bluuebunny/crossref_metadata_2025 huggingface dataset:
Reverse Cardiac Remodeling Response and Its Effect on Quality of Life After initiation of Sacubitril/valsartan in Heart Failure with Reduced Ejection Fraction
Authors: Darwish M.S. , Hamouda M.A. , Aboul-Enein H. M. , Metwally M.A. , Eldin M.A.E.
Published: April 2023

Objective: To evaluate if switching therapy from an angiotensin converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) to sacubitril/valsartan induces incremental left ventricular (LV) reverse remodeling and the effect of switching on quality of life (QOL) in heart failure with reduced ejection fraction (HFrEF). Methodology: This prospective multicenter study included 100 patients with HFrEF. The patients were subdivided into two equal groups: Group one included patients who were switched to sacubitril/valsartan and group two included patients continued on ACEIs or ARBs as control group. The patients were subjected to medical history taking, clinical examination, heart failure related data, New York Heart Association (NYHA) functional classification, blood samples and chemistry, transthoracic echocardiography (TTE) and quality of life assessment. Results: There was marked improvement in all two dimensional (2D) echocardiography parameters, as left ventricular end-systolic volume (LVESVI), left ventricular end-diastolic volume index (LVEDVI) and left atrium volume index (LAVI) which significantly reduced after 3 months of therapy with significant improvement in LV function (P-value < 0.05). Moreover, mitral regurgitation (MR) severity significantly decreased (P-value < 0.05). Regarding quality of life, there was a significant improvement in QOL. KCCQ score was significantly improved after 3 months of treatment (P-value < 0.05). Conclusion: In HFrEF patients, sacubitril/valsartan significantly improves LV function; furthermore, it induces incremental LV reverse remodeling as well as improves QOL.
Factors Affecting the Decision of a Customer While Booking a Hotel Using the SERVPERF Scale
Authors: Khanna S. , Sharma A.M.
Published: April 2023

In today’s highly competitive market when it comes to having a competitive advantage over others, providing superior service quality to the customers is the most important criteria for any industry. To provide superior service quality, it is a must for businesses to recognize the factors contributing to the customer perception towards service quality. The primary purpose of this study was to decide the factors influencing the decision of a customer while booking a hotel using performance only scale SERVPERF. The SERVPERF scale aims to measure the customer perception regarding the services offered. The performance only scale comprises of 22 service quality items under four factors, namely, Tangibility, Reliability, Assurance – Responsiveness, and Empathy. A primary survey was floated which was validated in person before floating to check the reliability of the questions asked in the survey. The data collected was analyzed using supervised classification technique – Logistic Regression to determine the factor that has the highest contribution in customer perception for the decision making while booking a hotel. The study and the overall findings depicted that the highest contributing factor among all the dimensions’ is tangibility as the model has the highest accuracy and precision, followed by Empathy. Hotel operators and Hotel managers can focus their major efforts in these two factors to provide superior service quality based on the customer perception to have a competitive advantage in the market to maximize their overall sales in this service industry.
COVID-19 Impacts On Indian Economy And Technology
Authors: Lende S. , Pillai S.
Published: April 2023

The world witnessed the biggest pandemic in almost 100 years, the impact of which is felt in all walks of life. It will be early days to predict too many things. But it is essential to foresee the economic impact of COVID-19. In India, which was already in economic turmoil, it remains to be seen how this new blow will affect the economic cycle. The paper attempts to do this in various sectors like agriculture, tourism, and industrial sectors. Secondary data is reviewed for the study. The paper also discusses innovations in this reference, and it also discusses the steps that the country is taking to sustain this situation. It uses estimation techniques for predicting the economic impact in the various sectors. The paper identifies and analyses the various factors that led to the significant disturbance of farming systems and the agricultural sector as a whole following the lockout, using quantitative and qualitative sources of knowledge with an emphasis on the Indian state of Uttar Pradesh, including expert elicitation and a farmer survey. Our research found that a shortage of migrant labor in some regions and a surplus of jobs in others had a significant impact on the April crop, resulting in a decrease in agricultural wages in some communities and an increase in others, as well as significant production losses.
Work-Life Balance Among the IT Professionals During Covid-19
Authors: Mazumdar M. , Chitranshi J.
Published: April 2023

Work-life balance is highly desirable and involves maintaining equilibrium between professional and personal work. With the onset of a novel coronavirus pandemic, the workforce has seen unprecedented changes. Instead of the COVID-19 pandemic, the Government of India implemented a nationwide lockdown and several isolation policies. IT industry has seen a massive increase in work from home policy. Many companies permanently shift working patterns to embrace remote working. Because of this lockdown, many employees working in this sector have experienced psychological distress. With companies expecting their employees to perform with the same productivity, worklife balance has taken a toll. It becomes imperative to identify the factors that most influence the balance. The responses are collected from employees across the IT industry in various regions of India. Factor analysis is employed to identify the most and least important factors that affect work-life balance during COVID-19 lockdown.
Covid-19: throttling the fear and embracing the science of prevention
Authors: Khismatrao D.S.
Published: April 2023

Covid-19 is creating a flurry of fear and stigma across the globe. The individual fear is of discrimination at isolation centers, fears of dying alone with no funeral as per rituals. The mass fear is fueled by social and news media through negative news, disseminating medical knowledge, and confusing multiple mathematical projection models. Hence, firstly need to impede this pandemic of fear and stigma. Equally vital is to embrace the science of prevention by stringently following WHOguidelines. The general population should not fall prey to non-scientific news on social media. There should be restricted, systematic, and timely dissemination of medical knowledge to the medical fraternity. Identify limited expert spokesperson to present factual positive data and strategies of prevention. Disengaging politics and conflicts of commercial interests and educating the population for social changes and norms are required to control the pandemic. Increased GDP allocation to the health sector; Population Control, Improved Literacy rates are other long-term measures.
Analysis and Comparison of Prediction of Heart Disease Using Novel Support Vector Machine and Logistic Regression Algorithm
Authors: Pavithraa G.
Published: April 2023

Aim: prediction of coronary disease using novel support vector machine and comparing its accuracy with logistic regression algorithm. Materials and methods: Two social affairs are proposed for predicting the accuracy (%) of coronary disease. To be explicit, the novel supports vector machine and logistic regression algorithms. Here we take 20 samples each for appraisal and compare. The sample size was calculated using G power with pretest power at 80% and the alpha of 0.05 value. Result: The logistic regression gives better precision (87.82%) than the novel support vector machine (SVM) accuracy (81.30%). Thus the real significance of logistic regression is better than novel support vector machine algorithms. Conclusion: From the result, it might be gathered that logistic regression helps in expecting the coronary sickness with more accuracy to appear differently in relation to novel support vector machine algorithms.
Analysis and Comparison of Kidney Stone Detection using Gaussian Maximum Likelihood Classifier and Bayesian Classifier with Improved Accuracy
Authors: Kishore U. , Ramadevi R.
Published: April 2023

Aim: The aim of this study is to figure out how to predict and detect kidney stones using Gaussian maximum likelihood classifier and Bayesian classifier and also to compare the results of classification accuracy between Gaussian maximum Likelihood classifier and Bayesian classifier. Materials and Methods: This study data was gathered via the kaggle website. Samples were considered as (N=10) for gaussian maximum likelihood classifier and (N=10) for bayesian classifier according to clinicalc.com, by keeping alpha error-threshold value 0.01, enrollment ratio as 0.1, 95% confidence interval, G power as 80% the total sample size was calculated. The accuracy was calculated using MATLAB with a standard data set. Results: Comparison of accuracy is done by independent sample t test in SPSS software. There is a statistical significant difference between Gaussian maximum Likelihood classifier and Bayesian classifier.Comparison results show that innovative Gaussian maximum Likelihood classifier give better classification with an accuracy of (81.34%) than bayesian classifiers (71.1314%). The gaussian maximum likelihood classifier with p=0.122, p>0.05 hence there is a statistically insignificant difference between gaussian maximum likelihood classifiers and bayesian classifiers. Gaussian classifiers showed better results in comparison to Bayesian classifiers. Conclusion: Gaussian maximum likelihood classifiers showed better accuracy than Bayesian classifiers on kidney stone detection in a faster way.
Analysis and Comparison of Kidney Stone Detection using Minimum Distance to Mean and Gaussian Maximum Likelihood Classifier with Improved Classification Accuracy
Authors: Kishore U. , Ramadevi R.
Published: April 2023

Aim: The goal of this research is to use Gaussian maximum Likelihood classifier and Minimum distance to mean Classifier to predict and detect kidney stones. Materials and Methods: This investigation made use of a collection of data from Kaggle website. Samples were collected (N=10) for normal kidney images and (N=10) for kidney with stone images. Total sample size was calculated using clinical.com. As a result the total number of samples 20 was considered for analysis. Using Matlab software and a standard data set collected from Kaggle website, the classification accuracy was obtained. Pretest G power 80, sample size calculation can be done through clinicalc.com. Results: The accuracy (%) of both classification techniques are compared using SPSS software by independent sample t-tests. There is a statistical significant difference between Gaussian maximum Likelihood classifier and Minimum distance to mean Classifier. Comparison results show that innovative Gaussian maximum Likelihood classifiers give better classification with an accuracy of (81.34%) than Minimum distance to mean Classifiers (78.85%).There is a statistical significant difference between Gaussian maximum Likelihood classifier and Minimum distance to mean Classifiers. The Gaussian maximum Likelihood classifier with p=0.022, p<0.05 hence significant and showed better results in comparison to Minimum distance to mean classifiers. Conclusion: The Gaussian maximum likelihood classifier appears to give better classification accuracy than the Minimum distance to mean Classifier.
Detection and comparison of Diabetic Maculopathy using C-Means Clustering Algorithm and Watershed Algorithm
Authors: Naz F. , Rani D.J. , Rajakumari R.
Published: April 2023

Aim: The aim of this research work is for the presence of Novel Diabetic Maculopathy Detection using modern algorithms, and comparing the Peak Signal to Noise Ratio (PSNR) between the C-Means clustering Algorithms and Watershed Algorithm. Materials and Methods: The sample images were taken from kaggle’s website. Samples were considered as (N=24) for C-Means Clustering Algorithm and (N=24) for Watershed algorithm in accordance with total sample size calculated using clinicalc.com by keeping alpha error-threshold value 0.05, enrollment ratio as 0.1, 95% confidence interval, G power as 80%. The Peak Signal to Noise Ratio was calculated by using the MATLAB Programming with a standard data set. Results: Comparison of PSNR is done by independent sample t-test using SPSS software. There is a statistical insignificant difference between C-Means Clustering Algorithm and Watershed algorithm with p=0.11, p>0.05 (PSNR = 35.3411) showed better results in comparison to Watershed Algorithm (PSNR =9.7420). Conclusion: C-Means Clustering Algorithms were found to give higher PSNR than in Watershed Algorithms for the Novel Diabetic Maculopathy Detection.
Detection and comparison of Diabetic Glaucoma using K-means Algorithm and Thresholding Algorithm
Authors: Naz F. , Rani D.J.
Published: April 2023

Aim: The aim of this research work is for the Innovative Diabetic Glaucoma Detection using modern algorithms and comparing the peak signal to noise ratio (PSNR) between K-means Algorithm and Thresholding Algorithm. Materials and Methods: The sample images were taken from Kaggle’s website. Samples were considered as (N=24) for K-Means Algorithm and (N=24) for Thresholding Algorithm in accordance with total sample size calculated using clinicalc.com by keeping alpha error threshold value 0.05, enrollment rati as 0.1, 95% confidence interval, G power as 80%. The PSNR was calculated by using the MATLAB Programming with standard datasets. Results: Comparison of PSNR is done by independent sample t-test using SPSS software. There is a statistical significant difference between the K-Means Algorithm and Thresholding Algorithm with p= 0.001, p<0.005 (PSNR = 12.6320) showed better results as compared to the K-Means Algorithm (PSNR = 9.8375). Conclusion: Thresholding Algorithm was found to give a higher PSNR than in K-Means Algorithm in the Innovative Diabetic Glaucoma Detection.
Analysis and Comparison for Innovative Prediction Technique of Breast Cancer Tumor using Decision Tree Algorithm over Support Vector Machine Algorithm with Improved Accuracy
Authors: Srinivasulureddy Ch. , Kumar N.S. , Binu V.S.
Published: April 2023

Aim: The major goal of this research is to improve the accuracy of the Decision Tree (DT) and Support vector machine (SVM) algorithms and compare their efficiency in detecting breast cancer tumors. Materials and Methods: This work depends on the data obtained from the UCI Machine Learning Repository and used to acquire the data sets for the research of Innovative breast cancer prediction using machine learning algorithms. The sample size of breast cancer prediction involves two groups: Decision tree (N=20) and Support vector machine (N=20) according to clincalc.com by keeping 0.05 alpha error-threshold, 95% confidence interval, enrollment ratio as 0:1, and 80% G power. The accuracy, sensitivity, and precision are calculated using MATLAB software. Result: The accuracy of the DT is 83.83% (p<0.001) while the accuracy rate of the Support vector machine is 97.50%. The Decision tree outcomes have a sensitivity and precision rate of 87.46% (p<0.001) and 84.13% (p<0.001) respectively, whereas the Support vector machine sensitivity and the precision rate are 95.83% and 100% respectively. Conclusion: Support vector machine algorithm performed significantly better with improved accuracy of 97.50% for breast cancer prediction.
Analysis and Comparison for Innovative Prediction Technique of Breast Cancer Tumor by Linear Discriminant Analysis Algorithm over Support Vector Machine Algorithm with Improved Accuracy
Authors: Srinivasulureddy Ch. , Kumar N.S.
Published: April 2023

Aim: The objective of this study is to use machine learning algorithms to detect the presence of breast cancer tumors and compare accuracy, sensitivity, and precision between the Linear Discriminant Analysis (LDA) and Support vector machine algorithm (SVM). Materials and Methods: The research uses two sets of data from the Wisconsin Breast Cancer dataset, which is obtained from the UCI Machine Learning Repository. Linear Discriminant Analysis (N=20) and Support vector machine (N=20) with sample size in accordance to total sample size calculated using clincalc.com by keeping alpha error-threshold at 0.05, confidence interval at 95%, enrollment ratio as 0:1, and power at 80%. The accuracy, sensitivity, and precision are calculated using MATLAB software. Results: Comparison of accuracy (%), sensitivity (%), and precision (%) are done using SPSS software using independent sample t-test. Linear Discriminant Analysis algorithm results in an accuracy of 88.25% (p<0.001), the sensitivity of 94.68% (p<0.001), and precision of 84.35% (p<0.001). Support vector machine algorithm results in an accuracy of 97.50%, sensitivity of 95.83%, and precision of 100%. Conclusion: Support vector machine algorithm performed significantly better than Linear Discriminant Analysis algorithm with improved accuracy of 97.50% for breast cancer prediction.
Analysis and Comparison of Neural Network Algorithm for Prediction of Cardiovascular Disease over Support Vector Machine Algorithm with Improved Precision
Authors: Gadde R. , Kumar N.S.
Published: April 2023

Aim: To find the best algorithm for the prediction of Innovative cardiovascular disease accurately, with fewer errors between Neural Network and Support Vector Machine classifiers. Materials and Methods: Data collection containing various data points for predicting Innovative cardiovascular disease from UCI machine learning repository. Classification is performed by Neural Network classifier (N=20) over Support Vector Machine (N=20) total sample size calculation is done through clinical. com. The accuracy was calculated using Matlab software and the outputs are graphed using SPSS software. Results: comparison of accuracy rate is done by independent sample test using SPSS software. There is a statistical indifference between Neural Network and Support Vector Machine. Support Vector Machine algorithm (87.38%) showed better results in comparison to Neural Network (81.12%). Conclusion: Support Vector Machine algorithm appears to give better accuracy than Neural Network for the prediction of Innovative Cardiovascular Disease.
Analysis and Comparison of Image Enhancement Techniques for Improving PSNR of Liver Images by Median Filtering over Mask Filtering
Authors: Prasad K.D. , Ramadevi R.
Published: April 2023

Aim: The goal of this research is to employ median filters and mask filters to reduce noise in liver images so that they can be improved. In addition, the Peak Signal to Noise Ratio of both filters’ outputs was examined (PSNR). Materials and Methods: The afflicted and normal liver photos were obtained from the Kaggle website for this investigation. Then, using Matlab software, the mask filtering and median filtering algorithms were run. Clinicalc. com was used to compute sample size, and SPSS software was used to conduct the comparative analysis. This study has two groups, each with a sample size of 20 people with an average G power of 80%. The innovative median filter’s performance is assessed, and the PSNR performance metric is compared to that of the mask filter. Results: The PSNR of innovative median filters is 64.0310, while mask filters have a PSNR of 78.0095, according to Matlab simulation data. The significant value of PSNR (Peak Signal to Noise Ratio) (0.409) and p>0.05 was found in the statistical analysis. Conclusion: The innovative median filter delivers greater PSNR than the mask filter for medical image enhancement on ultrasound liver pictures, according to this study.
Retrospective analysis of a cohort of HIV-infected patients on antiretroviral therapy in Abidjan (2003 to 2017)
Authors: Lenoir T. A. Djadji  , Silue Awa N. G. , I. N’guessan Geneviève A. , S. Kouakou Gisèle N'Doua , Eholie Serge P.
Published: April 2023

Background: Antiretroviral therapy (ART) has been successful in improving clinical outcomes for HIV-positive patients, but efforts are needed to improve life expectancy and quality of life. This study aimed to analyze a long-term ART cohort and assess patients' life expectancy.
Methods: A retrospective cohort study was conducted at the infectious and tropical diseases department of the University Teaching Hospital of Treichville from 2003 to 2017. Data analysis was done using VBA access and XLSTAT 2018 excel software. Patients on post-exposure chemoprophylaxis and prevention of mother-to-child transmission were excluded.
Results: Out of 19,567 patient records, 49.60% were included, 72.43% were in 1st line, and 50.10% were over 50 years old, mostly female 58.49%, 98.4% HIV1. 74.31% had a CD4/mm3 (Nadir) count <350. The patients were essentially on the 2IN+INN regimen (72.31%), TDF + XTC + EFV (20.57%). The average duration under treatment 6.15 [0-13.67] ±3.94 years, the average duration under a line of treatment 4.33 [0-14.04] ±2.96 years. Life expectancy was 10.37 years. It is higher in patients on 2IN+IPr (12.21 years) versus 10.12 years in patients on 2IN+INN. The comparison of duration on a line according to the CD4 counts and the line of treatment did not show a significant difference p>0.05.
Conclusions: The study concluded that ART significantly improved the life expectancy of patients, adherence could be improved to further enhance the benefits of ART. The use of new combinations of ART may reduce events related to non-compliance.
Pattern of adverse drug reactions reported at the adverse drug reaction monitoring centre at tertiary care teaching hospital in North India
Authors: Jindal Amita , Kumar Raj , Kumar Sumir , Kaur Amandeep , Kiranjit  , Tilak Raj Rakesh
Published: April 2023

Background: The aim of the present study was to determine the pattern of adverse drug reactions (ADRs) reported at ADR monitoring centre (AMC) in Punjab.
Methods: This observational retrospective study was done in department of Pharmacology, GGS Medical College and Hospital, Faridkot from September 2020 to August 2021. A total of 148 ADRs were reported during the study period. Each ADR was analyzed for demographic data and characteristics of ADR. Assessment of causality, severity and preventability was done according to WHO UMC scale, modified Hartwig and Siegel scale and Modified Schumock and Thornton Preventability Scale respectively.
Results: A total of 148 ADRs were reported from both outpatients and in patients of various departments. Most of the ADRs were found in males (55%) and patients of age group 31-45 years (33%). Majority of ADRs were reported from dermatology department (40%). Overall, 38% of ADRs were due to antimicrobial drugs. Most of the ADRs were reported as possible (57%), followed by probable (41%) as per WHO causality assessment. Most of the ADRs were moderate severity (83%). 97% of the ADRs were found to be definitely preventable type.
Conclusions: We concluded that most of the ADRs were reported from antimicrobial drugs, so it is advisable to have close monitoring of the antimicrobial drug therapy to prevent ADRs in the patients. Although the majority of ADRs were moderate in nature but mostly were recovered. The study of ADRs in a particular institute using demographic patterns will contribute to patient safety by sensitizing the clinicians in that particular institute.
A comparative evaluation of placebo effect on pain perception parameters in open-label versus double-blind groups: a prospective randomized pilot study in healthy volunteers
Authors: Bhargava Shashikant , Sarangi Sudhir Chandra , Kumar Vijay L.
Published: April 2023

Background: Considerable placebo response rate is commonly observed in placebo-controlled trials involving analgesics. However, there is paucity of evidence with regard to comparison of effect of open-label placebo versus double-blind placebo on pain perception.
Methods: In this study, cold water maintained at 4±1°C was used to induce experimental pain. Enrolled subjects were randomized to receive either 2% lignocaine gel as active drug or K-Y jelly as placebo as per the groups in open-label (two groups) and double-blind (two groups) study. Pain perception was evaluated using pain threshold time and pain tolerance time after immersion of subject’s hand in the cold water. Pain intensity was assessed using visual analogue scale (VAS).
Results: Sixty-nine subjects were randomized into 4 study groups namely open-label lignocaine (OLL; N=17), open-label placebo (OLP; N=18), double-blind lignocaine (DBL; N=17) and double-blind placebo (DBP; N=17). OLP application increased pain intensity on VAS from 67 (47, 84) to 72 (39, 88) mm (p=0.018). OLL application reduced pain perception pain threshold time from 20.4 (4.0, 45.1) to 24.1 (6.3, 124.2) seconds (p=0.049) and pain tolerance time from 32.7 (6.8, 110.2) to 40.0 (7.7, 156.7) seconds (p=0.019). The change in pain parameters (before and after application of study intervention) was comparable without any significant difference among the four study groups (p=0.257 for pain threshold time, p=0.165 for pain tolerance time and p=0.563 for pain intensity score).
Conclusions: Lignocaine and placebo gel application showed comparable change in pain perception irrespective of blinding.
A prospective observational study of prescription pattern in dermatology outpatient department of associated hospitals of Rajasthan University of Health Sciences-college of medical sciences, Jaipur
Authors: Dinesh Kumar  , Lokendra Sharma  , Punam Jakhar  , Alka Bansal  , Rajveer Singh Rathore  , Susheel Kumar
Published: April 2023

Background: Skin diseases are chronic in nature and they require lifetime treatment. Prescription pattern reflects health professional attitude towards the disease and role of drugs in its treatment. The study of prescription pattern is important to make medical care rational and monitoring adverse drug reactions.
Methods: An observational and prospective study was carried out in Skin and VD department along with department of pharmacology, RUHS college of medical sciences, Jaipur. Data collection was done in three months after ethical approval. Data was entered and analysed with latest Microsoft Excel version. Descriptive statistics were used to analyse the results.
Results: During the study period, a total of 979 prescriptions were included and analysed, out of which the usage of dermatological drugs was maximum among males (n=520, 53.11%). Total 2848 drugs were prescribed in 6 different dosage forms. The most common dosage form prescribed was tablet (1267, 44.49%) followed by cream (685, 24.05%). Total 1632 (57.30%) drugs were prescribed through oral route and 1216 (42.70%) drugs were prescribed through topical route. the present study depicted that dermatophytosis (n=243, 24.82%) was one of the most common dermatological manifestations. antihistaminic (673, 23.63%) were the most commonly prescribed drug.
Conclusions: The study of drug use is an effective tool to promote rational drug prescribing. Such type of study will help in formulation of proper antibiotics, drugs policy, prescription of cost-effective drugs, improvement in the patient compliance and reduction in undesirable effect of drugs.
Analysis of voluntary reported adverse drug reactions in a tertiary care hospital
Authors: Sivakumar V.  , D. Annie Christy , V. Devashree , S. Kaviya , T. Krishnan
Published: April 2023

Background: Adverse drug reactions are the major cause for increased hospital stay and it increases the economic burden of the patients. Reporting of ADR helps in signal generation and to ensure safe use of a drug. Present study was conducted to analyse the ADR reporting pattern and completeness of the ADR forms.
Methods: This was a retrospective study conducted for 6 months in a tertiary care hospital. A total of 330 ADR forms were analysed and completeness of ADR forms were assessed.
Results: A total of 330 ADRs were reported. 46% ADRs were reported in 2018, 23% in 2019, 11% in 2020, 8.9% in 2021 and 10.7% in 2022. 177 (53%) were males and 153 (47%) were females. Most occurred reaction was Hyponatremia 22 (6%), followed by Hypokalaemia 18 (5%). Neuropsychiatry cases were 62 (18.78%), Urinary system cases were 45 (13.63%). 122 (88%) patients were taking concomitant drugs whereas only 17 (12%) patients were not taking. Above 80% completeness were seen in 155 (46.96%) forms. Above 70% completeness in 292 (88.68%) forms.
Conclusions: ADRs occurrence was high in male compared to female. Most of the ADRs affected Neuropsychiatry followed by Urinary system. Antimicrobials are responsible for majorly reported ADRs followed by cephalosporins (17.6%) and Penicillin (11.76%). Overall completeness of reported ADR form was 80%, 67.87% of forms were not adequately filled with mandatory fields.
Influence of reserve antimicrobial indent form in antimicrobial utilization pattern in intensive care unit of tertiary care hospital in North India
Authors: Shashank Sahu
Published: April 2023

Background: Misuse and overuse of antimicrobials in intensive care units is of particular concern as it creates selective evolutionary pressure and thereby enables antimicrobial resistant bacteria to increase rapidly resulting in loss of antimicrobial effectiveness. The aim of the present study was to evaluate influence of Reserve Antimicrobial Indent form in Strengthening the antimicrobial stewardship in intensive care unit of tertiary care hospital, Rajasthan.
Methods: An observational study was conducted over a period of 18 months, and the data was obtained from MRD and from the ICU after introduction of reserve antimicrobial indent form, of a tertiary care hospital. All the data was tabulated in summery sheets and were analyzed by using computer software SPSS version 20 and Microsoft Excel 2019.
Results: A total 257 cases were reviewed during the study period, among these 46.77% were males and 53.23% were females in MRD group, out of 124 cases and 53.38% were males and 46.62% were females in MICU group, out of 133 cases. Total number of reserve drug prescribed was 444 out of which in MRD group Amoxicillin /Clavulanic acid were commonly prescribed followed by piperacillin/tazobactumand in ICU group Meropenem were commonly prescribed followed by piperacillin/tazobactum.
Conclusions: Study showed reducing trend in overall consumption of reserve antimicrobial drugs, which also gave an overview of antimicrobial consumption pattern in intensive care unit.
USG guided indices as a tool for prediction of difficult airway in obese: an observational study
Authors: Paleti Sophia  , Kuppili Geethika  , Jalaja Praveena B.  , Vishnuvardhan A.
Published: April 2023

Background: Now a days, Ultrasound has been the gold standard and an invaluable tool in the field of regional anaesthesia, especially for upper limb and truncal blocks where general anesthesia is associated with high risk and also in patients posted for general anesthesia with anticipated difficult airway. Recently, few studies have published the importance of Ultrasound in the evaluation of airway and related procedures. Aim of this study is to evaluate the use of USG guided indices for prediction of difficult airway in obese patients and correlating them with clinical parameters.
Methods: This study was a prospective observational study done in a tertiary health care center, Government General hospital, Kakinada over a duration of two months from August 2022 to September 2022. Eight Ultrasound parameters like tongue thickness, skin to hyoid distance, pre-epiglottic space, skin to midpoint of vocal cords, skin to thyroid isthmus, anterior soft tissue thickness at suprasternal notch, hyomental distance and thyromental distance were correlated with clinical evaluation (Cormacke-lehane grading) in this study and conclusions were drawn.
Results: Out of 30 cases studied, 20 (70%) were predicted to be difficult with Ultrasound airway examination and 16 (53.3%) were found to have difficulty in intubation clinically.
Conclusions: The following USG indices like pre-epiglottic space, Skin to midpoint of vocal cords, Anterior soft tissue thickness at Suprasternal notch, Hyomental distance in mid-extended position and thyromental distance were found to be clinically correlated to predict difficult airway and intubation in obese patients.
Treatment results of children with the diagnosis of acute myeloid leukemia. Is trisomy 21 an important cause of mortality?
Authors: Sarbay Hakan , Gundogdu Muge , Atay Avni , Malbora Baris
Published: April 2023

Background: Acute myeloid leukemia (AML) is the second most common leukemia accounts for 20% of childhood leukemia. Intensive chemotherapy and hematopoietic stem cell transplantation (HSCT) improve outcomes. In this study, it was aimed to present the clinical features and treatment results of patients diagnosed with pediatric AML in the last three years.
Methods: It is an observational clinical study, patients who received chemotherapy and HSCT with the diagnosis of AML between 2018 and 2020 were retrospectively evaluated. Age, gender, AML subtype, genetic characteristics, laboratory findings, treatment responses, febrile neutropenia and fungal infection frequencies of the patients were evaluated. HSCT indications, pre-transplant bone marrow aspiration results, transplant type, donor characteristics, and post-transplant complications of patients who underwent HSCT were recorded. Post-treatment status and treatment success rates of the patients were evaluated.
Results: Of the 46 patients included in the study, 26 were female and 20 were male. The mean age was 8.2 ± 5.75 years. The most common subtypes were AML M4 and M5 with 9 patients. Total of 201 febrile neutropenia attacks were observed. Suspicious or definite proven Aspergillus infection was detected in 20 of the patients. HSCT was applied to 27 of the patients. Four patients were Down syndrome-myeloid leukemia (DS-ML) and FLT3-ITD mutation was detecetd in 5 patients.
Conclusions: FLT3-ITD mutation, relapse disease, and pre-HSCT M2 bone marrow were found to be highly correlated with progressive disease and mortality. In addition, patients with Down syndrome had a high mortality due to additional comorbidity and drug adverse effects.
Effect of phototherapy on platelet count in neonates with unconjugated hyperbilirubinemia
Authors: Akash Y. Malekar  , Nitin S. Mehkarkar  , Vaibhav J. Pustake  , Ashwini B. Kundalwal
Published: April 2023

Background: Hyperbilirubinemia in newborn is quite common. Phototherapy (PT) is one of the most common noninvasive methods for the treatment of this hyperbilirubinemia. There are limited studies available on effect of PT on platelet count with contrasting results. So, this study was conducted to determine the effect of phototherapy on platelet counts of hyperbilirubinemic neonates in tertiary care hospital.
Methods: This was a hospital based prospective study on 60 eligible neonates admitted in neonatal intensive care unit (NICU) for neonatal hyperbilirubinemia and phototherapy during January 2021 to June 2022. Platelet count was done before starting phototherapy, 24 hours after phototherapy and before discontinuing phototherapy. The results were analyzed statistically using Chi square test and t-test. P value <0.05 was considered as statistically significant.
Results: In this study, total of 60 neonates were included of which 33 were males and 27 were females. The mean (±SD) platelet counts were 201764.92±18 before phototherapy and 156578.33±38 after phototherapy. There was a significant decline in the mean platelet count 24 hours after phototherapy and before stopping phototherapy. (p<0.05).
Conclusions: In our study, the mean platelet count was decreased significantly after phototherapy. Hence, unnecessary use and prolongation of phototherapy should be avoided.
Study of clinical profile and outcome in children aged 1-12 years presenting with Guillain Barre syndrome
Authors: Adhikari Arpita D. , Shinde Aditi P. , Siddhu Sharandeep Kaur G. , Gajre Mona P.
Published: April 2023

Background: Guillain-Barré syndrome (GBS) is a group of clinical syndromes involving acute polyneu­ropathy secondary to an immune-mediated process. The aim of the research is to study clinical profile and outcome in children aged 1-12 years presenting with GBS.
Methods: It is a prospective plus retrospective observational study (5-year retrospective + 18 months prospective). All cases of GBS admitted from January 2020-july 2021 were enrolled for the study and retrospective cases were taken from case record from January 2015 onwards in a tertiary care centre.
Results: Total 45 children were enrolled. The male: female ratio was 1.64:1. Mean age at presentation was 6.3 years, in a range of 1.5 -11.5 years of age. History of antecedent illness prior to the occurrence of GBS was present in 93.3% patients with upper respiratory tract infection being most common seen in 53.3% patients. Following variants of GBS were seen on NCV study performed in 34 patients, the most common was AIDP in 46.7% patients, followed by AMAN in 22.2% subjects and AMSAN in 6.7% patients. All children presented with lower limb weakness which progressed to involve upper limbs. Other associated features like bulbar cranial nerve involvement, respiratory muscle weakness, sensory symptoms and autonomic disturbance (arrythmia, hypotension, tachycardia, bradycardia) was observed in 30,12,7,16 patients respectively. Out of the total 45 patients, 12 patients required mechanical ventilation.
Conclusions: Male predominance seen in GBS. AIDP the most common subtype of GBS. Respiratory distress and autonomic instability were associated with greater severity of Hughes disability score. Factors associated with poor outcome were sensory symptoms, autonomic instability, respiratory distress and bulbar cranial nerve involvement.
Evaluation of diastolic dysfunction in multi-transfused thalassemia patients
Authors: Vithalani Mitsu P. , Vyas Bhadresh R. , Makvana Namrata
Published: April 2023

Background: An important complication of thalassemia is iron deposition in the cardiac tissue resulting in degeneration, fibrosis and dysfunction. Cardiac disease is the primary cause of death. Aims and objectives were to detect early cardiac involvement in patients with transfusion dependent thalassemia by conventional doppler echocardiography and tissue doppler imaging while they are still asymptomatic.
Methods: 150 patients in the age group of 2-18 years who were receiving regular and frequent blood transfusions were enrolled in this study. Institutional ethical clearance was taken. After informed consent, 2D echocardiography was performed on all the patients. Previous blood reports reviewed. Various parameters like mitral flow pattern, LVEF and Tricuspid regurgitant jets were taken into account to diagnose cardiac dysfunction. Results analysed by standard statistical tests.
Results: Out of 150 patients, 58% were males and 42% were female patients. The 13 (8.6%) patients were diagnosed as having diastolic dysfunction. Out of 150, majority (86.6%) were below the age of 15 years, 81.33% children were diagnosed as having thalassemia before the age of 2 years, 97% patients were on regular iron chelation therapy, 32% patients had pre-transfusion Hb <7 gm/dl, 78.66% patients had S. ferritin levels >2500 ng/ml and more number of males (7.33%) have undergone splenectomy than females.
Conclusions: Diastolic dysfunction on Doppler echocardiography is an early sign of myocardial dysfunction in patients with beta thalassemia.
ECHO ADHD in India: a feasible and acceptable training model for child-care physicians to identify and manage attention deficit hyperactivity disorder
Authors: Srinivasan Roopa , Marathe Ashwini S. , Mukhija Manisha K. , De Souza Nandita
Published: April 2023

Background: Children with attention deficit hyperactivity disorder (ADHD) have complex unmet needs. Physicians cite lack of knowledge, skills and resources as barriers to meeting these. ECHO (Extension of community health outcomes) ADHD, a case based tele-mentoring model was designed to address gaps in physician knowledge and skills regarding ADHD. A study was conducted to assess 1. Acceptability and feasibility of the program 2. Change in knowledge, self-efficacy and perception about appropriateness and feasibility of role in ADHD diagnosis and management pre and post program. 
Methods: The 6-month pilot trained pediatricians, developmental pediatricians, psychiatrists, neurologists through 14 sessions comprising lectures, case discussions. Participants completed measures for knowledge (KADDS-knowledge of attention deficit disorders scale), self-efficacy, and acceptability and feasibility of role at baseline and endline. Descriptive and non-parametric analysis assessed acceptability and feasibility of program and change in knowledge, self-efficacy, appropriateness and feasibility of role. De-identified case summaries helped in analysing participant queries.
Results: Sixty four percent (57/88) participants completed baseline and endline evaluations and were included. Most were pediatricians and developmental pediatricians who found the model acceptable and feasible. Significant improvement was noted in knowledge about ADHD diagnosis, self-efficacy and perceptions about appropriateness and feasibility of role. Improvement in knowledge about ADHD comorbidities and management was not significant on KADDS. Case summaries, questions to hub team, discussions indicated participant focus on ADHD diagnosis. 
Conclusions: ECHO ADHD is an acceptable and feasible model in low- and middle-income country (LMIC) setting which improved knowledge and self-efficacy among participants.
Pulmonary hypertension and the common organisms present in the sputum culture in children with cystic fibrosis
Authors: Fayaz Aakifa , Memar Elmira Haji Esmail , Vaseefat Ul Zehra  , Mir Naseer Yousuf
Published: April 2023

Background: Cystic fibrosis is an autosomal recessive genetic defect that affects multiple organs in the body. These patients present with progressive obstructive lung disease, sinusitis, exocrine pancreatic insufficiency and male infertility. The respiratory tract of these patients is more vulnerable for bacterial colonization, most commonly Pseudomonas aeruginosa, Hemophilus influenza and Staphylococcus aureus. There is a possibility of pulmonary hypertension development in these patients due to alveolar hypoxia alongside chronic systemic inflammatory response causing endothelial dysfunction.
Methods: This was a descriptive cross-sectional study which studied 109 cystic fibrosis patients admitted to CMC, Tehran in 2 years.
Results: In this study 109 patients were studied. 35 patients (32.1%) were <1 year of age, 11 patients (10.1%) were 1-5 years of age, 26 patients (23.9%) were 5-10 years of age and 37 patients (33.9%) were >10 years of age. 61 patients (56%) were females and 48 patients (44%) were males. The most common organisms encountered in sputum culture were Staphylococcus aureus (23.9%), Pseudomonas aeruginosa (18.3%) and Candida albicans (11.9%). Pulmonary arterial hypertension was present in 24.7% of the target population, out of which 22.9% were having mildly elevated PAH and 1.8% had severely high PAH.
Conclusions: The most common organism seen is S. aureus followed by P. aeruginosa. A significant number of patients presented with mildly elevated PAH and some with severely high PAH.
Mermaid baby or sirenomelia: a lethal congenital anomaly
Authors: Ram Jeewan Singh  , Bijay Kumar Suman  , Keerthana Bachala  , Amit Kumar  , Rashi Rashi  , Amit Kumar Sinha
Published: April 2023

Mermaid syndrome is a very rare, lethal congenital anomaly. It is associated with other congenital anomalies and is incompatible with life. Typical clinical features are fused lower limb from perineum to ankle and single umbilical artery. Etiology is multifactorial and is extreme form of caudal regression syndrome.  When diagnosed in early gestation, termination of pregnancy may be considered.
A case of clitoral Crohn's disease
Authors: Soukaina Sektaoui , Zoubida Mehsas , Laila Benzekri , Karima Senouci
Published: April 2023

Crohn's disease (CD) is an inflammatory bowel disease (IBD) that can present with cutaneous lesions, including metastatic lesions. Vulvar CD is a rare manifestation of the disease, with only a few reported cases in the literature. Here we present the case of a 45-year-old woman with metastatic vulvar CD who presented with a one-year history of painful genital swelling. Diagnosis was confirmed through histopathology of the genital lesion. Diagnosis of vulvar CD can be challenging, as the clinical presentation is highly variable. Clinicians should consider the possibility of vulvar CD in patients presenting with aphthous ulcerations, vulvar edema, lymphedema, or lymphangiectasia. Medical treatment options for vulvar CD include corticosteroids, azathioprine, systemic sulfasalazine, cyclosporine, ciprofloxacin, and long-term metronidazole, while surgical interventions include partial or total vulvectomy, laser vaporization, or excision of the lesion. Diagnosis of CD is important, and various diagnostic tools should be used to search for digestive CD. The evolution of vulvar CD can be unpredictable, and surgical intervention may be required when medical treatment fails.
Folliculitis barbae caused by Staphylococcus lentus: a rarity with its dermoscopy features
Authors: Ankad Balachandra S. , Smitha Sankappanavar V. , Nikam Balkrishna P. , Janagond Anand B.
Published: April 2023

Dermoscopy of folliculitis is typified by white roundish globules around the hair follicles. Clinically, folliculitis mimics pseudo folliculitis which results from close shaving of beard hairs. Thus, management in both is entirely different. Dermoscopy of latter entity reveals buried hair at both ends. Here, authors described a case of folliculitis caused by Staphylococcus lentus.
Информационные технологии, противодействующие распространению преступлений, совершаемых в сети интернет с применением криптовалюты
Authors: Дворянкин О.А.
Published: April 2023

В статье представлена информация о развитии и становлении сети Интернет и нового финансового инструмента в ней – криптовалюта. Изучены особенности, положения и характеристики криптовалюты. На основании положений учебной дисциплины «Информационно аналитическое обеспечение правоохранительной деятельности» представлена методика выявления и пресечения преступлений, совершаемых в сети Интернет с применением криптовалюты.
Правовая сущность корпорации
Authors: Леонов Н.С. , Давудов Д.А.
Published: April 2023

В последнее десятилетие вызывает особый интерес феномен корпорации. Корпорация представляет особую правовую форму организации предпринимательской деятельности в виде АО, ввиду чего она имеет характерные для нее особенности. Особенно вызывает интерес правовая сущность корпорации, а также правовое регулирование данной формы.
Содержание корпоративных отношений
Authors: Мотовилина А.В. , Давудов Д.А.
Published: April 2023

В настоящее время корпоративное право занимает особое место в российской системе права. Корпоративные отношения в свою очередь представляют особую разновидность обязательственных гражданско-правовых отношений, которые возникают в связи с участием в корпоративных организациях по поводу имущественных прав, а именно долей, поев, акций и вознаграждений, участников корпорации. Необходимо признать, что корпоративные отношения несут в себе самостоятельное значение, относительно обязательственных и вещных.
Источники финансирования жилищно-строительных кооперативов
Authors: Пузикова П.С.
Published: April 2023

В данной исследовательской работе автор изучает вопрос финансирования жилищностроительных кооперативов. В ходе изучения темы, рассматриваются аспекты организации ЖСК, а также их деятельность и положение в законодательстве. внедрения в российский гражданский процесс суда присяжных. При изучении проблемы, автор приходит к мнению, что государству необходимо ввести дополнительные источники финансирования жилищностроительных кооперативов, т.к. это поспособствует улучшению качества их функционирования.