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Aim & Scope

Medicon Medical Sciences

Medicon Medical Sciences (MCMS) journal is a double-blinded peer reviewed scientific journal with 0.733 impact factor and high quality research information on Medicine, Preventive Medicine, Rural Health, Medical Research, Evidence Based Medicine, Epidemiology,  etc,. The main aim of this Journal is to publish up to date information regarding medical themes.

Major subject areas of Medical Science, but not restricted to following fields:

Cardiovascular medicine, Medication management, Surgical outcome, Surgical risk scoring, Cardiopulmonary exercise testing, Surgical optimization, Kinesiology, Military sports, Physical Exercise and Health, Sports Facilities, Arthritis, Injury Management, Neuromotor Psychology, Sports Pedagogy, Stress Management, Sports in public/private sector, Sports Law,  Tropical biomedicine, Toxocariasis, Neglected Tropical Diseases, Tropical pediatrics, Avian influenza, Influenza, African meningitis, Anthracia pestis, Enzootic hepatitis, Rheumatology, Osteoporosis, Physical therapy, Rehabilitation, Interventional procedures, Palliative care, Diabetes Mellitus, Molecular Diagnosis, Metabolomics, Bioengineering, Medicinal Biotechnology, Genetics/ Genomics, Somatic gene therapy, Molecular genetics, Epidemiology, Human Genomics, Medical genomics, DNA Replication, Gene knockout, Health plan and Administration, Real-time PCR, Toxicology, Cancer genetics, Adolescent Medicine, Otolaryngology, Occupational safety and health, Critical Care Medicine, Geriatric Medicine, Neuroscience, Palliative Medicine, Pathology and Physiology, Sports Medicine, Health Education, Dermatology, Diabetes, Obesity, Pediatric Sports Medicine, Exercise Medicine, Molecular biology, Biostatistics, Pharmacology and Pharmacogenomics, Pain and Anesthesia, Biomedical Sciences, Health informatics, History of Medicine, Neurological Sciences, Pediatrics, Forensic Sciences.         

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  • Medicon Medical Sciences is an international, profound Journal which publishes Articles on various disciplines of Medical Science.
  • Publication certificate will be provided to author.
  • Rapid publication process.
  • Reasonable publication Fee. 
  • Immediate Acknowledgement to author after article accepted for peer review.
  • High visibility of published work.
  • Best Knowledge sharing platform.
  • Thorough Double Blinded peer review.

Latest Article

Five Phases System in Chinese Medicine

Alex Kung-Hsiung Chang

Published: August 01, 2021.

In traditional Chinese medicine (TCM) philosophy, we believe that Human body are holist, it is a small universe. We also believe the corresponding relationship between five Yin organs, six Yang organ, five tissues, five sense organs with five directions, four seasons and five tastes in the nature. It unify the human body and nature environment together, reflecting the mutual acceptances of the human body and universe, which just reflects the concept of harmony between human and nature.

Role of Medicine and Meditation in Microvitopathy

S. K. Verma, Vartika Jain

Published: August 01, 2021.

Microvita are the smallest living entities, the concept which was first propounded by Shrii P. R. Sarkar in 1986. The science of Microvitology has categorized the microvita depending on their subtlety and field of activity. Positive microvita are conducive for human psycho-spiritual progress while negative microvita are detrimental for physico-psychic health. All the viral diseases are in fact negative microvita diseases affecting both physical (Microvitopathy) and psychic structures (Microvitopsychopathy) and the world has faced many epidemics of such diseases. According to Microvitotherapeutics, negative microvita could be destroyed only by increasing the number of positive microvita. For this purpose, sentient diet and environment, adopting moral cardinal principles along with regular practice of psycho-spiritual meditation are mandatory pre-requisites. In this context, the science of microvita should be thoroughly explored in physical and mental laboratories to combat with such negative microvita diseases.
Keywords: Microvita; Microvitotherapeutics; Virus; COVID-19

A Descriptive Study to Assess the Lifestyle Changes Adopted During Covid-19 Among Young Adults Residing in Selected Districts, Kerala

Rinu David, Jilu Jinu, Jismol Jitha, Jiya Lavanaya, Megha Merin, Merlin Minnu

Published: August 01, 2021.

Corona virus disease 2019 (COVID 19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. It is transmitted chiefly by contact within factious material (such as respiratory droplets) or with objects or surfaces contaminated by the causative virus and is characterized especially by fever, cough, shortness of breath and may progress to pneumonia and respiratory failure. The present study was a descriptive study to assess the lifestyle changes adopted during covid-19 among young adults residing in selected districts, kerala. The research approach was quantitative, and the research design adopted was descriptive survey design. 100 samples were selected by purposive sampling technique. An informed consent was obtained from the study subjects. The study was done using online structured questionnaires. Data was analyzed using descriptive and inferential statistics. The result revealed that majority of samples 62% have changes in dietary habits and 69% preferred indoor activities during this pandemic. Among samples 33% gained weight, 41% had mild anxiety during this period and 46% preferred cooking as most common leisure activity during this time. There is a greater elevation in social media usage. There was a significant association between lifestyle changes and selected demographic variables. The various changes that have become a part in our lives during this pandemic tragedy. The way forward must also be to learn the art of living with corona. And this cannot be without some changes to our lives.
Keywords: Covid-19; Lifestyle changes

Note on Pertinence of Graph Theory for Genetic Networks

V. Yegnanarayanan

Published: August 01, 2021.

Data collection process has witnessed explosive growth that could even outsmart the measurable gains in the field of power of computation as speculated by Moore’s Law. However, scientists spread over various domain are smearing victory through network models to denote their data. Graph- algorithms come in handy to investigate the topological structure and bring out the hidden relationships and attributes among variables. But the task of finding dense subgraphs, are still hard to negotiate from a computational viewpoint. So, it is stimulating to find new algorithmic methods in the probe of graphs derived from huge data sources that are complex. We provide a bird’s eye view of application of graph theoretic tools crisply for the probe of complex networks based on gene expression signatures and to find exact and effective solutions to hard combinatorial tasks such as epigenetic biomarker detection. To make an efficient design which is algorithm based, a probe of two core components of fixed parameter tractability namely branching and kernelization is suggested for parallel imposition of vertex cover. We have also discussed the concept of Para clique and domination concept to better handle gene expression networks.
Keywords: Genes; Genetic Networks; Data Types; Graphs; Clique Domination

Food hygiene practices to human existence cannot be over-emphasized. It bring about good health, growth and development of the people when it is properly maintained, while improper handling of hygiene practices could lead to illness and diseases, poor health, increased medical bills and reduced productivity. This study work on the state of hygiene practices and its important in promoting good health and development of human growth in Ekiti State. The aim is to foster proper hygiene practices among people in the State. The research will shows among others that the campaign for good hygiene alone does not assure quality and safety hygienic practice, that high premium must be placed on ascertaining compliance with proper hygiene Practice by people, food manufacturers and food agencies. Its suggested that citizens, food handlers and manufacturers should maintain high level of personal hygienic practices, and health practices in line with regulatory standards.
Keyword: Food Hygiene; Hospitality Industry

Neutrophilic urticarial dermatosis is a rarely discovered entity manifesting as a maculopapular, barely pruritic or non-pruritic, fleeting erythema with a specific histological appearance showing a perivascular infiltrate of unaltered neutrophils without associated vasculitis. This entity is associated with certain systemic diseases such as Still’s disease, Gougerot-Sjögren syndrome and Schnitzler syndrome. We report the case of a patient who presented with neutrophilic urticarial dermatosis (NUD) associated with systemic lupus erythematosus (SLE) with extracutaneous renal involvement.
Keywords: Neutrophilic urticarial dermatosis; lupus nephropathy

The Rage on Pedophilia

Adesanya Omowumi

Published: August 01, 2021.

Pedophilic disorder is characterized by recurring, intense sexually arousing fantasies, urges, or behavior involving children (usually 13 years old or younger). In some undeveloped countries, a lot of sensitizations hasn’t been done yet to defend pedophilia as a maladaptive condition and even give room for treatment of pedophiles.

Machine Learning based CAD for Breast Cancer Detection

Manoj Kumar

Published: August 01, 2021.

Breast cancer is the second most driven reason for the deaths among women, globally. Breast cancer is a category of cancer that develops in the breast tissue with the main observable symptom that is a lump which feels irregular from the remaining tissues. According to the reports, this cancer is affecting 2.2 million women every year . In this disease life threatening (malignant) cells in the breast multiply out of hands, making it the second most fatal type of cancer in women widely. Hence, to diminish the mortality rate and increase the chances of survival, it is crucial to uncover it as early as attainable. There have been numerous researches addressing breast cancer using machine learning and its subset techniques. Researchers claim that their algorithms are faster, simpler, and more precise than others are. This study is based on computer aided systems (CAD) and machine learning algorithms that aim to construct a framework to precisely distinguish between benign and malignant breast tumors in a screening mammogram .

Substance Abuse among the Medical Students

Bibek Raj Parajuli

Published: September 01, 2021.

The use of illegal drugs, excessive consumption of drugs with or without prescription, alcohol, and marijuana is known as substance abuse. There can be both physical or psychological dependence [2]. Substance abuse is one of the main problems among medical students. The reason behind substance abuse among medical students is the stress of the study, the curiosity of how it tastes, party and occasion celebrations. Medical students were getting those substances through their friends [9]. Risk factors for substance abuse disorder are family history of substance abuse, peer pressure, mental health disorder, use of abusive substances at an early age, and lack of support from the family. Different types of substance abuse disorders are Opioid Use Disorder., Marijuana Use Disorder. Alcohol Use Disorder. Sedative Use Disorder., Nicotine Use Disorder. Stimulant Use Disorder. Hallucinogen Use Disorder [2].

      In a study looking at potential impact to respiratory health of quarry workers exposed to airborne respirable crystalline silica (RCS) in Queensland, Australia, respirable dust exposure sampling was undertaken using the method specified in AS 2985-2009. Analysis of the collected samples for alpha quartz was carried out using infrared spectroscopy. Lung function tests for the exposed workers at each quarry were conducted using an Easyone® spirometer. The aim of this study was to determine whether increased RCS exposure is associated with a reduction in lung function. Personal RCS exposures were pooled into similar exposure groups (SEGs), minimum variance unbiased estimates (MVUE), were plotted against the forced expiratory volumes in one second (FEV1) % of predicted for corresponding SEGs. Non-linear correlations were observed including natural log and polynomial function. Estimated (full shift) exposures pooled for each Similar Exposure Group (SEG) correlated with lung function measured as FEV1 % of predicted (p<0.05) as confirmed by the Kolmogorov goodness of fit test. Furthermore a trend test using SAS 9.4 resulted in p = 0.0013. A major finding for those workers exposed to RCS at 0.1 mg/m3 was loss of lung function greater than 20%. The increased loss of lung function was positively correlated with jobs associated with increased RCS exposure. When similar exposure groups were combined into three RCS exposure ranges categorised as high (≥ 0.09 - ≤ 0.20 mg/m3), medium (≥ 0.04 - ≤ 0.08 mg/m3) and low (< 0.04 mg/m3), analysis of variance (ANOVA) confirmed that the loss of lung function below the lower limit of normal (LLN) at 0.1mg/m3 TWA-8hrs, is significant (p < 0.05). 

      A major finding from this study predicts that an abnormal loss of lung function may occur even when workers are exposed to RCS where the occupational exposure limit (TWA) is 0.1 mg/m3 or greater which is the case in many jurisdictions.
Keywords: Respirable Crystalline Silica; lung function; quarries

Assessment of Knowledge regarding Human Breast Milk Bank among the Nursing Officers in JIPMER Puducherry

Safeena Beevi S S, Adline Shanu, Akila, Ananda Geethan, Anjaly Suryan, Asuthosh Kumar, Aswathy, Bavithra, Bharathi, Bharath Kumar

Published: September 01, 2021.

     World Health Organization and United Nations Children’s Fund in 1980 has stated that if the baby does not get his/her own mother’s milk, the best food for that baby is Human breast milk from another lactating mother. Donor milk has a broad range of therapeutic uses. Common reasons for prescribing donor milk are prematurity, allergies, feeding formula intolerance, immunologic deficiencies, etc. Breastfeeding is not recommended for mothers who have specific health problems. In the absence of the infant’s mother’s milk, donor milk offers the benefits of human milk for the infant, including optimal nutrition, easy digestibility, and immunological protection against many organisms. Human milk also contains growth factors that can protect immature tissue, promote maturation, particularly in the gastrointestinal tract, and promote the healing of tissue damaged by infection.

     A human breast milk bank is a service that collects, screens, processes, and dispenses by prescription. Human milk is donated by nursing mothers who are biologically not related to the recipient infant. The optimum nutrition for newborn is breastfeeding, if possible for the first year.

     Human milk is recognized for its numerous benefits, including tolerance to allergens, providing passive immunization, improving lipid profile, and controlling blood pressure. In studies conducted in the neonatal unit, infants fed human breast milk had fewer severe infections, less necrotizing enterocolitis, and less colonization by pathogenic organisms. The majority of mothers are encouraged to breastfeed their babies. However, breastfeeding arises when the baby is sick or admitted to the hospital, particularly in premature infants. Also, the mothers may be unable to provide an entire volume of milk due to numerous physical and emotional behaviors to breastfeeding. So, the pasteurized donor milk from a healthy mother should be the first consideration for supplementation. In such cases, the role of breast milk banks becomes crucial as these are the place where the donor milk is stored and is made available for use in vulnerable populations. India is a developing country where neonatal mortality is  very alarming. Breast milk banks are essential for the control of cases of neonatal mortality and malnutrition.

Methodology-This cross-sectional study aimed to assess the level of knowledge of nursing officers regarding the human breast milk banks and to identify service-related factors associated with the level of knowledge on human breast milk banks among nursing officers. One hundred seventy-six participants were selected for the studies who fulfil the inclusion criteria of the study. A structured questionnaire was used to assess the knowledge level among the nursing officers. Both inferential statistics and descriptive statistics were used in this study.

Results-A total of 176 nursing officers were analyzed. Findings revealed that most nursing officers had inadequate knowledge (93.18%) regarding the human breast milk bank.

Conclusion-Most of the nursing officers are having inadequate knowledge regarding the breast milk bank. The study also reveals the clinical experience; the area of posting has a significant correlation in the knowledge level of the participants so that the institute can plan for in-service education programs to update the staff’s knowledge.

Keywords: Human breast milk bank; Preterm neonates; Nursing officers; Nutrition

A Descriptive Explorative study on Sleep Disturbances during Pregnancy among Pregnant Women, in a Selected Hospital at Puducherry

Jayasankari S, Leena L Raju, Kiruba Prasanna, Jayapriya

Published: September 01, 2021.

Background: Pregnancy involves many maternal physiological and psychological changes both of which has implications on sleep. During the first trimester, sleep is disturbed by the hormonal changes and in the last trimester the grown up fetus and the anxiety regarding delivery disturbs the sleep. Objectives: This study was done to evaluate the Sleep Disturbances during Pregnancy among Pregnant Women, in a tertiary Hospital at Puducherry. Methods: 238 pregnant women were interviewed using modified Pittsburgh Sleep Quality Index (PSQI) to evaluate the Disturbances in sleep during Pregnancy. Results: The findings of the study showed that that almost all the subjects (87.3%) had poor sleep in their pregnancy. Only 12.7% had good sleep quality. The mean Pittsburgh Sleep Quality Index Score was 7.60 (SD - 1.83), which shows poor sleep during pregnancy. No significant relationship was identified between sleep quality with selected socio demographic and clinical variables. Conclusion: Sufficient good sleep during pregnancy is important to improve the pregnancy outcomes. It can be conluded that there is a great need to sensitize antenatal women on this issues appropriately.

Key words: sleep quality; pregnant women

     We performed in 1975, the first heterotransplantation of invertebrate A.O in nude mouse, then a double heterotransplantation of human tumor and axial organ next to this last one, always in nude mouse: The human tumor was rejected in 50% of observed cases. Some years later, we found that A.O cells exerted an induced and spontaneous cytotoxicity against SP2 and MBL2 mouse tumoral cells. Recently, we discovered a sea star Igkappa gene with immune properties. This gene was inserted in a CMV (cytomegalovirus) and finally in a plasmid called « young » plasmid.

     The induced « young » protein exerted a spontaneous cytotoxicity against osteosarcom cells (U2oS cells) against A-375 melanome cells and Hela cells.

A Study to Assess the Impact of Online Learning Among School Children in Kerala

Sreeraj R N, Soorya Joy, Lijisha P V, Senthilkumar T

Published: September 01, 2021.

Due to the ongoing pandemic of Covid-19 almost all the sectors in the world left the traditional ways behind and the educational sector was no exception. Nowadays the school children are able to pursue their education remotely inside their most familiar physical setup, their home, with the help of information technology. This study aimed to find out the impact of this ‘online learning’ among school children. Methods: A quantitative approach which adopted a descriptive survey design was used for this study among 30 school going children from selected schools in Kerala. These 06-18 years aged children were selected using convenient sampling technique and data collection was done through a structure checklist. The collected data was analyzed using descriptive and inferential statistics using Minitab Version 16. Results: The impact of online learning was graded in to positive and negative for analysis and interpretation of the data. The findings showed that majority of the school children (63.33%) were positive impacted from online learning and there was no association found between online learning and demographic variables at 5% confidence level (p<0.05). Discussion: Even though the online learning had a positive impact on school children, to get most out of the online learning, the teachers must have to adjust the materials and methods used for remote teaching to make them more interesting for the learners.

Solving Global Problems using Neural Network

Nabeel Khan

Published: September 01, 2021.

Human Brain is made up of interconnected cells called neurons. The connection between these neurons is called neural network.Thoughts are created by interconnected brain cells called neural network. It is the result of hidden data and input data. If suffering, then it is because there is something wrong in your hidden data. Take good input data that will override the hidden data to create good thoughts. Artificial neural network is the pattern to work like the human neural network.

Neurological and neurodegenerative diseases have become a major social and economic burden worldwide with more individuals predicted to be affected in coming decade. Therefore, understanding the neuropathological mechanism and identifying the promising target for intervention has become an active area of research in neurodegeneration. The chronic neuroinflammation has considered to be fundamental mechanism causing progressive loss of dopaminergic neurons as observed in clinical course of various neurodegenerative diseases. Microglial proliferation and activation are the hallmarks of several neurological disorders.

A study to assess the knowledge, opinion of faculty and post graduate students of nursing regarding translational Research in nursing in Tirupathi was conducted on 50 nursing faculty and 50 nursing post graduate students in Tirupathi, with the objectives to find out 1. Knowledge regarding translational Research 2. Opinion regarding translational research. Method and Material It was an incidental study conducted by the investigator when nearly 500 nursing personnel came to participate in the national workshop organised by Sri Padmavathi Mahila Visva vidyalayam in Tirupathi. The study comprised of survey questionnaire of multiple choice type to elicit the information and an opinion check list. The sample of study is selected randomly from 2 groups comprised of faculty and post graduate students. The data was collected before starting of the Workshop when participants assembled for registration. Results showed that the knowledge score’s levels of nursing faculty was almost the same as that of post graduate nursing students. However, both groups showed slightly different responses on opinionnaire regarding translational research. Conclusion Translational research in nursing is not a myth and distance dream but can be a realty.

Keywords: Nursing; Evidence Based Practice; Nursing Education; Nursing Research; Translational Research; Knowledge and Opinion

BrainGate - A Computer Innovation for Patients with Paralysis

Senthilkumar T, Varuna Padmajan

Published: October 01, 2021.

Brain gate is an electrode chip that’s implemented in the cortex of the brain. It is a system developed by cyberkinetics, a biotech company in the year 2003 in connection with neuroscience department at Brown University. It helps to exchange the electrical signals between brain and the electrical gadgets. The principle behind this brain implant system is with normal brain functions, brain signals are been generated, but they can’t be sent to arms, hands or legs, these signals are understood and translated to cursor movements, which helps the individual to regulate the computer by his or her thoughts. Special software carries all the signaling processes.

Keywords: Brain gate; Electoral signals; Cursor movements

Evaluation of Smile Components in Males of Skeletal Class III compared to Skeletal Class I

Abdallah S Nouh, HM Abdel Majeed, Essam Mohamed Nassef Selim

Published: October 01, 2021.

Objective: Smile plays a vital role in facial appearance. The current study was performed to evaluate the smile parameter variations between Class I and Class III male subjects aiming to obtain a full understanding to smile features serving in diagnosis and treatment planning for highest patient satisfaction.
Materials and Methods: This study was performed on 30 skeletal Class III and Class I males. Two frontal digital photographs were taken for each subject, one at rest and the other in the posed smile position. Photographs were uploaded on Photoshop software for standardization and then uploaded on the Digital Smile Design software (DSD) where the actual incisogingival height of the central incisor was used for automatic calibration.
Results: At rest, there was no significant difference for all soft tissue measurements of Class I and Class III males, while on smiling, Class III males tended to have wider smile widths, less incisor display, wider smile width and a higher percentage of non-consonant and flat smile arcs than normal Class I subjects.
Conclusions: The maxillary incisor display for Class I was found to be significantly greater than that for Class III. The smile width and smile height for Class III was found to be significantly greater than that of Class I.

Keywords: Class III males; Esthetics; Malocclusion; Smile

Orthopedic Device and Data Visualization: A Way to Optimize the Therapeutic Process

Gabriele Pontillo, Roberta Angari

Published: October 01, 2021.

Medical design may intervene to improve, prolong and save lives. Many health critical problems can be addressed thanks to the power of design, which solutions, developed in academic and business settings, can answer in an innovative way to the needs of patients. It is in this context that is located the ongoing research presented, which is based on the integration between parametric design and data visualization, whose convergence leads to the realisation of medical devices customized on specific morphologies and needs of users and, as well, - thanks to the integration of IoT - capable to record and return data related to the course of the therapeutic advancements, made readable for both patients and doctors. As highlighted by the most recent scientific literature, the development of technological medical devices, able to reduce steps and simplify the doctor/patient relationship, is becoming an important field of research, most of all if we consider the condition of endemic fragility that characterises the contemporary society. In this perspective, the aim of the paper is to introduce the concept and design of orthopedic devices, through the description of the methodology and approaches applied and of the protocol outlined during the research.

Keywords: Medical Design; Parametric Design; Information Design; E-health; Personalized medicine

Using Kitchen Resources and Home Remedies to Cure common Cold

Saba Khan, Sarah Malik

Published: October 01, 2021.

For boosting the immune system, to promote optimum health & to reduce the complications or risks of the disease, kitchens ingredients play a significant role. The objective of this study was to find out the popular home remedies for common cold and to modify them for better results. Survey and interview method helped in collecting the field information from the sample of hundred respondents. The most popular remedies were identified and modified by addition of any three more ingredients from the kitchen shelf. The modified recipes were subjected on the sample of twenty-five adults suffering with common cold. Their experiences showed reduced recovery time and better response in improving their general health condition.

Keywords: Common cold; Home remedies; Kitchen ingredients

Anesthesia and Patient Safety

Serdar Epozdemir

Published: October 01, 2021.

Anesthesiologist plays a role in the recovery of the patient without any risk with the ideal anesthesia management, under the responsibility that the science of anesthesiology is not a preventive, protective, therapeutic method alone.

The practice of anesthesia requires a high level of medical expertise as well as significant practical skill, and most importantly, anesthesia is a team effort. In many cases, the responsibility of not only the expert but also the departments and regulatory authorities that set up the system should be considered. Therefore, the appropriate method for patient safety should often be the systems approach. However, this does not remove the responsibility that each doctor should strive for quality, safe approach and excellence in his work for his patient [1].

The objective of this project was to build a system software that could assist any first responder irrespective of their background in first-aid. It employed a combination of Internet of Things (IoT) technologies to dial for emergency medical assistance and make a diagnosis of the treatment needed. An Image Recognition (IR) service was trained using IBM Watson to assess the casualty’s primary condition. Training phrases were fed into Dialogflow to construct a voice and text-based conversational interface for Google Assistant’s Artificial Intelligence (AI) to give a secondary diagnosis. Vuforia’s Augmented Reality (AR) engine in Unity was then enlisted via Target Detection to display a virtual assistant applying first-aid on the casualty. The components were amalgamated using the AI’s autonomous control over the IR and AR applications to create the end-to-end system software. Lastly, XCode, an app-building engine, developed the components into prototype mobile applications. Future prototyping could assist first responders during an actual emergency and complement the Singapore Civil Defence Force’s efforts of promoting high
standards of first-aid.

Keywords: Internet of Things; Augmented Reality; Artificial Intelligence; Deep machine learning; First-aid

In the last decade great strides have been made towards the discovery of molecules whose aberrant functioning has been held responsible for the genesis and progression of Non-Small Cell Lung Cancer (NSCLC). Broadly speaking there are two types of lung cancers: NSCLC, and Small Cell Lung Cancer (SCLC). The majority of lung cancers are of the type NSCLC. In this paper the therapeutic molecular targeting of aberrantly functioning molecule has been dealt with in the context of NSCLC, but, however, the conclusions derived in this paper hold for any molecular targeted therapy for any cancer. Different molecules are functioning aberrantly in different NSCLC patients, some of them being Mesenchymal–epithelial transition factor (MET), Kirsten Rat Sarcoma (KRAS), Epidermal Growth Factor Receptor (EGFR), etc. The paper analyzes the limited success of molecular targeted therapies in NSCLC in the context of MET inhibitors, and generalizes the results of analysis for any molecular targeted therapy against any cancer. The paper ends with the suggestion that the targeted molecular therapy in NSCLC be combined with the depressants of the Pentose Phosphate Pathway to improve patient response to the therapy.

Keywords: Clinical trial; Clinical success; Inhibitors; Proliferation; Apoptosis

Let’s Talk Gluten

Esniya Antonieta Andrade

Published: October 31, 2021.

When we hear the word gluten we usually associate it with the fad diet either as a gluten-free diet (GFD) or a healthy diet.

What is Gluten?
It is a storage protein found in grass-related grains like barley, rye, oats, wheat (BROW). It nourishes the seeds during flowering and germination.

Gluten itself is a complex mixture of proteins. In wheat, rye, barley, oats this storage protein exists as gliadin, secalin, hordein and avenins respectively. All these proteins are collectively referred to as gluten. Gliadin has many peptide sequences which are resistant to our gastrointestinal enzymes.

Colchicine Poisoning: Case Report and Literature Review

Almas Ashraf, Ahmarin Zahid, Zaheer-ud-Din Babar and Amaad Fahim

Published: October 31, 2021.

Colchicine is an active alkaloid that is commonly used for treatment of multiple diseases including gout, primary biliary cirrhosis and familial Mediterranean fever. Less commonly, it has been implicated in cases of fatal overdose owning to its narrow therapeutic index. Clinical presentation of colchicine poisoning follows a well described but swift course with gastrointestinal symptoms being the earliest manifestation. Death usually occurs either directly due to multiorgan failure or indirectly due to secondary sepsis. We report an extreme case of colchicine ingestion by a 22 years old female who intentionally ingested 45 to 50mg of colchicine. Six hours later she presented in local hospital where gastric lavage was performed. Four days later, on continual deterioration of her condition, she presented with poor prognosis in the tertiary care emergency. She exhibited symptoms of coagulopathy, respiratory distress, multiple organ failure and eventually suffered fatal cardiopulmonary collapse approximately 14 hours after admission. Use of Colchicine specific Fab fragments have been shown to reverse symptoms of Colchicine poisoning in experimental settings however they are not available for general use. Currently treatment options are limited to specific supportive measures.

Keywords: Colchicines; Poisoning; Multiple organ failure; Cardiopulmonary resuscitation; Respiratory distress syndrome

Prevalence of Anemia among AdolescentGirls.

Chinmay Muralidharan, Leena Muralidharan and Sangeeta Gaur

Published: October 31, 2021.

Anemia is widely spread nutritional problem in world. Low BMI value (Underweight condition) and anemia are associated and together it’s a big problem in developing countries like India. Anemia among adolescent girls is problem not limited to any region, and caste but a problem faced across the world. By the help of present study we tried to investigate and understand about the prevalence of Anemia among adolescent students especially in females.

Keywords: Anemia; BMI; Adolescent; Females; Underweight

Neuroprotective potential of Sargassum wightii against scopolamine - induced dementia like symptoms in Wistar albino rats

Sradhasini Rout, Bandana Rath, Subrat Kumar Bhattamisra, Anjan Kumar and Ishani Rath

Published: October 31, 2021.

This research work was undertaken to explore the neuroprotective potential of Sargassum wightii against scopolamine-induced dementia in rats. Progressive loss of memory is a most prominent symptom in neurodegenerative diseases. Five groups of animal were used for this experiment and scopolamine (16 mg/kg body weight/ i.p.) was administered to induced dementia like symptoms. Behavioral study was performed by Morris Water Maze test (MWM) to assess learning and memory, biochemical parameter such as acetylcholinesterase enzyme (AChE) activity was measured to analyze cholinergic activity in brain, the oxidative biomarker enzyme status was estimated by analysis of malondialdehyde (MDA), GSH and histopathological assessed were then performed. Scopolamine 16 mg/kg body weight significantly impaired acquisition and memory in Morris water maze test. Pretreatment with Sargassum wightii (methanolic extract) both the doses 200mg/kg and 400mg/kg showed significant improvement in MWM performance and learning memory deficit. Scopolamine also enhanced brain acetylcholinesterase activity, MDA level and decreased in GSH level. Sargassum wightii extract reversed the change in AChE activity, brain oxidative stress and histopathological changes in a significant level. The conclusion of this study suggested that the neuroprotective activity of Sargassum wightii against scopolamine-induced dementia like symptom probably through enhancement of cholinergic activity and reduced oxidative stress action.

Keywords: Neurodegenerative; Scopolamine; Sargassum wightii; Morris water maze; Acetylcholinesterase

Sustainable manufacturing is the demand of time. Due to limited availability of natural resources, there is constant demand to reduce consumption [1]. Manufacturers are seeing the carbon footprint associated with the process. Mass manufacturing has given rise to newer techniques of manufacturing which are highly advanced techniques and the energy consumption of such processes is very high. For example CNC (Computer and Numerically controlled) machining centers consumes a lot of energy [2] and are associated with enhanced carbon footprints.

This proposed commercial model is based on deep Long Short-Term Memory Network (LSTM), used because of its ability to learn long term dependencies, in taking the concatenated function and market data as input, while integrating Smart Data encapsulations, retrieving information by combining various search results (all the Web). It provides some good ideas for that we have extended to improve Corporate Marketing and Business Strategies. We show that the proposed model learns to both localize and recognize their different aspects. We evaluate it on the challenging task of detecting Fraud in Financial Services and Financial Time Series Forecasting and show that it is both more accurate than the state-of-the-art of other neural networks and uses fewer parameters and less computation.

Keywords: Awareness; Business; Education; LSTM; Smart Data

Review on Pharmacological and Therapeutic Potential of Cuscuta species

Narmatha G, Sandhiya S, Kokila J, Poovizhi T and Savitha T

Published: November 19, 2021

The plant genus Cuscuta, belongs to the family Cuscutaceae, has been traditionally used as therapeutic treasure against various metabolic and neurological diseases such as mental abstraction, headache, spleen disease, jaundice, diabetes mellitus and hypertension. There are numerous secondary metabolites have been identified that are considered as phytochemical constituents, such as alkaloids, flavonoids, lignins, steroids, phenolic acids, fatty acids, glycosides and polysaccharides. Due to the presence of these bioactive ingredients, various ethnopharmacological actions including anticancer, antiviral, antisapasmodic, antihypertensive, antibacterial, antioxidant, diuretic, antihypertensive were explored. This review brings eyesight for the explorations of novel therapeutic agents for the various ailments of mankind. 
Keywords: Therapeutic treasure; Phytoconstituents; Pharmacological activity

Evaluation of Impact of SARS COVID-19 Virus on Sexual Assault Cases in India

Yogesh Yadav, Gosia Khan and Garima Chaudhary

Published: November 26, 2021

Children are the gift given by God to humanity. Sexual abuse of Children is one of the most heinous crimes. CSA (child sexual abuse) and SA (Sexual Assault) is the most reported crime against children across worldwide. It affects not only physically but also mentally it may lead to death. Both girls and boys in India face severely assault like early marriage, domestic violence, bullying, child labor, and many more children can be sexually assaulted in any place like home, streets, schools, workplaces, prisons, orphans. It affects the overall development of the children. According to NCRB 109 children face any form of CSA every day in India. Keeping in view the alarming situation of sexual crime against children. Indian government passed a law against the crime against women in 2018 and the crime against children in 2012. In 2012, the amendment of the POCSO (Protection of children from sexual offenses) act in sections 4, 5, 6, 9, 14, 15 and 42 is made to save the children from sexual assaults. 

     The objective of our study is to describe the overall crime rate of DELHI NCR on child abuse and sexual assaults in the year 2019, March 2019 to June 2021, under IPC 376, 377, 354, POCSO Act 2012, etc. Forensic Laboratory receives 5-10 cases of child sexual abuse every month. In most cases, the criminal is known and/or unknown to the victim. In this study, we also try to create awareness towards the Sexual Assault and the POCSO Act.

The Water Protects a Virus with the Weak Energy Involving the Elementary Particles

Sunao Sugihara and Yuji Nagasaka

Published: November 30, 2021

There have been published many researches about water in the various fields such as agriculture, chemistry, biology, medicine and physics. The targets of water research are these in daily life, ocean and in the air besides in the substances. Moreover, there are the theoretical study of water (H2O) itself. Ab initio calculation and the density-functional theory have been reported on the hydrogen bond of water molecules and interaction between monomers, which research issue is associates with the water molecule itself. Here we present the theoretical concept to protect any virus involving in COVID-19, and the mechanism based on the reaction of amino acids with water involving a proton and electron which are essential to our body. It has been performed with the dissociation of hydrogen bond due to pressurization (more than 200 MPa) applied to ordinary water. Besides the smallness, the proton and electron may play a role to pass an electric current to protect a virus and a germ through the water in the body. The information of the water is supposed to be “momentum” (spin, mass and velocity) may protect any virus and germ due to chemical reduction by proton and electron in the water.

Keywords: Weak energy water; Proton & electron; Hydrogen bond; COVID-19, Amino acid

A New Generation of Translational Tools designed to Monitor Multiple Sclerosis (MS) at Clinical and Subclinical Stages

Mariya Studneva, Noel Rose, Aleks Gabibov, Veronika Medvedeva, R. Holland Cheng and Sergey Suchkov

Published: November 30, 2021

According to tremendous translational researchers, biomarkers as a part of the ligand-receptor tandems have induced an impulse to prompt the evolution of an upgraded concept of the targeted therapy. It is health indicators that justifying the necessity to create targeted drug of the next-step generation to be implemented at the clinical and sub-clinical key stages of the disease process and to get involved into a multi-stage process to get the shifts appeared modified.

There is an evident-based outcome of the latest studies in multiple sclerosis (MS) related fields that illustrates the proved targeted activity of Ab-proteases. High impact of Ab-proteases can be used to monitor both clinical and subclinical courses of chronic autoimmune inflammation (MS) to predict stepwise transformations of the course and to prognosticate the clinical illness  finally. In this sense, Ab-proteases can be programmed and reprogrammed to suit the requests and standards of regenerative medicine and re-myelination, in particular. This data makes it possible to design the algorithms for combinatorial (preventive, prophylactic, therapeutic and rehabilitative) treatment, whilst developing unique tools for individually therapy, especially, for autoimmune diseases which holds a particular position.

It was 1938 and China was in dire need of healthcare workers during the Sino Japanese war when Japan attacked China and China turned to India for help.

Dr. Dwarkanath Shantaram Kotnis was an Indian Doctor who volunteered to go to China as a part of a medical assistance team sent by India. He was born in Solapur District in the state of Maharashtra on 10th October 1910 and went to medical school at Seth GS Medical College in Mumbai and was preparing for Post-Graduation.

Homeopathy - Myths and Facts about Gastric Issues

Dr. Yatri Thacker

Published: November 30, 2021

Mrs. XYZ36-year-old lady recently consulted me for severe acid reflux, migraine headache and indigestion since past 9 months. She tried various conventional treatment without relief. Finally decided to try homeopathy and our holistic treatment.

Bullying, a Major Contributor to Cultism

Adesanya Omowumi

Published: November 30, 2021

Bullying”, a neglected psychological factor that has encouraged cultism in the society. Looking at the society in all its different units, every unit of the society has a major role influencing the growth of a particular pattern either negative or positive and this has influenced the society so much that it is no longer a thing of supernatural forces but a thing of manmade inventions. Man influences his society either positively or negatively consciously or unconsciously. How about the introduction of ignorance, till the root of the problem is tackled, man will keep adding to his problem even as he is providing solutions to his problem. The smallest unit of the society is Family and this has shaped a lot of individuals into what they are today. The mind of the man is a Tabula Rusa as the psychologists describes it. It is plain and filled with experiences and information acquired daily. When a child is born, the first place of imprinting new information is the family he finds himself. From the language, smell, taste of food, music heard and other behaviors exhibited by his family members. The school is only a place where behaviors and morals are shaped generally unlike the family where only your
family pattern or style is tolerated.

COVID-19 Pandemic: Upswing in Antibiotic Misuse

Novy Gupte and Sapna Pradhan

Published: November 30, 2021

The ongoing COVID-19, caused by the new coronavirus, SARS-CoV-2, after originating from the Wuhan City of China, was declared a “pandemic” on 11 March 2020 by the World Health Organization (WHO). Availability of a number of vaccines against COVID-19 may prove a game-changer. However, in the absence of an acceptable specific antiviral agent, therapeutic approaches in an overwhelming majority of the cases are a cocktail of symptomatic/supportive measures, immunity boosters, immunomodulators, immunotherapy, steroids and antimicrobials. In life-threatening situations in hospitalized patients, critical care measures are adopted. In deference to the recommendations of the WHO, antibiotics such as azithromycin and doxycycline continue to be consumed irrationally in a large proportion of the patients even in absence of a bacterial coinfection, especially in the resource-limited countries. The widespread misuse of antibiotics is likely to have worsened the already existing problem of antimicrobial resistance (AMR). The endeavors aimed at controlling the COVID-19 pandemic (that has been causing huge morbidity and mortality worldwide and adversely impacting economy), need to be complemented with spirited and restrengthened campaign against irrational antibiotic use that is augmenting the AMR. Also, there is a need for promoting antibiotic prudency through alternative and complementary therapies. Most importantly, developing the new antibiotics from new classes should be a top priority.

Keywords: Antibiotic prudency; Antimicrobial resistance; Multidrug resistance; New antibiotics; Superbugs

Identify Emotion using Neuromarketing to define Consumer Behavior

Alma Casas Frausto and Bogart Yail Marquez

Published: November 30, 2021

At present the interest inidentify and satisfy consumer needs for this companies use various techniques such as the study of market, conducting surveys, product testing by mention a few, nowadays to get a better result precise techniques and tools have evolved a lot. Neuromarketing is one of those advances, which helps us to determine with greater accuracy and depth the preferences of the consumer. Focus on knowing conscious behavior, while the consumer buying behavior is fundamentally  unconscious. Today with the help of new technologies more interest has developed in applying the methods of neurology in various areas other than medicine, that are related to human behavior, being the Neuromarketing one of the ways to investigate and know consumer behavior and decision-making purchase, thus supporting us to better understand the psychological behavior and dictate more precise actions to marketing based on the knowledge of the reactions cerebral.

Keyword: Neuromarketing; Emotion; Neuroscience; Neuron; Neural network

Health Science

Athraa Abdulameer Azeez

Published: December 28, 2021

Health Science is one of the multidisciplinary sciences that aims to publicize information, grant experience in education, practice and research between health status and quality of live for all society’s categories including individuals, families and communities. Nowadays, Health Science considered as an emerging field. The aspects of health science contribution in the scientific research include factors that nations, developing and developed, can be evaluated via the advancement of its health science.

There are many kinds of research about water in various fields such as agriculture, chemistry, biology, medicine, and physics. The targets of water research are these in daily life, the ocean, in the air and the substances. Moreover, there is the theoretical study of water (H2O) itself. They have reported Ab initio calculation, and the density-functional theory have on the hydrogen bond of water molecules and interaction between monomers, which research issue is associated with the water molecule itself. Here we present the theoretical concept to protect us from any virus involved in COVID-19.The mechanism based on amino acid reaction with water involved a proton and electron are essential to our body. Due to pressurization (more than 100 MPa) applied to ordinary water, hydrogen bond dissociation can work for various functions. Besides smallness, proton and electron may play a role passing an electric current to protect viruses and germs through the water in a body. The information of the water is supposed to be “momentum” (spin, mass, and velocity) may protect us from any virus and germ due to chemical reduction by proton and electron in the water.

Keywords: Weak energy water; Proton & electron; Hydrogen bond; Amino acid; Electrical current

Role of Reactive Oxidative Species in Periodontitis: A Review Article

Nanda Rachmad Putra Gofur, Aisyah Rachmadani Putri Gofur, Soesilaningtyas, Rizki Nur Rachman Putra Gofur, Mega Kahdina and Hernalia Martadila Putri

Published: December 28, 2021

Introduction: Common periodontitis that attacks the human population is periodontitis induced by plaque. Periodontitis begins with the ordering of plaque that adheres to the tooth surface. Dental plaque is a thin layer of multi-species biofilm containing colonization of bacteria, bacterial products, and food debrish. The dental plaque that causes periodontitis is usually located in the subgingival area, then extends apical to the tooth, causing inflammation of the periodontal tissue. The causes of periodontitis in general are bacterial species found in dental plaque, and about 10 species have been identified as pathogens in periodontal disease, especially gram-negative stem bacteria, including Porphyromonas gingivalis, Prevotella intermedia, Actinomyces viscosus, Bacteroides forsythus, Campylobacter rectus, Treponema denticola, and Fusobacterium nucleatum.Apart from plaque factors, periodontitis can also be caused by systemic factors, genetic disorders as well as environmental and risk factors. Studies show that people with diabetes mellitus and smokers suffer from periodontitis a lot. Whereas in patients with periodontitis due to genetic disorders caused by damage to the periodontal tissue by macrophages that respond to IL-1 excessively. ROS, also plays role in pathophysiology in periodontitis.
Discussion: Chronic periodontitis is a chronic infectious disease with a complex etiology. The main etiology is bacteria and is exacerbated by various other factors. In this case, excessive production of ROS and changes in state can lead to abnormal activation of apoptosis, approaches important factors involved in the production of periodontitis extensions and various clinical features of periodontitis. Several studies have demonstrated a role for ROS in the deregulation of apoptosis. Between ROS and the body can produce neo-epitopes which then stimulate a broad spectrum associated with tissue damage and breakdown of the periodontium. Studies in periodontitis patients and involves oxidative stress in disease pathogenesis. Polymorphism genes coding for superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and the gene encoding NADPH oxidase NCF2 have been identified in many ways with a risk of periodontitis. All biomolecules (lipids, proteins and DNA) can be damaged by the overproduction of ROS. 
Conclusion: During infection, immune system produce reactive oxygen species (ROS) which are released into the extracellular environment. The ROS does not have a specific target that could damage tissue especially in periodontitis.

Keywords: ROS; Pathophysiology; Periodontitis

Medicare for All Takes Center Stage

Preston L Williams, Bryce R Williams and Joanna P Williams

Published: December 30, 2021

Rising interest in a single-payer healthcare system known as Medicare for All (MFA) has reached the support of nearly 55% of physicians and two-thirds of Americans polled [1]. This comes at a time when nearly 29 million Americans remain uninsured in the setting of a 4.6% increase in healthcare spending in 2019 totaling $3.8 trillion in expenditures, despite the implementation of the multitude of insurance options within the Affordable Care Act (ACA) of 2010 [2]. Presently, there are two bills in the legislature being considered to address this matter with the Medicare for All Act of 2019. Lobbyists are considering a government- funded healthcare system that would serve to reduce burdensome administrative and health-related costs and simplify an already multiplex insurance-laden system. 
Keywords: Medicare programs; Fee-for-service; Private insurance; Selection bias; Drug costs; Medicare reimburse

This thesis mainly studies the social environment of pharmaceutical industry development in China and the United States in the early days of the founding of the People’s Republic of China. By analyzing various factors of social development, this paper points out that historical factors greatly affect the development mode of national industry on the basis of combining industrial characteristics.
Keywords: Pharmaceutical industry; Historical factors; Industry characteristics

Study of Development of Pneumonias in Patients undergone Neurosurgical procedures in Health Care Institutions

P K Upadhyay, G Tiwary, KartikeyaU, Kritika U

Published: December 30, 2021

Ventilators induced pneumonias are usually associated with some predisposing risk factors. Predisposing factor which were taken into account during this study were prior antacids, prior aspiration, alcoholism, smoking, prior hospital stay and underlying diseases which includes chronic lung disease, diabetes mellitus, neoplasia and heart insufficiency, antibiotic therapy. 50 such case undergone neurosurgeries were studied and detailed analysis is presented.
Keywords: Pneumonia; Ventilator; Consolidation; Hospital acquired infection; Hospital associated infection; Kerby-Bauer method

Neurophysiological monitoring (IONPM)

P K Upadhyay

Published: January 12, 2022

Application of Neuro-physiological monitoring (IONPM)
Application of neurophysiological monitoring during surgery (IOM) in intra operative Neurospinal surgery, cases reduces the chances of neuro-spinal surgery complications at all neurological level. Many techniques are available and motor and SSEP (evoked potentials somatosensory) are thought to be essential for better results of IONPM. Spinal cord - evoked potentials (SEP) are observed and recorded over cord where stimulation by electrical means is given on directly over the spinal cord (posterior column) by an epidural stimulation by electrodes. SSEP (somatosensory evoked potentials) provide the functional and anatomical continuity of sensory tracts .starting from peripheral most nerve and posterior column to the sensory cortex.

Anosmia of Covid 19 - A Transient Symptom?

Amrapali Keny Pawar, Palak Bhatti and Prashant Kewle

Published: January 13, 2022

Aims and objectives: Covid 19 pandemic brought a host of symptoms in the last 2 years. Amongst these anosmia or loss of smell and taste were some of the striking though less common symptoms. Significant rise in Anosmia with or without onset of upper respiratory tract infection prompted a study in which patients with loss of smell were screened over a period of one year to study the nature of this symptom.
Materials and Methiods: A questionnaire had to be filled by patients visiting in our clinics or through online consultations. 53 patients were selected.
Observations: Our observations showed that in 86.8% of patients, anosmia was the only symptom and 73.6% required no specific treatment. In 89.3% anosmia resolved within 3 months.
Conclusion: Hence it is concluded that anosmia can be used as a marker for COVID 19 testing. It appears to be a transient symptom which resolves spontaneously.

Keywords: Anosmia; loss of smell; COVID 19; SARS-CoV-2; Olfactory dysfunction

Breast Cancer Distribution Pattern in a Pathology Center in South East Nigeria

Samuel I Ogenyi, Nancy C Ibeh, June A Onu, Jonathan U Madukwe, Onyekachi A Onu and Felix E Menkiti

Published: January 13, 2022

Breast cancer remains the most commonly diagnosed cancer in women accounting for about 11% of all cancer types diagnosed globally annually and one of the leading causes of women mortality in spite of significant improvements in treatment. Treatment of breast cancer in Nigeria is based of expression pattern of ER, PR and HER2 using targeted therapies.
Two hundred and seventy three (273) archived paraffin wax processed breast tissue samples were sorted and selected from the histopathology laboratories and museums of the facility. Data were realized from clinical records, operation notes and histopathology results of the patients involved. HER2, ER and PR expressions were assessed by immunohistochemistry (Avidin-biotin complex method). Expression patterns were scored based on proportion and intensity of immune-labeling using semi-quantitative method.
The age of patients ranged from 30 to 75 years with greater population falling between 30-45 years. Numerically, breast cancer cases seen increased progressively from 2015 to 2019. Most breast cancer tissues were ER positive 146 (53.5%) while 65 (23.8%) samples were HER2 positive. A greater percentage of the samples assessed were ER/PR/HER positive (Triple positive) while ER negative/PR positive accounted for the least case.
The present study revealed a progressive increase of breast cancer incidence from the year 2015 to 2019 in the centre studied with ER/PR positive cancers being the most prevalent followed by triple negative cancers. More awareness to breast cancer risk factors, prevention, screening and early presentation to hospitals should be intensified with emphasis on early detection and targeted and personalized management.

Keywords: Breast Cancer; ER; PR; HER2

Concepts of Healing

E F Block IV

Published: January 20, 2022

This work addresses the concepts that surround what comprises healing modalities in these days and times. The concepts discussed do not involve those of surgery. There are three major thrusts in the origin of healing concepts that have been developed over the ages. The more advanced Eastern concepts first originated in the sub-continent of India and were later transferred to the area that is now known as China. All Eastern concepts began development some 4000 years ago and eventually yielded a comprehensive treatment system that lasted into modern times. The Western concepts originated in Europe and progressed much more slowly than those in the East. In all cases, most of what would be known as medicines were for the most part derived from herbal sources with a minority from mineral of animal sources.

Exploration of Renal Function in Patients under Treatment for Tuberculosis

Aikou Nicolas, Coulibaly Founzégué Amadou, RA Lapo, Aikou Nadine Lucrece Mirèze, Aikou Arielle Nadège Emerentienne, Gnangle Bidossessi Rosen, Zannou Lydie, Sezan Alphonse, Baba-Moussa Lamine

Published: February 01, 2022

The objective of this study is to determine serum and urinary creatinine levels, hematies leukocytes per minute and the albuminuria/urinary creatinine ratio in tuberculosis patients at the National Hospital Center for Pneumo-phtisiology (CNHPP) in Cotonou. This is a prospective, descriptive and analytical study that included 42 patients over 15 years of age followed for 6 months at the National Center for Pneumo-Phtisiology (CNHPP) in Cotonou. Serum creatinine and urinary albumin levels were determined by the enzymatic method. The count of red and white blood cells in the urine was done under the microscope on Malassez cells. The results show that out of 29% of men and 71% of women, the majority age group is between 39 and 58 years old. The weight of the tuberculosis subjects according to the treatment at the beginning of the treatment is around 52.5Kg and at the end of the treatment is around 57.5Kg. White blood cell counts/min in TB patients on treatment at the end of the intensive phase (p<0.03) and at the end of treatment (p<0.01) were significantly lower compared to TB patients not yet on treatment. Urinary creatinine levels increased significantly in TB patients at the end of treatment (p<0.05) compared to TB patients not yet on treatment and at the end of the intensive phase. From these results, it is important to note that anti-TB drugs must be used with great care to ensure the proper functioning of the vital organ that is the kidneys. The impact of these antituberculosis drugs, which does not appear to be significant, can become so very quickly with the use of other molecules and in the worst case lead to dialysis.
Keywords: Tuberculosis; hematuria; creatinine; renal clearance; renal failure

Correlation between C-Reactive Protein and Prostate Specific Antigene

Aikou Nicolas, Olounlade Pascal, Rock Allister Lapo, Ahoyo Angèle Théodora, Gominan Moutawakilou, Coulibaly Founzégué Amadou, Aikou Nadine Lucrèce Mirèze, Aikou Arielle Nadège Emérentienne, Lydie Zann

Published: February 01, 2022

Objective: The overall objective of the study was to evaluate the relationship between C-reactive protein (CRP) and prostate specific antigen (PSA).
Material and Methods: This is a cross-sectional and descriptive study that took place from April 2019 to September 2019 in the Biomedical Analysis Laboratory (SPACE-LABM). The CRP was determined by the agglutination technique on 85 samples of which 30 were PSA negative and 55 PSA positive.
Results: In PSA (-) subjects, we have 5 cases of positive CRP for a frequency of 17%. In PSA (+) subjects, we have 34 cases of positive CRP for a frequency of 62%. PSA (+) subjects are more likely to have a CRP (+) than PSA (-) subjects. There is a positive correlation (r = 0.38) between CRP and PSA.
Conclusion: At the end of our study, we observed a positive correlation between CRP and PSA in patients with positive PSA.
Keywords: Prostate Specific Antigen (PSA); C Reactive Protein (CRP); correlation; prostatitis

Bacteriological Profile of Urinary Tract Infections in Pregnant Women at the Atakora Departmental Hospital, Benin

Aikou Arielle, Aikou Nadine and Aikou Nicolas

Published: February 01, 2022

Introduction: Urinary tract infections (UTIs) are the second most common infectious disease in humans after respiratory diseases [1]. In pregnant women, any UTI is by definition at risk of complication [1]. Urinary tract infection (UTI) can have harmful consequences for the mother and the fetus. It can manifest itself in three forms: gravidic urinary tract colonization, acute gravidic cystitis and acute gravidic pyelonephritis (AP). The urine cytobacteriological examination (UCE) is the only way to confirm the diagnosis and to guide the treatment. It is also by far the most frequently requested examination from a microbiology laboratory [2].
Objectives: The aim of our study is to establish the bacteriological profile of germs involved in urinary tract infections in pregnant women at the Departmental Hospital Center of Atacora, Northwestern BENIN from March to October 2021.
Methods: This is a prospective, descriptive, cross-sectional study with an analytical focus that included 192 ECBU samples collected from pregnant women in prenatal consultation at the Departmental Hospital Center of ATACORA. On these samples we performed the following examinations: ECBU followed by antibiogram.
Results: The study revealed that out of 192 ECBU 19 were positive, i.e. a frequency of 9.9%. This result was confirmed by [3] and [4] who found 10% and 9.9% respectively. The most frequent germ was Escherichia coli (68.4%) followed by Staphylococcus aureus (21.1%) and finally Klebsiella pneumoniae (10.5%). However, we found a resistance to (90.1%) ampicillin and a sensitivity to (100%) ceftriaxone in Gram-negative bacteria, in Gram-positive bacteria we noted an effective activity of third generation cephalosporins, fluoroquinolones.
Conclusion: The results of this study allow us to highlight the problem of treatment of urinary tract infections in pregnant women. In the absence of bacterial identification and antibiogram, the problem of the choice of antibiotics arises. One possibility is to choose the less expensive aminopenicillins, knowing that very few of the isolated strains are sensitive to amoxicillin and that the combination of amoxicillin and clavulanic acid is only active on a small proportion of the isolated strains. The choice of other more active antibiotics is limited, either by the numerous contraindications (quinolones), or by their high cost, especially the third generation cephalosporins
Keywords: Urinary tract infection, Bacteria; Asymptomatic bacteriuria; Acute gravid cystitis; Acute gravid pyelonephritis

Evaluation of the Level of Exposure to Benzene and the State of Health of the Workers of “ORYX-BENIN SA”

Aikou Nicolas, Serge ADE, RA Lapo, Coulibaly Founzégué Amadou, Ahoyo Angèle Théodora, Gominan Moutawakilou, Aikou Nadine Lucrèce Mirèze, Aikou Arielle Nadège Emérentienne, Lydie Zannou and Ibrahim Al

Published: February 01, 2022

Aim: To evaluate the level of exposure to benzene and the state of health of the workers of “ORYX-BENIN SA”. It is a descriptive and analytical cross-sectional study aimed at evaluating the level of exposure to benzene in 18 workers of ‘’ ORYX- BENIN SA ‘’. 
Materials and Methods: It was carried out with their informed consent and after they had completed a questionnaire. The data collection was carried out by questionnaire, a direct observation grid, a summary clinical examination of the workers and a composite biological assessment: Blood count and leucocyte count by the Culter method and the determination of urinary phenol by the nitro-4-aniline spectrophotometric method.
Results: 55.55% of the workers are between 26 and 40 years old. They are all male. 61.11% of the workers have less than one year of experience and 22.22% have at least three years of experience. All the workers, grouped in three shifts, work 8 hours a day. None of the workers wear a mask while working. The only means of protection used by all workers are gloves, gowns and safety shoes. No agent of this company works with his back to the wind. The clinical manifestations recorded during the survey are 50% nausea, 38.89% asthenia and 16.16% eye irritation. A total of three chargers show hematological signs of benzene intoxication. The rate of urinary phenol is largely higher than 250 mg/g. of creatinine at the end of the shift.
Conclusion: It is observed that the inversion of the leucocyte formula is moderate in only one charger while it is severe in five and very severe in six. All of the loaders involved in this study were exposed to benzene at more than 25 ppm per working day.
Keywords: benzene; urinary phenol; exposure level; loading activity

Where are we on Alzheimer’s Disease?

Alp Yigit Özdemir

Published: February 05, 2022

Alzheimer’s disease is the most common type of neurological disorder called dementia and, it affects people from every gender, region, culture, ethnicity, religion, and sexual orientation. Research shows that in 2021, approximately 6 million seniors in the U.S. suffered from Alzheimer’s [1, 2].

Cytomorphology of a ‘Benign Follicular Nodule’ of Thyroid

Abdulaziz Radhi S ALjohni, Ahad Amer Alsaiari, Omar Abdulrhman Alfaroq, Amar Hassan Hussain Bashir and Azeza Abdulrhman Alfaroqie

Published: February 05, 2022

There is 4 to 7 percent of the population who have palpable thyroid nodules; nevertheless, there is 19 to 67 percent of the population who have nodules identified accidentally on ultrasonography. The great majority of thyroid nodules do not manifest themselves with symptoms. As malignant nodules account for around 5% of all palpable nodules, the major purpose of investigating thyroid nodules is to rule out the presence of cancer. One of the tests that may be used to differentiate between a thyrotoxic nodule and a euthyroid nodule is the thyroid-stimulating hormone test. Thyroid nodules should be fine-needled aspirated in individuals who are otherwise healthy but have a thyroid nodule, and radionuclide scanning should be reserved for patients with equivocal thyroid cytology or thyrotoxic endocrine disease (thyrotoxicosis). Using ultrasonic guidance during fine-needle aspiration, the frequency of inadequate specimens from fine-needle extraction is reduced. Operation is the most common treatment for malignant lesions, and the amount of the surgery is decided by the severity and kind of the sickness. Postoperative radioactive iodine ablation is done on high-risk patients who have cancer that has spread or that has returned after treatment. However, thyroxine suppression therapy is often employed surgically to treat malignant lesions. 
Keywords: Thyroid thyroid nodules; Epidemiologic presentation; Lymphocytic thyroiditis; Diagnosis; Treatment

Knowledge and Attitude Regarding Crisis Management of Natural Disaster among People of Selected Rural Community in Kannur District kerala

Valsamma Cherian, Senthilkumar T, Shimjitha Zacariah and Vipin Sreenivasan

Published: February 05, 2022

Background: The aim of the present study was conducted to assess the level of knowledge and attitude regarding crisis management of natural disaster among people of selected rural community at Kannur district.
Objectives: Assess the knowledge and attitude about the crisis management in natural disaster among local people. Find out the association between knowledge and attitude of people with selected demographic variables. Find out the correlation between knowledge and attitude regarding crisis management in natural disaster.
Setting and Sample: Study was conducted in 250 families at pattuvam Gram Panchayath, Taliparamba, Kannur, Kerala. 
Materials & Methods: Quantitative descriptive approach and cross-sectional design were used for this study and sample selected by convenient sampling technique. A self-structured knowledge questionnaire and attitude scale comprised of 10 items and 15 statements respectively.
Results: The study result shows that majority of samples were very good knowledge (81%) and positive attitude towards crisis
management on natural disaster.
Keywords: Knowledge; Attitude; Crisis management; Natural disaster

New Trend in Neuromyelitis Optica Spectrum Disorder (NMOSD)

Adel Ekladious

Published: February 10, 2022

NMSOD is an inflammatory disease affecting the optic nerves and spinal cord. It is an uncommon disease but is a differential that presents similarly to a few common diseases. Misdiagnosing NMOSD for multiple sclerosis might result in severe health consequences and the rapid deterioration of the patient if they are treated with disease modifying agents like interferon beta, fingolimod or natalizumab. It is noted that this disease affects females predominantly.

Curing diseases and achieving complete recovery is challenging particularly with complex diseases such as cancer, where complete remission is most likely the preferred option that can be achieved. The hope for a complete recovery is inspired by cancer patients who have successfully beaten cancer and achieved a complete recovery. Despite physicians referring to these stories as “miraculous” recoveries, nevertheless, they reveal that victory over cancer can be achieved. According to Halalopathy, a key role in complete recovery is played by setting up the favourable circumstances for the cure, a process that can be achieved by involving the patient in the therapeutic process. Entropy and potential energy are inversely proportional, and both are key elements in the process of prevention and cure. The catabolic reaction is driven by entropy, while the anabolic reaction is driven by potential energy. The stimulation of potential energy and the reduction of entropy contribute greatly to the activation of the immune system and thereby create the necessary circumstances required for effective prevention and therapy. 
Keywords: Cancer; miraculous cure; potential energy; entropy; immune system

Seasonal greeting to the editorial staffers, staff, and readers of MCMS globally. In the 20th and now 21si centuries, exponential uses and applications of medicinal plants, and herbs from different sources, in diverse forms, had become the basic fundamental norm in the health sector of the global population. In accordance to WHO findings, about 80% of the world population use one form of medicinal plants or herbs at their homes for prevention, and curing different types of diseases that have bedeviled humans in the 21st century largely due to our lifestyles-food materials that we eat, numerous different drinks either soda or alcohol or otherwise that most cases if not check are inimical to our health at a long run; smoke pluming into the air, and find their ways into our lungs with lots of chemical compositions that are often lethal to the hosts in no time.

A Novel Method for Mining Heterogeneous Lung Cancer from Computer Tomography (CT) Scan

Denny Dominic and Krishnan Balachandran

Published: March 03, 2022

Early detection of any type of cancer, especially lung cancer, one of the world’s worst diseases, can save a lot of lives. By using the early forecast, we will be able to increase life expectancy and decrease death. While there are other approaches for detecting lung cancer cells, such as X-rays and CT scans, CT pictures were found to be more preferred. CT scans, for example, use 2D images to get more accurate results. The proposed approach here will cover how to interpret CT pictures from a Computer Tomography (CT) Scan with the Confusion Matrix for Mining Heterogeneous Lung Cancer. This study will look at how image conversion may be performed using various image processing approaches to get better outcomes from CT images. The Confusion Matrix is a tool for calculating inequality in an image pattern. Following Confusion Matrix’s examination of the processed images, a final accuracy of 93 percent is attained.
Keywords: Computer Tomography (CT); Mining; Confusion Matrix; Lung Cancer

Home health care management for dwellers and the elderly is much of a desire than a real time opportunity for most. The future points to homes having a room designated for health care just as a kitchen, bathroom or dining room form essential rooms in a house. This choice of location however must be outfitted with equipment capable of monitoring health, logging and retrieving data for remote communication to those involved in virtual medicine, for diagnosis.

During the 20th century, the sociocultural paradigm of the West underwent a significant change, imposing antihuman values. This metamorphosis (individualism, the desire for power and wealth prevailed over brotherhood and compassion) was coincided with extraordinary scientific and technical development. The new paradigm colonized the minds of physicians and medical training curricula. Medicine became self-centered, cold, fragmented, and practically ignored affectivity. The reaction to this spiritual degradation of medicine was the humanist movement in medicine that originated in the twentieth century but has been developed more in the XXI century, spreading through many countries in the West and also in the East. Currently in the curricula of many schools we find the area of “Humanization of medicine”. In the Faculty of Medicine of the CLAEH University of Uruguay “Humanismo Medico” (HM) is a compulsory subject that is taken during 3 clinical years (70 hours per year) and its practice is experiential. Likewise, we have found it of great interest to know the perceptions, reflections and feelings (self-declared) of the students about their own changes at the end of all the training cycles of HM. Based on 77 opinions (out of 111 issued) of 20 4th year students, we were able to verify that taking HM had caused very important changes in them towards a more humanistic identity. They state that they perceived; 1) a deep inner rational and affective transformation and they observed an increase in their introspection, critical thinking, self-analysis, empathy and emotional balance, 2) greater capacity to plan a professional life with greater well-being, 3) improvement of group interrelationship, which has been more open, sincere and fraternal; 4) ability to share reflections and anguish and 5) acquisition of a holistic view of sick people and better skills to listen and accompany them, and relate to their families.

Reduction and Relief of Cancer using Activated Light Emitting Diode

Sunao Sugihara, Hiroshi Maiwa and Kunihiko Hatanaka

Published: March 29, 2022

We report various researches on minimal catalyst (MICA) water and spin information gauge network (SIGN) water from 2009 to the present. The theme is our body, besides plants, animals, and substances like vinyl bags, fiber and LED light even atmosphere. Furthermore, we also reported the change of atoms from radioactive cesium to stable barium after the Fukushima accident in 2011. Our water science and technology are relevant to dissociating hydrogen bonds in water. We fabricated SIGN water under the pressure of more than 100MPa rather than 3MPA for MICA water. The difference may be the abundance rate of the elementary-like particle (infoton) after hydrogen bond dissociation; namely, we assume three times in SIGN water than MICA water, although it is the same works, and both emit far-infrared through terahertz. Here, we focus on SIGN water and present recent research of oxidation-reduction potential and blood tests involving diabetes besides user’s comments after using the water and the activated LED light to the affected parts of our body.

Efforts to improve prevention and cure are commendable. Many concepts have been introduced and implemented for this purpose. However, improving the effectiveness of existing medicines remains a challenge for research. Permissible medicine “Halalopathy” offers a new perspective to prevent disease by controlling the entropic state and/or facilitating cure by implementing the concept of permissible medicine. The entropic state is controlled by enriching the state of “no fear, no grief”, while permissible medicine establishes a compatible relationship between therapeutic medicines and people’s lifestyle. The healing power of each effect contributes to the healing process and enhances the overall effect of the medicine.

The Impact of Behavioural Change Counseling on Depression among the Elderly

Asma Hamdoon Hamad AL and Alya Ali Abdullah AL Hasni

Published: March 29, 2022

Objectives: Depression is the second leading cause of disability among elderly patients and negatively affects quality of life. This study aimed to explore the impact of a behavioural counselling intervention on elderly patients with depression in Oman. The hypothesis was that, as engagement with social support and activities increased, depression score would decline. Methods: This observational cross-sectional study included 16 elderly patients attending the elderly outpatient clinic of Al Ghubra Health Centre, a primary health care (PHC) institution in Muscat, Oman. All patients had been diagnosed with depression using the 15-item Geriatric Depression Scale (GDS-15). Each patient underwent short weekly behavioural counselling sessions involving cognitive behavioural therapy, problem-solving therapy and interpersonal therapy over a period of four months. Pre-and post-intervention GDS-15 scores were compared to assess the impact of the intervention using a paired sample t-test. Results: There was a significant reduction in mean GDS-15 score following the intervention (mean score: 8.63 ± 3.18 versus 6.00 ± 3.69; P <0.001). Moreover, the mean number of weekly social activities increased from 0.75 ± 0.93 to 5.50 ± 2.92. Conclusion: The findings of this study support the implementation of brief, cost-effective behavioural counselling interventions at PHC institutions in Oman in order to prevent or reduce depression among the elderly.

Dose Evaluation of a Car Occupant in Dual Energy X-Ray Automobile Inspection System

Mahdi Kahani and Samaneh Hashemi

Published: March 29, 2022

The aim of this study is to assess the risk of car passengers in Dual Energy X-ray inspection devices and to determine the maximum number of passes through the system in a given amount of time. The MCNPX code was used to simulate a newly fabricated dual-energy X-ray car inspection device, which included an X-ray tube, detector arrays, and a rando phantom, to their exact specifications. A Rando phantom was placed in a car and TLD dosimeters were placed within different sections of the phantom for experimental dosimetry. The maximum equivalent dose was absorbed in the gastric, breast, and lungs in experimental results, while simulation results showed that this quantity belongs to bone surfaces and gastric. Based on simulation results and experimental dosimetry, the total equivalent dose of 155 kVp is 0.256 and 0.276 Sv, respectively, with a difference of 7%. The results showed that the MCNPX is suitable for dosimetry in this case. The system falls into the category of devices of limited utility, according to the ANSI standard. Anyone can move through this machine a maximum of 806, 66, and 15 times in a year, month, and week.

Service Marketing

Santiago Restrepo Garizabal

Published: March 30, 2022

Is important to bear in mind that the company may be within of a market with the different product and service, need to know, which is what the consumer wants or what you are looking wing when purchasing a product or service, these, which must have strategies to fully satisfy customer needs and achieve the objectives and targets in the company. The service sector is of great importance in the global economy, because the services are found in all parties, is for a medical consultation, restaurant, travel, daily transportation, school or university, at the supermarket or market. From there, the importance of knowing a little about the marketing of services.
Use the marketing services to increase sales and must be designed and offered in such a way that meets customer needs.

Importance of Journals, Scientific Writing and Publishing

Said Kural

Published: April 12, 2022

The Covid 19 pandemic has affected every aspect of our lives and changed the way the world works, and also changed people’s perspective on health systems so far. Patients stay away from hospitals, hinder their checkups during this time, and cause significant diagnosis or treatment delays [1]. People who do not know how to deal with such a shocking disaster and seek alternative solutions were easy prey for pseudo-scientists. Who uses the reputation and power of medical science and thus gains trust, serves their own personal interests and disregards public health by trying to sell some herbal mixtures and homeopathic pseudo-drugs. Thus, modern and accurate health care was blocked or delayed more in many scenarios; the problems caused by the pandemic have deepened, and inequalities in health have increased more and more. As this whole process and short-term results show, the most critical way to deal with all developments in life is to be on the path of science. Because even against a virus effective enough to affect the world and cause a pandemic, four different vaccines were developed for coronavirus, a little more than a year after the first case of COVID-19 was identified [2]. This alone is a glorious victory for the medical and scientific community worldwide.

Perspective study on Pharmacological and Therapeutic potential of Centella asiatica

Poovizhi T, Krishnaprabha V and Uthira L

Published: April 12, 2022

Centella asiatica (L.) is a perennial, climbing plant, barely fragrant and an expensive therapeutic herb worldwide. It is commonly disseminated all the way through humid and subtropical provinces. The appliance of Centella in foodstuff and beverages has improved in modern era due to its favourable functional properties. The plant and its synthetic constituents are recurrently utilized for the therapy of several nootropic disorders, cognitive disorder, platelets conglomeration, burn wounds, hypertonic scars, insomnia, psoriasis, skin cell reconstruction and curing. Centella determines the greater part of its pharmacological actions from four foremost bioactive triterpene glycosides specifically, asiatic acid, asiaticoside, madecassoside and madecassic acid (termed as centellosides). This current search have another look at focuses to impart inclusive information on pharmacology, various preclinical and clinical studies, safety precautions, mechanisms of action and present research scenario of the herb.

The Personality pattern and coping skill both are very important aspects for a dancer because these characteristics support them to resolve the stress of stage performance in front of the audience or if doing any mistakes in the dance. The main aim of the present study is to analyze and compare the personality pattern, coping strategies of Indian classical dancers (Bharatnatyam Dancers) and Contemporary dancers. The sample size was 90, divided into 3 groups, i.e., Indian classical Dance Group (Bharatnatyam Dancers), Contemporary Dance Group, and Control group (non-dancer). Each group consisted of 30 female participants, age ranging between 19 to 22 years, selected from different established dance institutes across Kolkata. The NEO Five factor Inventory- Revised (Costa, Robert & Mc.Crae, 1991) and Coping Checklist II (Rao, Subbakrishna, and Prabhu,1989) were administered to the participants. For data analysis, descriptive statistics (mean, SD), Inferential Statistics (ANOVA one way and Post Hoc- Turkey Tests) and product moment correlation were applied. Results – 1) Indian classical dance Group (Bhartanatyam Dancers) is using a significantly greater amount of agreeableness, conscientiousness, religion & faith coping strategies, and social support seeking coping strategies. 2) Contemporary Dance Group is using a significantly greater amount of extraversion, openness and acceptance coping strategies.

Our health on the earth has been threatened since the middle of the 1990s. Mostly, Flood and droughts due to climate change also affect the food supply in agriculture. We need healthy soils, clean water, and sunlight as well known. On the other hand, they want enough harvest and efficiency in plant growth. However, they are also a necessary theme for everybody globally, and they fertilize and spray pesticides containing various chemical medicine. As a result, we may damage, and the risk will be spread because of scattering from the air. Therefore, what we take the balance of these themes must be an increasingly imminent issue. Therefore, the purpose of the article is to inform why we use SIGN water so that we can achieve decrease of the damages with agricultural chemicals, and good harvest to use it. Here, we propose the usage of pesticides as little as possible so that we reduce the effects on crops and soils with our pico-sized water.

Water studies are widespread globally, and the methods are various kinds of technology. Some researchers study soft X-ray emission spectrometer [1], neutron diffraction [2], Raman scattering spectroscopy [3], Fourier transfer infrared spectra (FTIR) [4]. Those studies are mostly on H2O or any substance’s compound with water. The contents are a structure like an angle of the O-H bond in the water molecule. Some interesting issues include hydrogen cation [5], Rydberg, and valence-shell character in H2 [6].

Introduction: Pregnancy is a time of many physical and physiological changes. Increased ligamentous laxity and hormonal changes leads to significant postural deviations and musculoskeletal changes. In addition, increased body weight of pregnancy, fluid retention lowers the arches of the foot, further adding to foot’s length and width.
Objective: The purpose of the study was to find and compare the dimensional changes of feet during pregnancy in nulliparous (Group-A) primiparous (Group-B) and multiparous (Group-C) women.
Methods: A cross- sectional study involved a sample of 90 participants (30 in each group), in the age group of 18 – 35 years with gestational age of 32- 36weeks were measured for Foot arch index (FAI) and Navicular drop Test (NDT). Baseline characteristics were recorded, and BMI was calculated.
Results: Results showed a statistically significant difference in dimensions of foot markedly in group-B (P-value 0.00001) and group-C (P-value 0.0008) as compared to group-A. However, no significant difference was found between the trimester and total foot length in all the groups. There was significant change in Width of the foot (P- value 0.0018) markedly in group-B (P-value 0.0127) and group-C (P- value 0.0005). The Foot arch Index was positively correlated with Navicular Drop test, but negatively
correlated with total length and width of foot.
Conclusion: The study concluded that there are dimensional changes of foot that occurs during pregnancy more in multipara than primipara irrespective of the trimester.