%) and females were 550 (55.0%). Out of 20 patients of biliary leak, males were 8 (40%) and females were 12 (60%). Site of injury was CBD in 3 cases, CHD in 8, GB Bed in 5 and cystic duct in 4 cases. The difference was significant (P< 0.05). Management performed was primary suturing in 4, hepaticojejunostomy in 5, conservative with controlled external fistula in 8 and suturing of cystic duct in 3 cases. The difference was significant (P< 0.05).
Conclusion: Bile leak from major bile duct injury should be managed promptly and requires skilled surgical intervention. Management included primary suturing, hepaticojejunostomy, conservative with controlled external fistula in and suturing of cystic duct.

APPLICATIONS OF MACHINE LEARNING TO BIOMETRIC SYSTEMS-A SURVEY

Dr.M.Rajaiah,Dr.P.Chandrakanth,Mr.M.Raja Rathnam,Mr.M.Phaneesh,Ms.P.Lahari,Mr.N.Sreedhar .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 313-321

        A summary of existing work on the use of machine learning and deep learning       methods in biometrics is presented here. Biometrics traits covered include physiological (image, voice) as well as behavioral (gait, signature) features. This study shows that machine learning has a high potential to improve the performance of biometrics systems due to ML’s ability to mine, search and analyze big sets of data, performing matching tasks more quickly and reliably than the conventional methods. At the end some key challenges in use of adopting ML in biometrics systems are pointed out.

IMAGE PROCESSING USING MACHINE LEARNING

Dr.M.Rajaiah,Dr.P.Chandrakanth,Ms.P.Akanksha,Ms.N.Neeraja,Ms.K.Bhuvaneswari,Mr.P.Venkata Subrahmanyam .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 322-330

Much attention has been paid to the usage of handwritten mathematical equations and symbols, including pattern recognition industry consolidation Using a novel and sophisticated algorithm, it is now possible to identify the handwritten characters, a more diverse variety of handwritten digits is now visible. A number of machine learning algorithms, including conventional Neural Networks, Support Vector Machines, and Multilayer Perception. Finding the most effective and efficient approach for pattern recognition is the key goal or objective. Paper displays the accuracy of various classification methods varies. The Bayesian Network makes a "rough" classification of a binary image. The use of neural networks for classification contents.

IoT Based House Intruder Detection and Alert System

Dr.M.Rajaiah, Mr.D.V.Varaprasad, Mr. K. Sai Dileep Kumar, Mr. M. Madhan Kumar,Ms. P.Ankitha,Ms. N. Hema .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 331-340

This research aims to design and implement a home security system with human detection capability. Traditional home security systems, i.e., Closed-Circuit Television (CCTV) can only capture and record videos without the ability of giving warning feedback if there is any suspicious object. Therefore, an additional object detection and warning method is required. The proposed design is implemented using Raspberry Pi 3 and Arduino, that is connected by USB cable. The PIR sensor is installed on Arduino and webcam is mounted on Raspberry Pi 3. The Raspberry Pi 3 is used to process inputs from sensors and process images for human detection. PIR sensor detects the movement around the sensor to activate the webcam to capture a picture. Then, the object recognition is performed using Histogram of Oriented Gradients (HOG) and Support Vector Machine (SVM) to detect the suspicious object.

Credit Card Fraud Detection Using Machine Learning

Dr.M.Rajaiah, Dr.N.Krishna Kumar, Mr.M.Lakshmi Prasanna Kumar,Ms.P.Maneesha, Mr.P.Pavan Kumar, Mr.P.Suneel .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 341-347

IoT The rapid growth in the E-Commerce industry has led to an exponential increase in the use of credit cards for online purchases and consequently they have been surging in the fraud related to it. In recent years, it has become very difficult to detect fraud in credit card systems. For predicting these transactions banks make use of various machine learning methodologies, past data has been collected and new features are being used for enhancing the predictive power. The performance of fraud detecting in credit card transactions is greatly affected by the sampling approach on dataset, selection of variables and detection techniques used. This paper investigates the performance of logistic regression, decision tree and random forest for credit card fraud detection. The three techniques are applied for the dataset and work is implemented in R language.

VEHICLE NUMBER PLATE RECOGNITION BY USING ANN

Dr.M.Rajaiah,Dr PVRD Prasada Rao,A.Sunil,B.Divya,G.Hemanth Kumar,G.srilekha .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 348-359

Number Plate Recognition technique is widely used in identifying vehicle identity across the world where a standard plate size and font are maintained which makes recognition easy. For implementing number plate recognition specifically in India a lot number of issue comes up like hundreds of different forms of fonts being used, size of plate not maintained, five different color number plate, double line number plate etc. All these problems are being taken care while developing a software for Indian number plate recognition and is tested in real Indian road conditions. Support Vector machines are trained & used for detection of number plate contours. ANN is used for character recognition from number plate and various algorithm for plate enhancement, noise reduction and ultimately neural networks are most efficient for result with erasing lot of camera constraints. The ANPR software is designed in C++ using Qt for GUI designing, OpenCV as image processing libraries and SQL as database management thereby making it a complete software implementation of idea.

Home Automation using SMS

Dr.M.Rajaiah,Dr.U.Thirupalu,Ms.K.Nikhila, Ms.N.Priyanka, Ms.K.Harshitha, Mr.P.Nikhil Kumar .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 360-367

Various electronic  equipment available for remote operation of grid control. However, the main disadvantage of is these systems that they can be operated only short ranges and also less reliable. Thus, to overcome the from above drawbacks, we are using one of the wireless communication techniques i.e., GSM (Global System for Mobile communications) is a digital cellular communications system which has rapidly gained acceptance and market share.world wide. The development of GSM is the first step towards a true personal communication system that will allow us to communicate anywhere, anytime and with anyone. GSM (Global Systems for Mobile Communication) is vastly used because of its simplicity in both transmitter and receiver design, can operate at 900 or 1800 MHZ band, faster, more reliable and globally network.

Traffic Sign Detection And Recognition Using Artificial Intelligence –Deep Learning Algorithm

Dr. M. Rajaiah,Mr. V. Chandhra Sekhar,Ms. K. Poojitha,Mr. G. Suneel,Mr. G. Santhiswaroop .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 368-377

Due to the large number of deaths and car accidents caused by the driver's lack of attention, car manufacturers are trying to integrate ADAS systems with artificial intelligence and CV. One function that helps the driver is traffic sign recognition (TSR). This is a technology with which a vehicle is able to recognize road signs placed on the road, e.g. "speed limit" or "give way" or "stop" all this being possible with the help of computer vision and Convolutional Neural Networks. In this article we propose an implementation based on LeNet architecture for traffic sign recognition using CNN. We preferred the deep learning approach for this challenge as methods like shape based or color based share a common weakness in factors as light changes, scale change, rotation. The paper presents implementation of the network architecture based on LeNet5 using Keras and TensorFlow library, how we trained the CNN using the GTSRB dataset, and what results we obtained training and using the network for real time applications using only CPU power, with Intel i7 7700K. The experimental results showed a 95% accuracy in recognizing traffic signs. Keywords – Artificial Intelligence, AI, Convolutional neural network, deep learning, LeNet architecture, traffic signs recognition.

Speech Recognition using Machine Learning

Dr.M.Rajaiah, Mr.B.Hari Babu, Mr.N.Sateesh kumar reddy, Mr.K.Madan, Mr.P.Hema krishna reddy, Mr.P.Gowtham .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 378-386

Speech recognition is one of the fastest-growing engineering technologies. It has several applications in different areas, and provides many potential benefits. A lot of people are unable to communicate due to language barriers. We aim to reduce this barrier via our project, which was designed and developed to achieve systems in particular cases to provide significant help so people can share information by operating a computer using voice input. This project keeps that factor in mind, and an effort is made to ensure our project is able to recognize speech and convert input audio into text; it also enables a user to perform file operations like Save, Open, or Exit from voice-only input. We design a system that can recognize the human voice as well as audio clips, and translate between English and Hindi. The output is in text form, and we provide options to convert audio from one language to the other. Going forward, we expect to add functionality that provides dictionary meanings for Hindi and English words. Neural machine translation is the primary algorithm used in the industry to perform machine translation.

SECURE LOGIN AUTHENTICATION SYSTEM FOR ACCESSING ANY WEB APPLICATIONS

Dr. M. Rajaiah,Mr.U.Thirupalu ,Ms.T.Bhavana, Ms.Sk.Karishma, Ms.V.Kusuma Kumari ,Mr.S.Mohammad Huzaifa .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 387-396

              The security of our data on the Internet is MYTH now a day’s. Regularly we are using lots of services and applications to accomplish a small task   or works. Like converting documents to PDF, playing online games knowingly / unknowingly we are giving permissions to the apps for accessing our data   by using options like the sign in with Google or sign in with Facebook. Most people are not aware that these apps can access all the information available on that particular platform this user and they can use it for customizing applications and to provide a better experience to the user. 

ADVANCED TRANSPORT PROPULSIONS :MACHINE LEARNING SYNTHESIS FOR REAL TIME MIRRORING

Dr.M.Rajaiah, Mr.B.Hari Babu, Ms.A.Vineetha, Mr.I.Siva Krishna Reddy,Mr.B.Venkata Krishna, Mr.A.Nagendra Reddy .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 397-407

Major industries throught the world are being transformed by the artificial intelligence (AI) revolution. Many engineers and scientists are interested in AI because it makes correct inferences. After careful consideration, it appears that hardware- in- the-loop (HIL) emulation may choose to use this kind of modeling approach as one of the choices. In this article, a method for simulating power electronic motor drive transients for advanced transportation applications (ATAs) without a conventional circuit- oriented transient solver is proposed. To verify the realtime emulation application-specific labs, the more electric aircraft (MEA) power system is used as a case study. MLBs have used neural networks (NNs) to create component-, device-, and system-level models for diverse pieces of machinery. These models have been successfully trained in a cluster and are now being used with field-programmable gates. Based hardware platform (FPGA). The results of the MLBB emulation are then contrasted
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ISSN2515-8260 Volume10, Issue 02, 2023
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with those obtained by PSCAD/EMTDC for the system level and SaberRD for the device level. The
which has been applied in the areas of face verification , image resolution processing , human results of the comparison revealed great consistency for modelcorrectness and high speed-up forhardware execution.

AUTOMATED SELF SUPERVISED IMAGE COLORIZATION USING GAN

Dr.M.Rajaiah, Mr.P.Venkataradhakrishnamurty, Mr.T.Sai Kumar, Mr.P.Vivek Manindra, Mr.N.Sai, Mr.S.Manoj, .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 408-419

Image colorization is a fascinating and challenging topic in image-to-image translation. Image Colorization is the process of coloring a grayscale image by using a black and white image known as a grayscale image as input and obtaining the output in RGB format simply known as a color image. The fundamental aim is to convince the spectator that the outcome is genuine. Many cameras, such as surveillance cameras and satellite cameras, still capture grayscale images which are kind of hard to analyze. Over the last 20 years, a wide range of colorization methods have been created, ranging from algorithmically simple yet time- and energy-consuming procedures due to unavoidable human participation to more difficult but also more automated methods. Image colorization by hand is time-consuming and prone to human error. Automatic conversion has evolved into a difficult field that combines machine learning and deep learning with art. In this project, we built an image colorization framework based on a deep learning method known as Generative Adversarial Networks, or GANs for short. GANs are a type of generative modelling that employs deep learning techniques such as convolutional neural networks.

Buy Beauty Online Shopping Experience For Women

Dr.M.Rajaiah, Mrs.Katta.Lakshmi, Ms.M.Rama Rakshitha, Ms.R.Thanuja,Ms.M.RajyaLakshmi, Mr.N.PrudhviRaju, Mr.M.KamalTeja .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 420-430

The project's primary goal is to improve the shopping experience for women while buying cosmetics.There are websites that have many brands in the market and products for every sort of client; nevertheless, these products do not always reach the people who need them the most, and some products are overpriced or not worth the hype. Additionally, some websites' user interfaces are not particularly excellent. Some websites don't offer simple return policies, and the tracking ID isn't updated promptly. User information is misused, and the services are not continuous. No FAQs or question areas, which are essential for a general audience that relies on these websites.The project's major goal is to provide ideas based on user problems, display the best products that are reasonably priced on the screen

Designing of Smart Educational Institution using Internet of Things

Dr. M. Rajaiah, Mr. K. Venkataratnam, Ms. K. Shushitha, Ms. K. Bhoomika,, Mr. G. Anil .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 431-436

This paper describes the design of smart Education Institute using Internet of Things Technology (IoT). Smart Educational Institute can be also known as the smart campus, developing of smart educational institute leads to smart campus development. Through smart campus, it is possible that a campus is connected via online by the outside entity. So that the teaching entity will be done technology in real time. The study of smart campus consist of smartroom, smart parking and smart education. By the study of this paper we can able to design the smart campus by which we can save time, power, etc.

EMAIL SERVICES FOR VISUALLY CHALLENGED

Dr.M.Rajaiah, Mr.Surendra, Mrs.Sindusha, Mr.Tej ganesh singh, Ms.Mahitha, .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 437-445

Communication plays a crucial role in every field in one’s life. It is an integration of the communicating technologies with the help of internet. But this facility is not for blind people. Hence, we aimed to develop an Android based email application that can facilitate visually challenged people to use email services for communication. The application will work solely on voice commands spoken by the user which will enable them to communicate with the world. They can send and receive any mails whether it is a text document, picture, audio, video, etc. using this system using the internet. By providing the platform in which they can speak the operation and can able to send and receive the messages. The system will be build using Google Text-to-Speech and Speech-to-Text APIs, which will make it efficient, accurate to a certain limit and user friendly. We describe the Voicemail system architecture that can be used by a Blind person to access eMails easily and efficiently. The contribution made by this research has enabled the Blind people to send and receive voice based e-Mail messages in their native language with the help of a computer.

Home Automation using SMS.

Dr.M.Rajaiah, Dr.U.Thirupalu, Ms.K.Nikhila, Ms.N.Priyanka,, Ms.K.Harshitha,, Mr.P.Nikhil Kumar, .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 446-452

Various electronic equipment available for remote operation of grid control. However, the main disadvantage of is these systems that they can be operated only short ranges and also less reliable. Thus, to overcome the from above drawbacks, we are using one of the wireless communication techniques i.e., GSM (Global System for Mobile communications) is a digital cellular communications system which has rapidly gained acceptance and market share.world wide. The development of GSM is the first step towards a true personal communication system that will allow us to communicate anywhere, anytime and with anyone. GSM (Global Systems for Mobile Communication) is vastly used because of its simplicity in both transmitter and receiver design, can operate at 900 or 1800 MHZ band, faster, more reliable and globally network.

IMAGE ENCRYPTION USING AES FEATURE EXTRACTION AND RANDOM NO. GENERATION

Dr.M.Rajaiah, Mr. Syed Akthar Basha,, Mr.D.Hidayathulla, Mr.V.Anirudh Reddy, Ms.S.Kusuma,, Mr.S.Ansar Ahammad, .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 453-460

During data transmission, data can be transmitted in the form of text, image, audio and video, hence securing all kinds of data is most essential in today’s era. With the advent of internet technology, the number of unauthorized users to access the data increases.so, the transmission of information through imagesbecomes more. And it also becomes a more reliable form to transmit data. There are a number of algorithms available to solve this problem. One of the efficient methods is to use the AES (Advanced Encryption Standard) algorithm, the most notable and extensively used cryptographic algorithm because itis six times faster than 3- DES and much faster than the RSA algorithm. In this paper we proposed an image encryption and decryption algorithm using AES in which encryption contains a random image and decryption contains the original image. The efficiency of AES is compared using image and text and it is analyzed. The result thus shows that the sharing of information through image is much more reliable and efficient than sharing information as text. Index Terms: AES, Cryptography, Decryption, Encryption, Image.

IOT BASED AUTOMATEDATTENDANCE MANAGEMENT SYSTEM

Dr.M.Rajaiah, Mr.V.Chandrasekhar, Mr. Parlapalli Pavan Kumar Reddy, Mr.Posina Praveen ,, Ms. Menakuru Uma Maheswari, Ms. Kudiri Swetha .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 461-468

The use of Radio Frequency Identification (RFID) systems in industrial technologies, health, agriculture, transportation, etc. has suddenly increased in recent days. The internet of things is flourishing.With the help of the Raspberry Pi 3 and RFID Technology, the attendance management system uses the Internet of Things to speed up the time-consuming process of documenting daily attendance in schools and other institutions. Thus, everything in this place becomes mechanised. The creation of an Android application (app) to enable students to view their attendance from any location has also been attempted.

SPEECH STRESS ANALYSIS BASED ON LIE DETECTOR FOR LOYALITY TEST

Dr.M.Rajaiah, Mr.Venkataradhakrishnamurty,, Ms.P.Sasisree, Mr.K.Poornanandam, Mr.K.Harshavardhan, Ms.P.Hema, .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 469-472

Human being has lot of virtual mask in their behaviour (mind or brain). By the way of probability study alone, be able to find a person’s loyalty through their emotions, stress of speech, way of expressions and so on. It is not a novel technique to this world. The judgement and the hearings are finalizing in accordance to passed parameters (questions, transparent as well hidden test) and the result. Artificial Neural Network (ANN) is one of the best methods meant for speech stress analysing based cheap lie detection for the loyalty test. To show the results, polygraph is a comprehensible demonstration oriented approach. These methods are already used by the insurance fraud investigations and police. Through an individual’s stress (stress percentage or else range) voice as well their emotions are able to detect the loyalty. Lie detection techniques require being extremely confidential and dynamic. For the reason that voice stress analysis (VSA) parameters have to be an encrypted for avoiding speech practise with testing tool. Here this paper, outlooks by using for predicting the liars through Speech VSA

LUNG CANCER DETECTION USING MACHINE LEARNING ALGORITHMS

Dr.M.Rajaiah, Mr.D.V.VaraPrasad, Mr.T.Siva,, Mr.T.Chaitanya, Ms.S.Bhavana,, Ms.Ch.Praveena .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 473-484

Lung Cancer detection making use of medical imaging is still a challenging task for radiologist. The objective of this researchis to classify the types of lung tumours for extracted and selected features using learning algorithms. In this paper, an experimental study is conducted on 100 cases of lung cancer to evaluate the performance of learning classifiers (DNN, SVM,Random Forest, Decision Tree, Naïve Bayes) with different medical Imaging (DICOM) features to identify the two types ofLung cancer (Benign and Malignant). The proposed methodology intends to automate the entire procedure of diagnosis byautomatically detecting the tumor, measuring the required values such as diameter, perimeter, area, centroid, roundness,indentations and calcification. Experiment is conducted in to two phases: In the first phase, identify the most significantfeature used in lung cancer analysis by CT scan and perform the mapping to computer related format. In the second phase,feature selection and extraction is performed to machine learning algorithms. To evaluate the performance of classifiers interm of classification accuracy and improving the false positive rate, every stage of evolution is divided into four differentphases: single phase module, single slice testing, series testing and testing of learning algorithms. Experimental resultsshow significant improvement in false positive rate up to 30% for both Benign and Malignant. Whereas, Deep NeuralNetwork (DNN) demonstrate high values in term of classification accuracy in comparison with other classifiers.

Lung cancer medical image recognition using Deep Neural Networks

Dr.M.Rajaiah, Mr. A .Hemanth Kumar, B. Sai, D. Vishaka,G. Sirisha, K. Balaji .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 485-492

Medical images (Magnetic Resonance Imaging scans) are used by doctors and medical specialists to determine the possibility that a cancer is present in the lungs of a patient. We are using these images, along with Deep Neural Network algorithms to help doctors with image diagnostics by training the Deep Neural Network (DNN) to recognize lung cancer. Our Deep Neural Network introduces novelty by making extensive search by adding additional layers of convolution and max pooling. Moreover, we are using images from slow progressing lung cancer to determine the threshold or at which point in the progression, our Deep Neural Network, will diagnose the cancer. Using this, doctors will have additional help in early phase lung cancer detection and early treatment. These are the main purposes of our research, which includes thorough search of possibilities of lung cancer and early detection.

MARKETING STRATEGIES FOR E-COMMERCE WEBSITES UNDER THE NEW MEDIA TREND

Dr.M.Rajaiah, Dr.D.V.Varaprasad, Ms.K,Naga sulochana devi, Ms. A.Aparna, Ms. K.Keerthi .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 493-500

With the continuous development of information technology in China, it has become an indispensable part in the daily life and production. As an economic model based on extended information technology, E-commerce technology has gradually been accepted by the public, from the traditional passive acceptance to active cooperation and active use, which serves as an opportunity as well as a challenge for e-commerce enterprises. They must ensure good performance in marketing, such as website marketing. Website marketing is an essential part of the e-commerce marketing process, and its level will directly determine the overall operation quality and efficiency of e-commerce enterprises. Therefore, the relevant staff must conduct in-depth research on it, optimize and innovate traditional marketing methods in the context of new media technology, improve the level of website marketing, to improve the influence of enterprises in all aspects and enable them to obtain a certain share in the e- commerce market. Based on this, this thesis makes an in-depth analysis of e-commerce website marketing against the backdrop of new media and formulates corresponding marketing strategies according to its characteristics.

Symmetric Key Based Verification On Dynamic Encrypted Cloud Data By Using Keyword Search

SK.MAMOLA, T.SAIPRASAD, V. RAJITHA, SK.NAVEED .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 501-557

Communication is the main channel between people to communicate with each other. In the recent years, there has been rapid increase in the number of deaf and dumb victims due to birth defects, accidents and oral diseases. Since deaf and dumb people cannot communicate with normal person so they have to depend on some sort of visual communication. Sometimes people interpret these messages wrongly either through sign language or lip. Hand gesture is one of the method used in sign language for non- verbal communication. It is most commonly used by deaf & dumb people who have hearing or speech problems to communicate among themselves or with normal people. Various sign language systems has been developed by many makers around the world but they are neither flexible nor cost-effective for the end users. Hence in this paper introduced software which presents a system prototype that is able to automatically recognize sign language to help deaf and dumb people to communicate more effectively with each other or normal people. Pattern recognition and Gesture recognition are the developing fields of research. Being a significant part in nonverbal communication hand gestures are playing key role in our daily life.

SECURE FILE STORAGE USING HYBRID CRYPTOGRAPHY

Dr.M.Rajaiah, Mr. S. M. Rafi,, Ms. K. Yasaswetha, Mr. K. PardhaSaradhi, Mr. G. Jayanth, Ms. K.Lakshmi Prasanna .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 558-565

Cloud is used in various fields like industry, military, college, etc. for various services and storage of huge amount of data. Data stored in this cloud can be accessed or retrieved on the users request without direct access to the server computer. But the major concern regarding storage of data online that is on the cloud is the Security. This Security concern can be solved using various ways, the most commonly used techniques are cryptography and steganography. But sometimes a single technique or algorithm alone cannot provide high-level security. So we have introduces a new security mechanism that uses a combination of multiple cryptographic algorithms of symmetrickey and steganography. In this proposed system 3DES (Triple Data Encryption Standard), RC6 (Rivest Cipher 6) and AES (Advanced Encryption Standard) algorithms are used to provide security to data. All the algorithms use 128-bit keys. LSB steganography technique is used to securely store the key information.

SECURE LOGIN AUTHENTICATION SYSTEM

Dr.M.Rajaiah, Mr.S.M.Rafi, Mr.Sk.Karimulla,, Mr.Sk.Mahammad, Mr.Sk.Mahammad Ali,, Mr.S.Ajay Kumar, .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 566-578

The security of our data on the Internet is MYTH now a day’s. Regularly we are using lots of services and applications to accomplish small tasks or work. Like converting documents to PDF, and playing online games knowingly / unknowingly we are giving permissions to those apps for accessing our data by using options like the sign in with Google or signing in with Facebook. Most people are not aware that these apps can access all the information available on that particular platform of this user and they can use it for customizing applications and to provide a better experience to the user.In some cases, the app does not require all the information about the user but collects it. And users don't want to share the information with a particular website or app which they don't trust. So to overcome the scenario we came up with a user verification alternative (Secure Login Authentication System). Where the user can provide his full name, mobile number, email address, date of birth, and password. Apart from this, we will not collect any other information so that if that app tries to access the information it will be available on the server. Users who don't like to share their information online can use this alternative (Secure Login Authentication System) to verify themselves and share as much as less data.

SKIN DISEASE DETECTION USING ARTIFICIAL NEURAL NETWORK

Dr.M.Rajaiah, Mr.D.V.Varaprasad, Ms.T.Lakshmi Chathurya,, Ms.S.Kavya, Mr.T.Sasidhar, Mr.P.Mahesh .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 579-588

Skin diseases are one of the common health problems that can be diagnosed by examining the physical structure of diseases and history. At present, diagnosis of skin disease is done by invasive techniques like clinical examination and histopathology. The tests are very efficient and helpful. But these methods require subject experts, more time, and have less data reproducibility. Since diagnosis needs an expert, making it reachable to all places is difficult. So this research came up with a solution using a clinical feature-based diagnosis tool to diagnose certain skin diseases. The tool was developed with the help of image processing and deep learning algorithms.

A cost sensitive Random Forest Algorithm for Detecting a credit card Fraud techniques

Dr.M.Rajaiah, Dr.P.Chandrakanth, Ms.Sk.Sumaya, Ms.Sk.Shabeena, Mr.U.Surendra,, Mr.S.Abhinav .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 589-600

As technology developed, new business-making mechanisms emerged in the financial sector. One of them is the credit card system. But due to several flaws in this method, numerous issues are raised in this system by credit card frauds. The industry as well as customers who use credit cards is suffering greatly as a result. Lessons on investigating actual credit card figures in relation to privacy concerns are lacking. In the publication, an effort has been made to uncover credit card fraud using algorithms that used machine learning approaches. In this regard, two algorithms are used via Fraud Detection in credit card using Decision Tree and Fraud Detection using Random Forest. Some available online data can be used as a sample to determine the model's efficacy. Then, a financial institution's genuine globe credit card details group is analyzed . Additionally, additional noise is added to the data samples in order to auxiliary assess the systems' durability. The first approach in the study is significant since it builds a tree against the user's behaviors, and by utilizing this tree, frauds will be detected. In the second way, a user activity-based forest will be built, and it will be attempted to identify the suspect using this forest. The findings of the analysis unequivocally demonstrate that the common elective method detects credit card fraud situations with respectable degrees of precision.

HAAR CASCADE ALGORITHM FOR FACIAL RECOGNITION

Dr.M.Rajaiah,, Ms. G.Haripriya, Ms.D.Asha, Mr.A.Nikhil Reddy, Mr.Ch.Syam Raj,, Ms.K.Neeraja .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 601-612

To maintain the attendance record with day to day activities is a challenging task. The conventional method of calling name of each student is time consuming and there is always a chance of proxy attendance. The following system is based on face recognition to maintain the attendance record of students. The daily attendance of students is recorded subject wise which is stored already by the administrator. As the time for corresponding subject arrives the system automatically starts taking snaps and then apply face detection and recognition technique to the given image and the recognize students are marked as present and their attendance update with corresponding time and subject id. We have used deep learning techniques to develop this system, histogram of oriented gradient method is used to detect faces in images and deep learning method is used to compute and compare feature facial of students to recognize them. Our system is capable to identify multiple faces in real time.

PERFORMANCE ANALYSIS OF VARIOUS MACHINE LEARNING ALGORITHMS FOR FALL DETECTION-A SURVEY

Dr.M.Rajaiah, Mr.V.Sreenatha sarma, K.Thanuja, D.Chaitanya, G.Madhuri, K.Reddaiah .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 613-624

Improper activities appear nowadays for the human (i.e.) falling without aware, and numerous techniques had been developed to reduce them. In this essay, critically analysis of the various proposed methodologies by comparing their strength and their weakness. The complexity and diversity of actions make it difficult to recognise them. The conventional (CCTV) method is ineffective and expensive for monitoring patient activities by using sensor based is also difficult due to drained battery life. So we need real time system for activity recognition with more efficiency and accuracy to avoid people from morality problems or it may lead to causes to major injuries. By comparing various algorithm Support vector machine (SVM) is a discriminative classifier belonging to supervised learning. Recurrent neural network (RNN) is one of the concepts in deep neural network. The main intention of the RNN is to minimize the preprocessing. This application will seem like visual imagery analysis. The convolutional neural network (CNN) it is more cost expensive compared wearable and ambience based

Analysing Metallic Nanoparticles in Plant Extract

Yogeshwer R Ramasane, Sanjeev M. Reddy .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 625-633

Metal nanoparticles (MNPs) Medical imaging, bioengineering, photoelectricity, antibacterial, anticancer, and catalysis are just a few of the many areas where their unique physical and chemical properties have been extensively utilized. In the conventional MNP synthesis method, toxic chemicals are typically used as reducing and stabilizing agents. This method is extremely harmful to the environment and takes a long time. Because of this, environmentally friendly MNPs synthesis has recently received a lot of attention. Utilizing plant extracts as reductants and stabilizers enables MNP synthesis to be simple, cost-effective, and long-lasting. In addition, unlike their conventional counterparts, the as-synthesized MNPs are uniform in size, less toxic, and more stable. Green preparation methods are becoming an increasingly important focus in MNPs synthesis research. This systematic review provides a summary of the most recent developments in the utilization of plant extracts as reductants and stabilizers in the green synthesis of MNPs. The potential applications of MNPs made from plant extracts have also been studied in greater detail.

Effects of Placental Morphometric Measurements on the Newborn's babies Body Mass Index

Dr. K. Zia Ul Haq, Dr. Vimal Modi, .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 634-644

Placenta is a functional unit between the mother and the foetus. Only eutherian mammals possess placenta. Human placenta is discoid, deciduate, haemochorial, chorioallantoic, labyrinthine and endocrine gland which connects developing embryo by umbilical cord to the endometrium of mother’s uterus. It develops from two sources. The fetal component which is the principal component develops from chorion frondosum and the maternal component from decidua basalis. The fetal surface is smooth, covered by amnion and presents the attachment of the umbilical cord close to its centre. The maternal surface is rough, irregular and spongy and is mapped out into 15-20 convex polygonal areas known as lobes or cotyledons which are limited by fissures

Effects of Placental Morphometric Measurements on the Newborn''''s babies Body Mass Index.

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 634-644

Placenta is a functional unit between the mother and the foetus. Only eutherian mammals possess placenta. Human placenta is discoid, deciduate, haemochorial, chorioallantoic, labyrinthine and endocrine gland which connects developing embryo by umbilical cord to the endometrium of mother’s uterus. It develops from two sources. The fetal component which is the principal component develops from chorion frondosum and the maternal component from decidua basalis. The fetal surface is smooth, covered by amnion and presents the attachment of the umbilical cord close to its centre. The maternal surface is rough, irregular and spongy and is mapped out into 15-20 convex polygonal areas known as lobes or cotyledons which are limited by fissures

Relationship between self-care and sleep impairment on glycemic control in patients with type 2 Diabetes in a hospital population– A cross sectional study

A. Nitin Aras, U.B. Vijayalakshmi, Jaidev Sudagani .; A. Nitin Aras1, U.B. Vijayalakshmi, Jaidev Sudagani .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 645-653

Introduction: Diabetes mellitus being a chronic metabolic disease responds well to self-care practices. Improper self-care and insomnia have been associated with poor glycemic status with its associated micro and macrovascular complications.
Materials and methods: The data regarding self-care and insomnia were collected from 90 consecutive adult patients with type 2 diabetes at a tertiary care teaching hospital, using Diabetes Self-Management Questionnaire and Insomnia Severity Index questionnaire. Glycated haemoglobin was used as a measure of glycemic status.
Results: There was a significant association between poor self-care with insomnia (p=0.001) and glycemic status (p=0.03), but there was no association between insomnia and glycemic status (0.95). Conclusion: Poor self-care is associated with poor glycemic status and insomnia.

MAGNETIC RESONANCE CHOLANGIO PANCREATOGRAPHY EVALUATION OF BILIARY TRACT AND HEPATIC ARTERY VARIATIONS

1Dr. K.K. Harshyenee ,2 Dr. Dileep Reddy Ayapaneni, 3Dr. V.M. Kulkarni, 4Dr. Ajay Dahiya* .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 695-702

Aim: This study was made to determine the efficacy of visualization of hepatic artery without contrast and to determine the branching patterns of biliary tract by using MRCP. Methods: This was an observational cross sectional study in the department of Radio- diagnosis, Dr. D.Y. Patil Medical College and Hospital, Pune. All the patients who were referred to the Radiology department for routine MRCP were considered as study population. The data collection for the study was done from January 2021 to June 2022. Consecutive sampling was done and the sample size achieved was 30. Results: The normal course of common hepatic duct was found in 80% of patients where the remaining 20% were variants formed by RAHD and LHD and the other being RPHD and LHD. Considering the cystic duct, the normal lateral insertion was found in 76.7% of the study population whereas medial insertion was found in 13.3%. In case of hepatic artery, Michel’s type I was found in 86.7% of the study population. Other variants found are Michel’s type III and IX. In 6.7% of subjects, the hepatic artery could not be visualized. Normal anatomy of left hepatic duct was seen in 66.7% of females and 33.3% of males with a significant p value of 0.0135. Right hepatic duct was normal in 69.6% females and 30.4% of males with a significant p value of 0.05. The lateral insertion of cystic duct which is considered normal is found in 52.2% of females and 47.8% of males with a significant p value of 0.56. Michel’s type I variant was observed in 61.5% of females and 38.5% of males with a p value of 0.5. Conclusion: Our study described the prevalence of anatomical variations of biliary tract in our study population and also delineated the hepatic artery and its variations to some extent without using contrast.

A Randomized Control Trial of Percutaneous Ultrasound Guided Needle Aspirations Versus Incision and Drainage for the Management of Breast Abscesses in the Garhwal Region of Uttarakhand

Dr.Shwetabh Pradhan1, Dr. Sophiya2, Dr.Biant Singh3 .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 682-689

Objectives: This present study was aimed to compare the clinical outcomes of the two treatment modalities:percutaneous ultrasound guided needle aspirations versus incision and drainage inthe management of breast abscesses.
Methods: A total of 50 breast abscess patients were enrolled in this study. All the patients were randomized and allocated into 2 groups of 25 patients each.25 patients in one group were subjected topercutaneous ultrasound guided needle aspiration (Group A) under local anaesthesia and 25 patients in another group to incision and drainage (Group B) under general anaesthesia respectively. A detailed history and clinical examination was done for all the patients and multiple clinical variables were recorded prospectively to evaluate the differences in theclinical outcomes of the two modalities used for the management of breast abscesses.

Case Report: Unexpectedly a Missing Tooth, post Extubation after an uncomplicated surgery!

1Dr. Bhavini Shah, 2Dr. Fateh Pal Singh, 3Dr.DipanjaliMahanta, 4*Dr. SriramMahalingam .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 695-702

A young male with no known comorbidities, posted for an uncomplicated ENT procedure, had his tooth missing immediately post extubation from Anesthesia. In this case report we explore the possibilities and expected complications of a missing foreign body in the oropharynx, the need for vigilance and immediate action to prevent further injury to the patient.

Mechanism For Recommending Web Series

Dr.M.Rajaiah, Mr.A.Venkateswarlu,Mr.T.Sai Sudeep, Mr.T.Harish, Mr.S.Sumanth, Mr.Sk.Wahed Ali .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 703-719

Many businesses today aim to provide useful product suggestions to online users in order to increase their consumption on websites. People usually choose or buy a new product based on the recommendations of friends, comparisons of similar products, or feedback from other users. A recommender system must be implemented in order for all of these tasks to be completed automatically. Recommender systems are tools that provide suggestions that best suit the client's needs, even if the client is unaware of it.Personalized content offers are based on past behaviour, and they entice customers to return to the website. A web series recommendation mechanism for Netflix/Prime/Disney plus Hotstar will be built in this paper. The dataset used in this study contains over 5 K web series and 500 K+ customers. Popularity, Collaborative Filtering, Content-based Filtering, and Hybrid Approaches are the four main types of recommender algorithms. This paper will introduce all of them. We will choose the algorithms that best fit the data, implement them, and compare them

The Effects of Working Capital Management on the Financial Performance of Trading Companies

Nisha Patel, Anjali Hira, Shikha Soni, Dipika Sahu and Shilpa Sharma .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 720-724

The efficiency with which a business manages its working capital determines how well it can fulfil its operating expenses and its short-term debt obligations. It is important for businesses to balance the demands of effective working capital management with their overall financial and operational health. It is anticipated that the strong financial performance will be supported by an effective Working Capital Management. This research set out to learn how effective management of a company's working capital can boost its bottom line. Working capital management effectiveness was studied by analysing the cash conversion cycle. Here, we ask, "To what extent does the management of working capital affect the financial results of trading firms?" ― Working capital management is found to have a significant impact on bottom line results, according to the literature. The assumption was that a company's bottom line would benefit from better attention to its working capital. The relationship between the key performance indicator return on assets and the controllable factor of working capital management was studied.

Shear Bond Strength Testing Of Newer Generation Dentin Bonding Agent

Dr. Damini Bhagwat, Dr .Ashwini Gaikwad, Dr. Varsha Pandit, Dr. Rajlaxmi Patil, Dr. Ruchira Bhamare, Dr. Sailee Kalyankar .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 725-732

Aim: Comparison of the shear bond strength of universal bonding agent to the traditionally used total-etch bonding agent
Materials and methods: Total 18human permanent mandibular second molars with sound roots and crowns extracted for periodontal reasons were collected. These were sectioned into 2 halves to obtain 36 samples and then they were divided into three groups randomly: Group A (No bonding protocol), Group B (Universal Bonding agent) , Group C (Total-etch Bonding agent). Post the bonding protocol, composite build up was done for the samples and they were subjected to Universal testing machine for shear bond strength testing.
Results: Between the two experimental groups, significant difference was seen in shear bond strength.
Conclusion: Universal bonding agent used in self-etch strategy showed better shear bond strength than total-etch bonding agent.

Airway Assessment In Patients Undergoing Oral And Maxillofacial Surgical Procedures Under General Anesthesia: An Institutional Study

A. Shamaa Anjum,Dr. Santhosh Kumar M P .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 733-745

BACKGROUND:
Preoperative management of the patient is the liability of a medical attendance. An understanding of risk factors before general anaesthesia [GA] is an important factor for preoperative management.The present study was aimed at assessing the airway of patients undergoing oral surgical procedures under general anaesthesia in our institution.
 
MATERIAL AND METHODS:
The study was performed under a university setting where all the data of patients who underwent oral and maxillofacial surgical procedure under general anaesthesia.The collected data was compiled, reviewed , tabulated and entered in SPSS software and statistically analysed.
 
RESULTS:
55% of the patients were males and the rest (45%) were females. Airway assessment in patients according to mallampati classification revealed that 57% were of class I, 38% were of class II , 3% were of class III and less than 1% were class IV. Patients who underwent FMR (40%) and cleft lip/palate (14%) had class I airway. Patients who underwent ORIF and enucleation both had class I (19.5%), class II (3.5%) airways and class I (4%), class II (1%) airways respectively. Patients who underwent orthognathic surgery had class I (11%) and class II (3.5%) airways. Patients undergoing TMJ surgery including ankylosis release, surgery for Oral submucous fibrosis had predominantly class III (1%) and class IV (2.5%) airways. Difficult airways (class III, Class IV) were present in patients undergoing procedures like TMJ ankylosis release, and surgery for oral submucous fibrosis.The association between the mallampati classification and the treatment [oral and maxillofacial surgical procedures] done under GA was statistically significant with p=0.025 (p<0.05) [chi square test].
 
CONCLUSION:
Assessing airway is crucial before any surgical treatment. The modified Mallampati test is easy to perform, more accurate and is commonly used to assess the airway of patients undergoing oral and maxillofacial procedures under general anesthesia. Complications might not occur if the pre operative assessment of the airway of the patient is done properly using this classification, and the surgery is planned accordingly.

Mandibular Premolars, an Enigma to Endodontists : A Case Series

Dr. Sailee Kalyankar, Dr. Anupam S Sharma, Dr. Aniket Jadhav, Dr. Rajlaxmi Patil, Dr. Nirmitee Gujarathi, Dr. Damini Bhagwat .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 746-752

Successful endodontic therapy depends on understanding, knowledge and possible anatomical variations of the root canal system to locate, prepare and obturate the canals. There is a considerable variation and aberrant root canal anatomy in mandibular premolars that can be difficult to diagnose. Mandibular premolars usually have a single root and single canal, presence of 2 or 3 canals in separate roots is rare. Diagnosis and endodontic treatment of such teeth is challenging. This case report describes three cases of endodontic management of mandibular premolars with 2 and 3 root canals in separate roots. The possibility that there is more than 1 root canal in mandibular premolar teeth must be considered in the radiographic and clinical examination during root canal treatment.

MANAGEMENT OF FRACTURED ANTERIOR TEETH BY REATTACHMENT TECHNIQUE: CASE REPORTS

Dr. Rushikesh Gir, Dr .Jyoti Mandlik, Dr. Sarita Singh, Dr. Nirmitee Gujarathi, Dr. Shiksha Dhawan, Dr. Ashwini Narayanan .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 753-759

Background: Anterior crown fracture is the most common sequel of dental trauma. Management of fractured teeth is challenging. The fractured segment of the tooth can be reattached. Aim: To evaluate success of reattachment technique, as a treatment modality for fractured maxillary incisors. Case description: In these case-reports, the patients presented with complicated crown fracture of maxillary central incisors (# 11 in both the cases) due to trauma. The treatment included root canal treatment and reattachment of the fractured segment, using resin luting cement. At recall visit after 12 months, a stable reattachment was observed in both the cases with good esthetics and periodontal health. Discussion: Reattachment technique for fractured anterior crowns has many advantages over routine restorative procedures like composite build-ups, onlays and crowns. It can be done immediately and results in better esthetics. Conclusion: We obtained expected clinical success with desirable esthetics in both the cases with reattachment technique.

Nutrition Intervention Practices in Family Medicine

Mustafa Abedali Abdelhadi Douglah , Abdelwaley Zuhier Abdelwaley Alrfooh .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 760-772

The theoretical foundation of dietary recommendations in family practice is covered in this paper. Nutrition counseling is an essential aspect of everyday practice due to the many conditions and disorders encountered in family medicine about which nutrition and diet are effective therapies. The advantages of the family doctor, including the patient-centered methodology that allows for different goals and consistency of care, which gives the family doctor multiple contacts over time to current and reinforce advice, must be linked to the success of diet-related suggestions and counseling in family practice. From this stance, family doctors should encounter their patients with guidance and counseling in "ready bits" that fit the time restrictions of routine consultations. They should also ensure that these portions are consistent throughout the years and identify particular patients' value systems and barriers to changing their eating habits. Individuals' indicated willingness to alter orientation can serve as a model for patient-centeredness. The benefits of family medicine should be highlighted in primary care nutritional recommendations. The first part looks at some of the traits of public health, family medicine, and the communities in which family medicine is practiced. This then leads to exploring several food, nutritional, and consumption goals that establish the background for family physicians' work. These schedules outline the range of nutritional advice provided by family doctors. They imply that the existing nutritional objectives are just one option among several. Ultimately, several potential actions are suggested to enhance family doctors' influence on patients' lives.

Importance of Emergency Medicine in Public Health

Asad Said Asad Amro, Mahmoud Chahda .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 773-786

A global field of study called emergency medicine (EM) offers both primary and secondary illness prevention. It is a laterally intelligent approach in emergency care that includes patient access to EM care, EM care delivery in the area and during the level of mobility, and EM care delivery in the admitting facility or hospital ED. EM can provide a variety of methods to enhance public healthcare. Such tools encompass primary preventative medicine, drug abuse and violence-related treatments, safety skills training, epidemiologic studies monitoring, patient enrolment in acute intervention-focused clinical research trials, education and medical experience of healthcare professionals, and involvement in local and regional disaster relief efforts. Advocates for public health and healthcare decision-makers may profit from EM's prospects and contribute to overcoming its difficulties. In addition to enhancing the capacities of EM for primary and second-line prevention for the benefit of general health, promoting the advancement and acceptance of the speciality of EM on a global scale can positively affect education programs.

Impact and Influence of Deficiency of Vitamin D on Asthma in School-Aged Children

Zainab S Abdul_hafed Shagloof ,Najia Albashir Mahdawi .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 787-798

Over the past few decades, environmental modifications (lower availability to sunlight owing to operating indoors or use of protective clothing and sunblock; food modifications) have been mainly blamed for vitamin D and inadequacy in the wider public. Being overweight, living in the inner-city and having African American ancestry are possible causes for asthma and vitamin D insufficiency. While the musculoskeletal effects of chronic insufficiency of vitamin D are very well recognized, a variety of other illnesses, particularly respiratory problems, have recently been related to vitamin D insufficiency. The potential significance of vitamin D as an increasing mediator that supports lung health is becoming well understood. In children with asthma, vitamin D insufficiency appears to be more common. According to epidemiological data, children with asthma with low blood levels of vitamin D suffer from more pain, exacerbations, lung damage, medication usage, and severe illness. Research published in vitro has shown that adult asthmatics' steroid sensitivity is improved by vitamin D. By preventing disease, in particular by retaining regulatory T cells, and by directly inducing intrinsic antimicrobial systems, vitamin D may have a significant impact on lung health. To resolve the diagnosis and treatment significance vitamin D could have in treating asthma in the long term, more investigations are essential to completely comprehend the impacts of vitamin D in preserving airway homeostasis. Along with prospective defence mechanisms like antiviral impacts and augmented steroid attentiveness, considerable uncertainty concerning the impacts of vitamin D insufficiency and inadequacies in kids with asthma and a thorough analysis of present experimental and observational studies substantiation of relationship among vitamin D levels and asthma or bronchitis comorbidities.

Current Challenges and Future Perspectives of Family Medicine

Abdelwaley Zuhier Alrfooh .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 799-811

According to this article, incentives for conducting family medicine investigations should be scientific and rationalistic, focusing on objectives like scientific discipline and development. Indirect incentives, or the "personal agendas" of investigation, do exist, though, and they have the potential to affect the goals, strategies, and findings. Furthermore, the development of interpretations specific to a highly emotional activity like a study complicates its varied forms. Three of these symbolic connotations are highlighted in this article: legitimacy and belonging, maturity and competence, and goal and earnestness. This article explores the role of behavioral scientists in contributing to a research agenda for the discipline and emphasizes qualitative data as a methodology consistent with many of family medicine's theoretical and philosophical underpinnings. 

ANESTHETIC IMPLICATIONS IN A PATIENT WITH A CHRONIC MASSIVE UNRUPTURED ILIAC ARTERY ANEURYSM!

Dr. Sheetal Jayakar, Dr. Naveen Kumar, Dr. Sreemayee Kulkarni, Dr. Sriram Mahalingam .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 812-817

This is a case of a patient that presented to the outpatient department with a large chronic iliac artery aneurysm and the anesthetic complications that occurred during the surgical resection of the swelling and associated management of massive blood loss, and hemodynamic changes that occurred during the cross clamping and unclamping of the aorta. In this case report we discuss the importance of being prepared for the expected and unexpected complications, accepted ischemia time, need for inotropic supports, and then the management of associated hypotension during the unclamping of the aorta, and most importantly, a vigilant anesthetist!

A Research Comparing The Lipid Profiles Of Those With Type 2 Diabetes Without Complications Versus Those With The Condition Having Nephropathy

Dharmendra Prasad, Vijay Shankar, Rishi Kishore .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 818-824

Introduction: One of the most serious complications of diabetes is diabetic nephropathy, which is also known to increase the risk of cardiovascular events. Patients with diabetic nephropathy have abnormal lipid levels, which raises their risk of cardiovascular problems. In this study, type 2 diabetes mellitus (T2DM) patients with and without nephropathy had their levels of dyslipidemia compared, and the causes of nephropathy were examined.
Method: Patients with T2DM who had overt nephropathy were included in the study group and those without nephropathy were included in the control group in this retrospective analysis. Age and diabetes duration were matched between the two groups. The case sheets were used to gather information on total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), urea, and creatinine. Equations were used to compute the TG/HDL-C ratio, a proxy for small, dense LDL particles (sdLDL), and the estimated glomerular filtrationrate (eGFR). The variables linked to eGFR were identified using multivariate analysis.
Result: 56.51% of control individuals and 75.28% of nephropathy subjects both had dyslipidemia (P=0.011). In comparison to controls, people with nephropathy had a higher percentage of subjects with atherogenic dyslipidemia (high TG+low HDL-C+sdLDL) at 14.60 than controls did at 14.12. Despite there being no discernible differences in serum creatinine, patients with nephropathy had significantly lower mean eGFR values (P=0.001). Multivariate analysis revealed that TC (P=0.007) and HDL-C (P=0.05) were linked to eGFR among the participants in our study.
Conclusion: According to our findings, dyslipidemia was very common in nephropathy patients. Regular testing for dyslipidemia may help diabetic nephropathy patients reduce their risk of adverse outcomes.

The Detection of Metallo Beta Lactamase Producing Pseudomonas Aeruginosa in A Tertiary Care Hospital

Naini Divya, Kadasu Rajashekhar .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 825-833

Background: Pseudomonas species is responsible for 10% of nosocomial infections particularly in patients with burns and in an ICU environment. The most frequent mechanism of resistance to carbapenem, the most widely used medication to treat Pseudomonas, is the synthesis of metallo-β-lactamases (MBL). Both microbiologists and clinicians need to know the incidence of MBL-producing Pseudomonas in their area in order to develop an infection control plan for hospitals. The current study aimed to identify the incidence of MBL among clinical isolates of Pseudomonas species in a tertiary care hospital.
Methods: The samples include blood, urine, pus, body fluids, and catheter tips.  The samples were cultivated on Blood agar, MacConkey's agar, and Thioglycolate broth, except for blood and urine samples. Brain Heart Infusion broth was used to culture blood. Blood and MacConkey's agar were used to culture urine. All culture plates were incubated overnight at 37°C. Identification of organisms was done by standard laboratory technique based on colony characteristics, Gram staining, and biochemical tests.
Results: All n=50 pseudomonas isolates were tested for antibiotic sensitivity testing by using the Kirby-Bauer disk diffusion method. Among the n=50 isolates n=45 isolates showed resistance to imipenem remaining n=5 isolates were intermediate sensitive. The highest sensitivity was noted to Polymyxin-B (100%) followed by Piperacillin+tazobactam (70%), Amikacin (50%), Cefoperazone+Sulbactam (36%), Gentamycin (28%), Netilmycin (26%), Cefotaxime (12%), Ciprofloxacin (10%) and Ceftazidime (2%). Pseudomonas aeruginosa isolates tested for metallo β-lactamases by using imipenem-EDTA combined disk method (CDT). N=18 (36%) isolates were shown positive results and the remaining n=32 (64%) isolates were shown negative results.
Conclusion: The development of MBL genes and their proliferation among bacterial pathogens are a topic of concern concerning the future of antimicrobial therapy since more and more MBL-producing Pseudomonas aeruginosa isolates are being identified as a major source of nosocomial infections. To conclude there are 36% of metallo beta-lactamase-producing pseudomonas aeruginosa prevalent in our area. Therefore, detection of these MBL-producing P. aeruginosa is crucial for the optimal treatment of critically ill patients and to prevent the spread of resistance.

Comparative Study of Epidural Butorphanol and Tramadol for Postoperative Analgesia in Orthopedic Lower Limb Surgeries

Pradeep Kumar, Ravindra Kumar, J.N. Thakur, H.D. Singh .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 834-840

Background and objectives: Epidural analgesia is a safe technique for post-operative pain relief and equivalent to traditional analgesic methods. Epidural narcotics have been extensively used for post- operative analgesia. In a quest to find a better and safer alternative to older drugs like morphine this study was undertaken to compare the safety and efficacy of postoperative analgesia with epidural butorphanol and epidural tramadol in patients undergoing orthopaedic lower limb surgeries.
Methods: A total of 100 patients of either sex, belonging to 20-60 yrs of age, ASA grade I and II admitted for orthopedic lower limb surgeries in the department of Anesthesiology, DMCH Darbhanga. were selected randomly for the study. Combined spinal-epidural was administered to all the patients. Postoperatively when patient complained of pain (Visual Analog Scale > 4), either butorphanol 1mg or tramadol 50mg diluted to 10ml was given epidurally and all the parameters were recorded.
Conclusion: Epidural butorphanol (1mg) is a safe and efficacious drug for post-operative analgesia. Epidural butorphanol provides a rapid, excellent but shorter duration of analgesia when compared to epidural tramadol. It has mild sedation which is advantageous in the postoperative period.

A Prospective Clinical Study of Comparison Between General Anaesthesia and Epidural Anaesthesia in Lumbar Microdiscectomies

Dr. Tulika Singh, Dr. Kislay kant,Dr. Gopi Kumhar .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 841-847

Background: The main aim of our study was to compare the intraoperative and postoperative outcomes of general anaesthesia and epidural anaesthesia in single level lumbar microdiscectomies.
Methods & materials: 40 ASA I and II, both male and female patients, posted for single level lumbar microdiscectomies were chosen for the study. Group GA underwent the operation under general anaesthesia and group EA underwent the surgery under epidural anaesthesia. Patients were observed in the recovery room for 24hrs.
Conclusion: Epidural anaesthesia may be used as an alternative to general anaesthesia in single level lumbar microdiscectomies.

Requirement of Vitamin D in Patients with Nephrotic Syndrome on Long Term Steroid

Pankaj Bhansali, Apurva Deshmukh, Lalit Une, Aisha Siddiqui .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 848-858

Introduction: Nephrotic Syndrome is characterised by nephrotic range proteinuria and the triad of clinical findings i.e., hypoalbuminemia, edema and hyperlipidemia. Glucocorticoid-sensitive nephrotic syndrome remits completely and quickly in response to glucocorticoids. Steroids are known to cause osteoporosis and loss of bone mineral density in NS patients.  So, we decided to study requirement of vitamin D in nephrotic syndrome in patients who are on remission during steroid therapy and Comparison of normal and high dose of vitamin D supplementation to achieve normal vitamin D level in nephrotic syndrome patient, in remission on prednisolone therapy.
Material And Methods: The present descriptive observational study, was conducted amongst 31 patients from August 2014 to August 2016 in the pediatric department of tertiary care centre on both indoor (IPD) and outdoor (OPD) patients of Nephrotic syndrome those who are in remission on steroid. Patients having normal 25 OH Vitamin D level were included in study. These patients were randomly divided in two groups using random sampling by lottery method. a. First group was given vitamin D therapy as 20, 000 IU/month (600IU/day) for three months b. Second group was given 60,000 IU /month (2000IU/day) for three month.
Results: Out of 31 patients in this study, mean age at inclusion in group A was 5.4 years whereas, it was 7.2 years in group B. Majority 12 of the patients were having SDNS as diagnosis. Both the groups showed elevated levels of 25(OH) after supplementation.  The levels of serum ionic calcium levels were not affected in both the groups, but the mean values of serum Ionic Calcium was found to be on higher side after Calcium supplementation especially in group B. The serum values were not affected in both groups.
Conclusion: The results concludes that there is no need for vitamin D supplementation in higher doses in steroid-sensitive nephrotic syndrome in patients those who are in remission and on minimal dose of steroids. So, dosage of vitamin D should be according to Recommended Dietary Allowances (RDA) when patient is on minimal dose of steroids.

Intravenous Lornoxicam for Attenuation of the Cardiovascular Response to Laryngoscopy and Endotracheal Intubation

Febin Sathar, Sreedevi CR, Roshin Reeba Joseph, Divya D .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 859-865

Purpose: The purpose of this study was to determine the hemodynamic effect of intravenous lornoxicam during laryngoscopy and endotracheal intubation and to determine whether intravenous lornoxicam is effective in reducing the hemodynamic stress response to laryngoscopy and endotracheal intubation.
Methods: It was a double blind randomized control trial to investigate the effect of lornoxicam on the change in blood pressure, heart rate observed during laryngoscopy and tracheal intubation in 50 ASA class I and II patients. 50 patients with similar characteristics were divided into groups of 25 each. One group received lornoxicam, while the other received a placebo.
Results: Blood pressure and heart rate was recorded at various intervals during laryngoscopy and endotracheal intubation.  It was observed that there was a significant attenuation in heart rate and blood pressure response to laryngoscopy and intubation for the lornoxicam group.
Conclusion: The use of IV lornoxicam during laryngoscopy and intubation can save lives since it significantly lowers the hemodynamic reactions to intubation when administered 30 minutes prior to the surgery.

Evaluation Of Immunoglobulin E And Histamine Levels In Patients With And Without Drug Allergy.

Vivek V, Lavanya K , Maignana kumar R, Ruckmani A .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 866-885

Objectives:

To estimate IgE and histamine levels in patients with drug allergy and with past history of drug     allergy.
Compare these levels with that of normal individuals
Assess the association of demographic factors, nature of drugs and clinical presentation with IgE and histamine levels. 

Methodology: 113 potential participants were totally interviewed. 66 selected based on selection criteria. 22 had current allergy (CA), 22 past history of allergy (PA) and 22 without any allergy (NA). Study was initiated after getting IHEC approval and informed consent from each participant. Estimation of serum IgE and histamine was done using ELISA kits. Demographic details, details of drugs and clinical presentation were recorded. Time interval between onset of allergy and estimation of IgE and histamine was recorded for patients with PA. Results were analyzed using ANOVA and student t test. p<0.05 was considered significant. 
Results: IgE and histamine levels were significantly higher in CA compared to NA and PA subjects.
Normal mean level IgE was 72.6 IU/ml and histamine 42.53 ng/ml. In PA levels were higher than that of NA but lower than CA. Males and civil workers had a higher level than females. Age related difference in the levels was not observed. NSAIDs induced allergy resulted in maximum elevation of IgE (538.74
IU/ml) and histamine (158.32 ng/ml) followed by antimicrobials (IgE 395.97 IU/ml) and histamine
(133.42 ng/ml ).Patients who developed maculopapular rashes had maximum level of IgE (627.87 IU/ml) and histamine (182.25 ng/ml). The time dependent decline in both the levels was observed in PA.
Higher IgE level was associated with higher level of histamine in all the groups.
Conclusion: In CA, NSAIDs and maculopapular rashes resulted in maximum elevation of IgE and histamine. In PA, IgE level was higher than NA group. Whether estimation of IgE would indicate past allergy or the tendency to develop allergy has to be assessed by further studies with large samples.

CYBER CRIME DETECTION USING MACHINE LEARNING APPROACHES

Dr.M.Rajaiah,Mr D. SUREDNRA,Mr.K. LOKESH,Ms.A. DIVANYA,Ms.K. JANSI,Mr.A. HEMANTH .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 886-898

Now a days the use of social media has grown exponentially over time with the growth of the Internet and has become the most powerful networking platform in the 21st century. However, theimporvement of social connectivity often creates negative impacts on society that contribute to a couple of bad phenomena such as online abuse, harassment, cybercrime and online trolling. Cyber crime leads to serious mental and physical distress, particularly for women and children, and even sometimes force them to attempt suicide. Some kind of fake message can impact women to consider as suicide. Online harassment attracts attention due to its strong negative social impact. Many incidents have recently occurred worldwide due to online harassment, such as sharing private chats, rumours, and sexual remarks. Therefore, the identification of bullying text or message on social media has gained a growing amount of attention among researchers. The purpose of this research is to design and develop an effective technique to detect online abusive and bullying messages.

Intrathecal 1% chloroprocaine with 25μg fentanyl during spinal anaesthesia for elective perianal surgeries: An observational study

Dr. Jyothsna M, Dr. Parimala, Dr. Devaraj IC, Dr. Pavitradevi

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 899-903

Preservative free Chloroprocaine (CP) seems like a promising alternative, being a short acting agent of increasing popularity in recent years. While Chloroprocaine was withdrawn from the market in the 1980s because of concerns about neurotoxicity a new formulation without preservatives that has no longer been associated with neurotoxicity was introduced in clinical routine. After taking informed and written consent, 40 patients of either sex, aged between 18-60years, belonging to American Society of Anaesthesiologists Physical status I to III, undergoing elective perianal surgeries under spinal anaesthesia enrolled in this observational study. Our study showed mean time of onset of motor block was 8.38±1.25 minutes, mean time to achieve maximum motor block 9.45±0.71 minutes and mean time for motor regression to bromage scale 0 was 65.68±15.19 minutes. The time to void was 98.32±15.80 min and time to ambulation was 89±15.30 min the time of first postoperative analgesic requirements was 96.32±12.83 min.

0.5% levobupivacaine and 0.5% levobupivacaine with dexamethasone 8mg combination under USG guided brachial plexus block by supraclavicular approach: Hemodynamic changes

Dr. Jyothsna M, Dr. Parimala, Dr. Anusha G Hiremath, Dr. Devanand B

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 904-909

Ultrasound guidance in anaesthesia is becoming an important tool in Anaesthesiologists. Sonography helps in addressing a variety of consequences such as patient safety, economic burden, duration of the procedure and success rates associated with invasive anaesthesia procedures. Consent from 50 patients were obtained in their own understandable language. After thorough pre-anaesthetic evaluation and overnight fasting, patients shifted to operation theatre and following monitors are connected. (Pulse oximeter, electrocardiogram, capnograph and non-invasive Blood pressure) Patients were randomly allocated into 2 groups (Group D and Group S) as per computer generated randomization table. The average diastolic blood pressure in both the groups was maintained from the baseline till 24 hours of observation. There was neither clinical nor statistical significant variation found. We did not find any clinical variations in the heart rate, SBP, DBP, MAP, RR of the patients preoperatively, intra and also postoperative period. All the recruited patients had maintained oxygen saturation >95% throughout the surgery.

A Comparison of Crystalloid Preloading and Co-Loading for Hypotension Prevention During Elective Caesarean Section Under Spinal Anaesthesia

Sushant Satya Priya, Anshuman, Krishna Kumar .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 910-914

Introduction: Patients undergoing cesarean sections frequently have hypotension following spinal anesthesia; maternal hypotension occurs 60%–70% of the time. By giving intravenous fluid boluses, hypotension brought on by spinal anesthesia can be treated or avoided. The purpose of this study was to assess the efficacy of crystalloid fluid preloading and co-loading in reducing the occurrence of hypotension following spinal anesthesia in cesarean delivery.
Method: There were 54 participants total who took part in this investigation. Subjects chosen through successive sampling who met the inclusion criteria for elective cesarean sections under spinal anesthesia were gravida individuals between the ages of 15 and 41 with an ASA 1 or ASA 2 physical condition. Three groups- the preloading group, the co-loading group, and the control group- were formed from the participants. Mean arterial pressure (MAP), pulse rates, and systolic and diastolic blood pressure are assessed in resting conditions and 2, 3, 5, 7, 9, 11, 13, 15, and 25 minutes following spinal anesthesia. The Repeated Measured Multivariate Analysis of Variance (MANOVA) test was used in the statistical analysis to see how the three groups of patients differed in terms of several hemodynamic parameters. The variations in hemodynamic parameters between each group were compared using the Bonferonni post hoc test.
Results: Results of the Bonferroni post hoc test revealed significant differences in the decline in systolic, diastolic, and MAP blood pressure between the co-loading group with the preloading group and the control group (P < 0.002); the co-loading group experienced the lowest decline.
Conclusion: Compared to the preloading and control groups, crystalloid fluid co-loading dramatically reduced the incidence of hypotension following spinal anesthesia in cesarean delivery.

“AN EXPLORATION OF DETECTING METHODS FOR KEEPING TRACK OF AUTOMOBILE TRAFFIC”

Dr.M.Rajaiah,Prof.V.Sreenatha Sarma,Mr.S.Satwik, Ms.T.Thanusha, Ms.V.Hemalatha, Ms.D.Rachana Pravalika .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 915-925

General traffic administration as well as infrastructure design may benefit from real-time vehicle surveillance on motorways, roads, and streets. This study introduces Traffic Detector ,a technology that makes use of deep learning methods to automatically monitor and classify vehicles on roads using a precise and stable camera. Despite being a well-established area visual programming research, improvements in neural networks for object recognition and categorization, particularly in the last years, made this area even more intriguing owing to efficacy of these methods. It is concentrated on region-based approaches like R-CNN (Region-based Convolutional Neural Network) and regression-based methods like YOLO (You Only Look Once) and also provided each enhanced versions in the subject of motor identification is being tackled by the quickly expanding domain of supervised learning approaches. Last but not least, we have a traffic offence detection module in place that examines traffic patterns and identifies various traffic offences in real-time. The Deep Neural Network (DNN) module of OpenCV accustomed implement the complete system. With excellent accuracy, We have indeed been fortunate in locating automobiles on the roads using YOLOv4. We used a quick YOLOv4-tiny model for motorcycle riders without helmets. Real-time vehicle tracking is accomplished using Deep SORT algorithm. For vehicle detection, YOLOv4 achieves a precision of 89%, while for helmet detection, YOLOv4-tiny achieves a delicacy of 96%. YOLOv6 97%. The backbone, neck, and head are the three crucial components the majority recent iteration, known as YOLOv5.YOLOv7 is anticipated to overtake YOLO v4This review paper aims to advance sophisticated deep learning frameworks for real-time vehicle detection.

A Clinical Comparison between 0.5% Levobupivacaine and 0.5% Levobupivacaine with Dexamethasone 8mg Combination under USG Guided Brachial Plexus Block by Supraclavicular Approach

Dr. Anusha G Hiremath, Dr. Parimala, Dr. Jyothsna M, Dr. Devanand B .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 926-933

Regional anaesthesia has been preferred over general anaesthesia in many orthopaedic surgeries due to lack of associated complications in regional blocks. Increasing the duration of local anaesthetic action can obtain the desired effect of prolongation of the postoperative patient comfort. Many adjuvants to local anaesthetics such as epinephrine, clonidine, opioids, dexmedetomidine and also neostigmine have been tried. Recently, dexamethasone has been found to prolong postoperative analgesia, reducing the requirement of the local anaesthetic and also the side effect profile. Hence our study was conducted to analyse the efficacy of dexamethasone as an adjuvant drug to levobupivacaine. After institutional ethical committee approval, CTRI registration and patient consent, a double blinded randomised controlled study was conducted in 50 patients aged 18-65 years of ASA I&II undergoing upper limb surgeries distal to mid-humeral level over a period of 1year. The mean duration of postoperative analgesia in Group D was 1022.2±62.67 minutes and in Group S was 777.40±34.19 minutes (p<0.001). The mean total dose of rescue analgesics required was more in Group S when compared to Group D in the first 24hrs. The onset of sensory and motor block was faster in Group D when compared to Group S. The mean duration of sensory and motor block was significantly longer in Group D than Group S. The addition of dexamethasone to levobupivacaine in SCBP blockade was associated with faster onset as well as prolonged duration of sensory and motor block, prolonged duration of post-operative analgesia and required less rescue analgesics.

MULTIPLE OBJECTS TRACKING BY AN EVIDENCE BASED APPROACH

Dr.M.Rajaiah, Mr.D.V.Varaprasad, Mr.SK.Shahul Hameed, Mr.Y.Venkatesh, Mr.U.Jagadeesh, Mr.V.Rohith .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 934-945

The issue of choosing appearance features for multiple object tracking (MOT) in urban scenes is addressed in this paper. Numerous features have been employed for MOT over the years. Whether some of them are superior to others is unclear, though. Colour histograms, histograms of oriented gradients, deep features from convolutional neural networks, and re-identification (ReID) features are examples of frequently used features. In this study, we evaluate the performance of these features in urban scene tracking scenarios to distinguish objects from a bounding box. Several affinity measures, including the Rank-1 counts, the cosine similarity, the L1, L2, and Bhattacharyya distances, are also evaluated for their effect on the discriminative power of the features. . Results from several datasets demonstrate that, regardless of the detector quality, features from ReID networks are the best at differentiating between instances. Colour histograms may be chosen in the absence of a ReID model if the detector has a good recall and few occlusions; otherwise, deep features are more resistant to detectors with lower recall. An picture's colour histogram shows how the colours are distributed throughout the image. The number of pixels in each type of colour and the various colour variations are displayed. Re-identification is a general term for any process that re-establishes the relationship between data and the subject to which the data refer.

Assessment Of Increased First Trimester Serum Uric Acid As A Predictor Of Gestational Diabetes Mellitus

Chandersheikhar, Devinder Kumar .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 946-950

Background: To assess increased first trimester serum uric acid as a predictor of gestational diabetes mellitus.
Materials and Methods: Seventy- six antenatal women in first trimester were selected for the study. Approval from ethical review committee was obtained. Patients’ consent was obtained before starting the study. 5 ml venous blood sample was taken from antenatal women of less than 12 weeks of gestation. Venous sample was measured after fasting, one hour and two hours and assessed for GDM using ADA criteria.
Results: Age group 20-25 years had 11, 26- 30 years had 34, 31-35 years had 20, 36-40 years had 6 and 41-45 years had 5 patients. The difference was significant (P< 0.05). Parity found to be primi in 46 and multi in 30. GTT was normal in 68 and positive in 8. Serum uric acid was elevated in 27 and normal in 49 cases. The difference was significant (P< 0.05). Out of 27 patients with elevated uric acid, 26 had normal GTT and out of 49 normal uric acid patients, 42 had normal GTT.
Conclusion: There was increase in the risk of development of GDM with increased levels of serum uric acid in the first trimester.

Study of Free Anterolateral thigh (ALT) flaps in reconstruction of traumatic complex lower limb soft tissue defects

Dr. Jainath R, Dr. Suhas T R, Dr. Shreyas Umesh

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 951-955

The reconstruction of extensive traumatic lower limb defects need free flaps for covering the defects when no local flaps are available for covering the defects. Free ALT flap is one of the most commonly used flaps for reconstruction of extensive lower limb defects. This is a prospective study of the thirty seven patients who had undergone Free ALT flap cover for the extensive traumatic lower limb wound defects between January 2018 to April 2021 at our Trauma care Hospital. One hundred and thirty patients had undergone reconstruction of traumatic lower limb with one of the flap surgery. Thirty seven of this patients had underwent a free ALT flap surgery for limb reconstruction. Only traumatic lower limb wound defects were included in the study. Nontraumatic wounds like diabetic limb wounds or cancer wound defects were excluded. All the patient data including (age, sex and comorbidities), mode of injury (Road traffic accident, Fall of heavy object, Crush injury), wound defect data (site, size, underlying fracture and exposed structures), presence of any vascular injury in the limb, the microvascular flap data, postoperative complications and management data, follow up data were recorded. Among patients who were managed with ALT flap, 62.6% of patients presented with Post traumatic raw area, 25% of patients presented with Heel pad avulsion, 6.2% of patients presented with Post fasciotomy wound and 6.2% of patients presented with Ankle contracture. Among patients who were managed with ALT flap, the success rate was found to be 81.2%, 9.4% of patients had partial flap necrosis and 9.4% of patients had complete flap necrosis.

A study on clinical profile of patients who underwent laparoscopic cholecystectomy at a tertiary care hospital

Dr.Vignesh Varma, Dr. Bhoomika R Gowda, Dr. Sagar Z, Dr. Subhash Nadagouda

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 956-961

Gall stones are found in middle aged females who with higher BMI. In younger patients with gall stones, hemolytic diseases should be considered. Inpatients admitted in General Surgery Department, who underwent laparoscopic Cholecystectomy were the study subjects. All the patients were scored pre-operatively according to history, clinical examination, biochemical parameters, and sonological findings. Out of 60 patients, 44 patients had history of gall bladder disease with symptoms of which 24 patients had easy surgery and 20 had difficult surgery. Out of 60 patients, 18 patients had tenderness in right hypochondrium of which 6 patients had difficult surgery.

Doppler study in second and third trimester in high risk pregnancy and perinatal outcome

Dr. Surayya Tahseen, Dr. Thajammul Samrin, Dr. Juveriya, Dr. Patan Rubeena Khanam, Dr. Syed Rubina Taranum, Dr. Shwetha H

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 962-975

In order to screen for defective placentation and related consequences such pre-eclampsia, intrauterine growth restriction, and infant death, doppler examination of the placental circulation is crucial.
Methods: From August 2021 to July 2022, the study was carried out in the Department of Obstetrics & Gynecology, Owaisi Hospital and Research Centre, Hyderabad, Telangana, India. Prospective observational study conducted in a hospital involving 100 patients.
Results: Any gestational age after 32 weeks where REDV is detected should warrant consideration for an urgent delivery. Guidelines from the Society for Maternal-Fetal Medicine, which suggest intensive fetal monitoring of these fetuses and continuing expectant treatment until 32 weeks as long as fetal monitoring is still reassuring, support this.
Conclusion: Doppler velocimetry can be a valuable addition to standard antepartum surveillance procedures in patients with IUGR fetuses. If other antepartum surveillance tests are reassuring, an abnormal Doppler should not necessitate an obstetric intervention. When an aberrant Doppler finding is discovered, the obstetrician is made aware of the potential problems, and the delivery should be scheduled at a tertiary care center with good neonatal facilities.

COVID-19 positivity and clinical outcome in COVID positive neonates of COVID-19 mothers at a tertiary care COVID treatment centre in South India

Dr. Sanuja Sarasam, Dr. Sini Vijayan, Dr. Belgin Premkumar, Dr Binu Abraham, Dr. Savitha H, Dr. Athira Murali

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 976-984

With increasing number of COVID infections, more and more pregnant women were affected and hence more vertical transmissions to newborns were reported. There was scarcity of dedicated studies in newborns related to clinical profile and outcome in COVID. This study was aimed at estimating the prevalence of COVID-19 positive babies born of COVID-19 infected Mothers and to describe the early clinical outcome in their COVID positive babies.
Methods: The study was done as a cross sectional study conducted at a tertiary care dedicated COVID treatment Centre in a sample of 388 babies of COVID positive mothers. Along with the prevalence of COVID positive babies, the early clinical outcome at 48 hours after birth was also evaluated.
Results: A total of 388 COVID positive mothers were studied and among them 85 babies were found to be COVID positive. The COVID positivity rate was 21.9% (95% CI 17.83 -25.97). Out of 85 babies 34(40%) babies were male and 51(60) babies were female. The proportion of LBW was 13(15.2%), proportion of preterm babies was 13 (15.3%) and only 19(22%) babies required NICU admission. Among the maternal variables of COVID positive babies, 38 (44.7%) were primi gravida and 46(54%) mothers had vaginal delivery. Regarding the COVID clinical status, 70(82.4%) mothers were asymptomatic and 15(17.6%) were symptomatic. After the subgroup analysis, 22(25.8%) babies were symptomatic and 63(74.1%) babies were asymptomatic. Out of 22 symptomatic babies 13(59.1%) were male and 9(40.9%) female babies (P value 0.03). The mean birth weight in symptomatic and asymptomatic babies was 2.96 kg and 2.98kg respectively (P value 0.687).
Conclusion: The newborn COVID positivity rate was found to be around 22% and majority had good early clinical outcome. The findings from this study helped to assess the burden of COVID pandemic in newborn babies and would help in the higher level of analytical research.

A Clinical Comparison between 0.5% Levobupivacaine and 0.5% Levobupivacaine with Dexamethasone 8mg Combination under USG Guided Brachial Plexus Block by Supraclavicular Approach.

Dr. Anusha G Hiremath, Dr. Parimala, Dr. Jyothsna M, Dr. Devanand B

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 985-992

Regional anaesthesia has been preferred over general anaesthesia in many orthopaedic surgeries due to lack of associated complications in regional blocks. Increasing the duration of local anaesthetic action can obtain the desired effect of prolongation of the postoperative patient comfort. Many adjuvants to local anaesthetics such as epinephrine, clonidine, opioids, dexmedetomidine and also neostigmine have been tried. Recently, dexamethasone has been found to prolong postoperative analgesia, reducing the requirement of the local anaesthetic and also the side effect profile. Hence our study was conducted to analyse the efficacy of dexamethasone as an adjuvant drug to levobupivacaine. After institutional ethical committee approval, CTRI registration and patient consent, a double blinded randomised controlled study was conducted in 50 patients aged 18-65 years of ASA I&II undergoing upper limb surgeries distal to mid-humeral level over a period of 1year. The mean duration of post-operative analgesia in Group D was 1022.2±62.67 minutes and in Group S was 777.40±34.19 minutes (p<0.001). The mean total dose of rescue analgesics required was more in Group S when compared to Group D in the first 24hrs. The onset of sensory and motor block was faster in Group D when compared to Group S. The mean duration of sensory and motor block was significantly longer in Group D than Group S. The addition of dexamethasone to levobupivacaine in SCBP blockade was associated with faster onset as well as prolonged duration of sensory and motor block, prolonged duration of post-operative analgesia and required less rescue analgesics.

To compare the sensitivity of blood cultures on Day 1 (24 Hours) Day 3 (72 Hours) & Day 5 (120 Hours) in neonatal sepsis

Farooq Ahmed Shah, Sheikh Mushtaq Ahmad, Javeed Iqbal Bhat, Bashir Ahmad Fomda, Syed Wajid Ali, Muzamil Mushtaq

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 993-998

To compare the sensitivity of blood cultures on Day 1(24 Hours) Day 3 (72 Hours) & Day 5(120 Hours) in neonatal sepsis.
Materials and Methods: The study was a hospital based observational study conducted in the neonatal ICU, Dept. of Paediatrics and Dept. Of Microbiology, SKIMS, Srinagar, from 1st January 2016 to 1st June 2017. All those neonates with features of sepsis like lethargy, refusal of feeds, irritability, fever, seizure and deranged lab values like CRP, Procalcitonin, and CBC were considered in study. Before drawing blood culture samples, neonates already on antibiotics were excluded from the study. In addition, participants with incomplete details were also excluded from the study.
Results: In our study 1060 cultures were sent from neonates suspected to have sepsis. A total of 85 cultures were found to be positive with an overall culture positivity of 8%. Out of them 64 (75.3%) were positive within 24 hours of incubation (subsequently referred to as culture positive on day 1), 17 (20.0%) were culture positive on day 3 (within 72 hours of incubation, but not within 24 hours) and 4 (4.7%) were culture positive on day 5 (within 120 hours of incubation but not within 72 hours of incubation).
Conclusion: We recommend incubating cultures for 5 days to pick up additional 5% cases of neonatal sepsis.

Heterozygous neonatal DM: Case report

Dr. S Ranjith Pratap, Dr. E Suresh

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 999-1002

Chronic increase and high level of glucose results in a metabolic disorder termed as Diabetes Mellitus. Diabetes occurs as a result of some genetic factors, namely the mutations of single gene. Permanent neonatal diabetes is very rare form of disorder, termed as monogenic diabetes. This type of rare diabetes presentation is seen in the child of age less than 6 months.
Presenting the single case of neonatal diabetes reported from Chennai. A 2 month old female child is actually diagnosed with permanent neonatal diabetes-4 because of the heterozygous mutation of INS gene present in chromosome 11p15.
Though the occurrence of permanent neonatal diabetes is very rare, this diagnosis has to be made when the infants are presenting with features of persistent hyperglycaemia and also in need of the insulin therapy. Children with the INS mutation will exhibit overall good prognosis when they are adequately managed with insulin therapy

IMPACT OF ADR ON VARIOUS ORGAN SYSTEM WITHIN 30 DAYS AND 60 DAYS OF FIRST LINE ANTI-TUBERCULAR THERAPY IN DOTS CATEGORY-1 PATIENTS

Dr Rahul Agarwal, Dr Shilpi Agarwal, Dr. Shyam Sunder Keshari

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1003-1008

Pulmonary tuberculosis is respiratory infection caused by M.tuberculosis bacilli which occur via aerosol. First line drugs used in the treatment of TB are Isoniazid (H), Rifampicin (R), Pyrazinamide (Z) and Ethambutol (E). Use of multidrug regimens has been associated with increased incidence of adverse drug reactions, involving all the major organs. However the frequency of occurrence of ADRs to ATT involving major organs are not well known, so in this study we tried to find out the most commonly affected organ due to ATT

Assessment Of Effect Of Body Mass Index On Fetal Outcome In Pregnancy

Chandersheikhar, Devinder Kumar .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1009-1013

Background: To assess effect of body mass index on fetal outcome in pregnancy.
Materials and Methods: One hundred ten first trimester women were selected. Parameters such as BMI, gestational age at delivery (in weeks), birth weight (in kg) APGAR Score, meconium- stained liquor, NICU admission etc. was recoded.
Results: There were 30 underweight, 40 normal and 40 overweight patients. The difference was non- significant (P> 0.05). The mean APGAR score 1t 1 minute in underweight patients was 6.8, in normal was 6.2 and in overweight patients was 6.4. At 5 minutes was 8.9 in underweight, 8.7 in normal and 8.4 in overweight patients. The difference was non- significant (P> 0.05). 11% underweight and 34% overweight required NICU admission. The difference was significant (P< 0.05). 12% underweight and 38% overweight had meconium- stained liquor. The difference was significant (P< 0.05). 76% underweight, 91% normal and 100% overweight had >36 weeks gestational age. 40% underweight, 50% normal and 45% overweight had 2.5- 3 kgs birth weight. Apgar score at 1 min was seen in 90%, 92% and 88%, NICU admission in 11%, 0% and 34% and meconium- stained liquor in 12%, 14% and 38% underweight, normal and overweight babies respectively. The difference was significant (P< 0.05).

Conclusion: Underweight and obese mothers had increased risk of adverse perinatal outcome

Assessment Of Risk Factors, Clinical Presentation And Management Of Ectopic Pregnancy

Chandersheikhar, Devinder Kumar .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1014-1018

Background: To assess asymptomatic bacteriuria in pregnant women and treatment effect on outcome of pregnancy.
Materials and Methods: One hundred five pregnant women of age group 18 – 45 years were involved. Collection of clean catch, mid- stream urine sample was done. Urine routine and microscopy was done. Maternal and fetal outcomes was recorded.
Results: Significant bacteriuria was seen in 25, insignificant growth in 10 and negative in 70 cases. There were 10%, 6% and 0 pre- term, 81%, 90% and 100% term and 9%, 90% and 100% post- term birth in patients with significant bacteriuria, insignificant growth and negative bacteriuria. In significant bacteriuria patients, 86% patients had >2.5 kg weight and 14% had <2.5 kg weight. In insignificant growth patients, 91% had >2.5 kg weight and 9% had <2.5 kgs weight. 100% in negative growth patients had >2.5 kgs weight of babies. 91%, 93% and 100% patients had APGAR score between 9-10 at 1 minute and 95%, 99% and 100% had between 9-10 respectively. 10%, 5% and 0 required NICU admission respectively.

Conclusion: Significant bacteriuria was seen in 25 patients. Maximum were term and normal vaginal delivery. Maximum babies were with birth weight of >2.5 Kg and APGAR score of 9 and 10 was seen in patients with significant bacteriuria with minimum NICU admission

Clinical Spectrum of Infections in Chidlren with Nephrotic Syndrome

Pankaj Bhansali, Anjali Kale, Ajay Kale, Nitin Adhane .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1019-1026

The incidence of Nephrotic Syndrome is 2-7 cases per 1, 00,000 children per year and prevalence is nearly 16 cases per 1,00,000. Various infections are considered as most important complications of Nephrotic Syndrome associated with high mortality. Loss of complement factors in urine is one of the major factors in etiopathogenesis of infections. Acute Renal Failure was also described as one of the complications of Nephrotic Syndrome. The present study was carried out to study the incidence and severity of infections in Nephrotic Syndrome with respect to various parameters like the age of patients, number of relapses, duration of disease and mortality. Methods: The present descriptive observational study was conducted in indoor (IPD) and outdoor (OPD) patients in the pediatric department of tertiary care center amongst 82 Nephrotic syndrome patients visiting for various infectious complications from August 2013 to August 2015. Results: Maximum incidence was found in the age of 1-3 years (37%) and male predominance (61%) was seen.Commonest symptom was generalised swelling/facial puffiness (92%), followed by fever (58%), cough (48%). Anasarca was commonest sign (92%), followed by pallor (39%), Scrotal/Vulval edema (22%). 31% were infrequent relapsers and 22% were frequent relpasers.On Ultrasonography, ascites was the commonest finding in 42% of patients and on Chest radiographs, perihilar opacities were seen in 40% of patients. 49% of patients had respiratory tract infections and 34% of patients had Urinary Tract Infections. Conclusions: From our study we concluded that infections are found to be common complication of Nephrotic Syndrome amongst of which respiratory tract infection appears to be the commonest infection. WhileSerum Albumin and Serum Immunoglobulin levels are considerably low while serum cholesterol level is considerably high in severe infections requiring hospitalization.

INVESTIGATING THE EFFECTS OF WATER-BASED AND PİLATES EXERCISES ON PAIN THRESHOLD AND BALANCE IN SEDENTARY WOMEN WITH CHRONIC BACK PAIN

1Esin Çağla ÇAĞLAR 1İrem TÜRKMEN .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1027-1039

Water-based and pilates exercises are commonly used exercises and rehabilitation methods. The aim of this study is to investigated  the effect of water-based and pilates exercises on pain threshold according to anthropometric, motor properties, and posture position in sedentary women. A total of 45 volunteer women participated in this research, 15 (33.3%) of whom performed water-based exercises, 15 (33.3%) performed pilates exercises, and 15 (33.3%) served as a control group. The average age of participants in the water-based group was (59.6±7.55) (41-71), the average age of participants in the pilates group was (61.13±6.94) (50-72) and the average age of participants in the sedentary group was (53.93±7.4) (41-68) made up of sedentary women. Body composition analysis was determined using the bioelectrical impedance method. Body weight (bw) and height, waist, hip, chest, thigh measurements, and pain threshold measurements were taken before and after the study for all subjects. For statistical analysis, the paired sample t-test and the Wilcoxon signed-rank test were used.  When the pre- and post-exercise values of the groups were compared, significant differences were found in weight, BMI, FAT, FFM, berg balance, and water in the body in the weight, BMI, FAT, FFM, balance variables in the sedentary group (P>0.05), but no significant differences were found in the pilates group. In the pilates group, statistically significant differences were found in the chest, waist, hip, and thigh variables between pre-and post-test values, whereas no statistically significant differences were found between pre-and post-test values (P>0.05). Upon evaluating the comparisons between groups, statistically, significant differences were found in the change values of weight, BMI, FAT, FFM, chest, waist, hip, thigh, and berg balance variables between pre-and post-test measurements in the research groups. When the intra-group comparisons were evaluated, statistically significant differences were found in the occiput and medial knee variables between pre-and post-test values in the water, pilates, and sedentary groups. Statistically significant differences were found in the upper trapezius variable between pre-and post-test values in the pilates and sedentary groups. However, statistically, significant differences were not found in the upper trapezius variable between pre-and post-test values in the water group. Statistically significant differences were not found in the supraspinatus variable between pre-and post-test values in the water, pilates, and sedentary groups. Statistically significant differences were found in the cervical variable between pre-and post-test values in the pilates group, while no statistically significant differences were found in the cervical variable between pre-and post-test values in the water and sedentary groups.

ASYMPTOMATIC BACTERIURIA DURING PREGNANCY IN SOUTH INDIAN POPULATION

Dr. Swetha Munivenkatappa, Dr. Vasavi Mounika Sampathi, Dr. Srinivas MG, Dr. Kandregula Pavani

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1040-1047

Asymptomatic bacteriuria (ASB) is common during pregnancy and must be identified and treated to prevent poor maternal and obstetric outcomes. This study aims to determine the prevalence of asymptomatic bacteriuria among pregnant women in our antenatal clinic. The study also looks at any associated factors predisposing to the development of ASB, to identify the causative pathogens and their antibiotic susceptibility profile. Methods: It is a hospital based observational study involving 100 pregnant women with no symptoms of UTI at various gestational age. ASB was identified by urine culture and sensitivity studies. Results: 15% of the participants were found to have ASB. There was no significant difference in the prevalence of ASB based on age groups, number of pregnancies, gestational age or presence of anemia. Gram negative organisms were the cause of ASB in two thirds of cases. Escherichia coli is the most common isolate followed by Staphylococci. Gentamycin, cefotaxime and nitrofurantoin were the most efficacious of the antibiotics studied. Conclusion: ASB is quite prevalent in the pregnant population. E.coli continues to be the leading cause of ASB over the decades but Gram positive organisms are increasingly being recognized as pathogens responsible for ASB during pregnancy. Antibiotic susceptibility pattern differ widely among different study populations and antibiotic stewardship is a must for appropriate treatment and to prevent resistance development.

Utility of fine needle aspiration cytology (FNAC) in granulomatous mastitis with clinical, radiological and cytological findings association

Dr. Jaymala Solanki, Dr. Hiren Mundiya

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1048-1055

Granulomatous Mastitis is chronic inflammatory disease of breast which almost always mimics cancer in young individuals. Although Histopathology remains gold standard for the correct diagnosis, FNAC plays a pivotal role in the early diagnosis of GM as a minimally invasive, simple and cost effective outpatient treatment.
Material and Method: In present study cases reported as GM during period of 2018-2019 (2 year period) were retrospectively searched. In all cases, FNAC of the breast were performed by the pathologist using 22 or 23 gauge needle. Smears stained with H and E stain, Pap stain, giemsa stain and ZN stain. In cases of Pus material TB PCR run on CBNEET machine.
Result: In the present study 19 cases of GM were obtained over period of 2 years. Out of 19 cases 4 cases were diagnosed as TBM (21.05) bases on positive AFB staining and positive Gene Expert for tuberculosis (CBNAAT). Remaining 15 cases were labelled as IGM (78.94%) because of negative culture from pus discharge, negative PAS and AFB staining. In all patients there were no history of other causes of GM like sarcoidosis, fungal infection, previous trauma or surgery, autoimmune disease. So our study consists of TBM and IGM patients. All patients of TBM and IGM were female and presented with breast lump.
Conclusion: Granulomatous Mastitis including NGM and TBM are an uncommon chronic inflammatory disease of breast which almost always mimics cancer in young individuals and have overlapping clinical and cytological finding. FNAC along with proper clinical history help in differentiating these two entities.

Appraisal of rabies immunoglobulin among the animal bite cases

Mamata Rani Giri, Tripathy Abinash, Kar Krishna

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1056-1059

Rabies is widely prevalent in India. Estimated annual death in India due to rabies is 20000. Prompt and adequate treatment of animal bite is of utmost important in the prevention of rabies. Wound infiltration with RIG in Cat-III animal bite cases is to neutralize the virus at the wound site. It is to be infiltrate thoroughly in all sides of the wound with minimum tissue damage. With this background the present study was conducted with the following objectives.
Objectives

To assess the proper method of administration of RIG in Cat-III animal bite cases.
To assess the time lag between bite bite and RIG administration.
To assess the availability, accessibility, acceptability and adverse effect of RIG among patients.

Study Design: Cross-sectional study.
Place of study: ARV Clinic of PRM Medical College & Hospital, Baripada, Mayurbhanj, Odisha.
Study Subjects: All new cases of Cat-III animal bite attending the ARV Clinic during the study period.
Study Period: September 2022 to November 2022.
Study Instrument: A per-designed pretested questionnaires.
Data analysis: It was analyzed with MS Excel.
Result: A total of 281 Cat-III new animal bite cases were participated, out of them 55(19.57%) were belong to pediatric age group (<14 year) and 226(80.43%) study subjects were more than 14 years. Regarding the reporting time to the health facility after animal bite, most of the cases 253(90.04%) reported to the ARV Clinic within 24 hrs & less numbers 28(9.96%) reported more than 48 hrs. All the Cat-III bites had given anti rabies vaccination along with Rabies Immunoglobulin. Out of 281 study subjects Paediatrics age group 55(19.57%) were administered human rabies immunoglobulin (HRIG) & 226(80.43%) administered equine rabies immunoglobulin (ERIG). In all the cases RIG was administered as per the WHO recommendation with respect to dose & method of administration. ERIG was administered after doing skin sensitive test. There were no side effects among the study subjects after RIG administration. All the Cat-III bites had given the vaccine and RIG for the animal bite management on the day of their visit to the ARV clinic. During the study period both HRIG & ERIG were available in the ARV clinic which was free of cost for the patients. No side effects were reported among the study subjects after RIG administration

BURDEN OF SOIL TRANSMITTED HELMINTHIASES FROM MIDDLE AND UPPER ASSAM: A RETROSPECTIVE STUDY FROM A TERTIARY CARE HOSPITAL

Dweep Jyoti Baishya, Bipanchi Mahanta, Geetumoni Sonowal, Atanu Chakravarty, Monica Devi, Pragyashree Borah

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1060-1067

Soil-transmitted helminthic (STH) infection is a significant public health concern in India and a leading cause of morbidity, particularly in resource-constrained regions. Human transmission occurs through eggs or larvae in faeces, which contaminate soil in areas with poor sanitation. Infection results in intestinal blood loss leading to iron deficiency anaemia and protein malnutrition, impaired physical and cognitive development, abdominal pain and diarrhoea.
Aims & Objectives: To study the six-year prevalence trend of STH infections in middle  and upper Assam region from the records of patients attending JMCH.
Materials & Methods: This retrospective cross-sectional study was done by collecting data from records of STH isolates from January 2017 to November 2022. Data were analyzed using EpiInfo and chi square test to analyze the association between different variables using p value < 0.05 as statistically significant.
Results: From a total of 1352 stool samples received over 6 years, 200 (14.8%) were positive for intestinal parasites among which STH were 102 (51%). Six different parasites were reported with Ancylostoma duodenalae       being the predominant (59.8%) followed by Trichuris trichura (22.5%) and Ascaris lumbricoides (19.6%). Further, 2% recorded co-infection with 3 parasites and 6.5% with 2 parasites. The prevalence was higher in males (86%) than females (14%) (p=1.27) and 40-60 years age group showed highest prevalence.
Conclusion: Intestinal infection due to Hookworm was the most common STH identified in this study. Improvement in sanitation, periodical deworming and health education schemes are indispensable for the prevention and control of STH

Assessment Of Asymptomatic Bacteriuria In Pregnant Women And Treatment Effect On Outcome Of Pregnancy

Chandersheikhar, Devinder Kumar .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1068-1072

Background: To assess asymptomatic bacteriuria in pregnant women and treatment effect on outcome of pregnancy.
Materials and Methods: One hundred five pregnant women of age group 18 – 45 years were involved. Collection of clean catch, mid- stream urine sample was done. Urine routine and microscopy was done. Maternal and fetal outcomes was recorded.
Results: Significant bacteriuria was seen in 25, insignificant growth in 10 and negative in 70 cases. There were 10%, 6% and 0 pre- term, 81%, 90% and 100% term and 9%, 90% and 100% post- term birth in patients with significant bacteriuria, insignificant growth and negative bacteriuria. In significant bacteriuria patients, 86% patients had >2.5 kg weight and 14% had <2.5 kg weight. In insignificant growth patients, 91% had >2.5 kg weight and 9% had <2.5 kgs weight. 100% in negative growth patients had >2.5 kgs weight of babies. 91%, 93% and 100% patients had APGAR score between 9-10 at 1 minute and 95%, 99% and 100% had between 9-10 respectively. 10%, 5% and 0 required NICU admission respectively.

Conclusion: Significant bacteriuria was seen in 25 patients. Maximum were term and normal vaginal delivery. Maximum babies were with birth weight of >2.5 Kg and APGAR score of 9 and 10 was seen in patients with significant bacteriuria with minimum NICU admission

A STUDY OF TUBERCULOSIS IN PATIENTS WITH DIABETES MELLITUS

Dr.M.L.V.Radhika, Dr.Harish Kumar Y, Dr.K.Nandhini, Dr.Rajasekhar Naidu, Dr.Uma. M.A .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1073-1078

Background:  The present study was carried out to describe the clinical profile of tuberculosis in cases with type 2 diabetes mellitus
Methods- After obtaining the consent, a detailed investigation reports were collected from the study population like CBC, ESR, FBS, PPBS, HBA1C, HIV, Chest x-ray and Sputum for acid-fast bacilli, sputum culture and sensitivity, tissue for biopsy. Histopathological, Hematological and Radiological data were assessed and recorded. Sampling method was purposive sampling method and sample size was 106.Data were analyzed using SPSS (Version 19).Descriptive statistics, Chi-square test, and independent sample t-test were done appropriately. p-value <0.05 was considered statistically significant.
Conclusion
In this study, the common presenting complaints noticed were fever (82%) and  cough (78%) and 13% of the participants had a history of contact with TB cases and 1.6% of the cases were HIV status positive.
The prevalence of Tuberculosis among cases with diabetes mellitus in this study  was 24.1%. Among all the tuberculosis cases, 77.4% were pulmonary tuberculosis cases and 22.6% were extra-pulmonary tuberculosis cases.
Significant associations were noted between socio-economic status, duration of symptoms suggestive of tuberculosis, the habit of smoking, history of contact with TB case, history of COPD, history of HIV with the presence of tuberculosis.

Effectiveness of Empirical Antimicrobial Therapy on Clinical Outcome in Adult Critical Care Patients with Sepsis

Amita Dabhi, Chirag Modi, Rachit Patel .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1079-1089

Context: Sepsis is one of the leading causes of death in hospital settings. Timely administration of rational and effective antimicrobial therapy, as per hospital’s antibiotic policy, is one of the components of antimicrobial stewardship program. In absence of definitive pathogen identification and susceptibility pattern, initial antibiotic regimen is selected which is defined as empirical antibiotic therapy. Although an empirical antimicrobial policy is in place at our institute, it has not been evaluated since its inception for its effectiveness.
Aims: To assess the adherence to the empirical antimicrobial policy for sepsis and to evaluate its effectiveness on clinical outcome of sepsis in adult critical care patients.
Setting and study design: A prospective, cross-sectional study was conducted in adult non covid critical care units of Shree Krishna Hospital.
Methodology: Following approval from Institutional Ethics Committee, prospective cross-sectional study was conducted from 1st August-2021 to 31st July-2022 at non-covid intensive care units. The adherence to the empirical antibiotic policy was calculated as percentage of patients with sepsis in whom antimicrobial agent was started as per the policy. The effectiveness of the antimicrobial policy was assessed on the basis of the improvement in the clinical and laboratory parameters as well as Sequential organ failure assessment (SOFA) score of the patient over a period of five days.
Statistical analysis: Microsoft Excel 2019, Version 2209 was used for data entry and data analysis. Proportions were calculated using descriptive analysis. Data was analysed using Chi-square calculation. Significance was considered at P-value <0.05.
Results: The adherence to the antimicrobial policy in sepsis was 59.80%, (n = 61 out of 102) whereas adherence to initiation of antimicrobial agent within one hour of diagnosis of clinical sepsis was 96.07% (n =98 out of 102). The antimicrobial agent started as per antibiotic policy was susceptible in culture report in 55.31% (n = 26 out of 47) of patients. Effectiveness of empirical antimicrobial policy in patients with sepsis in adult critical care units based on improvement of SOFA score after five days of diagnosis of clinical sepsis was 51.06%, (n=24 out of 47). There was no significant correlation (P ≥0.05) found between age groups, gender, risk stratification categories, type of blood stream infections and type of organisms isolated, i.e., Gram negative and Gram positive with regards to effectiveness of empirical antimicrobial policy. There was no significant difference noted between improvement in SOFA score of the patients in whom antimicrobial agent was started as per policy and in whom the antimicrobial agent was not started as per policy (P = 0.72).
Conclusion: The adherence to antimicrobial policy for sepsis was low and further studies to evaluate the reasons for low compliance need to be conducted. Although the effectiveness was not significantly different when the antimicrobial agent was started as per policy compared to when it was not started as per policy, we still recommend using antimicrobial agent as per policy in order to avoid non uniformity in prescriptions and development of antimicrobial resistance.

Observational Study to Compare Bupivacaine & Tramadol with Ropivacaine & Tramadol Among Patients Undergoing Abdominal Surgeries.

Hanna Musa, Anita J Patel , Manthan Parmar, Dixitkumar Modh, Nisarg Patel .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1090-1097

Introduction: Ropivacaine, a newer long acting amide local anaesthetic and it has lesser side effects compared to Bupivacaine and is increasingly replacing Bupivacaine because of its similar analgesic profile and lesser cardiotoxicity.  Tramadol hydrochloride is a weak centrally acting analgesic commonly used as adjuvant with local anaesthetic agents in epidural analgesia.
Aims and objectives: The aim of this study was to compare the  hemodynamic changes of 0.125% Bupivacaine with that of 0.125% Ropivacaine along with tramadol in patients undergoing intra abdominal surgery for post-operative analgesia.
Material and Methods: Total 60 patients were taken scheduled for intra operative surgery ranging from 18-55 years in ASA grade I and II. They were randomly allocated to two groups of 30 each. Group R (n = 30) received an Epidural loading dose of 10ml 0.125% of Ropivacaine with 50mg tramadol. Group B (n =30) received an Epidural loading dose of 10ml 0.125% Bupivacaine with 50mg tramadol. Patients were assessed post-operatively every 15 min for heart rate, blood pressure, SPO2 for first hour and then after every 30 min till patient complained of pain.
Result: Hemodynamically, patients in both the groups, were equally stable. Group-R (412 ± 46.56 min) was having much longer duration of post-operative analgesia as compared to Group-B (348 ± 48.31 min, p < 0.001).
Conclusion: Ropivacaine and Bupivacaine shows a similar hemodynamic profile. Thus, Ropivacaine can be used as an alternative to Bupivacaine for postoperative pain relief through the epidural route in patients undergoing intra abdominal surgeries ,as a safe and effective agent.

Assessment of left ventricular filling pressure and its correlation with severity of chronic kidney disease

Siddhartha Rout, Mohammed Mudassir Ali, Amritarnav Rout, Mohammed Asif Muzafer Iqubal

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1098-1103

Chronic kidney disease (CKD) is a common health problem worldwide. Cardiovascular disease is the most common cause of morbidity and mortality in CKD. In CKD patients, use of Echocardiography can help in establishing a diagnosis of acute decompensated heart failure. Present study was aimed to assessment of left ventricular filling pressure and its correlation with severity of chronic kidney disease. Material and Methods: Present study was single-center, prospective, observational study, conducted patients aged >18 years, either gender, diagnosed cases of CKD as per KIDGO criteria underwent resting 2-D transthoracic echocardiography. Results: In present study, 80 cases of CKD underwent 2-D transthoracic echocardiography evaluation. Majority were from 50-59 years age group (53.75 %), male (66.75 %). In present study majority were from CKD stage 2 (53.75 %) followed by CKD stage 3 (28.75 %), CKD stage 4 (22.5 %) & CKD stage 5 (13.75 %). Among study patients, 45 patients (56.25 %) had normal LVFP, while 27 patients (33.75 %) had 9-13 LVFP & increase in LVFP (> 13) was noted in 8 patients (10 %).  Mean value of LVFP in CKD stage 2 was 8.68 ± 2.15, mean LVFP in CKD stage 3 was 10.34 ± 2.64, mean LVFP in CKD stage 4 was 12.92 ± 3.84 & mean LVFP in CKD stage 5 was 13.46 ± 3.23. We noted statistically significant association between increase in stage of CKD with progressive rise in mean LVFP value. Conclusion: The increase in left ventricular filling pressure is directly proportional to the CKD stage i.e., severity of renal failure. 
Chronic kidney disease (CKD) is a common health problem worldwide. Cardiovascular disease is the most common cause of morbidity and mortality in CKD. In CKD patients, use of Echocardiography can help in establishing a diagnosis of acute decompensated heart failure. Present study was aimed to assessment of left ventricular filling pressure and its correlation with severity of chronic kidney disease. Material and Methods: Present study was single-center, prospective, observational study, conducted patients aged >18 years, either gender, diagnosed cases of CKD as per KIDGO criteria underwent resting 2-D transthoracic echocardiography. Results: In present study, 80 cases of CKD underwent 2-D transthoracic echocardiography evaluation. Majority were from 50-59 years age group (53.75 %), male (66.75 %). In present study majority were from CKD stage 2 (53.75 %) followed by CKD stage 3 (28.75 %), CKD stage 4 (22.5 %) & CKD stage 5 (13.75 %). Among study patients, 45 patients (56.25 %) had normal LVFP, while 27 patients (33.75 %) had 9-13 LVFP & increase in LVFP (> 13) was noted in 8 patients (10 %).  Mean value of LVFP in CKD stage 2 was 8.68 ± 2.15, mean LVFP in CKD stage 3 was 10.34 ± 2.64, mean LVFP in CKD stage 4 was 12.92 ± 3.84 & mean LVFP in CKD stage 5 was 13.46 ± 3.23. We noted statistically significant association between increase in stage of CKD with progressive rise in mean LVFP value. Conclusion: The increase in left ventricular filling pressure is directly proportional to the CKD stage i.e., severity of renal failure. 

Study of effectiveness of surgery in improvement of pain associated with endometriosis by comparison of preoperative and postoperative pain score at 3months and 6 months follow up

Samita Bhat, Rooma Sinha, Madhumati Sanjay, Bana Rupa, Fozia Jelani

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1104-1111

Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, which induces a chronic, inflammatory reaction. Present study was aimed to the study effectiveness of surgery in improvement of pain associated with endometriosis by comparison of preoperative and postoperative pain score at 3months and 6 months follow up. Material and Methods: Present study was single-center, prospective, observational study, conducted in women in the reproductive age group of 18-45 yrs, with laparoscopically confirmed endometriosis. The patients were followed at 3 months and 6months and evaluation of pain relief was done using Visual analogue scale as well as Bibergolu and Behrman score.  Results: Among 92 women, predominant age group in the study was 26-30 years (31.52%), mean age of the patients was 32.03 ± 5.969 years. Most of the patients 87 (94.57%) presented with dysmenorrhea, pain abdomen (61.96%), dyspareunia (59.78%), back pain (32.6%), infertility (27.17%), dyschezia (22.83%) & premenstrual gaseous distension (11.96%). On 3 months evaluation 26 (28.26%) patients improved in their bleeding pattern. On 6 months evaluation 32 (34.78%) patients improved in their bleeding pattern, this improvement in heavy menstrual bleeding was clinically significant (P value = 0.0001). At 6 months follow-up 35 (38.04%) had mild pain, 7 (7.61%) had moderate pain & no one had severe pain. The two-tailed P value was < 0.0001, difference was extremely statistically significant. As per Visual analogue scale, at 6 months follow-up 62 (67.40%) patients completely freed of pain, 32.60% (30) of patients had only mild pain. The two-tailed P value was < 0.0001, difference is considered to be extremely statistically significant. Conclusion: This study demonstrates significant decrease in pain scores (Bibergolu and Behrman scale and visual analog scale) at 3 and at 6 months follow up (P<0.05) when laparoscopic surgery was offered to patients.

COVID 19 infection in Health care workers working in COVID and non COVID facility: A Retrospective cohort study

Neelam Attar, Nasreen Bagwan Malik, Akshay Joglekar

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1112-1117

We plan to study the prevalence of COVID infection in the health care
workers working both in COVID and non-COVID facility and also identify source of
infection, the demographic pattern, difference in infection rate in health care workers
working in COVID facility and non-COVID facility, compliance to use of PPE and
following social distancing norms.Material Method:The RT PCR Positive health care
workers were interviewed telephonically with informed consent for presence of
symptoms, source of infection, method of donning and doffing of PPE while working in
COVID and Non COVID facility, social distancing norms followed or not followed.
Result: 117 staffs got tested. 40 found positive by RT PCR. The infection rate was more
amongst staff working in non-COVID facility (65%) in comparison to COVID facility
(22.5%). Infection rate among nursing staff was the highest (40%), followed by Doctors
(35%), technicians and attendants. Male were more affected than females. 25 staffs
reported not wearing appropriate PPE, 16 staffs reported breaching social distancing
protocol. Conclusion: Though all health care workers are equally trained during
COVID pandemic, there is somehow low adherence to infection prevention practices
among the health care workers working in non-COVID facility, thereby increasing the
risk to infection. Non COVID facility staffs need to be specifically targeted for training
and implementation of infection prevention practices

Evaluation of the variability of imaging characteristics in normal pressure hydrocephalus

Dr. Soundara Pandian M, Dr. Praveen Elaprolu, Dr. Ranjith Kumar Siripurapu

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1118-1125

Normal pressure hydrocephalus (NPH) is a syndrome found in the elderly, which is characterized by the clinical triad of gait disturbance, dementia, and urinary incontinence without overt signs and symptoms of elevated intracranial pressure. NPH has been estimated to account for upto10% of cases of dementia and is significant because it is treatable by ventriculoperitoneal shunting. NPH can be idiopathic or can be secondary. The secondary causes are: traumatic brain injury, meningitis, subarachnoid haemorrhage (SAH) or intracranial surgery. Patients with Idiopathic NPH respond better to treatment than secondary
Materials and Methods: It is a prospective cross-sectional study. Inpatients and outpatients of age group more than 40 years of age, of both gender (males and females) diagnosed with normal pressure hydrocephalus as per consensus criteria were referred to Department of Radiodiagnosis from the department of. The patients underwent Magnetic resonance imaging/computed tomography study of brain.
Results: A total 40 patients were included in this study according to consensus criteria. Computed tomography (CT) and Magnetic resonance imaging (MRI) show ventricular enlargement disproportionate to cerebral atrophy, with associated ballooning of frontal horns, periventricular hyperintensities, thinning and elevation of the corpus callosum and widening of temporal horns without evidence of hippocampal atrophy in NPH.
Conclusion: Although diagnosis can be made based on CT findings alone, MRI is more accurate for disclosing associated pathologies (such as cerebrovascular disease) and for detecting NPH typical signs of prognostic value, besides avoiding exposure to ionizing radiation. MRI is the best modality to image anatomical changes and can further support the diagnosis with CSF flow studies.
 

Evaluation of correlation of clinical outcomes with severity index in acute pancreatitis patients

Dr. Praveen Elaprolu, Dr. Soundara Pandian M, Dr. Ranjith Kumar Siripurapu

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1126-1132

Acute pancreatitis is a significant cause of morbidity and mortality and is known to run an unpredictable course. Severe pancreatitis occurs in 20%-30% of all patients with acute pancreatitis and is characterized by a protracted clinical course, multiorgan failure, and pancreatic necrosis. Computed Tomography Severity Index (CTSI) andModified Computed Tomography Severity Index (MCTSI) is used as a scoring system in acute pancreatitis. This study aims to correlate the CTSI and MCTSI grading system with patient outcome in terms of organ failure, mortality and duration of hospital stay.
Materials and Methods: This was a prospective study conducted for a period of two years. 40 Cases diagnosed as acute pancreatitis were included in this study. These patients underwent contrast enhanced computed tomography (CECT) of the abdomen and pelvis. The findings were recorded as per the CT severity index and modified CT severity index.
Results: There was significant correlation between necessity of ICU admission and duration of hospital stay and grade of pancreatitis, positive correlation with duration of ward stay and strong correlation with total duration of hospital stay. Higher CT grade is positively associated with development of local complications and systemic complications.
Conclusion: Grading by modified CT severity index has a significant correlation with necessity of ICU admission and total duration of hospital stay. CT severity index and Modified CT severity index can be used to predict the possibility of developing local and systemic complications, the need for interventions and necessity of hospital stay.