Online ISSN: 2515-8260

Issue 4,

Issue 4


Synthesis and Characterization of Mn-Zn soft ferrite nanoparticle of Gd3+ doped

Indu Sharma, Pankaj Kumar

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1-9

Manganese-Zinc Ferrite is a very high permeability magnetic material. The permeability is
depended on the amount of manganese and zinc used in the synthesis of ferrite
material.Reagent graded raw materials were used as initial material to synthesize and get a
characterization of Mn-Zn based spinel ferrite. The nanocrystalline powders of manganese
ferrite were obtained by the process of citrate precursor method. The obtained nanocrystals
of Mn-Zn were doped by Gadolinium which further it was employed to produce specimens
of Mn0.5Zn0.5GdxFe2-xO4 (x = 0, 0.01, 0.03). The study of doped (Gd) Mn-Zn ferrite
nanocrystals was characterized by X-ray diffraction (XRD) and scanning electron
microscopy (SEM). The results of XRD data determine the average crystallite size of doped
(GD) Mn-Zn nanocrystals in the range of 40nm to 45nm. The images obtained through
FE-SEM shows the flake-like structure of doped (Gd) Mn-Zn ferrite nanocrystals. Further
studies of doped (Gd) Mn-Zn ferrite were done by FTIR and Raman spectroscopy.

ONLINE BANKING SYSTEM

Miss. Komal T. Jangid, Miss. Santoshi R. Sharma, Miss. Vrushali P. Chaudhari, Miss. Samruddhi K. Joshi, Miss. Harsha V.Nikhade, Prof. A.V. Mahalle

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 10-16

Online Banking Services are accessible to all the customer who have their valid user and id allocated by
the bank. The System provides the different facilities like Balance enquiry, Funds transfer to another
account in same or different bank, Request for cheque book, change in address, stop payment of cheques,
viewing monthly and annual statements. Online Banking System has attractred the attentions of banks,
securities, insurance companies in developing nations sice the 1990s and the rapid and significant growth
in electronic sectors and commerce.
The main motive of the online banking system is is to provide customer with alternative that is more
responsive and less expensive also time saving.
Online banking system is the most important financial activity which is now a days mostly carried out by
any person who has an account in the bank. Not only unique id and password is allocated with that an
new UPI code system is added as a security the bank.If a wrong password is given thrice in the session,
that account gets locked and the customer is not able to use their account and an warning is pop up that
the account is locked and the same locking system goes with UPI code.
Whenever we deal with the Online banking system services the main concern of the customer is always
related to the security regarding to the banking transaction and account login activities.
The E-Banking services now deals with the single sign-in log on and it is not secured . Authentication is
now an proposed system, in this activity of linking an individual process on the basis of username and
password and basically the password is consist of characters, numbers, alphanumeric values, special
character and etc.. to make the password strong so that the attackers chould not guess the password easily
it might be difficult to remember the password but the strong password are mandatory otherwise the
software shows the message as the password is weak and it doesnot accept that weak password until we
create the strong password.

Gynecologic Imaging Reporting and Data System (GI-RADS) for revealing OvarianMasses based on Ultrasonography

Rana Ibrahim Ali Hassan, Ahmed Sabry Ahmed Ragheb, Ahmed Mohammed AlaaEldeen,Mohamed Ibrahim Amin

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 17-38

The adnexal masses represent a variety of diseases, ranging from normal luteal cysts
to ovarian cancer, from gynecological or non-gynecological origins. Transvaginal sonography
(TVS) has turned into the first step imaging method for describing adnexal masses. Transvaginal
ultrasonography is the initial method for detection of adnexal masses, it can visualize the deeper
structures and even note the fine details of the organs like fallopian tube and ovary, also
distinguish between benign and malignant lesions. Gynecologic Imaging Reporting and Data
System (GI-RADS): is a new system based on BI-RADS for reporting findings in adnexal masses
identified by TVS. Thick papillary projections, thick septa, solid areas with/without ascites,
defined according to the International Ovarian Tumor Analysis criteria and vascularization within
solid areas, papillary projections or central area of a solid tumor on Color or Power Doppler
assessment are suggestive signs of malignancy.

Comparative study of functional outcome of distal humerus intra-articular fracture treated with parallel plates and with orthogonal plates (A study of 30 cases)

Dr.Daljinder Singh, Dr Akashdeep Singh, Dr Sanjeev Sareen, Dr Annie Sandhu

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 39-52

Intra-articular distal humerus fractures remain one of the most difficult injuries to
manage. These fractures comprises 2-6% of all fractures and have bimodal age
distribution. The majority of these fractures occur either as low energy falls or high
energy trauma. Most fractures in elderly patients are intra- articular with bi-columnar
involvement. They are commonly multifragmental and occur in osteopenic bone. High
energy injuries occur in adults, which are accompanied with other associated injuries.
The elbow is anatomically a trocho-ginglymoid joint in which distal humerus bifurcates
into two divergent cortical columns, termed as medial and lateral columns. The articular
segment functions architecturally as a tie arch. The elbow is one of the most constrained
joints of the body and tolerates immobilization poorly and any alteration within the
architecture of the joint has the potential to limit motion and compromise
function.Treatment outcomes are often related to elbow stiffness, weakness and pain.
Meticulous planning is required in obtaining an anatomic intra-articular reduction, and
creating a fixation construct that is rigid enough to tolerate early mobilization. Usually,
70% of patients that sustain an elbow fracture, fall directly on to the elbow because they
are unable to break their fall with an out stretched arm. This randomized, prospective
study was undertaken to compare the functional outcomes of distal humerus intraarticular
fractures in adults treated with parallel plates and orthogonal plates. From a
clinical perspective, a parallel plating method appears to provide better rigid fixation that
is adequate for obtaining bone union. However, no statistical significant differences were
observed between the orthogonal and parallel double plating methods in terms of clinical
outcomes and complication rates. If meticulously applied, with suitable plates, both
parallel and orthogonal positioning can provide adequate stability and anatomic
reconstruction of the distal humerus fractures.

Serum Prolactin: A Possible New Marker for Severity of Liver Cirrhosis

Deepak Raj Sakhnani, Chetanya Kumar Sharma, Ajay Mathur, RajendraKasana, SandeepSaini

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 53-59

Background: Liver cirrhosis (LC) is an irreversible condition which results from necrosis
of hepatocytes with loss of reticular network and nodular regeneration of residual liver
tissue. This study was undertaken to assess the relation between serum prolactin levels and
the severity of the liver cirrhosis.Materials & methods: This cross-sectional observational
study was conducted during one calendar year at a tertiary care center in Western India
among 50 cases of established liver cirrhosis. Serum Prolactin was estimated using ADVIA
Centaur® CP Immunoassay System (Siemens®) by Chemiluminescent technique. The
modified Child Pugh score was calculated for each study participant. The patients were
categorized into Classes A, B or C based on the score obtained. Hepatic encephalopathy
was diagnosed and graded as per West Haven classification system. The grade I-II were
taken as mild and grade III-IV as advanced hepatic encephalopathy for calculation of the
modified Child-Pugh score. Ascites was graded as mild, moderate and severe. All the data
were stored in excel sheet using Microsoft® Office 2007. Results: The mean serum
prolactin, serum albumin, serum Bilirubin and INR were 48.1±26.8 ng/ml, 2.8±0.6 g/dl,
4.8±4.9 mg/dl and 2.2±1.0 respectively. (Table No. 1) The mean serum prolactin level in
alcoholic cirrhosis (49.2±25.1 ng/ml) does not statistically differ from non-alcoholic
cirrhosis (46.6±29.4 ng/ml) cases (p > 0.05). The mean serum prolactin level was
statistically significantly higher among cases in Modified Child Pugh Class-C (68.91 ±
17.80 ng/ml) compared to Class B (33.26 ± 7.41 ng/ml) and Class A (10.03 ± 4.01ng/ml)
cases. The mean serum prolactin level was 81.36 ± 19.85 ng/ml in cases with severe ascites,
60.09 ± 18.05 ng/ml in moderate ascites cases, 36.1583 ± 15..06 ng/ml in mild ascites cases
and 19.79 ± 12.29 ng/ml in cirrhosis cases without ascites. The difference in mean serum
prolactin level was significant among different severity of ascites. The serum prolactin
level was 81.08 ± 18.04 ng/ml in cases with advanced hepatic encephalopathy, 56.89 ±
15.05 ng/ml in cases with mild hepatic encephalopathy and 26.16 ± 13.99 ng/ml in
cirrhosis cases without encephalopathy. Conclusion: Serum Prolactin levels showed
positive correlation with Modified Child Pugh Score and Fibroscan in predicting the
severity of disease.

Factors that Influence Schoolchildren’s Willingness to Participate in Leisure-Time Physical Activities: Questionnaire Development and Content Validity Testing

Mei-Li Tsai,Tzu- Lin Lin,Chi-Jane Wang

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 60-71

Leisure-time physical activities (LTPA) can improve children’s physical fitness, their ability to control negative emotions, even their school performances. As the factors that influence schoolchildren’s willingness to participate in LTPA are multifaceted, an appropriate and valid measurement tool is critical for advancing the discussion of this topic. The purpose of this study is to develop a questionnaire about schoolchildren’s willingness to participate in LTPA and to verify its content validity and potential user validity. The research procedures involved three stages. The first stage was the development of the questionnaire. The questionnaire items were developed through systematic collection, review, and summary of the literature. The second stage involved eight experts in testing the content validity of the questionnaire. The third stage was to test the potential user validity with eight upper-grade students as questionnaire respondents. The systematic collection, review, and summary of the literature resulted in five factors: individual, interpersonal interactions, parents, environment, and school policies. Based on these, 36 items were drafted for the questionnaire, named “Influences on Schoolchildren’s Willingness to Participate in LTPA.” The questionnaire was validated by the eight experts. The item-content validity indexes (I-CVI) ranged between .88 and 1.0, and the summative content validity index (S-CVI) was .9. As for the items’ wording appropriateness, the I-CVI ranged between .75 and 1, while the S-CVI was .96. For potential user validity, the students rated the comprehensibility of the 36 items. Their responses fell between 3 (mostly understandable) and 4 (completely understandable). In conclusion, the expert content validity and potential user validity testing confirmed that the questionnaire has good content validity. In the future, the questionnaire will be administered to a large sample of schoolchildren to verify its construct validity and reliability

CLINICAL PROGNOSTIC FACTORS IN OROPHARYNEAL CARCINOMA PATIENTS TREATED WITH CONCURRENT CHEMORADIATION.

Dr Sonali Karnwal, Dr Raja Paramjeet Singh Benipal, Dr Jai Lal, Dr Pardeep Garg, Dr Manraj Singh Kang, Dr Romi Kant Grover

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 72-78

Worldwide, oropharyngealcancer accounts for 1.6% of all the new cases and 1.5% deaths in 2020. Overall42176, is the incidence of oropharyngeal cancers occuring in Asia, and account for approximately 30% of all the cancers in India. Oropharyngeal carcinoma is eleventh most common cancer worldwide and accounts for approximately 10 per cent of the annual worldwide incidence of head and neck squamous cell carcinoma. In India, head and neck cancers contribute up to 7.8% of the global cancer burden and 8.33% of the global cancer deaths.In 2020, the incidence of oropharynx cancer worldwide is 98,412 1. In India incidence rate is 6794 2. Incidence rates are more than twice as high in men as in women3.The tonsil is the most frequent subsite of oropharyngeal cancer followed by the base of tongue.

PRESCRIPTION PATTERN STUDY IN TYPE 2 DIABETES MELLITUS IN DIABETIC OUT PATIENTS AT PRIVATE CLINIC

Dr. Bharti N. Karelia Dr. Kiran G.Piparva Dr. Parulben A. Patel

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 79-87

Aim: To evaluate drug utilization pattern of antidiabetic drug in type-2 diabetic patients
attending at private diabetes clinic. So that, this information can be used in assessment of
quality of care provided as well as to facilitate the rational use of drugs in populations
Objective: To evaluate the current trends of prescribing patterns of antidiabetic drug in type
2 diabetic patients
Material and Methods: An observational prospective study undertaken at diabetes clinic from January 2015 to April 2016 after approval from institutional ethic committee. Total 600 patients of type 2 diabetes mellitus were enrolled. Data related to demographic details of the patient (age, gender and BMI, occupation, social status), past history, family history, personal history, all investigations, drug treatment and adverse drug reaction were recorded in suitable case record form. Follow up was carried out for all patients every 3rd, 6th, 9th and 12th month visit for glycaemic control. Data were entered into Microsoft excel 2010 and analysed by descriptive statistics (percentage, mean, standard deviation) and chi square test.
Results: Out of 600 patients, 58.67% were males and 41.33% were females. The mean age of the patients was 51.85 ± 4.24 years. Hypertension (31%) was most common co-morbid illness.Most common complaint was weakness (18.33%). Majority prescriptions had fixed dose combination (FDC) of two antidiabetic drugs (93.2%). Most commonly prescribed FDC was of sulfonylureas (Gliclazide) and Biguanide group (Metformin)in 552(92%). Average number of drugs per encounter was 3.02, 0.3 % drug was prescribed by generic name, 4.17% drug was antibiotic, 7.7% drug was injectable medicine, 14.27% drugs was prescribed from national list of essential medicine and 11.35% drugs were prescribed from WHO essential list of medicine. Fixed dose combinations were prescribed in 57.27% of patients. Glycaemic controlled was observed in 32.84 % patients.
Conclusion: Sulfonylurea and Biguanide combination most commonly used to treat type 2 DM and among them Gliclazide and Metformin combinations was most commonly prescribed.

Use of Retrograde Intramedullary Locking Nail in Ankle Arthrodesis for in Diabetic Patients: An updated Overview

Abubaker M R Zanbouzi, Omar Abd Elwahab Kelany, Walid Mohmmed Nafeh,Mohammed Khalid Saleh

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 88-100

Background: Ankle arthrodesis for diabetic complications, such as osteomyelitis and Charcot
neuroarthropathy (CN), constitute an entirely separate group that calls for different surgical
approaches for successful outcomes. Diabetes mellitus is currently the most common cause of
neuroarthropathy. Abnormal nociception and proprioception lead to progressive destruction of
the joint. Ankle arthrodesis and ankle arthroplasty are the two common operative treatments
used in end stage ankle arthritis (ESAA). Recent clinical evidence suggests that ankle
arthroplasty leads to superior functional outcomes over ankle arthrodesis. Ankle arthrodesis is
indicated for patients with ESAA that failed a minimum of 3 month of conservative treatment.
Both internal and external fixation may be used in ankle arthrodesis. Retrograde
intramedullary arthrodesis is typically reserved for arthrodesis of both the ankle and subtalar
joints. Two standardized methods of ankle arthrodesis for ESAA is described here: Open and
arthroscopic.

Expanding the Spectrum of Fatal Necrotizing Fungal Infections Presented as Sinonasal and Rhino Orbital Mucormycosis and Aspergillosis in Post Coronavirus Disease.

Patel Paras, Patel Purvi, Sapariya Brijeshkumar, Banergi Arunima , Patel Drasti, Bhatt Maitri

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 101-110

The present study is aimed to clinico pathologically characterize a subset of mucormycosis and aspergillosis cases presented as Sinonasal and rhino orbital fungal infection in post coronavirus disease. The study comprises a microscopic analysis of specific histopathologic variables on 35 cases of mucormycosis that were diagnosed and treated in a six month period. We reviewed Sino nasal and orbital biopsies of 35 patients whose specimens received in a tertiary care hospital histopathology lab. All patients were admitted for suspected fungal sinonasal and rhino orbital infections. Detailed microscopic examination  and clinicopathological correlation study were done. Fungal load in the tissue (graded as mild, moderate and marked), degree of neutrophilic and granulomatous response, tissue invasion and necrosis were graded.
We noted that necrosis is seen in all cases. Co infections with aspergillosis are also commonly noted. Vascular changes are marked. Angioinvasion, bone marrow invasion and peri neural/neural invasion are frequently noted. Fungal culture can become negative in histologically proven mucormycosis. History of diabetes present in majority of cases. Use of glucocorticoids and hypoxemia is also noted in many cases. The prevalence of mucormycosis  fungal infections is very high in post coronavirus patients especially in diabetic patients. Histopathologic examination remains one of the major diagnostic tools in diagnosis of mucormycosis. Early diagnosis with surgical excision, appropriate debridement, proper antifungal treatment and management of risk factors lead to subsequent reduction in mortality and morbidity.

Pattern of adverse drug reactions reported: A hospital based cross-sectional study

Dr. Gira Sulabh, Dr. Shweta Sulabh, Dr. Vinod Kumar, Dr. S.N.Singh

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 111-115

Aim: The aim of the present study to determine the patterns of adverse drug reactions reported in the tertiary care hospital.
Methods: This observational, retrospective study was done in the Department of Pharmacology, Darbhanga medical college, Bihar, India. A total of 200 ADRs were reported during the study period. Each ADR was analyzed for demographic data, relationship to drugs as per causality assessment, and frequency of ADRs.
Results: A total of 200 ADRs were reported from both outpatients and inpatients of various departments. Most of the ADRs were found in females (55%) and patients of the age group 20 to 50 years (85%). Most of the ADRs were reported from the ART center (39%), dermatology (20%), oncology (11%), pediatrics (9%), and medicine (8%). The number of ADRs was distributed according to the department where they were reported. Overall, 40% of the ADRs are due to the anti-retroviral therapy, 29% due to the antibiotics, and 14% due to the nonsteroidal anti-inflammatory drugs (NSAIDs). Causality assessment was done by using the WHO-UMC scale, in which most of the ADRs were reported as probable (50%) followed by possible (48%). Severity assessment was done by a modified Hartwig and Siegel scale, in which most of them are mild (74%).The most commonly occurred ADRs were rash (40%), followed by nausea and vomiting (25%).
Conclusion: The maximum number of ADRs were reported with ART drugs. So, it is advisable to have close monitoring of the ART to prevent ADRs in these patients. Serious ADRs such as SJS and TEN are most familiar with analgesics and sulpha antibiotics.

Mini-Gastric Bypass versus Sleeve Gastrectomy in Treatment of Type IIDiabetes Mellitus; a Randomized Comparative Study

Abdelshafy Mostafa Abdelshafy, Ali HelmyElshewy, Emad Mohammed Salah, Osama Abdelaziz Mohammed

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 116-129

Introduction Although, the primary goal of bariatric surgery is body weight control,
other various beneficial effects have been confirmed especially the improvement in type
2 diabetes mellitus and associated comorbidities after surgery.
Patients and Methods:
A prospective study to compare the effect of sleeve gastrectomy and minigastric bypass
on obese patients with type II DM, divided into 2 groups, each containing 22 patients.
Results:
The follow-up was 12 months for both groups. Duration of surgery was different in both
groups with Mean ± SD 89.5 ± 15 in SG group and 105 ± 11.1 in MBG. There was 2
cases had intraoperative bleeding that managed immediately intraoperative. Leak test was
done and 2 patients were positive in MGB and intraoperative repair was done One case of
leakage was detected after SG and managed nonsurgically with percutaneous drainage for
intraabdominal collection and Mega stent insertion. Both surgical procedures achieved
T2DM remission. Both FPG and HbA1c at 1 year are significantly lower in diabetic
patients treated by MGB when compared to SG patients (SG from 201 ± 17.8 to 98.8 ±
12.7, MGB from 214.2 ± 27.6 to 83.9 ± 6.3 for FPG); (SG from 7.6 ± 0.71 to 5.5 ± 0.41
,MGB from 7.9 ± 0.53 to 5.3 ± 0.38 for HbA1c).
Conclusion:
MGB and SG achieved T2DM remission, but MGB provided a better performance than
SG at 1 year.

Quantum Cryptography helps to enhance on security issues

Mr.BGiridhar .

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 130-139

Stegnography is the technique of hiding confidential information within
anymedia.Inrecentyearsvarious stegnography methods have been proposed to
makedatamoresecure.Atthesametimedifferentsteganalysismethods have also evolved. The
number of attacks used by thesteganalyst has only multiplied over the years. Various
toolsfor detecting hidden information’s are easily available over theinternet, so securing
data from steganalyst is still considered
amajorchallenge.Whilevariousworkhavebeendonetoimprove the existing algorithms and
also new algorithms havebeenproposedtomakedatabehindtheimagemoresecure.Wehave still
been using the same public key cryptography likeDeffie-
HellmanandRSAforkeynegotiationwhichisvulnerable to both technological progress of
computing
powerandevolutioninmathematics,sointhispaperwehaveproposeduseofquantumcryptograph
yalongwithstegnography.Theuseof this combination will
createkeydistributionschemesthatareuninterceptable thusprovidingour dataaperfectsecurity.

Effect OfYoga Practice On Anxiety During The COVID-19 Pandemic

Dr. PoojaTripathi Pandey,Dr.Manila Jain, Dr. Sapana Jaiswal

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 140-145

Stress and anxiety have been implicated as contributors to many chronic diseases and to
decreased quality of life, even with pharmacologic treatment. Efforts are underway to find
non-pharmacologic therapies to relieve stress and anxiety, and yoga is one option for
which results are promising. The focus of this review is on the results of human trials
assessing the role of yoga in improving the signs and symptoms of stress and anxiety. A
significant decrease in stress and/or anxiety symptoms when a yoga regimen was
implemented; however, many of the studies were also hindered by limitations, such as
small study populations, lack of randomization, and lack of a control group. Biochemical
and physiological markers of stress and anxiety, but yielded inconsistent support of yoga
for relief of stress and anxiety. Evaluation of the current primary literature is suggestive of
benefits of yoga in relieving stress and anxiety, but further investigation into this
relationship using large, well-defined populations, adequate controls, randomization and
long duration should be explored before recommending yoga as a treatment option.

EVALUATION OF SELF-MEDICATION PRACTICES IN PATIENTS COMING TO GOVERNMENT HOSPITAL VIJAYPUR FOR OPD CONSULTATION

Priyanka Sambyal, Reem Imtiaz, Paras Singh, Mustafa Imtiaz

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 146-150

Self-medication is an important health issue especially in developing countries like India.
This study aims to evaluate the practice of self-medication in the patients coming to A.H
Vijaypur for OPD consultation. The study was conducted on a total of 100 patients and
data was collected by interview using a questionnaire. Our study revealed the demographic
profile of the people who resorted to self-medication, the drugs used as self-medication,
reasons behind the practice, the source of information regarding the self-medication and
the depth of knowledge if any about the drugs used as self-medication. . It is hoped that
this study will stimulate more attention towards research on the practice of self-medication
which is an important but controversial medication issue.

SOX 2as A Prognostic Marker in Malignant Epithelial Ovarian Tumors

Menna Allah Ayman Mohammed, Yousria Mohamed MohamedEl-Gohary, EmanTaherNour El-Dien, Mona Mostafa Ahmed

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 151-173

Background: Ovarian cancer (OC) is considered the most lethal cancer of the female
reproductive system and ranked as the seventh most frequent cancer diagnosed
worldwide and the eighth leading cause of cancer-related death among women
worldwide. The most common type of Ovarian cancer is that originate from the ovarian
surface epithelium "Epithelial ovarian cancer" (EOC) which accounts for over 90% of
all ovarian malignancies and is the most lethal gynecologic malignancy. Sex
determining region Y-box 2 (SRY)-box 2 (SOX2) is one of the main members of the
Sox family which consists of at least 20 members that are divided into 8 groups (from A
to H, based on their high mobility group (HMG) sequence identity in humans). SOX2
expression has been reported at both the RNA and protein levels for many tumors, data
available from The Cancer Genome Atlas indicates that SOX2 mRNA is elevated in
many cancers, relative to normal tissue. The level of SOX2 expression in a tumor
represents a prognostic factor to determine the clinical outcome for a cancer patient.
As SOX2 has a great role in cancer stemness so SOX2 expression in OC is an
interesting issue for studying.

A Study on Women and Family Welfare Programmes ( Special Reference on two villages in the Dibrugarh District, Assam)

Jashashya Borah

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 174-180

Family planning or Family welfare means planning by individuals to have only the
Children they want, when they want them. Family welfare includes not only
planning of births, but also their welfare of whole family by means of total family
health care. The family welfare schemes has high priority in India, because its
success depends upon the quality of life of all citizen (specially women). Here, we
should know that the family planning program was started in 1951 and in 1977 the
government of India redesigned the "National Family planning programme" as the
"National Family welfare programme." This paper is primarily trying to highlight
the understanding of women about various Health Scheme under National Rural
Health Mission (NRHM).

The effect of body mass index (BMI) on the mortality among patients with stroke

Salah Elsayed, Muath Othman

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 181-186

Stroke is considered one of the leading causesof morbidity and mortality in many
countries. Many studies investigated the outcomes after the occurrence of stroke.
Some of those research studies indicated that obesity and the increasein the
bodymass index areestablished risk factors for mortality among stroke patients.
However, the results of these studies were inconsistent.The main aim of this review
article was to examine the association between bodymass index and mortality
among stroke patients. The majority of the studies had shown a possible effect of
overweight on mortality among stroke patients; the evidence regarding the
association's presence is limited.On the other hand, the majority of the studies had
shown a protective effect of obesity (mild obesity, bodymass index between 30-35)
onreducingthe risk of mortality among stroke patients. This means underweight
stroke patients have more risk of mortality. Thus, the argument regarding the effect
of high bodymass index on mortality has been explained by the obesity paradox.
However, most of those studies were observational, and results could be attributed
to the methodological flaw. There is a need to well-designed prospective studies that
to overcome the limitation of the previous studies.

The Influence of Hospital Marketing Mix on Inpatient Loyalty in Sarah Medan General Hospital

Abidah Ismail Lubis, Destanul Aulia , Siti Saidah Nasution

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 187-192

Sarah Medan General Hospital in recent years has faced the problem of decreasing
patient loyalty levels, this can be seen from the level of BOR in the last seven months in 2020
which tends to decrease every month. The marketing mix is considered to be a solution to the
problem of patient loyalty, especially related to service quality, price, promotion, and good
communication with customers. The study aimed to analyze the influence of marketing mix on
inpatient loyalty in Sarah Medan General hospital. The study was a quantitative survey with a
cross-sectional approach. The sample was 132 hospitalized. Data were analyzed using logistic
regression. The result shows that there was a significant influence between the marketing mix
seen from the process aspect and the physical appearance of the hospital on patient loyalty.
Where the physical appearance variable was the most dominant variable with a large odds ratio
of 5,134, which means that the better the physical appearance of the hospital, it is predicted that
it will increase patient loyalty by five times higher than the poor physical appearance of the
hospital. It is recommended for Sarah Medan Hospital to pay attention to and improve again
regarding the speed of availability of treatment rooms for inpatient registration and the speed
of response from medical personnel in taking medical actions, as well as maintaining
consistency of service flow.

STUDY OF MEDICAL MANAGEMENT OF AUB CASES IN RESPECT WITH PALM COEIN CLASSIFICATION AT TERTIARY CARE CENTER

Dr. Neethika Raghuwanshi, Dr. Harsha Karode, Dr. Aparna Wahane, Dr. Madhuri Dhakane, Dr. Sushma Deshmukh

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 193-203

Introduction: Abnormal uterine bleeding (AUB) is the most common problem among patients coming to gynaecology outpatient department. There are various pathologies which can lead to AUB. History, blood investigations, ultrasonography, hysteroscopy and endometrial aspiration are the methods to rule out different causes. Later on, they are classified as per PALM-COEIN classification. It helps in better and successful management of AUB patients.
Material and Methods: This prospective interventional study was carried out in the Department of obstetrics and gynaecology, in our institute enrolling 300 consenting subjects having AUB coming to outpatient department and in doored to gynaecology ward of our tertiary care hospital. Subjects with confirmed diagnosis of abnormal uterine bleeding as per “PALM- COEIN” classification and on ultrasonography, fulfilling the criteria and ready to follow up were enrolled in the study. The final medical treatment assigned to the patients depending upon aetiology (PALM-COEIN classification) ,age of the patient ,desire of fertility and options available. Different medical treatment options like LNG-IUS (MIRENA), ormeloxifene (SERM), progesterone only pills, OC pills, tranexamic acid were given to the patients in this study for treatment of AUB.
Results: In our study, out of 300 , total 121 (40.3 %) study participants were given ormeloxifene, 65 (21.7%) were offered OC pills, 60 patients (20.0%) given LNG-IUS(MIRENA), 44 patients (14.7%) were treated with Progesterone and 10 (3.3%) study participants were medically treated with tranexamic acid. Subjects were followed every monthly for initial 3 months of treatment, followed by 6 monthly up to 1 ½ year of treatment. In every follow up PBAC score, Haemoglobin level, endometrial thickness and quality of life (QoL) score was done to assess effectiveness of medical treatment assigned to patients. In our study out of 284 subjects who completed medical treatment for AUB, 72% subjects achieve normal menses, 14.3% subjects had scanty menses & 25(8.3%) subjects developed amenorrhoea. 2.7% subject loss follow up and 2.7% subjects underwent hysterectomy out of which 8 subjects removed LNG-IUS and opted for hysterectomy within 6 months of treatment.
Conclusion: Classification of AUB as per PALM-COEIN helps in better understanding of disease and successful management of patients. Medical management is found very effective in treatment of AUB so that unnecessary hysterectomies and morbidity associated to it can be avoided.

Role of Mutant P53 Protein Expression in Colorectal Carcinoma

Ola Abd El Rahman Yousse, Noha Farouk Elaidy, Mohamed Ali Alabiad, NesmaRashwan Abdelrahman

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 204-211

Introduction:Colorectal cancer (CRC) is the third most diagnosed malignancy and the
fourth leading cause of cancer-related deaths in the world. P53 protein is a nuclear
biomarker that is most investigated for its predictive value in CRCs.Aim: to evaluate the
relationship between P53 expression and colorectal carcinoma. Materials and methods:In
this study we investigated the expression of P53 in colorectal carcinoma using
immunohistochemistry on 60 cases collected retrospectively from Department of Pathology,
Faculty of Medicine, Zagazig University.Results:30/60 (50%) of the cases showed positive
P53 expression, the commonest Dukes stage was stageA which forms 25/60 (41.7%), There
was a high statistically significant difference (p<0.001) between the studied subgroups as
regard histopathology, age, lymph node metastasis, distant metastasis and DUKES, a
significant difference (p=0.002) between the studied subgroups as regard lymph vascular
invasion. Conclusion: P53 overexpression in colorectal carcinoma was associated with
DUKES stage, lymph node metastasis, distant metastasis, and lympho-vascular invasion.

EFFICACY OF FINE NEEDLE ASPIRATION CYTOLOGY IN TRIBAL AREAGUJARAT

DR GAURAV S PAWAR, DR CHARU TRIPATHI, DR RAM KUMAR

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 212-218

INTRODUCTION
NECK LESIONS ARE FREQUENTLY ENCOUNTERED IN CLINICAL PRACTICE AND FOUND RESPONSIBLE FOR SIGNIFICANT MORBIDITY AND MORTALITY IN INDIA. SOME OF THE LESIONS OF THE NECK REGION INCLUDE TUBERCULOSIS & OTHER CHRONIC INFLAMMATORY LESIONS, PLEOMORPHIC ADENOMA & CYSTS. MALIGNANT LESIONS-PRIMARY AS WELL AS METASTATIC, COMMON TO THE CERVICAL
GROUP OF LYMPH NODES, ARE ALSO FREQUENTLY NOTED.
FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) IS A SIMPLE, ECONOMICAL, HIGHLY ACCURATE TOOL IN THE DIAGNOSIS OF CERVICAL LESIONS. IT IS ALSO IDEAL FOR SAMPLE COLLECTION FOR ANCILLARY STUDIES SUCH AS CBNAAT. FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) SAMPLES FROM THE NECK REGION OF PATIENTS CAN BE REVIEWED IN ORDER TO EVALUATE THE EFFICACY OF THIS METHOD IN THE DIAGNOSIS OF CERVICAL LESIONS. THE MAIN EMPHASIS OF THIS STUDY IS TO DETERMINE DIFFERENT CYTOMORPHOLOGICAL ENTITIES
AND PROVIDE THE DETAILS OF BURDEN OF TUBERCULOSIS IN THE TRIBAL AREA.TUBERCULOSIS IS THE MOST COMMON CAUSE OF LYMPHADENOPATHY IN DEVELOPING COUNTRIES SUCH AS INDIA AND SHOULD BE CONSIDERED IN EVERY CASE OF GRANULOMATOUS LYMPHADENOPATHY UNLESS PROVED OTHERWISE.[1]

Evaluation Of Safety And Efficacy Of Vitamin D Supplementation Inerectile Dysfunction Patients With Vitamin D Deficiency

Dr. Anwar Ali, Dr. Prasant Ranjan, Dr. Shivam Priyadarshi, Dr. Ravi Pandey

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 225-230

Aim: To evaluate the safety and efficacy of Vitamin D supplementation in erectile dysfunction patients with Vitamin D deficiency.
 
Material and Method: This study was carried out in Department of Urology, S.M.S. Medical College and attached Hospitals between March 2018 to April 2019 among patients in the age group 20-60 years presenting with ED and having severe Vitamin D deficiency. Patients were randomized into three groups. First group was treated with Tadalafil 10mg once a day while the second group had Tadalafil 10mg once a day plus Vitamin D 60,000 IU once a week, and third group was given Vitamin D 60,000 IU once a week only. Efficacy of drugs was evaluated at base line and after 12 weeks on the basis of International Index of Erectile Function Questionnaire scoring.
 
Results: After 12 weeks of treatment IIEF-5 scoring was nearly same as that of the base line with no significant difference in group C patients. On the other hand, IIEF-5 scoring was significantly improved in group A and B patients (P<0.001). On comparing group A and B patients there was significant improvement in group B compared to group A (P < 0.05). In comparison to group C, group A and group B patients had more side effects (P<0.05), but of mild intensity and prescribed medications were well tolerated. Group A and B patients had no significant difference in side effects.
 
Conclusion: This study showed that the use of Tadalafil in combination with Vitamin D in Vit D deficient ED patients act better than Tadalafil or Vit. D alone.
 
Keyword: ED, Vitamin D, Tadalafil, IIEF

EVALUATION OF AN ANTIFUNGAL LULICONAZOLE GEL FORMULATION USING SEMI-AUTOMATIC DIFFUSION CELL APPARATUS AND APPLICATION OF MATHEMATICAL MODELS IN DRUG RELEASE KINETICS

Saba Maanvizhi, V.Iyyappan, P.G. Bhavishi

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 231-240

Luliconazole, an FDA sanctioned novel azole antifungal drug that combats fungal
contagions caused by Trichophyton rubrum and Epidermophyton floccosum, specifically
tinea pedis, cruris and corporis. It is existing in the souk as topical cream 1%. Topical
formulations possess diversified benefits for instance escaping of first pass metabolism,
easiness of application, evades oscillation in drug planes, tranquil cessation when
desirable, and amplified bioavailability. FDA advocates characterization parameters of
luliconazole cream should include assessment of appearance, particle/globule size
distribution, polymorphic forms, rheological behaviour, In-Vitro Release Test (IVRT), In-
Vitro Permeation Test (IVPT) and In-vivo bioequivalence study for a generic product.
FDA endorses usage of appropriate apparatus for IVRT technique as pronounced in USP
General Chapter <1724>. These comprise diverse models of a vertical diffusion cell (VDC),
an immersion cell, and a flow through cell used with USP Apparatus 4. The current
research work addresses the evaluation of IVRT of two luliconazole cream formulation
(Brands A and B) with that of lab made reference luliconazole gel using semi-automatic
VDC apparatus through synthetic membrane. The study was done for 4 hours and
analysed by UV-spectroscopy. The release kinetics was construed with various
mathematical prototypes like zero order, first order, higuchi model and korsmeyer-peppas
model. The outcomes showed that brand B of commercial cream formulations was found
to be analogous to that of the reference formulation. The release kinetics of the
formulations were found to be zero order that fits into Korsemeyar-peppas model. The
variance between the in-vitro release rate of the two brands may be ascribed to diverse
bases incorporated into the product. Zero-order indicates that the drug release is constant,
independent of concentration. Fitting into Korsemeyer-peppas plot indicates that the
release mechanism is diffusion controlled and follows Super case II transport as R2 value
is more than 0.89.

EVALUATION OF EFFICACY OF MTAD AND EDTA BASED ROOT BIOMODIFIER ON PERIODONTALLY INVOLVED TEETH – A SEM STUDY

Radhika Singhal, Sandeep Kour, Nitish Bhat, Binila S Babu, Sanjana Paul R, Ekta Parmar

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 241-248

Background: Tooth surface modification by root conditioning results in improved connective tissue attachment and advancement in the the goal of reconstructive periodontal treatment.
Aim:Evaluation and comparison of novel root canal irrigant- MTAD and QMix on periodontally involved teeth.
Settings and design:30teeth were collected and stored in saline.By making two parallel grooves with a cylindrical bur under copious saline irrigation, samples were taken from the cervical third of the root. First groove is prepared at cemento-enamel junction and another 7 mm apical to it. Root surfaces of  the teeth were scaled with an ultrasonic scaler and thoroughly planed with #1-2, 3-4 Gracey curettes for the elimination of all the diseased cementum. The dentin sample of dimension 4 mm x 6 mm were prepared and stored in normal saline before use.
Materials and method: Samples were randomly divided into three groups: BioPure MTAD ™, QMix TM 2 in 1 and saline. Specimens were actively burnished for 3 min and following treatment, were prepared for scanning electron microscopy and examined at 5000X magnification. Samples were scored according to sampaio’s index.  Mann - Whitney U test and chi square tests were being applied.
Results and conclusion: BioPure MTAD ™ is most efficacient in removing the smear layer and showed significant dentinal tubules opening followed by QMix TM 2 in 1 and saline.
Keywords: BioPure MTAD ™, QMix TM 2 in 1, saline, scanning electron microscopy

SEROPREVALENCE OF HEPATITIS B VIRUS AND HEPATITIS C VIRUS AMONG CHRONIC LIVER DISEASE PATIENTS IN A TERTIARY CARE HOSPITAL

Aliya Fatima, Mustafeed uddin, Efshana jabeen, Md. Rizwan Ansari

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 249-256

Background: Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections account for a
substantial proportion of liver diseases worldwide. These viruses are responsible for liver
damages ranging from minor disorders to liver cirrhosis and hepatocellular carcinoma
(HCC). Approximately 7% of the world’s population (350 million people) are infected with
HBV and 3% (170million people) with HCV.
Aim & Objectives: To study Prevalence of Hepatitis B & Hepatitis C viruses infections in
Chronic liver disease patients .
Materials & Methods: A total of 100 Cases of CLD attending Gastroenterology department
were included in the study during the period of January 2015 – June 2016. Demographic
data and clinical findings were recorded using a structured proforma. All the samples were
screened for HBsAg detection( ERBALISA SEN HBsAg)& anti HCV antibodies detection by
ELISA (HCV MICROLISA) following the kit manufacturer’s instructions.

A CLINICAL STUDY ON THE EFFICACY OF HOMOEOPATHIC POTENTISED MEDICINES IN VAGINAL CANDIDA COLONISATION IN WOMEN WITH TYPE II DIABETES MELLITUS.

Anu.K.Mohanan, L.Girija , Chandraja C.V, Sisir PR

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 257-270

One of the difficulties diabetic women face is recurrent yeast infection of the vulva
and vagina.The substantial increase in the incidence of vulvovaginal candidiasis
especially in diabetic women demands prompt treatment that would restore the
normal vaginal flora and also keep the blood sugar levels in check. Homoeopathy, a
safe alternative method, based on the idea of individualization uses a holistic
approach towards these cases. Being a safe and cost-friendly intervention, it not
only relieves the complaints of the individuals but also help them boost up their selfesteem.
This study aims at exploring the effectiveness of Homoeopathic medicines in
vulvovaginal candidiasis in women with type II Diabetes mellitus. In this study, 15
women with Candidiasis and type II Diabetes mellitus selected from SKHMCH
OPD and IPD and rural centers, were prescribed with the homoeopathic similimum
after thorough case taking and analyzing the investigation reports. Follow ups were
taken every month for three months and the improvement of the cases were
assessed based on the signs, symptoms and investigation reports. After the
administration of the Homoeopathic similimum, notable improvement was elicited
in the signs and symptoms and also the lab reports. Mercurius solubilis was noted to be
the most effectively used medicine and 200 th potency was noticed as the most
frequently used potency.

EFFECT OF ADDITION OF DEXAMETHASONE TO LOCAL ANAESTHETIC AGENTS ON ON SET OF SENSORY AND MOTOR BLOCKADE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

Dr. Dewendra J. Gajbhiye

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 271-276

Background: Brachial plexus block provides excellent anaesthesia and analgesia for upper limb surgeries. It was found that when dexamethasone was added as an additive to local anaesthetic agent, it shortens the onset of sensory and motor blockade. This study was carried out to compare the onset of sensory and motor blockade on addition of dexamethasone to local anaesthetics versus local anaesthetics only in supraclavicular brachial plexus block.
 
Materials and Methods: This was a prospective, randomized and controlled study conducted on 60 ASA class I & II physical status patients undergoing elective upper limb surgery after obtaining approval of Institutional Ethics Committee. After written informed consent, patients were randomly allocated to two groups i.e. Group A and Group B of 30 each. Group A (control) received lignocaine with adrenaline 14 ml and bupivacaine 16 ml. Group B (study) received lignocaine with adrenaline 14 ml and bupivacaine 16 ml along with dexamethasone 4 mg. Time for onset of sensory and motor blockade was recorded.
 
Result: The average age of the patients was 33.401±9.1 years in Group A and 35.101±6.8 years in Group B. The average weight of the patients was 60.411±3.4 kg in Group A and 63.349±4.1 kg in Group B respectively. Both groups had predominantly male patients accounting for nearly two third of the total study population in each group. The difference in age, weight and sex distribution was statistically insignificant. The observed average time for onset of sensory blockade was 10.18±0.87 minutes in Group A and 8.24±0.72 minutes in Group B. The average time for onset of motor blockade was 12.11±3.52 minutes in Group A and 10.51±2.38 minutes in Group B.
Conclusion: Dexamethasone when added to local anaesthetic agents in supraclavicular brachial plexus block significantly shortens the onset of sensory and motor blockade without any untoward side effect.
 
Keyword: Dexamethasone, anaesthetic, supraclavicular, brachial
 

EVALUATION OF OCULAR STATUS IN PATIENTS UNDERGOING COMBINATION CANCER CHEMOTHERAPY

Vaishnavi Ravi, Vishnu S, Jovita Martin-Daniel

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 277-281

Chemotherapeutic agents have long been used to treat cancer either as a single drug or as a
combination. Cancer drugs have a great potential to induce acute, chronic, reversible and
irreversible damage in any organ system. Ocular toxicity produced by chemotherapeutic
agents is relatively uncommon as eye is usually considered as a protected site. Many of the
side effects in the eye are usually undetected either by the patient or by the clinician.
However, some of these side effects which are potentially reversible and treatable in the early
stages, turn out to be irreversible by the time the symptoms are detected. Hence, it is
important for the ophthalmologist to be aware of the potential ophthalmic complications to
treat them or sometimes even to prevent them.
Ophthalmic complications of these chemotherapeutic agents are sometimes underestimated
and neglected. Priority is usually given to the life-threatening effects of the drugs. Ocular
surface side effects have been extensively examined by many authors, though the possible
underlying mechanisms are poorly understood [1][2].
The quality of life takes a huge hit when the patient develops side effects like continuous
watering or dry eye some of which can be easily managed before potential irreversible side
effects develop[3][4]. An ophthalmic baseline examination for all patients planned for multiple
chemotherapeutic cycles and those undergoing these cycles becomes indispensable part of
patient care.
The aim of our study was to compare the baseline ocular status of the patients undergoing
combination chemotherapy before the start of chemotherapy and after a minimum of three
chemotherapeutic cycles.

EVALUATION OF ROLE OF TRANSABDOMINAL ULTRASOUND IN UTERINE AND ADNEXAL FACTORS IN INFERTILITY

Dr Poonam Ohri, Dr Niveditha Basappa, Dr Kulwinder Kaur, Dr Manasi Kohli, Parushi Kohli, Dr Prabnoor Kaur

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 282-291

Background: The desire to procreate is universal phenomenon. Childlessness is considered
as a curse in many societies and is one of the causes of marital breakups. WHO has defined
infertility as ‘Failure to conceive over 12 months of uninterrupted sexual practice. USG has
become a well-established technique for imaging ovarian and uterine pathologies. Methods:
This is a hospital based cross sectional, observation study,included total of 51 cases. The
patients with chief complaints of infertility presenting to gynaecology OPDs were referred to
the department of Radiodiagnosis,Guru Nanak Dev Hospital, Amritsar and all patients were
subjected to transabdominal ultrasonography using 3.5 MHz sector transducer. Results: Out
of 51 cases studied, 35 were of primary infertility and 16 were of secondary infertility.
Duration of infertility varied from 1.75- 17 years in patients with primary infertility and 2-10
years in patients with secondary infertility,maximum cases between 2-4 years.. Nonspecific
enlargement of uterus on one case, 3 with fibroid, 3 with endometrial calcification, one with
infantile uterus and one bicornuate uterus. Ovaries were normal in 37 cases, abnormal in 9
cases, not visualized in 3 cases on left and 1 on right side. Left ovary enlarged in one case.
Ovarian cyst in 3 cases, T.O masses in 5 cases and PCOD in one case. Fluid in POD in 4
cases.Conclusion: It is concluded that ultrasound is very helpful in assessment of uterus and
adnexal pathologies. USG is non-invasive, cheap, acceptable, easily available modality. It can
diagnose structural abnormality and helps in making diagnosis of etiologic factor in patients
of infertility and also in management and follow up of patients of infertility.

Prevalence of Hepatitis B Virus and Hepatitis C Virus in Blood Transfusion in Tertiary Care Hospital of North India

Dr. Garima Singh, Dr. Avnish Kumar, Dr. Saurabh Yadav, Dr Nisha Chaudhary, Dr. Sanjay Singh, Dr. Shruti Singh, Dr. Rohit Patawa

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 292-297

Aims: Blood transfusion saves life but there is risk of Transfusion Transmission Infection (TTI), like Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Human Immunodeficiency Virus (HIV), malaria and syphilis. Aim of this study to find prevalence of HBV and HCV in blood centre.
Settings and Design: This is an observational study at Blood centre of Tertiary care hospital from January 2018 to December 2020.
Methods and Material: Donor Screened and selected according to National Aids Control Organisation (NACO), blood units were collected and processed. HBV and HCV reactive cases were diagnosed by enzyme-linked immunoassay (ELISA) analyser. HBV and HCV reactive donors further processed for Liver Function Test (LFT), Prothrombin Time (PT) and Complete Blood Count (CBC) were done.
Statistical analysis used:  Performed with SPSS software version 15. Chi-square proportion test has been used to compare the proportions of HBV seropositive between voluntary blood donor collection (VBD) and replacement blood donor (RBD) groups.
Results: Blood units collected were 9,750,) numbers of VBD was ) 5,305  and RBD was 4425, during the study periods of three years in the blood centre, HBV and HCV reactive cases were diagnosed 50 and 02 respectively, and 35 HBV reactive in RBD. The p value of chi square test for testing two group (proportions of HBV infection between VBD and RBD group) proportions at 95% confidence interval is 0.0017.
Conclusions: TTI can be prevented by promoting the voluntary donors, educate donors for TTI during donor screening, evaluate the methods of TTI screening.

Effect Of Midazolam Premedication On Dose Of Propofol When Given As Infusion For Induction Of Anaesthesia: A Randomized Controlled Trial

Dr. Dewendra J. Gajbhiye

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 298-307

Background: Propofol is a popular anaesthetic agent used for induction of general anaesthesia. However, it causes cardio-respiratory depression in vulnerable patients.
 
Materials and Methods: This prospective, randomized and controlled trial was conducted on 60 patients admitted for elective neurosurgical procedure after ethical clearance from Institutional Ethics Committee. After written informed consent, the patients were randomly allocated to two groups, I and II of 30 each. Group I received Inj. midazolam 0.02 mg/kg as premedication five minutes before induction with propofol infusion. Group II received only propofol infusion for induction of general anaesthesia. Total dose of propofol required for induction of anaesthesia was noted. Haemodynamic parameters were noted from baseline till 08 minutes post laryngoscopy and intubation.
 
Results: Samples in both the groups were comparable with respect to age, weight and gender. On comparison with the standard bolus dose of propofol (2mg/kg) for induction, reduction in the doses of propofol in Group I and Group II were 0.7 mg/kg and 0.3 mg/kg respectively. The reduction in the dose of propofol in Group I as compared to Group II was 0.4 mg/kg i.e. 20%. This difference was statistically significant (P<0.001). No statistically significant difference in the haemodynamic parameters between the two groups was observed (p>0.05).
 
Conclusion: Propofol infusion after midazolam premedication reduces the dose of propofol for induction of general anaesthesia and confers haemodynamic stability
 
Keyword: Propofol, midazolam, induction, infusion, premedication

Ultrasound Guided Interscalene Brachial Plexus Block In Arthroscopic Shoulder Surgeries: Clinical Profile

Dr. Manasa S, Dr. Sachin HG

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 308-313

Over years, many more techniques were developed as the plexus is accessible at different anatomical regions depending on the clinical purpose required. In 1970, Alon Winnie described the first consistently effective and technically suitable approach to the brachial plexus block at the level of the cricoid cartilage between the anterior scalene and middle scalene muscles called as interscalene brachial plexus block. This was a prospective observational study started after attaining approval from the departmental dissertation committee and institutional ethics committee. Clinical Trials Registry-India (CTRI) registration was also obtained. Informed consent was taken by all patients included. In DMD group, 30 subjects belong to ASA-PS-I and 16 subjects belong to ASA-PS-II, In DXM group, 35 subjects belong to ASA-PS-I and 11 subjects belong to ASA-PS-II. The mean duration of surgery in DXM group was 115.52 mins and in DMD group was 119.67 mins.
 
Keyword: Brachial plexus block, arthroscopic shoulder surgeries, clinical profile
 

Comparative Evaluation Between Propofol And Ketamine-Midazolam As Procedural Sedative Agent For Ease Of Induction Of Spinal Anesthesia In Patients Undergoing Abdominal Surgeries

Dr. Manasa S, Dr. Yuvaraj MK, Dr. Sachin HG, Dr. Pradeep Hosagoudar

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 314-318

Procedural sedation is not a routine during neuraxial blocks, but it is advisable that anesthesiologists should provide their blocks comfortably. Sedation also alleviates anxiety thereby reducing autonomic fluctuations and eases induction of spinal anaesthesia and improves its quality. All American Society of Anesthesiologists Physical Status-1 patients aged between 20 years to 60 years, undergoing elective surgeries under spinal anaesthesia, who can understand and willing to give consent will be included. In our study, there is no hemodynamic variation among the two groups as we had used bolus doses of propofol and ketamine itself has positive inotropic effects. However, one patient had airway obstruction due to tongue fall once sedated and was managed with nasopharyngeal airway in Group A. This can be attributed to deeper plane of sedation due to administration of high dose of propofol as the patient’s BMI was high.
 
Keyword: Propofol, ketamine, midazolam
 

A Study On Clinical Outcome Of Propofol And Ketamine-Midazolam As Procedural Sedative Agent In Patients Undergoing Abdominal Surgeries

Dr. Yuvaraj MK, Dr. Manasa S, Dr. Sachin HG, Dr. Pradeep Hosagoudar

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 319-323

Benzodiazepine receptors are closely linked with GABA receptors and appear to facilitate the activity of the latter. Activated GABA receptors open chloride ion channels which then either hyperpolarize or short-circuit the synaptic membrane. Propofol is one of a group of alkylphenols. The alkylphenols are oils at room temperature and insoluble in aqueous solution, but they are highly lipid soluble. It has pH of 7 and pKa of 11, appears as a slightly viscous, white milky substance. It is stable at room temperature and is not light sensitive. Detailed pre-anaesthesia check-up was be done on the day prior to surgery and appropriate investigations was be carried out. The anaesthesia technique and questionnaire was explained to the patient and written informed consent was be taken. Time to induce spinal in A+B group is 25.85 Seconds. Number of attempts on an average in A+B group is 1.35.Patient Comfort score in A+B group 8.33. Patient satisfaction score in A+B 86.42.
 
 Keyword: Nanoparticle, ferrite, structural, morphological and spectroscopy properties

Awareness And Perception Of Post Graduate Students Towards Denture Marking In Vidarbha Region

Dr. Sathe Seema, Dr. Jaiswal Tanvi, Dr. Borle Anjali, Dr. Kambala Rajanikanth, Dr. Dhamande Mithilesh

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 324-329

In extensive mishap such as those associated with earthquakes, tidal bore, airplane
crashes, and acts of terrorism, forensic odontology has exhibited a paramount relevance in
medico-legal investigations directed in identifying mortal remains. Denture recognition is
essential for ailing patients or patients in geriatric associations. One method of
identification in forensic odontology is labeled dentures. It is a well-documented practice to
mark dentures with some means of identification but not a very well-practiced one.

TO THE MECHANISM OF THE REGULATORY ACTION OF ECDISTEN AND NEROBOL ON THE PROCESSES OF PROTEIN SYNTHESIS IN THE BODY OF HIGHER ANIMALS

Vladimir Nikolayevich Syrov, Gulnara Abdullaeyvna Shakhmurova, Zaynab Abdurakhmanovna Khushbaktova

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 330-337

A comparative study of the regulatory effect of the preparation of ecdisten
(created based on the phytoecdysteroid ecdysterone) and nerobol (a synthetic anabolic
preparation) on protein biosynthesis was carried out in mammals (mice) in in vivo and in vitro
experiments. We have defined that the activation of protein-synthesizing processes by ecdisten
in the organism of higher animals is not associated with its effect on the synthesis of mRNA,
but is only a reflection of the acceleration of translational processes. The corresponding
action of Nerobol is directed primarily at transcription processes with subsequent generalized
stimulation of the synthesis of protein macromolecules at the cytoplasmic level due to an
increase in the number and activity of polyribosomes.

A Correlative Study on Menstrual Hygiene Among Rural and Urban Adolescent Girls in Field Practice Area of Darbhanga Medical College with Their Socio Demographic Profiles

Dr. Neha Savarna, Dr. Hem Kant Jha, Dr. Prabhat Kr Lal , Dr. Vijay Kumar Choudhary, Dr. Hemant Kumar, Dr. Chittaranjan Rai, Dr. (Mrs) Kamlesh Tiwari

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 338-350

Introduction: According to WHO, Adolescence has been defined as the period between 10-19years of life. Adolescents constitute one-fifth of the world’s population and in India. Adolescent girls constitute a vulnerable group, particularly in India, where the female child is the neglected one. For billions of women and girls worldwide, menstruation is a monthly reality. Menstrual Health and Hygiene encompasses Menstrual Hygiene Management and the broader systemic factors that link menstruation with health, well-being, gender equality, education, equity, empowerment and rights. The mothers play a vital role in shaping the girls’ ideology about Menstruation. The socio-economic status can also be a contributing factor in the knowledge regarding Menstruation and related aspects. 
Materials & Methods: A prospective study in 9-16 years 200 urban & 200 rural school going menstruating girls and their socio demographic Profile was done, and results analyzed. 
Observations: The observations were recorded in tabular form and analyzed.
Discussion: The age profile, maternal education, other socio demographic profiles and cultures practiced are similar to various other studies. 
Conclusion: Menstruation being a normal biological phenomenon has many implications on female health, and maternal education, socio economic status has a greater role in maintaining good healthy menstrual practices, minimizing adverse health conditions in adolescent girls. 

After Phacoemulsification, Visual Functions with Multifocal Vs Monofocal Intraocular Lenses in Individuals with Age-Related Cataracts: A Comparative Study

Dr. Kanhaiya Lal Agrawal, Dr. Sanjeev Kumar

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 351-358

Aim: To study of visual functions with multifocal versus monofocal intraocular lenses after phacoemulsification in patients with age-related cataract.
Methods: This prospective observational study was carried out in the Department of Ophthalmology, Madhubani Medical College and Hospital, Madhubani, Bihar, India for 10 months. Patients between 40-80 years reporting with cataract (less than grade 3), managed by phacoemulsification and willing for implantation of multifocal IOLs and having astigmatism less than 1.5D cylinder were included in the study. Group A underwent phacoemulsification with multifocal [refractive-diffractive design] IOL implantation. Group B underwent phacoemulsification with monofocal IOL implantation
Results: In multifocal group, the number of female patients were more as compared to male patients, thus difference among the two groups was not statistically significant, the p-value being 0.112(>0.05). On post-operative day 1, the UCVA was found to be 6/12 in 15 patients (30%), 6/9 in 11patients (22%), 6/18 in 11 patients (22%), 6/24 in 8 patients (16%) while 6/6 in 5 patients (10%) while in monofocal it was 6/9 in 21 patients (42%) and 6/12 in 17 patients (34%) while 6/18 in 7 patients (14%) and 6/6 in 5 patients (10%). At the last follow-up, there were 22 patients (44%) with 6/9 vision, 16 patients (32%) with 6/12, and 12 patients with 6/6 vision while in monofocal group 25 patients (50%) had 6/12 vision, 18 patients (36%) had 6/9 vision while only 7 patients (14%) had 6/6 vision (Table 1). However, both at first post-operative day and last follow-up the two group’s visual acuity was found to be statistically insignificant with p-value less than 0.05. There was no significant change in the near visual acuity in the monofocal group with 35 patients (70%) with N18 visual acuity, 9 patients (18%) with N12 and 2 patient (4%) with N24 visual acuity, thus showing there was paramount statistical significance between the groups with p-value higher than 0.05. In monofocal group at last follow-up 35 patients (70%) had N24 visual acuity, 12 patients (24%) had N18 visual acuity and only 3 patients with N10 visual acuity. Thus, showing there was paramount statistical significance between the groups with p-value higher than 0.05.
Conclusion: Mutifocal IOLs decrease the spectacle dependence of patients without compromising the subjective visual functions.

Prognostic Significance of Tumor Infiltrating Lymphocytes in InvasiveBreast Carcinoma

Dr.Safaa Qatleesh, Prof. Ayman Sammoun, Prof. Eyad M Chatty

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 329-366

Background:Breast cancer is a major public health problem for woman. Several
studies suggestedthat development and progression of malignant tumors are
characterized by an interaction with the cells in the tumor microenvironment
including infiltrating immune cells.
Aim:The aim was to investigate relationship between tumor infiltrating
lymphocytes(TILs) in infiltrating breast carcinomaand other recognized
clinicopathological factors.
Material and Methods: 100 cases of infiltrating breast carcinomas were included in
the study.Stromal.TILs status was evaluated using hematoxylin and eosin staining.
For all statistical data chi-square test was applied using SPSS and Spearman
correlation.P‐values of less than 0.05 were considered as significant.
Results: Stromal TILs correlated with well-established prognostic markers:HER2
positivity(P=0.001),higher tumour grade (P=0.016), ER negativity (P=0.015), PR
negativity (P=0.008),lymphnode status(P=0.005) and lymphovascular invasion(LVI)
(P=0.001), molecular classification (P=0.000) , and p53 positivity (P=0.013). No
correlation between CD10 positivity or high proliferative index( KI67)and stromal
TILs.
Conclusion:Stromal TILs is directly correlated more aggressive phenotype:HER2
positivity ,ER negativity, PR negativity ,molecular classification, present LVI,
higher tumor grade and greater nodal involvement;so TILs could be used as novel
predictive and prognostic parameter and used to develop newer drugs
(immunotherapy).

Neurocognitive Comorbidities in Pediatric Epilepsy

Ahmed HosnyMohamed, Mohamed Yousry Abdallah, AhmedGalalSiam .

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 367-372

Epilepsy is categorized as a prevalent misunderstood chronic neurologic disorder. Epilepsy
episodes occur as a result of abnormal neuronal excitability that was reported to occur due to a
disruption depolarization and repolarization mechanisms. In addition to that, currently there are
numerous studies that attribute idiopathic epilepsy to a genetic factor as it was found that there is
an increased familial incidence of epilepsy. Several studies estimated that around 69 million
people worldwide are diagnosed with epilepsy and it is one of the most common neurological
disorders occurs to children where approximately 150,000 children experience unprovoked
seizure every year, and about 30,000 of them develop epilepsy. Many of these cases
demonstrated some neuropsychiatric comorbidity, which consequently affects the quality of their
lives in a significant manner. Cognitive impairments might be represented as memory problems,
mental defects, and attention impairment, analyzed as the most common comorbid disorders in
epilepsy. Thus, it is important to analyze the factors that contribute to cognitive difficulties.
Many agents was shown to have a debilitating effect on cognitive function in epilepsy such as
the degree of epileptic activity and epilepsy causative factors, psychosocial status of patients in
addition to surgical or therapeutic treatment of seizures.

Management of Undisturbed Ectopic Pregnancy: A comprehensive Review.

Mostafa Mohamed Eltohamy1, Amr Ahmed Abdelrahman, Ahmed Hasan Elmasarawy,Tarek Mohamed Elbeheidy

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 373-384

Ectopic pregnancy occurs when a fertilized ovum implants outside of the uterine
cavity. In the United States, the estimated prevalence of ectopic pregnancy is 1% to
2%, and ruptured ectopic pregnancy accounts for 2.7% of pregnancy-related
deaths. Risk factors include a history of pelvic inflammatory disease, cigarette
smoking, fallopian tube surgery, previous ectopic pregnancy, and infertility. Ectopic
pregnancy should be considered in any patient presenting early in pregnancy with
vaginal bleeding or lower abdominal pain in whom intrauterine pregnancy has not
yet been established. The definitive diagnosis of ectopic pregnancy can be made
with ultrasound visualization of a yolk sac and/or embryo in the adnexa. However,
most ectopic pregnancies do not reach this stage. More often, patient symptoms
combined with serial ultrasonography and trends in beta human chorionic
gonadotropin levels are used to make the diagnosis. Pregnancy of unknown
location refers to a transient state in which a pregnancy test is positive, but
ultrasonography shows neither intrauterine nor ectopic pregnancy. Serial beta
human chorionic gonadotropin levels, serial ultrasonography, and, at times, uterine
aspiration can be used to arrive at a definitive diagnosis. Treatment of diagnosed
ectopic pregnancy includes medical management with intramuscular methotrexate,
surgical management via salpingostomy or salpingectomy, and, in rare cases,
expectant management. A patient with diagnosed ectopic pregnancy should be
immediately transferred for surgery if she has peritoneal signs or hemodynamic
instability, if the initial beta human chorionic gonadotropin level is high, if fetal
cardiac activity is detected outside of the uterus on ultrasonography, or if there is a
contraindication to medical management

Prognostic Significance of Tumor Infiltrating Lymphocytes in InvasiveBreast Carcinoma.

Dr.Safaa Qatleesh, Prof. Ayman Sammoun, Prof. Eyad M Chatty

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 385-392

Background:Breast cancer is a major public health problem for woman. Several
studies suggestedthat development and progression of malignant tumors are
characterized by an interaction with the cells in the tumor microenvironment
including infiltrating immune cells.
Aim:The aim was to investigate relationship between tumor infiltrating
lymphocytes(TILs) in infiltrating breast carcinomaand other recognized
clinicopathological factors.
Material and Methods: 100 cases of infiltrating breast carcinomas were included in
the study.Stromal.TILs status was evaluated using hematoxylin and eosin staining.
For all statistical data chi-square test was applied using SPSS and Spearman
correlation.P‐ values of less than 0.05 were considered as significant.
Results: Stromal TILs correlated with well-established prognostic markers:HER2
positivity(P=0.001),higher tumour grade (P=0.016), ER negativity (P=0.015), PR
negativity (P=0.008),lymphnode status(P=0.005) and lymphovascular invasion(LVI)
(P=0.001), molecular classification (P=0.000) , and p53 positivity (P=0.013). No
correlation between CD10 positivity or high proliferative index( KI67)and stromal
TILs.
Conclusion:Stromal TILs is directly correlated more aggressive phenotype:HER2
positivity ,ER negativity, PR negativity ,molecular classification, present LVI,
higher tumor grade and greater nodal involvement;so TILs could be used as novel
predictive and prognostic parameter and used to develop newer drugs
(immunotherapy).

Vacuum-Assisted Vaginal Delivery: A Comprehensive Review

Khaled ElShamy, Taha Abdelfattah, Ahmed ElMaasarawy, Hussein Abdeldayem

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 393-404

Approximately 5% (1 in 20) of all deliveries are operative vaginal deliveries. The
past 20 years have seen a progressive shift away from forceps in favor of the
vacuum extractor as the instrument of choice. This article reviews in detail the
indications, contraindications, choice of instrument, and Application and
Technique for vacuum-assisted vaginal delivery. The use of vacuum extraction at
the time of cesarean delivery will also be discussed. With vacuum extraction
becoming increasingly popular, it is important that obstetric care providers are
aware of the maternal and neonatal risks associated with such deliveries and of the
options available to affect a safe and expedient delivery.

Factors Involved in Predisposing Children with Critical Illness to Eventually Develop Hypophosphatemia at Zagazig University Hospitals

Dina Gamal Abdel Mohsen, Nahed Khater, Dalia A. Rahman , Abeer Abd Alla

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 405-414

Background: Hypophosphatemia is a metabolic disorder that can have significant
consequences and is frequently undiagnosed in critically ill children. While
hypophosphatemia is typically characterized by nonspecific symptoms such as
weariness and irritation, severe hypophosphatemia (less than 1.0 mg/dl) can result
in much more severe complications including such decreased diaphragmatic
contractility and cardiac arrhythmias.
Aim of the Study: Determine the prevalence of hypophosphatemia in critically ill
children, as well as the clinical consequences and risk factors associated with the
condition throughout patients' admission in the PICU.
Patients and Methods: A case-control study that was conducted over a period of one
year, from July 2019 to June 2021, at PICU of Pediatrics Department, Zagazig
University Hospitals.The study included 180 subjects that were classified into two
groups, each of 90 subjects as follows; patients group, which included 90 cases, and
the control group, which included 90 healthy infants and children.
Results: There was a statistically significant difference in weight, height percentile,
ESR and CRP, hemoglobin level, TLC, PT, INR, alkaline phosphatase a serum,
serum creatinine, PH, serum phosphorus level, presence of hypophosphatemia
(20%), number of patients with hypophosphatemia, percent change in serum
phosphorus, as well as percent change in serum phosphorus between the studied
groups.
Conclusion: In our investigation, the obvious probable source of hypophosphatemia
was prolonged TPN decision-making as well as sepsis. In the PICU, mild to moderate
hypophosphatemia occurred. Hypophosphatemia was related with an increased
length of stay in the PICU and poor outcomes.

OPEN HAEMORRHOIDECTOMY & STAPLER HAEMORRHOIDECTOMY: A COMPARATIVE CLINICAL STUDY

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 415-419

Haemorrhoids are one of the most common benign anorectal problem worldwide. Various techniques of haemorrhoidectomy have been reported in an attempt to find the ideal operation with low morbidity and good clinical results. Open haemorrhoidectomy (Milligan-Morgan) is a widely-used and accepted procedure. A total of 77 consecutive patients between the age group of 20 and 85 years, diagnosed to have grade III or IV haemorrhoids were included in the study, divided into 2 groups, Group 1 undergoing Open haemorrhoidectomy (41 patients) and Group 2 undergoing Stapler haemorrhoidectomy (36 patients). The mean hospital stay for patients with stapler haemorrhoidectomy was 2.4±0.8 days in comparison to the open group where the mean hospital stay was 5±2.6 days (P-value<0.001). There was significant difference in complication between the two groups, stapler group having lesser post op complications during the study period. The stapler group patients returned to normal activity significantly early.
 
Keyword: Hemorrhoids, Stapler Hemorrhoidectomy, open Hemorrhoidectomy
 

Efficacy Of Inguinal Hernia Repair By Prolene Hernia System

Dr. Sachin HG , Dr. Konappa V, Dr. Manasa S, Dr. Chandrashekar S

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 420-424

Hernia repair is the most commonly performed procedure in general surgery. Even though several techniques have been followed since ages none of them are without complications and recurrence. The objective of the present study is to look for the outcome of inguinal hernia repair with Prolene Hernia System in terms of post operative pain, post operative complications, duration of hospital stay, duration to return to normal activities and recurrence. All cases who presented with uncomplicated inguinal hernia who are more than 18 years were included in the study. Complicated hernias like obstructed and strangulated inguinal hernias presented as emergencies were excluded from the study. The mean VAS score at 72 hours postoperatively was 1.2. The mean duration of hospital stay was 3 days. During the follow up period of 6 months, no recurrence was noticed. The PHS is a tension free mesh repair that provides a complete closure of the myopectineal orifice. It is a feasible procedure with minimal postoperative pain and related complications. It shows acceptable short term results with low incidence of chronic groin pain and reccurence during the follow-up period.
 
Keyword: Inguinal hernia, Prolene hernia system, VAS score

A Study On Clinical Profile Of Patients With Haemorrhoids

Dr. Chandrashekar S , Dr. Sachin HG , Dr. Manasa S , Dr. Konappa V

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 425-429

Haemorrhoids can be categorized by their location as well as by the size and degree of prolapse of the involved tissue. Internal haemorrhoids are located proximal to the dentate line, external haemorrhoids are distal to it, and 'mixed' haemorrhoids arise from both the internal and external plexi along with their anastomotic connections. A detailed history was taken and all patients were subjected to clinical examination including per rectal and proctoscopic examination. Routine lab investigations like blood and urine examination and screening of chest was done. In our study, the patients were in the age range of 21-84 years. Most of the patients in the stapler group were in the age group of 41- 50 years, while in the open group, the majority were in the range of 21-40 years.
 
Keyword: Haemorrhoids, Mucosal prolapse, Internal haemorrhoids
 

Clinical Profile Of Patients With Inguinal Hernia Admitted At Tertiary Care Hospital

Dr. Sachin HG , Dr. Konappa V, Dr. Karunakar GK , Dr. Chandrashekar S

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 430-434

Indirect Hernia comprises around 80% cases of inguinal hernia. Almost all the hernias in women and children are indirect. It is also called oblique indirect hernia. The hernia enters through the internal inguinal ring lateral to inferior epigastric artery and descends obliquely downwards and medially and reduces obliquely. After routine investigations, Patients were informed about the various techniques and advantages of the PHS mesh. In those patients who agreed, consent was taken and patients were prepared for surgery. Patients were subjected to Prolene Hernia system repair. All patients were given preoperative antibiotic prophylaxis with Injection Ceftriaxone 1 gm. Spinal anaesthesia was administered. More than half of the patients presented with hernia on the right side (51.1%) followed by left (40.0%). Bilateral hernias were 8.9 %. The most common presenting symptom was swelling accounting for 66.7% followed by swelling with pain 33.3%.
 
Keyword: Inguinal Hernia, swelling, oblique indirect hernia

EXPLORING THE ASSOCIATION BETWEEN DERMATOLGYPHIC PATTERNS AND OCCURRENCE OF ORAL SUBMUCOUS FIBROSIS - A CASE CONTROL STUDY

Dr.Soumya Ojha ,Dr.Ananya Bhargava , Dr.Apoorva Bhargava ,Dr.Astha Bhargava

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 435-447

ABSTRACTBackground
and objectives:
Dermatoglyphics is a newer science of forensic based study involving the fingertip and palmar
prints. In the field of dentistry dermatoglyphics has been used to unveil various oral diseases like
precancerous lesion, malocclusion, dental caries, cleft lip and palate etc. Hence with the help of
dermatoglyphics we can explore the association between various dermatoglyphic patterns and
occurrence of Oral submucous fibrosis.
Methodology:
A total of 60 participants (30 Oral submucous fibrosis patients and 30 healthy controls) were
included in the study. Tobacco habits was recorded for all the participants. All the participants in
the study were examined for intra oral findings.Dermatoglyphic patterns were also recorded.
Results:
There was significant increase in the whorl pattern among Oral submucous fibrosis group
(55.8%), whereas in control group loop pattern (66.6%) was found to be significantly increased
(p<0.05) .dat angle was also significantly increased in Oral submucous fibrosis group.
Conclusion:
Whorl type of fingerprint pattern and dat angle found in our study would probably be served as a
candidate screening marker for susceptibility to oral submucous fibrosis in general population.

Comparison between the presence of cow milk protein allergy in asthmatic and non-allergic children

Hadeel I. Enany, M. H. M. Ebrahim, E. M. Rasheed, Eman M. Elbehedy, Shereen A. Baioumy

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 448-456

Background: Hypersensitivity to cow milk proteins is one of the main food allergies
and affects mostly but not exclusively infants, while it may also persist through
adulthood and can be very severe. Different clinical symptoms of milk allergy have
been established. The diagnosis of milk allergy differs widely due to the multiplicity
and degrees of symptoms, and can be achieved by skin or blood tests. The aim of
this study to assess the role of cow milk (CM) to induce asthma and compare
between the presence of cow milk protein allergy in asthmatic and non-allergic
children and to prevent occurrence of asthma among children, Subjects and
methods: This is a case control study, was conducted on 154 patients divided into
two groups (77 in each). This study was conducted in Pulmonology Unit of
Pediatric Department in Zagazig University Hospital. Result: There was high
statistically significant difference between the two studied groups as regards skin
pick test. There was high significant increase in the severity recorded in respiratory
function test in allergic group compared to control group. Conclusion: our study
showed that CMA can exacerbate the symptoms in children with asthma. Therefore,
it is worth considering a possible role of food allergy in asthma in young children,
particularly when asthma is not adequately controlled in spite of proper routine
management. Although SPT seemed to be more reliable than sIgE testing, both had
suboptimal reliability. A definite decision should depend on performing a titrated
oral challenge test.

Allergic Rhinitis in Relation to Gut Microbiota Composition among School-Aged Patients

Samir Sourour, Mahmoud Diab, Rania M. Amer , Tarek Abdelmouty, Gehan A. Elshenawy, Saeid Abdelmonaem

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 457-465

Background: Allergic rhinitis (AR) is one of the most globally commondiseases and
usually persists throughout life. First-line drugs can be successfully used to control
AR. However, once these medications are terminated, the majority of AR patients
will reappear the symptoms of AR within a brief period. Thus, these medications do
not appear to exert a long-term effect on the baseline Total Nasal Symptom
Score.To study the relationship between the gut microbiota types and allergic
rhinitis. Patients and Methods: This case control study was carried out on 52
school-aged patients presented at Oto-rhino-laryngology, Head and Neck (ORLHNS)
Department and Microbiology and Immunology department at Zagazig
University. The patients were classified into 2 groups: Allergic rhinitis group: 26
individuals with allergic rhinitis Control group: 26 individuals without allergic
rhinitis. All patients in this study were subjected to the personal history taking,
physical examination and laboratory investigations including: eosinophilic count,
skin prick tests (SPT) for common perennial and seasonal allergens, measurement
of (total Ig E) and identifing bacteria (lactobacillus and bacteroides) by SYBR
Green real time PCR. Results: Age was distributed as 11.19±3.26 and 11.65±3.24
respectively between case and control with no significant difference between
groups. Mean disease duration was 6.15±2.01, the majority were Intermittent and
mild regard classification also the majority were trigger by inhalation. Skin prick
test among cases group showed majority were house dust and date palm pollens.
Absolute eosinophils counting was significantly higher among cases compared to
control one. Cases were significantly higher regard IgE distribution. Lactic acid
bacteria RNA was significantly higher among control group compared to cases
group while Bacteroid bacteria RNA was significantly higher among cases group
compared to control group. Conclusion: Lactic acid bacteria in gut microbiota of
school-aged individuals may influence sensitization to different allergens.

Closure of Appendicular Stump in Laparoscopic Appendectomy by Ligation and Clipping Methods

Mohammed Gamal Youssef ; Samir Ibrahim Mohammed; Islam Mohamed Ibrahim, Mohammad Farouk Amin

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 466-476

Background: Laparoscopic appendectomy (LA) is now the standard of management
for cases of acute appendicitis. LA has the benefits of minimal access surgery.
There are many methods for securing the base of the appendix, some of which are
expensive others are not available or technically demanding. This study is aimed to
compare between ligation and clipping techniques regarding fesibility , safety ,
efficacy, operative time , postoperative outcome and complications. Patients and
methods: A randomized prospective clinical trial study included 90 patients with
acute appendicitis. The patients were randomly distributed into 2 main groups
(A&B): 54 patients we secured the base of the appendix by ligation methods (group
A) and in 36 patients by clip application (group B). All patients were subjected to
classic history taking and clinical examination. Radiological investigation:
ultrasonography was routinely done for all patients. CT with contrast was requested
when indicated in suspicion of complications. Surgical ligation or clipping were
performed. Results: There is statistically non-significant difference between
patients underwent different surgical techniques as regarding application of
peritoneal drainor conversion to open. Two patients within ligation group (A) had
been converted to open due to presence of friable base in one case and intraoperative
bleeding in other case while three patients within clipping group (B) had
been converted to open due to intestinal injury, friable base and intra-operative
bleeding .Two cases in clipping group (B) had been converted to ligation techniques
due to very wide base which can't be secured by clip application. Conclusion:
Ligation and clipping techniques were effective, safe ,feasible and same in
complications rate. Clip application is related to less operative time , easier
application and simpler for trainee than ligation techniques which require
more experiences.

Residual Dynamic Metatarsus Adductus Correction by Split Tibialis Anterior Transfer Following Ponseti Management of Idiopathic Clubfoot

Emhemmed Faraj Aboubreeg, Hosam Mohammed Khairy, Tawfik Omar, Mohammed AbdElAziz Gaith, Yamen Safwat Abd ElDayem

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 477-484

Background: Idiopathic clubfoot is characterized by an alteration of the morphology of the foot
that cannot physiologically move on the ground. Tibialis anterior tendon transfer was is an
effective method in the management of dynamic supination as well as prevention of clubfoot
relapse in children. The aim of the current study to confirm the best management of split tibialis
anterior tendon transfer in the treatment of residual clubfoot. Patients and methods: A
prospective study included 18 patients (22 feet) with residual dynamic supination deformity
following previous ponseti management. Patients underwent split transfer of the anterior tibial
tendon at Zagazig University hospitals. Clinical and radiographic assessment of outcomes is
performed at the end of healing. Results: The present study included 18 cases (12 males and 6
females) with mean age of 3.43 years ± 0.71 to assess outcome of split tibialis anterior tendon
transfer in management of residual clubfoot. Patient age ranged from 2.5 years to 5 years old at
the time of the operation, 9 with right foot affection, 5 with left foot deformity while 4 patients (8
feet) were bilateral. The majority of cases were males (66.7%) and females were (33.3%).Right
side was affected in 9 cases (50%), the left was affected in five .cases (27.8%) while four cases
(22.2%) were bilateral. The mean radiological measurment improvement of AP talocalcaneal
angle, AP talofirst metatarsal angle, Lattalocalcanael angle, Lattalo-first metatarsal angle, Firstfifth
metatarsal over lap, and the improvement of all angles were stastistically significant. The
complication rate was 16.7% (3 cases) all had superfecial infection only. Conclusion: The
anterior tibial tendon transfer is a practical method for achieving fully or split transfer due to
both techniques have an excellent outcomes with low complication. It is simple and effective softtissue
procedure to correct the muscle imbalance of the foot. The split tibialis tendon transfer are
still better because of low risk of over correction which preserve some inversion function.

Results of Fixation of Oblique and Spiral Fractures of Metacarpals and Phalanges of the Hand by Interfragmentary Mini Screws

Abdelrahman Ibrahim Noureldin, Alaa Mostafa Elngehy, Waleed Mohamed Nafea, Mohamed Adel Abdelrazek

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 485-492

Background: Surgical treatment is preferred in metacarpal and phalangeal
fractures in general can be treated surgically with K-wires, screws or hand plates.
Lag screws are the implant of choice for this type of fractures. The aim of this work
is to evaluate the outcome of fixation of oblique and spiral fractures of phalanges
and metacarpals of the hand by interfragmentary mini screws. Patients and
methods: Eighteen oblique and spiral fractures were included in this study with 6
metacarpals and 12 phalangeal fractures. Eight spiral and 10 oblique fractures
were followed up for 15 to 31 weeks. Gender distributed as seven females and 11
males with Patients’ mean age of 35 (range 19 - 51) years old. In range of motion,
functional and radiological results of treatment of oblique and spiral metacarpal
and phalangeal fractures by open reduction and internal fixation using
interfragmentary mini screws were evaluated. Results: In our study, the mean value
of TAM score for both metacarpals and phalanges at the end of follow up (mean
23.1 weeks) was 87% ± 11.6. Final range of motion assessment revealed three
(16.7%) fair, two (11.1%) good and thirteen (72.2%) excellent results. There was
statistically insignificant difference between the side of the affected hand with
phalangeal and metacarpal fractures and end results of final follow up.
Conclusion: Oblique and spiral hand fractures have special characters. They are
the result of torsional forces and can cause rotational mal-alignment. Interfragmentary
mini Lag screws fixation represents a very good method for dealing
with such rotationally unstable fractures.

Thyroid Dysfunction Prevalence in Elderly Patients with Chronic Liver Disease in Zagazig University

Mohamed Mohamed Hassaan, Zeinab Maher Mohamed, Aya Hefny Ibrahem, Mayada Mohamed Mousa

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 493-502

Background: Cirrhotic patients are more liable to thyroid dysfunction especially
hypothyroidism and may have thyroiditis and hyperthyroidism. The aim of this
work is the evaluation of thyroid dysfunction in elderly patients with chronic liver
disease. Patients and methods: A cross-sectional study included 54 elderly patients
with clinical, biochemical, and ultrasound evidence of cirrhosis of liver which was
carried out in Internal Medicine Department, Faculty of Medicine, Zagazig
University Hospitals. All subjects included in this study were elderly over 65 years
and subjected to through clinical examination and full history taking with special
stress on age, sex, comorbidities, medications, symptoms of hepatic decompensation
and symptoms of hypothyroidism or hyperthyroidism. The technical part was done
at Biochemistry Department in Zagazig University. We assessed complete blood
count, serm bilirubin, serum albumin, serum ALT and AST, serum creatinine,
serum urea, PT, PTT, INR, TSH, free T3, T4 and lipid profile. Results: There was a
statistically significant positive correlation between serum TSH and weight, BMI,
Child score, total, direct bilirubin, INR, serum cholesterol, LDL cholesterol and
triglycerides. There is significant negative correlation between TSH and total
leucocytic count, platelet count, serum albumin. There was a significant negative
correlation between free T4 and both weight and BMI. There is significant positive
correlation between free T3 and total leucocytic count, and platelet count. There is
non-significant correlation between free T3 and neither weight, BMI, age,
hemoglobin, serum albumin, serum creatinine, ALT, AST, INR, LDL or HDL
cholesterol There was a significant negative correlation between child score and
TSH while there is significant positive correlation between child score and both Ft4
and FT3. There is significant relation between presence and degree of ascites and
all of free T4, free T3 and TSH. Conclusion: There is important relation between
Child pough class and all of free T4, free T3 and TSH. There is significant relation
between grade of hepatic encephalopathhy and all of free T4, free T3 and TSH.

Efficacy of Tranexemic Acid in Prevention of Hemorrhage after Vaginal Delivery Postpartum

Moustafa Mohamed Ali, Wael Hussien El-Bromboly, Walid Mohamed Elnagar and Mohamed Fathy Abou Hashem

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 503-512

Background: Postpartum haemorrhage is still the primary cause of maternal
death, particularly in underdeveloped nations. We aimed to see how tranexamic
acid and oxytocin compare in terms of preventing postpartum haemorrhage and
lowering blood loss, hospital stay, morbidity, and death during vaginal
birth.Patients and methods: A prospective, randomised clinical trial study was
conducted on 92 pregnant women who were being prepared for vaginal delivery
and were divided into two groups: Group (A) (TXA group) (46 patients) received 1
gm of tranexamic acid and Group (B) (Non-TXA group) (46 patients) received 10
IU of oxytocin. Hemoglobin and hematocrit readings were tested before and 24
hours after vaginal delivery, and additional basic laboratory tests were
performed.Results: In our study, there was no significant difference in HB at the
pre-test, but the Non-TXA group was considerably lower at the post-test, and the
Non-TXA group had a significant reduction. At the pre-test, there was no
significant difference in HCT, but the Non-TXA group was considerably lower at
the post-test, and the Non-TXA group had a significant reduction. In the TXA
group, the difference in HCT was much smaller. The TXA group had considerably
less blood loss.Conclusion: The use of tranexamic acid during delivery may assist to
minimise blood loss. It is a low-cost and widely available medication. The use of
TXA reduces the requirement for uterotonics, lowering morbidity and mortality.

Comparison between Lichtenstein Hernioplasty and Laparoscopic Transabdominal Preperitoneal Repair According to Quality of Life Score

Raouf Muhammad Abd-Elfattah, Ali Helmy El-Shewy, Amr Ahmed Ibrahim, Mohammed Ezzat Al- gazzar

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 513-520

Background: Different approaches can be performed for repairing abdominal wall
hernias as as laparoscopic transabdominal preperitoneal (TAPP) approach. This
study aimed to compare quality of life after laparoscopic transabdominal
preperitoneal repair (TAPP) and Lichtenstein hernioplasty according to EuraHS
QOL SCORE. Patients and Methods: This is a prospective clinical comparative
study upon 132 patients with inguinal hernia admitted to the surgical department of
Zagazig University for inguinal hernia repair. The patients were allocated into two
groups using closed envelope method of randomization. The patients were allocated
into two groups: Laparoscopic group (n=66) and Open group (n=66). All patients
involved in the study were subjected to full history and clinical examination and
routine investigations and EuraHS QOL Score Evaluation. Results: There is
statistically significant difference among both studied groups as regard intraoperative
complications (p<0.05). Operative time showed highly statistically
significant difference among both studied groups (p<0.001) with laparoscpoic
group longer than open group. Duration of stay showed highly statistically
significant difference among both studied group as regard (p<0.001). There is no
statistically significant difference among both studied groups as regard preoperative
pain felt during last week score (p>0.05), but there is statistically significant
difference among both studied groups as regard post-operative pain felt during last
week score after 1 month and post-operative pain felt during last week score after 3
months (p<0.05). Conclusion: Trans-abdominal pre-peritoneal repair (TAPP) is
better than lichtenstein hernioplasty in terms of quality of life (QOL) according to
EURAHS QOL SCORE.

Patterns Variety of Rheumatic Diseases in Pediatrics

Mohamed Abd-Elkader Abdallah Almalky, Ehab Mahmoud Rasheed, MohamedAttia Mortada, Khairia Mohamed Kamel Ayyad

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 521-529

Background: Rheumatoid arthritis in children and their families can be a
significant health burden. They're linked to the risk of physical impairment, a
lower quality of life, and a lot of direct and indirect expenditures. The goal of this
study is to characterise the clinical spectrum of Juvenile Idiopathic Arthritis
(JIA) in children at Zagazig University hospitals, as well as the frequencies and
various patterns of JIA. Patients and methods: A cross-sectional research
comprised 120 patients with an average age of 16 years. From December 2017 to
December 2019, data on juvenile idiopathic arthritis was gathered during a twoyear
period. Complete blood count, reactive protein, ANA, RF, C3&C4, creatine
phosphokinase, and EMG were all performed. Management and treatment
strategies were implemented, and data on the outcomes was gathered.
Results:Females account for the majority of our rheumatological illness patients.In
our analysis, JIA was the most frequent rheumatological illness, followed by SLE
and lastly HSP.In our study, oligoarticular JIA was the most prevalent subtype of
JIA, followed by polyarticular and then systemic onset type.SLE is the second most
prevalent illness in our research, with the majority of patients being women.The
majority of individuals had cutaneous symptoms and a fever.The most commonly
utilised drugs were corticosteroids, cyclophosphamide, and mycophenolate
mofetil.HSP was the most prevalent kind of vasculitis found in our research.The
majority of patients are females, and those with severe GI symptoms and nephritis
got corticosteroids. Conclusion: The prevalence of rheumatological disorders in
children is underestimated, and there is a lot of overlap in diagnosis. Because
paediatric onset is less apparent than adult start, some patients have a significant
diagnostic lag. Early identification and proper care of these children is critical for
them to have a normal or near-normal life, particularly in patients with
rheumatological illnesses that cause chronic morbidity, such as JIA.

Periodontal Ligament Stem Cells: A Literature Review

Osheen Batra, Sandeep Kour, Garima Gulati, C V Sruthi Vyassini, Ekta Parmar, Fathima Amal

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 542-550

Due to specialized property of multipotency of adult postnatal stem cells , these can be
experimentally induced to differentiate into various specialized cell lineages. This has
generated considerable interest in the arena of stem cell based therapeutics. Periodontal
ligament stem cell (PDLSC) are one of these type of cells within the periodontal ligament
which represents a significant development in this regard. Achieving predictable periodontal
regeneration has long been a challenge, and it is known that cells involved in the mechanisms
of periodontal wound healing are of mesenchymal stem cell MSC type. Thus, periodontal
ligament stem cell (PDLSC) based therapeutics may be a step towards predictable periodontal
regeneration and also these cells may have alternative potential applications in hard tissue
and tooth engineering. PDLSC may be isolated, grown under tissue culture conditions,
expanded, optionally genetically modified and then collected and transplanted. This paper
aims to overview the current knowledge, recent developments and methodology regarding
PDLS based applications.

A quantitative analysis to evaluate the role of serum total and lipid bound sialic acid level as diagnostic markers in oral potentially malignant condition and oral squamous cell carcinoma

Dr. Saurabh Jain, Dr. Pranav Gupta, Dr. Naiem Ahmed

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 551-558

Oral cancer is the sixth most common cancer throughout the world and is a crucial issue in
regions where tobacco habits, in the form of chewing and/or smoking, with or without alcohol
intake, are common. Squamous cell carcinoma is the cause for 95% of oral cancers and is
associated with avoidable aetiological risk factors. The most successful means to enhance the
survival and reduce morbidity, damage, duration of treatment and hospital cost is the
detection of oral cancer at an early stage. It is essential to study marker levels in patients with
oral precancer who are at a high risk of developing oral cancer.
The present study was carried out to evaluate usefulness of serum Total Sialic Acid (TSA)
and serum Lipid-Bound Sialic Acid (LSA) as markers of oral submucous fibrosis and oral
cancer. Study consisted of 60 patients and 30 controls. There were 3 study groups, Group I
control, Group II OSMF, and Group III oral cancer consisting of 30 patients each. Serum of
all the patients in the control group and study groups were collected and stored at -20 oC until
analyzed. Levels of serum TSA and LSA were estimated spectrophotometrically. The results
also demonstrated that the assessment of TSA and LSA by simple, in-expensive and
reproducible methods can provide significant clinical information about the extent of
malignant disease and can differentiate between patients with oral precancer and oral cancer.

Percutaneous Fixation of Distal Radius Fracture using kapandji Technique: A comprehensive Review

Fathy Emad Othman, Ahmed Hatem, Mohamed Ismail, Sayed Abdel Moty

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 559-565

Distal radius fracture is a very common injury representing 17.5% of all fractures seen in the emergency room. However, the most effective treatment is still unclear and controversially debated. For ten years, we have been facing a true revolution by the increasing use of open reduction and fixation by volar locking plates as an alternative to previous less invasive treatment such as closed reduction and percutaneous k- wire pinning. Several meta-analyses have compared the clinical results after closed reduction and percutaneous pinning and volar locking plate fixation. Volar locking plate fixation achieves better early functional recovery, better radiological outcomes and less minor complications. However, long-term results were similar for both fixation methods. In addition, worse radiological outcomes and more minor complications after closed reduction and percutaneous pinning seem not to be clinically relevant. Interestingly, volar locking plate fixation continues to be a more dominant treatment method compared to percutaneous pinning in operative care of distal radius fractures. Surgeon characteristics such as age, profession as well as location and type of the clinic seem to play a role in the decision for the surgical treatment method. It appears that implant cost plays a minor role in treatment choice between closed reduction and percutaneous pinning and volar locking plate fixation.

Occult Hepatitis B Virus Infection: A Comprehensive Review

Osama Ebrahim Ali Elghamry, Sami Eissa, Mohamed Refaey

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 566-577

Occult hepatitis B (OBI) was defined as the detection of hepatitis B virus (HBV)
DNA in the liver (with or without HBV DNA in serum) without HBsAg[1].
The prevalence of OBI varies from region to region worldwide. This variability
relies upon the sensitivity of HBV DNA detection assays, the sample size, and the
detection of HBV DNA in liver tissue and serum by nested PCR or real-time PCR.
The prevalence of OBI varies from 1% to 87% in different regions of the world[2],
there is no standard assay for diagnosis of OBI in liver tissue or in serum, and the
only reliable method is the detection of HBV DNA by nested PCR or real-time
PCR[3].
The mutations in the HBsAg gene have been observed among patients coinfected
with hepatitis C virus (HCV)[4].
It has been described that about one-third of patients with chronic HCV infection
had detectable serum HBV DNA but undetectable HBsAg[5]. When the coexistence
of both HBV and HCV genomes occurs in the same hepatocyte, the replication of
HBV is inhibited due to the interference of HCV molecules, which therefore results
in the creation of OBI with low replication of HBV DNA[6].
The presence of OBI in chronic HCV infected patients increases the risk of
HCC[7]. Blood transfusion is a main risk factor for transmission of OBI and the
prevalence of OBI among blood donors varies from country to country provided
that the screening of blood donors is done with less security[8].

ANALYSIS OF DEXMEDETOMIDINE ADDED TO ROPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

Dr. Reena Sachin Bhandurge

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 578-585

Aim: To evaluate the effect of Dexmedetomidine added to Ropivacaine in Supraclavicular Brachial Plexus block.
 
Material and Methods: This study was performed in the Department of Anaesthesia at Shri Suman Subharti Medical College, Dehradun during March 2016-February 2017 after approval by the Institute Ethics Committee. After getting written informed consent from patients, this study was carried out as a controlled, randomized (chit method), double blind, prospective study in 60 patients. Sensory and motor blockade of radial, median, musculocutaneous and ulnar nerves were recorded at regular intervals (at each min till complete blockade) after drug injection. Following observations were noted intra and post operatively. The duration of analgesia or first request for analgesic defined as the time to attain a Visual Analogue Score (VAS) of 4 or >4 after Ropivacaine administration. The VAS was recorded post-operatively every 30min till the score of 4 or >4.
 
Results: Duration of sensory block was significantly longer in group RD as compared to group R (p<0.001). It was found that duration of motor block increased more with Dexmedetomidine addition (407.33±53.09 min) than with Ropivacaine alone (278.66±44.77 min). There was significant increase in duration of analgesia in group RD (685.33±90.02 min) than with group R (344.00±52.06 min). In RD group 2 patients developed haematoma and only 1 patient develop blood in aspiration due to arterial puncture, and in R group 1 patient develop haematoma and 2 patients developed blood in aspiration.
 
Conclusion: We conclude that Dexmedetomidine is a good adjuvant in supraclavicular brachial plexus block for upper limb surgeries.
 
Keyword: surgery, upper limb, VAS, dexmedetomidine, ropivacaine, supraclavicular brachial plexus block

Open cholecystectomy versus laparoscopic cholecystectomy: A comparative study at north Indian based teaching hospital

Dr. Vipin Kumar, Dr. E.D. Reddy, Dr. Chandra Shekhar, Dr. Madhu Sinha

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 586-591

Background: Gallstone disease (GSD or Cholelithiasis) is a significant health problem
both worlds over (in both developing and developed nations). The main objective is
Laparoscopic cholecystectomy has rapidly become established as the popular alternative to
open cholecystectomy, but it should have a safety profile better than of open procedure.
Aims and objectives: The aim of this study was to compare conventional cholecystectomy
and laparoscopic cholecystectomy with respect to duration of procedure, complications,
postoperative pain, analgesic requirement and period of hospital stay.
Materials and Methods: This study consists of 52 patients who have undergone gallbladder
removal in GMC Budaun. 26 patients who have undergone laparoscopic cholecystectomy
and 26 patients who have undergone open cholecystectomy for a study period of one year
have been taken into the study In method 52 consecutive patients below 70 years presenting
with calculous cholecystitis with no evidence of CBD stones were randomized to undergo
open and laparoscopic cholecystectomy.
Results: 9 patients of LC and 10 patients of OC were males. Among LC 16 patients were
females and among OC group 15 were females, 28% of patients who underwent open
surgery had complications and 16% of patients who underwent laparoscopic surgery had
complications. The overall percentage of complications is lesser in laparoscopic surgery
than open surgery, The VAS was median grade 2 in LC group as compared to median
grade 4 in LC group. The NSAID’S were used for more days in OC group compared to LC
group, 23 patients who underwent laparoscopic cholecystectomy were discharged before 5
days. All patients who underwent OC stayed >5 days in hospital.
Conclusion: Herewe conclude in results, the duration of pain, rate of complications and
hospital stay were significantly lower in laparoscopic group. However the main advantages
of LC were reduced postoperative pain with less duration of analgesic intake, more rapid
recovery, reduced hospital stay and early return to normal work.

Prevalence and risk factors associate with cholangiocarcinoma: A clinical study in tertiary care teaching hospital

Dr. Vipin Kumar, Dr R.P. Singh, Dr. Dillip Kumar Mohanty

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 592-599

Background: Cholangiocarcinoma, including intra-and extrahepatic cholangiocarcinoma,
is a rare but highly lethal cancer. Despite effort in finding the risk factors of
cholangiocarcinoma, the causes of most cholangiocarcinoma remain unknown.There are
considerable geographic and demographic variations in the incidence of
cholangiocarcinoma. Although it comprises only 10-15% of hepatobiliary neoplasms, its
incidence is increasing. There are several established risk factors for CC and few are
modifiable which will help in reducing the incidence.
Aims and Objectives: To study the Prevalence and risk factors of cholangiocarcinoma at
GMC Budaun.
Material and Methods: All types of cholangiocarcinoma cases above age of 40 years
admitted to Department of Surgery, GMC Budaun U.P., were studied for risk factors over a
period of two years.
Results: An incidence of cholangiocarcinoma was 0.032% in present study. Peak incidence
of cholangiocarcinoma was 4th to 6th decade of life with mean age of 61.92 years. out of
26 patients 13 patients (50%) were smoker and in those 13 patients 12 (92%) were smoking
for more than 10 years and 13 patients (100%) were smoking more than 10 cigarettes or
bidi per day. 18 patients were using chulha (69%) for cooking meals with coal as a primary
fuel.
Conclusion: In conclusion, we found associations with PSC, smoking and alcohol
consumption; however, further studies are needed to establish the risk factors in our
country Long term exposure to pesticides in patients, who are chronic smoker and exposed
to smoke from chulha are at higher risk of developing CCA than others in this socioeconomic
scenario.

Triple Positive breast cancer: A case series

Vivek Gupta, Prerna Agarwal, Sunita Vagha

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 600-607

Introduction: Breast cancer is the most common malignancy in women around the world,
accounting for 25.1 % of all cancers among women. Breast cancer are classified in different
molecular subtypes depending on hormone receptor positive or negative and human epidermal
growth factor receptor 2 status. All the three receptors labelled as ‘triple positive’ breast
cancer are rare entity. We herein describe a case series of three patients diagnosed as invasive
ductal carcinoma with Immunohistochemistry (IHC) positive for all three receptors (Hormone
receptors and human epidermal growth factor receptor).
Case presentation: Three patients aged 67, 40 and 34 years presented with breast lump and
were diagnosed invasive ductal carcinoma. There was no history of familial breast cancer, any
other malignancy, or hormonal medication.Modified radical mastectomy was done and
specimen sent to surgical pathology department for histopathology. Modified Bloom
Richardson’s score was 7 and 8 with histological grade 2 for two of the cases. IHC was
performed and was positive for Hormone receptor and human epidermal growth factor
receptor. All the three cases were labelled as ‘Triple Positive’.
Conclusion: Breast cancer with all three receptor positive are rare to find but these cases do
exist. The biological significance and cross talks of their related pathways should be
investigated further for ‘triple positive’ breast cancer to determine intrinsic as this would help
to view the treatment options if these patients receive endocrine treatment in combination with
HER2 blocking agents or a separate therapy.

Study of efficacy of superoxidised solution and gel (microdacyn) in the treatment of diabetic foot ulcer

Bhupinder Singh Walia, Pankaj Dugg, Navjot Singh, Sanjeev Sharma, Babu Lal Sunkaria

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 608-617

Introduction: Diabetic foot and diabetic ulcers are common complications of diabetes mellitus.
It affects daily life of patients and lead to amputations. The study was conducted to see the
effect and role of superoxidised solution and gel (microdacyn) in promoting the healing and
treatment of diabetic foot ulcer.
Material &Methods: The wound site was cleaned with normal saline followed by application
of superoxidised solution for 30 seconds and then followed by application of wound care
hydrogel. Observations were made during dressing and examination of the patients/ wounds
was done on the day 7,14,21,28 and at follow-up of 15 days. Rate of contraction of wound is
measured in cm2.
Results: Mean age of patients in the study was 50.0687±11.85 years with equal male to female
ratio. Superoxidised solution provides good wound healing and mean hospital stay was
10.49±4.24 days. Significant reduction of wound is seen in cases with short duration of ulcer
and short duration of diabetes (p<.05).
Conclusion: Superoxidised solution was associated with faster healing of ulcers without any
major complications, proving SOS to be safe and efficient as a wound care product in the
management of lower limb ulcers.

Vitiligo and Depression: Study from Rajiv Gandhi Institute of Medical Sciences (RIMS), Adilabad, Telangana

Dr. Om prakash

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 618-624

Background: Vitiligo is a condition that causes pale, white patches to develop and affect any area of the skin. Most of the patients with involvement of exposed areas of the body suffer from low self-esteem, embarrassment, emotional stress ultimately leading to social isolation. These factors along with a sense of stigma increase the risk of psychological disorders including depression.
Methods: It was a hospital-based cross-sectional study conducted at Rajiv Gandhi Institute of Medical Sciences (RIMS), Adilabad, Telangana, which is a tertiary care center and serves a large cater of sections including tribal areas. The duration of the study was for 8 months. The total sample size of the study was 80; out of which 40 were vitiligo patients and the other n=40 were non-vitiligo patients. A pre-designed proforma was used to get the basic demographic data and the Zung Self-rating Depression scale was used to assess depression in both groups. Statistical analysis was done using Epi Info 3.4.3 version which is a public domain software provided by the Centre for Disease Control and Prevention (CDC), Atlanta.
Results: Age group ranged from 18-60 years of age. The mean age among the Vitiligo patient group was 36.3±10.53 years and in the control group was 40.8±10.87 years. Sex distribution showed that among vitiligo patients 28 were male and 12 females. The overall prevalence of clinical depression among vitiligo patients was 55% compared to only 10% in controls and this association was found to be statistically significant. Among the patients with clinical depression, nearly two-thirds (63.6%) were male and 36.4% female indicating a high prevalence of clinical depression among males compared to females.
Conclusions: Present study found a high prevalence of clinical depression among vitiligo patients using the Zung Depression Scale. Clinicians should evaluate vitiligo patients for depression and provide appropriate referrals or advice to manage the condition accordingly.

A study on thyroid dysfunction in postmenopausal women

Dr.Lalitha R

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 625-629

Background:Thyroid dysfunction is common in the general population, especially among
older women. The present study was conducted to assess thyroid function in postmenopausal
women.
Materials & Methods:56 post- menopausal women and equal number of pre- menopausal
women were recruited and classified into group I and II respectively. All were subjected to
TSH estimation in RIA centre with Immunoradiometric assay kit. T3 and T4 were also
estimated if TSH level was abnormal. The sensitivity of TSH estimation was 0.05μIU/ml.
Normal level of TSH was taken as 0.5-4.5μIU/ml.
Results: There were 2 subjects in group I and 4 in group II with TSH level <0.5 μIU/ml, 50
in group I and 46 in group II had between 0.5-4.5 μIU/ml and 4 in group I and 6 in group
II had >4.5 μIU/ml. The prevalence of subclinical hypothyroidism was seen in 2 in group I
and 4 in group II and overt hypothyroidism in 1 in group I and 2 in group II. The
difference was significant (P< 0.05). The mean TSH level in group I was 3.02 μIU/ml and
in group II was 3.86 μIU/ml. The difference was non- significant (P> 0.05).
Conclusion: The prevalence of thyroid disorders especially hypothyroidism is more in
postmenopausal women than premenopausal women

ANALYZATION OF A FUZZY QUEUING MODEL WITH FLEXIBLE SERVICE POLICY USING PARAMETRIC PROGRAMMING APPROACH

W. Ritha and P. Yasodai

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 630-637

Fuzziness is a type of new incoherence. The fuzzy set theory is said to depict
ambiguity.Fuzzy queuing model with flexible service policy is being investigated in this
work. A parametric programming technique is designed to find the membership functions
of queue length and sojourn time in steady state, in which the arrival rate and service rate
are being pentagon fuzzy numbers. Based on  -cut approach and Zadeh’s extension
principle, the fuzzy queues are transformed into family of crisp queues. The model’s
potency is calculated for various possibilities of -cuts.

EPQ MODEL – AN ENDOMMAGER ETYMOLOGY

W.Ritha and R. Saarumathi

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 638-644

Economic Order Quantity (EOQ), an inventory model is ideal to produce cent percent
ordered items. But practically, this assumption becomes invalid as process deterioration,
production processes and other factors pop up. The customer’s expectation and marketing
demands can be satisfied, if only the production rate becomes a function of demand rate.
As the demand and deterioration products are time dependent function, eventually allowed
shortages will be partially backlogged. Rate of backlog is contingent on the waiting time up
to the arrival next lot. To prevail over these sparsities, this paper signifies the application of
EPQ model to contemplate the optimal production run time, production quantity and
shortage period aiming to minimise the total average cost.

CEPHALOMETRIC CHARACTERISTICS OF INDIAN ADULTS: WITH SPECIAL REFERENCE TO DELHI NCR HOSPITAL

Dr. Sharma Rati Vedprakash, Dr. Mehdi Mustafa, Dr. V. Subhash, Dr. Piyush Sharma

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 645-652

Objectives and Introduction
The majority of the predicted value used in Cephalometry which is used in assessing and performing the orthodontic procedure is Caucasian. In India (Delhi NCR), there is growing demand for its treatment, but there is little knowledge available in Cephalometry. So, the question arises, “Should we use Cephalometric norms from other countries?” To find the answer for this question, we have conducted a research in Delhi NCR hospitals for determining the craniofacial morphological characteristics of a group of Indian subjects. 
 
Methodology
The methodology was conducted from the month of January 2019 to June 2019.We have conducted an observational analysis on scout view scan graphic images of patients aged 25 to 45 years at the Delhi NCR Hospitals and remaining work at dental college Azamgarh. The mean score and standard deviations of 15 Cephalometric variables were determined. To calculate the reference values, we used indicator which means 95 percent of confidence interval as the best estimator of our population measures. 
 
Results 
The total number of participants was 1200, with an average age of 31.3 years. The only differences between the sexes in Indian subjects were for SNB and SND tests, which were higher in men. The Indian population had a protrusive Dento-Alveolar system with higher average values compared to Caucasian values, with an exception of inter-incisal angles 118.3º and SND 68.8º, which showed a lower value against Steiner 1310 and 790
 
Conclusion
The difference with SNB and SND measurements both between men and women in India is that the men in India are having higher SNB and SND values. Just in few measurements, sample statistics differ significantly from the Caucasian averages in India. Taking these differences into account, we were able to propose a map of Cephalometric values, which have given a clear indication of the Indian type.  
 
KEYWORDS: Cephalometric, Indian, Steiner
 

EFFICACY OF FINE NEEDLE ASPIRATION CYTOLOGY IN TRIBAL AREA- GUJARAT

DR GAURAV S PAWAR, DR CHARU TRIPATHI, DR RAM KUMAR

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 660-666

 
NECK LESIONS ARE FREQUENTLY ENCOUNTERED IN CLINICAL PRACTICE AND FOUND RESPONSIBLE FOR SIGNIFICANT MORBIDITY AND MORTALITY IN INDIA. SOME OF THE LESIONS OF THE NECK REGION INCLUDE TUBERCULOSIS & OTHER CHRONIC INFLAMMATORY LESIONS, PLEOMORPHIC ADENOMA & CYSTS. MALIGNANT LESIONS-PRIMARY AS WELL AS METASTATIC, COMMON TO THE CERVICAL GROUP OF LYMPH NODES, ARE ALSO FREQUENTLY NOTED. FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) IS A SIMPLE, ECONOMICAL, HIGHLY ACCURATE TOOL IN THE DIAGNOSIS OF CERVICAL LESIONS. IT IS ALSO IDEAL FOR SAMPLE COLLECTION FOR ANCILLARY STUDIES SUCH AS CBNAAT. FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) SAMPLES FROM THE NECK REGION OF PATIENTS CAN BE REVIEWED IN ORDER TO EVALUATE THE EFFICACY OF THIS METHOD
IN THE DIAGNOSIS OF CERVICAL LESIONS. THE MAIN EMPHASIS OF THIS STUDY IS TO DETERMINE DIFFERENT CYTOMORPHOLOGICAL ENTITIES AND PROVIDE THE DETAILS OF BURDEN OF TUBERCULOSIS IN THE TRIBAL AREA.TUBERCULOSIS IS THE MOST COMMON CAUSE OF LYMPHADENOPATHY IN DEVELOPING COUNTRIES SUCH AS INDIA AND SHOULD BE CONSIDERED IN EVERY CASE OF GRANULOMATOUS LYMPHADENOPATHY UNLESS PROVED OTHERWISE.[1]

Mast cell count in Alopecia AreataandScarring alopecia in patients referred to Imam Khomeini Hospital in Ahvaz (2014-2016)

Madineh Azizi,Nastaran Ranjbari

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 667-681

Alopecia is a Latin word meaning hair loss or baldness and includes many types of hair loss. The
underlying cause of AA is unknown, but recent evidence suggests that it is a chronic inflammatory
disease of the hair follicles. Based on the histological evidence of peripheral follicular fibrosis and an
increase in the number of mast cells - which can increase the synthesis of elastic fibers - it appears that
there may be a link between mast cells and alopecia. The present cross-sectional descriptive-analytical
study was performed on formalin and paraffin-embedded tissues of patients diagnosed with alopecia,
as well as 20 paraffin-embedded scalp samples of "healthy" patients without reporting Alopecia. In
order to evaluate the number of mast cells, Giemsa cytochemical staining was performed. The results
show that the mean number of mast cells in AA and AS patients was 18 and 19, respectively, which did
not show a significant difference. However, this rate was 18.75 in patients with Alopecia and 6.5 in the
control group, which shows a statistically significant difference between the two. Also, the number of
mast cells in the biopsy of patients with alopecia was significantly higher than normal individuals,
which indicates the role of these cells in the pathogenesis of alopecia.

Induction of Labor: A comprehensive review

Walid Abd-ELsalam, Youssef Abo-Elwan ,Fatma Al-Zahraa Sherif, Basem Hamed

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 682-687

Labor induction rates have more than doubled in the United States over the last two
decades. Indications and risk factors for induction of labor are also gaining in
popularity. Professional organizations such as the American College of
Obstetricians and Gynecologists and The Joint Commission have taken steps to
discourage elective induction of labor prior to 39 weeks' gestation and have defined
new terms such as early-term, full-term, late-term, and postterm gestation to assist
clinicians in determining the appropriate timing of birth for specified indications.
Induction of labor carries the risk of harm to both the mother and her fetus. The
cost of inducing labor and its influence on the health care system are a major
source of worry. Women's education and the shared decision-making process used
to get informed permission are critical elements in lowering early elective deliveries.
The use of scheduling forms, hard stop procedures, induction of labor indication
tools, and informed consents may assist the provider in reducing overdiagnosis,
overtreatment, and disease creep. This article discusses induction of labor trends,
medical indications and criteria, related dangers, cost and health system impact,
and measures to reduce induction of labor.

A prospective study to analyse the effectiveness of MRI while treating the knee joint injuries

Dr. Ayon Chakroborty, Dr. Partha Pratim Som

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 688-701

Background: The value of magnetic resonance imaging (MRI) for imaging the knee was apparent almost immediately after the introduction of this modality in the early 1980s. With the introduction of special closely coupled extremity coils, high field systems, open systems, extremity units and other technical advances, the utility of MRI in the knee has expanded dramatically. MR examination, a non-invasive modality, is now routinely used to assess a wide spectrum of internal knee derangements and articular disorders and has virtually replaced conventional arthrography in the evaluation of menisci and cruciate ligaments, decreasing both morbidity and costs associated with negative arthroscopic examinations. The knee joint is a biggest joint of the human body with complex articulation characterized by the presence of ligamentous and meniscal structures that play an important role in the stability and mobility. MRI due to its excellent soft tissue contrast resolution and multiplanar imaging capabilities provides significant advantages over other imaging techniques in the evaluation of traumatic injuries of knee joint. Study aimed to study the role of MRI in the evaluation of traumatic injuries of knee joint.
Material and methods: Our sample size was of 102 patients referred with history of knee injury were imaged with 1.5 Tesla GE-signa HdxII MRI machine in the department of radiology over a period of 18 months.
Results: Commonest injuries detected in the study are anterior cruciate ligament tear, tear of posterior horn of medial meniscus, bone contusions and joint effusions. Clinical presentation and radiographs of the patient did not help in diagnosis in most of the cases of acute knee injury, especially in multiple ligament and bone injuries. MRI detected soft tissue injuries very well in addition to the bony injuries.
Conclusion: MR examination, a non-invasive modality, is now routinely used to assess a wide spectrum of internal knee derangements and articular disorders and has virtually replaced conventional arthrography in the evaluation of menisci and cruciate ligaments, decreasing both morbidity and costs associated with negative arthroscopic examinations. Magnetic resonance imaging is the excellent non-invasive investigation tool for knee injury due to excellent soft tissue contrast resolution and multiplanar imaging capabilities which provides the most detailed evaluation in cases of various soft tissue injuries of knee joint.
 
Keyword:Non-invasive investigation, traumatic knee, joint injuries, MRI, acute knee injuries

Clinical and demographic features of SARS-COV-2 variants of concern (VOC): B.1.1.7 and B.1.617.2 At a tertiary care hospital in Southern Rajasthan

Dr. Neha Agrawal, Dr. Anshu Sharma, Dr. Sushil Kumar Sahu, Dr. Shubhangi Sharma, Dr. Lakhan Poswal

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 702-708

Introduction: As the global severe acute respiratory syndrome corona virus 2 (SARS-CoV-
2) pandemic expands, genomic epidemiology and whole genome sequencing are being
constantly used to investigate its transmissions and evolution.
Aims and Objectives: To ensure that best use is made of the whole genome sequencing
programmes for SARS-CoV-2 results, in improving public health. Analyze and establish a
correlation of demographic features and vaccination status with clinical outcome of
VOC’s.
Material and Method: 478 samples (December 15, 2020- June 15, 2021) were shortlisted as
per state government policy of sample selection criteria for genome sequencing, packed in
triple layer according to standard transportation protocol and sent to the National Public
Health Laboratory (NPHL) for whole genome sequencing.. The data collected by us were
analyzed and correlated with the results of whole genome sequencing, shared by the NPHL
to enhance public health impact of the variant identified.
Observation and Results: In our study we found 92% of B.1.617.2 (Delta) variants and 8%
of B.1.1.7 (Alpha) variant. We found significantly high mortality (25%) in age group > 60
years compared to other age group (20-40years, 40-60years) with Delta variant (p value <
.05). We also found that Delta variant is significantly more transmissible (p value < .05)
than Alpha variant. Mortality was significantly higher among unvaccinated patients
having co-morbid conditions rather than vaccinated patients having co-morbid conditions
with delta variant (p value <0.05).
Conclusion: B.1.617.2 (Delta) variant has emerged as a common VOC among SARS-COV-
2 patients in southern Rajasthan. Vaccination has a very high level of protective role in
decreasing mortality, especially old age patients with associated co-morbidities among
Delta variant.

Ocular findings in discoid lupus erythematosus-A case report

Preeti Singh, Ankit Gupta

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 709-711

Discoid lupus erythematosus (DLE) is an autoimmune disorder which encompasses broad
range of dermatologic manifestations. Ocular manifestations are rare and ocular
involvement has been reported in very few cases. They are often misdiagnosed as
blepharitis or eczema. Here we report a case of DLE with ocular involvement

Evaluation of the status of diabetic retinopathy after cataract surgery

Dr. Preeti Singh, Ankit Gupta

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 712-719

Diabetes mellitus (DM) affects about 400 million adults globally, a number that is predicted
to be doubled by 2035 according to the world health organization (WHO).When cataract
surgery is done on diabetic patient the status of retina and retrieval of vision depends on
severity of diabetic retinopathy and previous treatment received. In diabetic patients,
macular oedema after cataract surgery can be a frequent and complex problem, especially
in the patients with pre-existing diabetic retinopathy. The objective of present study is to
evaluate the status of diabetic retinopathy after cataract surgery. The hospital based
prospective, observational study was carried out. 50 diabetic patients underwent cataract
surgery between October 2017 to September 2018. All were studied postoperatively at 1
month and 3 months.
This study used OCT to evaluate macular oedema in patients which in turn helped to find
out the status of diabetic retinopathy. The present study does not show any progression in
diabetic retinopathy in the operated eyes over the short term follow up of 3 months. None
of the patients who were having no retinopathy pre-operatively developed retinopathy post
operatively.

Clinical and demographic features of SARS-COV-2 variants of concern (VOC): B.1.1.7 and B.1.617.2 At a tertiary care hospital in Southern Rajasthan.

Dr. Neha Agrawal, Dr. Anshu Sharma, Dr. Sushil Kumar Sahu, Dr. Shubhangi Sharma, Dr. Lakhan Poswal

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 720-727

Introduction: As the global severe acute respiratory syndrome corona virus 2 (SARS-CoV-
2) pandemic expands, genomic epidemiology and whole genome sequencing are being
constantly used to investigate its transmissions and evolution.
Aims and Objectives: To ensure that best use is made of the whole genome sequencing
programmes for SARS-CoV-2 results, in improving public health. Analyze and establish a
correlation of demographic features and vaccination status with clinical outcome of
VOC’s.
Material and Method: 478 samples (December 15, 2020- June 15, 2021) were shortlisted as
per state government policy of sample selection criteria for genome sequencing, packed in
triple layer according to standard transportation protocol and sent to the National Public
Health Laboratory (NPHL) for whole genome sequencing.. The data collected by us were
analyzed and correlated with the results of whole genome sequencing, shared by the NPHL
to enhance public health impact of the variant identified.
Observation and Results: In our study we found 92% of B.1.617.2 (Delta) variants and 8%
of B.1.1.7 (Alpha) variant. We found significantly high mortality (25%) in age group > 60
years compared to other age group (20-40years, 40-60years) with Delta variant (p value <
.05). We also found that Delta variant is significantly more transmissible (p value < .05)
than Alpha variant. Mortality was significantly higher among unvaccinated patients
having co-morbid conditions rather than vaccinated patients having co-morbid conditions
with delta variant (p value <0.05).
Conclusion: B.1.617.2 (Delta) variant has emerged as a common VOC among SARS-COV-
2 patients in southern Rajasthan. Vaccination has a very high level of protective role in
decreasing mortality, especially old age patients with associated co-morbidities among
Delta variant.

MEDICINAL USES OF GILOY:A REVIEW

Amandeep Singh, Nisha A Bhatt, Abhineskar Sagar, Amartya Kumar, Abhay Goswami

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 728-733

Gilo (Tinospora cordifolia) is a plant medicine which is widely used in Unani system of medicine
(USM) for various therapeutic purposes. It has antipyretic, analgesic, anti- inflammatory purpose
and antidiabetic potential. This is a review paper based on published literature which discusses
morphology, habitat, pharmacological actions and ethno-botanical therapeutic uses of this
medicinal plants. It is concluded that, this is one of the best herbal medicine for pyrexia, diabetes
mellitus and syphilis in USM.

A REVIEW ARTICLE ON RHEUMATOID ARTHRITIS: PATIENT EDUCATION

Neha Singh, Bhupendra Kumar,Gupta Anjan, Amandeep Baghla

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 734-744

Rheumatoid arthritis (RA) is a chronic, inflammatory, systemic autoimmune disease, affecting
the joints with varying severity among patients. The risk factors include age, gender, genetics,
and environmental exposure (cigarette smoking, air pollutants, and occupational). Many
complications can follow, such as permanent joint damage requiring arthroplasty, rheumatoid
vasculitis, and Felty syndrome requiring splenectomy if it remains unaddressed. As there is no
cure for RA, the treatment goals are to reduce the pain and stop/slow further damage. Here, we
present a brief summary of various past and present treatment modalities to address the
complications associated with RA.

REVIEW ARTICLE: INDOLE 3 CARBINOL A NOVEL APPROACH TO ANTICANCEROUS DRUG

Geetika chandra, Neha Singh , Dr.Amandeep Baghla

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 745-750

A diet rich in cruciferous vegetables such as cauliflower, broccoli, and cabbage has long been
considered healthy, and various epidemiological studies suggest that the consumption of
cruciferous vegetables contributes to a cancer-protecting diet. While these vegetables contain
a vast array of phyto chemicals, the mechanism by which these vegetables counteract cancer
is still largely unresolved. Numerous in situ studies have implicated indole-3-carbinol, a
breakdown product of the glucosinolate indole-3-ylmethylglucosinolate, as one of the phyto
chemicals with anti-cancer properties. Indole-3-carbinol influences a range of cellular
processes, but the mechanisms by which it acts on cancer cells are slowly being revealed.
Recent studies on the role of indole-3-carbinol in Arabidopsis opens the door for crosskingdom
comparisons that can help in understanding the roles of this important
phytohormone in both plant biology and combatting cancer.

PHARMACOLOGICAL USES OF COIR

Preeti Gautam, Mansab Raza ,Amandeep Singh ,Jyoti Saxena

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 751-759

The coconut, Cocosnucifera L., is a plant that has been cultivated for its many benefits,
especially in its nutritional and medicinal properties. Coconut is an unusual, edible fruit
produced from coconut trees. The coconut tree is a type of palm that has a single straight
stem and has been used for many purposes since prehistoric times. Every part can be used,
including fruit, wood, and leaves. As a result, the trees are widely grown in many parts of
South India for commercial and domestic use. From the coconut tree are found several
products including coconut, soft coconut water, coconut, coconut shell and so on. All
components are used. It is a unique source of various nutrients, so it has many medical
functions including anti-inflammatory, anti-bacterial, anti-plastic, anti-diabetic etc to
maintain good health. And this current review explains the facts of a healthy diet and several
activities of the Cocosnucifera drug.

A Review article of COVID-19 (Corona Virus Disease 2019) Introduction, Diagnosis, Treatment

Neha Singh, Bhupendra Kumar,F.Remruatfeli, Amandeep Baghla

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 760-774

Corona virus Disease 2019(COVID-19)has become a major health problem causing
severe acute respiratory illness in humans .It has spread rapidly around the globe since
its first identification in Wuhan,China,inDecember2019.Thecausative virus is called
severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), and the World Health
Organization (WHO) named the new epidemic disease Coronavirus Disease (COVID-19).
The incidence of COVID-19 continues to increase with more than three million
confirmed cases and over 244,000 deaths worldwide. There is currently no specific
treatment or vaccine against COVID-19. Therefore, in the absence of pharmaceutical
interventions, the implementation of precautions and hygienic measures will be essential
to control and to minimize human transmission of the virus. In this review, we highlight
the epidemiology, transmission, symptoms, and treatment of this disease, as well as future
strategies to manage the spread of this fatalcoronavirus.

In-vitro Anti-urolithiatic Activity of carica papaya roots

Amandeep Singh, Nisha A Bhatt, Abhishek Rana, Amar jit Singh

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 775-792

The fruit of Carica papaya Linn (Caricaceae) used in traditional medicine for the
treatment of urinary stones. The present study was undertaken to evaluate
theantiurolithatic effects of the aqueous and alcoholic extracts of the fruit of C. Papaya on
ethylene glycol (EG) induced urolithiatic rats. EG administration resultedin hyperoxaluria
as well as increased renal excretion of calcium and phosphate. Treatment with aqueous
and alcoholic extracts of C. papaya fruit significantlyreduced the elevated urinary oxalate,
showing a regulatory action on endogenous oxalate synthesis. The increased deposition of
stone forming constituents in thekidneys of calculogenic rats was also significantly lowered
by curative and preventive treatment using aqueous and alcoholic extracts of the fruits of
C. papaya. The results indicate that the fruit of C. papaya is endowed with antiurolithiatic
activity and scientifically valid the traditional use of the fruit of C. Papaya in the treatment
of urinary calculi.

A Comparison of Patient Pain and Visual Result Following Cataract Surgery Utilizing Topical Anaesthetic Versus Regional Anaesthesia: Comparative Study

Dr. Kumar Nishant, Dr. Sujata Kumari, Dr. Pragya Rai, Dr Nageshwar Sharma

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 793-799

Aim: A comparison of patient pain and visual outcome using topical anesthesia versus regional anesthesia during cataract surgery.
Methods: This comparative study was done at the Department of Ophthalmology, Patna Medical College and Hospital, Patna, Bihar, India for 13 months and patients enrolled for the study were operated at Drishtikunj Netralaya, Patna and Phulwari Eye Hospital, Patna.
Results: 100 patients (mean age 73.5±7.2 years) received topical anesthesia, 100 patients (mean age 70.5±9.4 years) received sub-Tenon anesthesia, and 100 patients (mean age 71.5±8.8 years) received intracameral anesthesia. There was a significant difference in mean age between the topical group and sub-Tenon group (P=0.032). The mean pain score on the visual pain scale in the sub-Tenon group was significantly lower than that in the topical group (P=0.0007) and in the intracameral group (P=0.0051). There were no statistical differences in mean pain score between the topical and intracameral groups (P=0.85). In our study, 70 patients received bilateral cataract surgery and 115 patients received unilateral surgery. The mean pain score was 0.435 in 70 eyes of 70 patients who received bilateral surgery and 0.478 in 115 patients who received unilateral surgery. There was no significant difference in mean pain score between the two groups (P=0.44).50 patients showed high myopia (>-6D). In 50 myopic eyes, there were no significant differences in age, duration of surgery, visual acuity, and mean percentage of corneal endothelial cell loss between the three groups (topical, sub-Tenon, and intracameral). The mean pain score in the sub-Tenon group was significantly lower than that in the topical and intracameral groups (P=0.0027 and P=0.0022, respectively). However, in 250 eyes without high myopia (<-6D), there were no significant differences in mean pain score between the sub- Tenon and intracameral groups (P=0.15).
Conclusion: Intracameral lidocaine provides sufficient pain suppressive effects in eyes with-out high myopia, while sub-Tenon anesthesia is better for cataract surgery in eyes with high myopia.

A Prospective Study to Measure Pulmonary Artery Hypertension Using Two-Dimensional Echocardiography in Thyroid Dysfunction

Dr. Manish Kumar, Dr. Archana Verma

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 800-805

Aim: To evaluate the two-dimensional echocardiographic assessment of pulmonary artery hypertension in thyroid dysfunction.
Methods: A prospective double blind randomized controlled study was conducted at ARC Hospital, Bhagalpur, Bihar, India for 1 year. Thyroid function tests were done in all cases using Enzyme immunoassay to confirm the presence of hypo or hyperthyroidism. Electrocardiography was recorded in all the patients. Chest X-rays were done and examined for roentgenographic signs of pulmonary hypertension, i.e. right descending pulmonary artery diameter of >1.5 cm. 2D-Echocardiography was done in all cases and screened for the presence and severity of pulmonary hypertension.
Results: In our study out of the 100 cases, 70(70%) cases were of Hypothyroidism and 30 (30%) cases were of Hyperthyroidism. Unpaired t test is applied. P value is significant if < 0.05 PASP value in patients with hyperthyroidism was 31.06mm Hg while that in the patients with hypothyroidism was 27.17mm Hg. Difference between them was comparable. 80% patients with hypothyroidism and 66.66% patients with hyperthyroidism had normal PASP level. While 20% patients with hyperthyroidism had mild and moderate PASP each, only 16.67% with hypothyroidism had mild PASP. The mean PASP by Doppler Echocardiography was 39.52 mm of Hg in the pre-treatment group. And the mean PASP during the follow up (after 10 months) was 31 mm of Hg. Among the patients in the Hypothyroidism group with PAH, the pre-treatment values of TSH and PASP were high and reduced in the follow-up (after 10 months of treatment) Among the patients in the Hyperthyroidism group with PAH, the mean pre-treatment value of TSH was 0.2 and increased to 2.35 in the follow up. Mean PASP value was 42.6 and reduced in the follow-up (after 10 months of treatment) to 31.7.
Conclusion: The PAH secondary to thyroid dysfunctions may be reversed by restoration of euthyroid state, and hence patients have a good prognosis if diagnosed and treated timely. So every patient of thyroid dysfunction should be screened for PAH, even though further studies are needed to substantiate this.

Risk Factor Assessment in Hypertensive Patients in Association with Framingham Criteria.

Dr. Krishnakant N Bhatt , Dr. Priyanka Patel, Dr. Tvisha Chaudhari , Dr. Tanya Batra

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 806-817

Introduction:  Guidelines for the prevention of cardiovascular disease recommend the use of risk scores to identify adults at higher risk for whom preventive therapy has absolute benefits. Coronary heart disease (CHD) risk estimation tools are a simple means of identifying those at high risk in a community and hence a potentially cost-effective strategy for CHD prevention. Understanding the risks of atherosclerotic cardiovascular disease (CVD) allows for better patient education and management. Aim: 1)To study various risk factors in hypertensive patients according to Framingham criteria. 2)To asses risk of future cardiovascular events in hypertensive patients. Methodology: Study was conducted in 255 hypertensive patients in tertiary care center in south Gujarat, age 18 years or more without any previous history of cardiovascular disease. Framingham risk score was used to assess for estimating 10 years risk of developing cardiovascular disease. Results: In our study 44.70%, 37.25% and 18.03% population had high, intermediate and low  10- year CVD risk. Males had significantly higher CVD risk as compared to females (60% of males & 28.80% of female had high CVD risk). Conclusion:  Higher risk in males was mainly due to history of smoking and diabetes. Significantly higher total cholesterol, low HDL cholesterol in the high risk group as against the low risk one.

A Questionnaire-Based Survey was Used to Examine Type 2 Diabetics' Knowledge of Diabetic Retinopathy

Dr. Pragya Rai, Dr. Kumar Nishant, Dr. Sujata Kumari, Dr. Nageshwar Sharma

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 818-824

Aim: The aim of the present study was to assess the awareness of diabetic retinopathy among Type 2 diabetes mellitus patients in Bihar region.
Methods: This was a descriptive, cross sectional, non-randomized, questionnaire based study conducted in the Department of Ophthalmology, Patna Medical College and Hospital, Patna, Bihar, India, for 12 months. A knowledge attitude practice questionnaire was prepared and pretested in a sample group of representative population. The response was analyzed as to whether the questions were understood or not. Social workers were trained in administering questionnaire. Diabetic patients were given questionnaires at primary health centre and filled in the presence of social workers.
Results: Out of the 100 patients, 59(59%) had no knowledge of diabetic retinopathy compared to 41 (41%) who had knowledge. This was statistically significant with p value <0.001. Patients in the upper socioeconomic group had more knowledge about diabetic retinopathy (62.5%) which was statistically significant with a p value of 0.001.There was no significant association between duration of diabetes and knowledge of diabetic retinopathy. About 82.93 % of individuals in knowledge group had right attitude which was significantly higher than non knowledge group (54.24%) with a p value <0.001. Regarding source of information, 44% of patients in knowledge group got information about diabetic retinopathy from physicians, 13% from eye specialists, 11% from reading books, 8% from various media and 24% from other sources like family and friends. About 38.46% in knowledge group had practice of visiting ophthalmologist for eye check-up which was significantly higher than non knowledge group with a p value <0.001.
Conclusion: we concluded that the Increasing knowledge about diabetic retinopathy through awareness campaigns can improve attitude & practice. Early detection & timely intervention can help in preventing sight threatening complications.

A Study of HIV infection in Pregnancy and its Outcomes in a Tertiary care Hospital of Adilabad in Telangana State.

Dr. Godipelli Laxmi , Dr. Numi Anjum , Dr. Sayuktha

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 825-832

Human immunodeficiency virus (HIV) infection has persisted as the world’s leading infectious killer. Most of the women infected with HIV are in the reproductive age group and are capable of passing this infection to their babies. Most (90%) of the infections in children aged under 15 years are from maternally-acquired HIV. The benefits of antiretroviral treatment (ART) in decreasing mother to child transmission (MTCT) of HIV infection. Present study is on HIV infection in Pregnancy  and its outcomes . This is a Retrospective study done in Tertiary care hospital of RIMS, Adilabad , Telanagana state . 255 HIV positive mothers registered in ART Centre were included in study. 215 were diagnosed in ANC and 40 during PNC. 12 mothers developed tuberculosis. 49 babies were HIV positive, out of which 2 died.15 women died and 216 are alive on ART treatment at present. Timely diagnosis of HIV infection during pregnancy is important for preventing MTCT. HIV infected mothers may give birth to HIV negative babies with the help of multidisciplinary teams. With good antenatal care and multidisciplinary approach HIV-infected women can have good pregnancy outcome.

Spinal Anesthesia Complications: A Comprehensive Review

Ahmed Abdelbaset Mostafa, Zainab Mostafa Attia, Olfat Abd el Moniem, Reham Mohamed

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 833-838

Spinal anesthesia (SA) is considered a safe procedure, but it may have some side
effects including hypotension and bradycardia. Sympathetic fiber blockade and
vasodilation are the main causes of hypotension. SA is performed more frequent in
elderly patients despite the higher risk of hypotension and its consequences. The
percentage of hypotension in elderly patients is estimated to be over 70%[1].
For prevention of hypotensive side effect may have risk of hypervolemia or
myocardial ischemia in elderly population. Hypotension and bradycardia both may
arise from Bezold-Jarish reflex (BJR), spinal anesthesia causes decrease in preload
that stimulates BJR which may be mediated by peripheral serotonin receptors
(5HT-3)[2]. These receptors are located peripherally as cardiac chemoreceptors on
the cardiac vagal afferent and centrally as chemoreceptor trigger zone[3].
Shivering is a common association with spinal anesthesia during intra and
postoperative periods. The causes of shivering are not clearly understood it may be
due to union of some mechanisms including modulation of thermoregulatory
thresholds, decreasing body core temperature, body heat distribution changes and
the cooling effect of the injected fluids into neuraxis[4].
While patients feel very uncomfortable due to shivering, it causes monitors artifacts
and increases the postoperative pain, heart rate,oxygen consumption and metabolic
rate.These effects may lead to myocardial ischemia, hypoxemia, hypercarbia and
lactic acidosis [5].

Optimal Pain Management After Cesarean Delivery

Mohamed SH. Ramadan, Khaled Mohamed, Omnya Khalifa Aldawy, Tarek Mohamed Elbeheidy

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 839-851

Effective pain management is critical for women after caesarean delivery, and
significant postoperative pain is related with persistent pain, higher opioid use,
delayed functional recovery, and postpartum depression. Intrathecal morphine is
the standard method for post-c-section pain, offering superior and extended
analgesia. Scheduled non-steroidal anti-inflammatory medications and
acetaminophen should be included in multimodal analgesia, with opioids reserved
for severe breakthrough pain. Wound infiltration and transversus abdominis plane
blocks are critical components of multimodal analgesia for patients who cannot
receive neuraxial opioids or who do not have appropriate pain management. While
analgesics may transfer to breastfeeding infants, transfer could be reduced by
careful drug selection and administration timing.

Laser Therapy of Nail Psoriasis

Amany Nassar, Rania Elakad,Hadeel Atef Saeed

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 852-856

Laser therapy has proved to be a safe and effective therapy for nail plate psoriasis,
alone or in combination with other therapeutic modalities, being especially
beneficial with topical treatments. Laser can help to improve this resistant form of
psoriasis with high patient’s satisfaction [1]. A positive clinical effect of the laser is
supposed to be caused by its effect on angiogenesis and vascularity within the
psoriatic nail unit. Several case reports and clinical studies have been reported;
however, the results are rather contradictory. While some authors claim effects
mainly on nail bed psoriasis, others report more positive results on nail matrix
psoriasis, or even negative effects on nail bed psoriasis [2].

Serum Renalase and its Relation to Left Ventricular Hypertrophy in Patients on Hemodialysis

Samar Gomaa Gamal, Adel Abd ElMohsen Ghorab, Islam Ali Elsayed, Said M Al-Barshomy,Nader Mohammad Mustafa

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 857-871

Background: Renalase is a blood-secreted protein produced only by the kidney; its
blood level approximately 3–5 μg/ml. The Left ventricular hypertrophy (LVH) is
defined by an augmented left ventricular mass that may be measured via
echocardiography or magnetic resonance imaging (MRI). The aim of the present
study was to study whether Renalase is a marker or has a potential role in
developing myocardial hypertrophy in CKD patients under hemodialysis (HD)
treatment.
Patients and methods: To achieve this target, 90 patients on maintenance HD were
incorporated in the present study.
Results: The mean renalase levels were 61.7±67.5 ng/mL in HD patients. The cutoff
value of Renalase was >57.9 ng/ml with a sensitivity of 92.3% and a Specificity of
84.0%. The mean LVMI of the studied dialysis patients was 138 g/m2. The majority
of cases were severely abnormal (60%). There was a statistically significant
difference between the age groups and the LVMI among dialysis patients. The level
of Renalase was significantly increased with the moderately and severely abnormal
LVMI among dialysis patients. The present study disclosed statistically significant
relations between the duration of dialysis and Renalase, HDL, CRP, and LVMI.
There were significant relations between the serum renalase and s. creat, bl. Urea,
Ph, LVMI and dialysis vintage. Also, there were significant positive relations
between LVMI and Hb, CRP, and dialysis vintage.
Conclusion: Renalase could be a novel predictive biomarker in the assessment of
LVH, which is closely associated with the increased risk of death in HD patients.

MICROBIOLOGICAL PROFILE OF DENGUE CASES REPORTED AT GOVERNMENT GENERAL HOSPITAL, SIDDIPET

Dr.Taruni, Dr. S.L. Annapoorna

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 872-877

Introduction: Dengue fever, a mosquito-borne disease that occurs in tropical and subtropical
areas of the world, is considered to be a significant threat for the mankind in both developing
and developed countries.It causes a wide spectrum of illness from mild asymptomatic illness to
severe fatal dengue hemorrhagic fever/dengue shock syndrome. Its impact today is thirty times
>50 years ago. Global incidence of dengue has drastically upped in the last few years.
Materials and Methods: The study was carried out in the department of microbiology at
Government general hospital,siddipet fpr a period of one year , that is from January 2019 to
December 20219. Blood was collected from each patient suspected to be suffering from
dengue, at least 3 days after onset of fever. Serum was tested for the presence of dengue NS1
antigen and antihuman IgM antibodies using Panbio Dengue Early enzyme-linked
immunosorbent assay (ELISA) kit and National Institute of Virology. Results: A total of
samples
2251 were tested over a period of one years i.e. from January 2019 to December 2019. Out of
which 592 (26.29%) were sero-positive for dengue with symptoms of classical dengue fever.
IgM in 349(58.9%) NS1- 243 (41.04%). Conclusion: As vaccines or antiviral drugs are not
available for dengue viruses, the only effective way to prevent dengue is to control the
mosquito vector, Aedes aegypti and prevent its bite.

Assessment of effectiveness of vitamin D supplements in the patients suffering from Alzheimer disease

Arghadip Das,Himani Jitendra kumar Suthar,Levis Abin Joy,Vinodh Boopalraj

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 878-881

Background: Patients with Alzheimer disease (AD), the most common form of
dementia. The present study was conducted to assess effectiveness of vitamin D
supplements in the patients suffering from Alzheimer disease.
Materials & Methods:60 patients of Alzheimer disease of both genders were divided
into 3 groups of 20 each. Group I were prescribed memantine alone, group II were
prescribed vitamin D alone and group III were prescribed memantine plus vitamin D
for 6 months. Cognitive change with the mini-mental state examination (MMSE) was
assessed.
Results: Group I had 20 males and 10 females, group II had 12 males and 18 females
and group III had 16 males and 14 females. The mean MMSE score before treatment in
group I was 16.8 and after treatment was 16.4, in group II before treatment was 18.3
and after treatment was 17.5, in group III before treatment was 13.4 and after
treatment was 17.2. The difference was significant (P< 0.05).
Conclusion: Patients who took memantine plus vitamin D had a statistically and
clinically relevant gain in cognition as compared to memantine and vitamin D alone.

Assessment of the nutrition using Scored Patient-Generated Subjective Global Assessment (PG-SGA) in 60 patients of Locally Advanced Head and Neck Carcinoma patients (LAHNC) treated with concomitant chemo-radiation

Dr Ashutosh Sharma, Dr Karun Kamboj, Dr Anbu C, Dr Tarun Kumar, Dr Anoop Goel

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 882-889

Background: The present study aimed to assess the frequency of components of Scored Patient-
Generated Subjective Global Assessment (PG-SGA) in locally advanced head and neck carcinoma
patients (LAHNC) treated with concomitant chemo-radiation. Materials & methods: The present study
was conducted on 60 previously untreated, histopathologically proven patients of locally advanced head
and neck carcinoma who received conventional radical external beam radiation therapy (66Gy / 33
fractions over 6.3 weeks / 2 Gy per fraction) concomitant with Inj. Cisplatin 75mg/m2, 3 weekly. The
frequency of components of the Scored Patient-Generated Subjective Global Assessment (PG-SGA) was
assessed at the time of presentation, at the end of treatment and three months after completion of
treatment. Results: The percentage of patients complaining of loss of appetite at the end of CCRT are
significantly (p =0.01) higher than the percentage of patients having loss of appetite before CCRT. A
decrease in throat pain at the 3rd month of follow up is significant (p = 0.008). At the end of CCRT,
significantly (p ≤ 0.001) higher patients were taking less than usual food and this food intake increased
(P≤ 0.001) in the 3rd month after completing CCRT. The number of patients with normal activities
significantly (P ≤ 0.001) decreases at the end of CCRT and then increases significantly (p = 0.028) at 3rd
month of follow up. At the end of CCRT, the percentage of patients with fairly normal activities
decreased significantly (p = 0.016). There is a significant (p =0.017) increase of patients with a moderate
deficit and there is also a significant (p=0.001) decrease of patients without deficit at the end of CCRT.
Loss of body weight ≥ 5% at the end of CCRT is significant (p = 0.001) then this ≥ 5% weight loss
significantly decreases at the 3rd month of follow up. The gain in weight at the 3rd month of follow up is
significant ( p =0.0004). Conclusion: The outcomes of this study provide a unique patient viewpoint of
using the PG-SGA valuable input for the use of assessing nutrition in the patients receiving concomitant
chemoradiation.

A Radiological Role of Proton Magnetic Resonance Spectroscopy in Characterization of Neoplastic and Non Neoplastic Intracranial Lesions

Dr. Kiran Desai, Dr. Girish Desai, Dr. Ananth Dhotre, Dr. Mohammed Soharwardi

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 890-903

The term “Intra-cranial space occupying lesion” (ICSOL) is used to represent any neoplasm, benign or malignant, primary or secondary, as well as any inflammatory or infectious mass lying within the cranial cavity. It also includes haematomas, different types of cysts, and vascular malformations Magnetic resonance spectroscopy is a simple, easily available, non-invasive, cost effective and easily reproducible investigation modality for intracranial pathologies. After undergoing this study, prompt and accurate diagnosis may help in better management.
Materials and Methods: The present study was conducted at Department of Radio-diagnosis, Basaveshwara Teaching and General hospital attached to M. R. Medical college, Kalaburagi. The study design was a one and half year observational study. The present study was conducted from December 2014 to June 2016.
Result: We found the predominant cause of intracranial space occupying lesions to be neoplasms (64%). Of the neoplastic lesions 65% were intra-axial and 35% were extra axial. Gliomas (14 cases) were the most prevalent intra-axial neoplasms and meningiomas (6 cases) the most prevalent extra-axial neoplasms. Infections comprised 30% of all cases most of which were tuberculomas. The rest 6% of cases were formed by tumefactive demyelinating lesions of multiple sclerosis. Irrespective of cause, the predominant presenting symptoms were headache and neurological deficits, seen in 22 patients each, followed by seizures (20 patients). Even in infections, whether tuberculomas or abscesses, many of the patients did not present with fever or meningismus making the diagnosis difficult clinically.
Conclusion: Magnetic resonance spectroscopy is a newer non invasive modality which provides biochemical information about different tissues that cannot be obtained by conventional MRI alone even after contrast administration. It complements MRI and is particularly useful when the MRI findings are inconclusive. It characterizes lesions based on metabolite patterns and ratios. Choline, N-acetyl aspartate, creatine, lactate, lipids, alanine, amino acids and myoinositol are the major metabolites studied.

Case series of Guillain Barre Syndrome variants associated with COVID- 19 infection

Vineet Sehgal, Priyanshu Bansal, Shaifali Arora

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 904-908

The novel corona virus has wreaked havoc in both developing and developed countries. The
respiratory effects of the virus were well reported early on but with each passing day, effects of
covid-19 on others systems came to light. In this report, we bring forward the series of Guillainbarre
syndrome (GBS) cases with the varying presentation in covid infected patients. In our cases,
GBS either occurred during ongoing covid symptoms or within the two weeks of resolution of covid
related pulmonary symptoms. Through this case series, we are reporting one case each of garden
variety, AMAN variety and Miller Fisher variant of GBS. We aim to supplement the already
existing limited data available on other systemic illnesses associated with covid-19 and to make
physicians aware of the potential neurological diagnosis in covid cases.

NeuromyelitisOptica like presentation following COVID vaccination

Shaifali Arora, Vineet Sehgal, Priyanshu Bansal

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 909-915

COVID vaccinations have been developed in the record time frame. But with such rapid
inventions, there comes a risk of potential side effects. Not many serious side effects linked to
vaccinations have been reported to date. Through our case report, we wish to present a 50-
year-old patient who suffered from a NeuromyelitisOptica-like presentation just 2 weeks after
the COVID vaccination. We aim to bring a potential side effect of the vaccine to physicians'
notice so that any patient with similar symptoms does not go undiagnosed. We do not want to
discourage people from taking vaccinations as these side effects are quite rare.