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February 2022

  1. Dr. Rahul Manchanda, Dr. Meenakshi Gupta and Dr. Apoorva Dave

    Introduction and background: Most common benign tumors of the female genital tract that we come across are uterine fibroids or leiomyoma and it occurs in about 70–80% of women over the age of 50 and in approximately 30% by the age of 35. In the recent years hysteroscopic myomectomy has emerged as most effective uterus preserving surgical treatment for submucous leiomyoma. Some of the determinants that play a vital role in selection of surgical technique are surgeons expertise, accessibility of operating instruments and myometrial invasion of the fibroid. Methods: A review of various articles on hysteroscopic myomectomy was undertaken using Google search and studies describing hysteroscopic myomectomy and its different techniques including efficacy and their role in clinical practice were included in the present study. Results: In thisstudy we have reviewed various published articles dealing with positive and negative aspects of hysteroscopic myomectomy techniquesand discussed in detail. Conclusion: The field of hysteroscopic myomectomy has immensely advanced out of all the hysteroscopic procedures that are done. It should result in complete resection of myoma without affecting the surrounding tissues. Ultimately, the choice should be individualized depending on fibroid classification, number, location, patient presenting symptoms and the surgeon’s expertise and experience.

  2. Madanlalsaini, Hansaram, Mrs. Sunita patney and Dr. Sharda rastogi

    Introduction: Swine Flu is a respiratory tract infection from the hogs. This infection is a worldwide virus outbreak which can kill the human race. It has affected nearly 42,592 people and claimed over 2,990 lives in India. Methodology: An experimental study with Pre-test, Post-test Control group design was conducted to evaluate effectiveness of structured teaching programme (STP) on knowledge and attitude regarding prevention and control of swine flu (H1N1) among school students at selected school of Rajasthan. Simple Random Sampling technique was used to select 60samples through lottery method to receive STP. Structured knowledge questionnaire and Attitude Scale were the tools. Result: Study found a statistically significant (P 0.00003) increase in Post-test knowledge score 18.46,±2.04 of the experimental group from pre-test knowledge scores of 10.2, ±2.21.The mean post-test knowledge score of experimental group (18.46, ±2.04) was statistically significantly (P 0.0145) higher than the mean post-test knowledge scores of control group (18.46, ±2.04). In experimental group, mean post-test attitude score (57.16, ±6.69) increased statistically significant (P 0.0068) from mean pre-test attitude scores (46.36, ±5.69). Similarly the mean difference (10.1) between mean post-test attitude scores (57.16, ±6.69) of experimental group and control group (47.06, ±5.63) was statistically significant (P 0.0186). Correlation (r = 0.67) between post-test Knowledge and attitude scores of school students in experimental group were statistically significant (P 0.000051). Post test knowledge and attitude score was independent of demographic variables. Conclusion: The structured teaching programme was found effective to improve the knowledge and attitude of school students regarding prevention and control of swine flu. This suggests the importance of adopting health education strategies through various mass media regarding swine flu.

  3. Maurice A Ndolo, Samwel O. Kwach and Olive T. Baraza

    The concept of Teacher Performance Appraisal and Development (TPAD) policy was officially operationalized in Kenya in 2016 with the main aim of improving the performance of teachers and consequently, academic achievement of pupils. Despite the good intentions of TPAD, pupils’ performance in Kenya Certificate of Primary Education (KCPE) in Ndhiwa Sub County has been low despite the operationalization of TPAD in 2016 with mean scores of 241.66 in 2016, 238.93 in 2017, and 238.65 in 2018 and 238.92 in 2019. This necessitated the current study which explored the perspectives on the effect of Teacher Performance Appraisal and Development on teachers` performance. The objective of the study was to establish perspectives on the effect of TPAD policy on promotion of co-curricular activities in public primary schools. The study established that teacher performance appraisal and Development policy had moderate effect on promotion and supervision of co-curricular activities. Thus Teacher Performance Appraisal and Development policy enhanced: teamwork in management of co-curricular activities, teachers’ involvement in students participation in co-curricular activities like games, sports, athletics, drama, music and debate, teachers’ interest in co-curricular activities, teachers’ ability to produce all round pupils in curricular and co-curricular activities, teacher-pupil impersonal relationship, teachers’ management of pupil discipline and teachers’ commitment to present pupils for competitions in co-curricular activities from regional to national level. The study recommended that stakeholders in education, particularly the Ministry of Education, Teachers Service Commission and Boards of Management should use these findings in policy formulation and implementation relating to Teacher Performance Appraisal and Development policy for enhancement of teacher performance in promotion and supervision of co-curricular activities in Kenya and globally. This is because co-curricular activities are part and parcel of holistic education that encourages creativity, knowledge application, decency, cooperation, integrity and selfless service to the community in the realm of learning and entertainment

  4. Samwel O. Kwach, Maurice A. Ndolo and Enose M W Simatwa

    The concept of Teacher Performance Appraisal and Development (TPAD) policy was officially operational zed in Kenya in 2016 with the main aim of improving the performance of teachers and consequently, academic achievement of pupils. Despite the good intentions of TPAD, pupils’ performance in Kenya certificate of primary education in Ndhiwa Sub County has been low despite the operationalization of TPAD in 2016 with mean scores of 241.66 in 2016, 238.93 in 2017, and 238.65 in 2018 and 238.92 in 2019. This necessitated the current study which explored the perspectives on the effect of TPAD on teachers` performance. The objective of the study was to determine perspectives on the effect of TPAD on professional knowledge application in public primary schools in Ndhiwa Sub County. The study established that Teacher Performance Appraisal and development policy had moderate effect on teacher professional knowledge application. This is because it enhanced the following aspects of knowledge application. This included: maintenance and use of schemes of work in teaching, maintenance and use of lesson plans that guide teachers in effectively managing lessons during lesson presentations, teachers’ ability to set examinations for pupils which is undertaken regularly, preparation and use of marking schemes by teachers to the expected standards, teachers’ commitment to timely marking of pupils formative examinations which are regularly administered to learners, teachers’ commitment to giving timely feedback to pupils on their academic performance in terms of weaknesses and strengths, maintenance and use of record of work covered, maintenance and use of pupils’ progress records, teachers’ commitment to regularly updating of lesson notes relevant to teaching, teachers’ organization of individualized education programmes for pupils, teachers’ effectiveness in invigilating formative and summative examinations, teachers’ ability in identification of weak learners in time and assisting them in improving academically. These findings are important to stakeholders in education particularly, the Ministry of Education, Kenya Institute of Curriculum Development, Teachers Service Commission, Kenya National Examination Council and Boards of Management in informing policy formulation relating to teacher professional knowledge application which is always at the centre of curriculum development and implementation.

  5. Maria Cecília de Almeida Monteiro Lemos, André Cleandro de Castro Dias and Fabrício Segato Carneiro

    Este artigo tratou a Reforma Trabalhista sob a perspectivade um processo composto de vários instrumentos normativos,abordouasprincipais normasque versaram sobre as relações trabalhistas, no período de 2017/2021, e objetivou analisar a contribuição de tais normas para a precarização dos direitos trabalhistas.Não contemplou toda a legislação editada naquele período, mas, selecionouas normas que estabeleceram um padrão de supressão da tutela justrabalhista. Para tanto, utilizou o método sociojurídico crítico e realizou pesquisa bibliográfica e documental. O tema justificou-se pelo impacto que a legiferaçãotrabalhista possui nas relações sociais, além do ordenamento jurídico brasileiro. Ademais, o entendimento do processo reformista é condicionante para a viabilização de meios de resistência. Constatou-se que os novos dispositivos legais buscaram desvirtuar o Direito do Trabalho de sua essência protetora do trabalhador fragilizado, na medida em que o afastaram do centro de um núcleo constitucional de proteção.

  6. Maurice A. Ndolo and Enose M.W. Simatwa

    Physical punishment and mental harassment as methods of managing pupil discipline in primary schools are currently unlawful in line with the Basic Education Act, 2013. However, despite the ban, by the year 2015 the status in Vihiga county was such that Emuhaya Sub-County had a higher rate of indiscipline cases where there were 833(53%) cases compared to 644(43%) in Vihiga Sub-County and 543(37%) in Hamisi Sub county. The objective of the study was to determine the extent of implementation of ban of physical punishment in Vihiga county. A conceptual framework consisting of implementation of ban of physical punishment as the independent variable and pupil discipline as the dependent variable were used. The results showed that the overall mean rating on extent of implementation of ban of physical punishment was rated 2.89, which translated to moderate ban in terms of implementation. The study concluded that the ban of physical punishment in Vihiga County and by extension in Kenya was only partially being implemented. The study recommended that ban of physical punishment be fully implemented in primary schools. The study findings are significant in informing the stakeholders in education, for example the Ministry of Education, Teachers Service Commission, learners, teachers, policy makers and members of school management boards that the ban on physical punishment and mental harassment is indeed being implemented and improving pupil discipline in public primary schools, and should be implemented fully.

  7. Ramiro J. Gutiérrez Vásquez and Yvana M. Carbajal Llanos

    The main purpose of the research was to establish the relationship between psychosocial factors and virtual teaching in conditions of social isolation, in university students in Lima. The research method was non-experimental, with a descriptive correlational design. For the statistical treatment of the data, the Pearson r correlation coefficient was applied. The study sample consisted of 80 university students of both sexes, between 18 and 25 years old. Two scales, elaborated by the authors, were applied to them, the same ones that were subjected to validation and reliability processes. The results indicated that there is a strong positive correlation between psychosocial aspects and virtual teaching, corroborated by an r = 0.777 obtained. It was concluded that in adequate psychosocial conditions, students adapt better to the virtual teaching modality in pandemic conditions by Covid 19.

  8. Balasubramanian, A., Bhanumati Giridharan, Vasanth, M., Shanmugasundaram, P.N. and Sathishselvakumar

    Primary paratesticular tumors are a rare group of tumors that present as a painless mass in the scrotum. Generally, due to the rarity and decreased awareness of their presence, they appear as an incidental finding on the operating table or in the postoperative pathology. Despite the fact that these tumors can be benign or malignant, they are entitled to be handled without preoperative biopsy. The presence of these tumors in younger individuals complicates management, and strong evidence is needed to justify orchidectomy in these cases. There has been a vast improvement in the literature regarding paratesticular tumors and their management strategies over the past few years which are a boon to the clinicians. We discuss here one such rare case of paratesticular tumor in an adolescent male and share our experience in its management.

  9. Dr. Sohini Banerjee, Dr. Chhanda Biswas and Dr. Debkamal Kar

    Free gingival grafts are widely used to treat gingival recession with inadequate attached gingiva in lower anterior teeth region. Although, it has got several disadvantages like poor colour match and donor site morbidity render it unsuitable for root coverage. Placement of free gingival graft continues to be the most anticipated method to increase the apico-coronal dimension of the keratinized mucosa. This article would highlight the efficacy and reliability of free gingival grafts in managing gingival recession in lower anterior teeth region.

  10. Tuvshinjargal Boldbayar, Baatarjav Sosor and Sergelen Orgoi

    Background and purpose: High tibial osteotomy (HTO) is a widely performed procedure to treat medial knee arthritis. Two basic HTO techniques are performed commonly, a lateral closing-wedge HTO and a medial opening-wedge HTO. Previous studies have not consistently demonstrated either technique to offer more clinical advantage than the other. Material and methodology: From 2019 to 2020, one hundred patients were randomized to receive either a closing-wedge or an opening-wedge high tibial osteotomy. The clinical outcome and radiographic results were examined preoperatively, at 2, 6 and 18 months postoperatively. Main demographic variables such as age, gender, body mass index (BMI) and previous non-surgical treatment data were collected and reviewed. The outcomes that we reviewed include maintenance of the achieved correction (pre- and postoperative wight bearing line, medial proximal tibial angle), progression of osteoarthritis (based on the Kellgren and Lawrence classification), severity of pain and quality of life (as assessed with an Oxford and a Lysholm knee score), knee function (pre- and postoperative knee range of motion), surgical duration and complications. Data analysis calculated by using Stata 13.0. Results: The mean age of study participants was 51±6 and 10 percent of those were men. The 51 percent of the total subjects underwent the lateral closing-wedge high tibial osteotomy and remained 49% received the medial opening-wedge technique. At 18 months, percent of weight bearing line increased to 57.1±4.2 in lateral closing-wedge osteotomy group and 58.8±4.0 in medial opening-wedge osteotomy group. The mean medial proximal tibial angle was 92.8±2.7 in lateral closing-wedge osteotomy group and 92.8±3.0 in medial opening-wedge osteotomy. The Oxford knee score and Lysholm knee score significantly increased at 6 months and 18 months follow-up in both study groups compared to pre-operation assessment (p < 0.0001). At 2 months follow-up period, participants in both groups obtained significantly lower score in the Oxford and Lysholm knee scale compared to both pre-operation and final assessment. Conclusion: Both method of tibial osteotomy, medial opening wedge and lateral closing wedge, depicted satisfactory result in our study. However, medial opening wedge technique may provide surgeons better possibility to correct weight bearing line more accurately than lateral closing wedge method.

  11. Patil, M.S., Sanap, V.B., Surashri Sonawane, Neeta Sarode, Dharmadhikari, N.P. and Kulkarni S.D.

    This paper incorporates some of the research findings related to detection and effect of Geoelectromagnetic Field (GEF) is presented. The effect of GEF on various areas of built environment in general is elaborated and hypothesis of origin of GEF is discussed. It is to be seen that underground water is the main source which produced GEF. Such location is very harmful to human being as well as animals. However in-depth study to detect GEF and to study its effects is necessary

  12. Hallan Dantas de Melo, Gabriel de Brito Fogaça Samuell Felipe Silva Lima and Emanuell Felipe Silva Lima

    A febre reumática (FR) e a cardiopatia reumática crônica (CRC) são complicações não supurativas da faringoamigdalite causada pelo estreptococo beta-hemolítico do grupo A e decorrem de resposta imune tardia a esta infecção em populações geneticamente predispostas. Essa é uma doença que está frequentemente associada à pobreza e às más condições de vida. Assim, apesar da reconhecida redução da incidência da FR nas últimas décadas nos países desenvolvidos, com consequente redução na prevalência da CRC, a FR permanece como um grande problema de saúde pública, principalmente nos países em desenvolvimento” (Diretriz brasileira Febre Reumática, 2009, p. 4). Neste relato de caso, buscamos evidenciar as características desse achado em que o acometimento cardíaco agudo e grave, evidenciou uma patologia de alta morbimortalidade, associada a endocardite não-infecciosa em uma criança com autismo.

  13. Jitendra Kumar Saini, Hansaram Suthar, Madhumita Dey and Sarita Shokanda

    Background: Alcoholism is gradually tearing down the college students worldwide. This is turning out to be a major social predicament. Alcohol misuse was reported as a strong predictor of students’ mental health. Objectives: To assess the prevalence of alcohol consumption, factors associated with it and its effects among undergraduate students. Methods: Cross-Sectional Survey was applied on 180 undergraduates at Shekhawati PG college, Rajasthan, India, using Stratified random sampling. Structured questionnaire and rating scale were used to collect the data. Result: The finding showed 25.55% prevalence of alcohol consumption with majority of being males (63.04%). Maximum number (47.8 %) of the students started alcohol consumption at18-19 years of age with reasons being: social gathering or marriage party (69.56%), peer pressure and curiosity about the effects of alcohol (13.04%), drinking habit of the parents (6.52%). Majority of the student (65.21%) drink outside the home and at night time (91.30%). Maximum urge (86.95%) was felt for pleasure (93.47 %) on special occasion or party function. Early onset of consumption made students (28.26%) addicted. Maximum students (78.3%) showed mild whereas 21.7% experienced moderate effect of alcohol consumption. Conclusion: The study showed that most common age to start consuming alcohol was between 18-19 years and common reasons to start included ‘social activities’ and ‘peer pressure’ for majority and for a few ‘curiosity’ and ‘family influence’. It becomes incumbent on the government, healthcare practitioners and other stakeholders to promote responsible drinking and discourage premature drinking.

  14. Guy C. WOKOU, Djafarou ABDOULAYE, Cyriaque AGBON, Angelo SODJI, Ibouraïma YABI

    Cette étude vise à une meilleure connaissance des perceptions socio-anthropologiques de l’évolution du climat. Le caractère sacré de l’évolution du climat découle du lien existant entre les composantes du milieu physique et les us et coutumes des groupes socio-culturels. Les données climatologiquesde la série 1985-2015 (station de Bohicon) ont permis d’analyser les tendances climatiques. L’accent a été mis sur l’analyse des perceptions populaires basées sur les croyances recueillies à partir des données d’enquête de terrain auprès de 312 producteurs agricoles. Les investigations attestent que 85,5 % des populations enquêtées perçoivent les fluctuations climatiques comme attribuables aux divinités ‘’vôdoun’’ du sud-Bénin. Dans les aires socioculturelles mahi et fon du sud-est, la croyance religieuse lie les événements climatiques extrêmes à un signe de colère ou de vengeance des divinités (65 %), par suite d’une négligence, d’une promesse non tenue (67 %), d’une offense ou d’une privation de cultes rituels (75 %). Bien que ces considérations religieuses tendent à disparaître dans les milieux urbains, elles continuent de régir la gestion des ressources dans les milieux ruraux. Le respect de l’inviolabilité des lieux sacrés constitue une attitude positive qui favorise la stabilité climatique (87 % des populations enquêtées). C’est pourquoi, des propositions des mesures de conservation basées sur la sacralisation des lieux (forêts d’Agbogbozoun, la rivière fétiche Hlan de Gbénou-hlanhonou ainsi que les forêts appelées « Lozounkan »)ont été faites.

  15. Dr. Yael D. Arnon

    This article is a preview of a comprehensive research study of one of the most prominent structures in the Galilean skyline. Their incommensurate height penetrating the natural landscape and their increasing numbers give the impression that the classic role of these buildings has shifted from serving a very defined function to acting as a symbol. The purpose of the study is to examine whether the "landscape text" has changed and to determine whether this change has any particular meaning. Beginning in the 1990s, the structure of the minarets became more externalized, their shape changed and they became higher. It seems that the events of the Land Day and the Nakba Day influenced this phenomenon. The minaret structure has become a proclamation: "We are here; we are on the map." From a structure defined by religion, the minaret has become a structure symbolizing territory and nationalism.

  16. Janaisa Gomes Dias de Oliveira, Ilma Rodrigues de Souza Fausto, Flavia Joziane Pereira da Motta, Edivânia Floro Nicácio Almeida, Fabiana Rodrigues Leta, Ruth Maria Mariani Braz, Sergio Crespo Coelho da Silva Pinto and Robisom Damasceno Calado

    According to official data from the Ministry of Health, at the same time, the number of cases and deaths increased worldwide. Since then, several initiatives have been developed in order to contain the contagion, prioritizing people considered to be at risk, such as the elderly. In view of this, isolation was adopted by several sectors. In view of this, the elderly had the eagerness to communicate with the family, the outside environment, promoted new attitudes in favor of information, contacts, news activities, that is, means that allowed solving of daily living. In this way, the elderly who had some kind of knowledge about technology, they could have access to several opportunities to reduce the effects of social isolation, whether for a video call, as well as conducting online searches in search of movies, or even for virtual mall. This article aims to study the use of Digital Technologies in Education and Health Promotion in the face of COVID 19 in institutionalized elderly. The research is an integrative literature review. The selection took place through reading titles, abstracts and, when necessary, the full reading of texts as a way of selecting them according to the inclusion and exclusion criteria. During this phase, the researchers critically and independently evaluated the full articles and made the appropriate selections. It was concluded that resources are present in the life of all technological possibilities increasingly within reach, and the positive impact they can cause to the elderly is impressive, because from them isolation can become less aggressive. However, the elderly are the age group with the lowest participation in the digital world. The results in relation to technology users were positive in the cases mentioned in the survey. Technology helps seniors to stay mentally active, which can bring a sense of well-being, such as talking to other people, reading, playing games, staying informed.

  17. Richa Sharma

    This case report focuses on the use of a minimally invasive transbuccal method in open reduction and internal fixation of mandibular angle fractures, as well as the limits and benefits of doing so. It entails a mix of transbuccal and intraoral techniques. Following reduction, the mandibular angle fracture was fixed transbuccally using a needle cap for drilling and miniplate fixation. With this approach, adequate reduction and firm fixation were obtained with less intraoperative time. The transbuccal method is a minimally invasive, cosmetic, and better alternative to the extraoral approach for rigid internal fixation of mandibular fractures, with a very low complication rate 1.

  18. N'Guessan Lucie Yeboue, Crolaud Sylvain Tra Bi, Senan Soro, Bamadou Traore, Yao Tano

    Cowpea (Vigna unguiculata L.) is a legume whose seeds and leaves are used for human consumption. However, many insects cause damage to inflorescences, fruits and / or leaves. The objective of the work was to take an inventory of insects, identify pests, describe their damage and assess the damage caused by pests in order to select resistant varieties. To carry out this study, 16 varieties were cultivated. The test was conducted using a three-block arrangement. A method was used to quantify the insects physical capture using the hay net. The visual method was used to quantify the damage by a simple count. The data collected indicate that the insects most harmful to cowpea belong to four orders: Lepidoptera, Heteroptera, Coleoptera and Orthoptera. The damage caused by insects on each variety is different. This damage is proportional to the number of pests. In conclusion the varieties N11BBoBp, N8BRcp, N18ZR, N21DR and N10BBrp would be the most resistant to pests. These results indicate a new approach to the dynamics of cowpea insect pests.

  19. Bushra Alahmadi, Hanouf Alsufyani and Hisham Bashawri

    Background: As a result of Covid-19 pandemic, doctors across the kingdom of Saudi Arabia were recruited to provide their services to cover hospitals and quarantine facilities. This recruitment included residents from local training programs. Objectives: To assess the knowledge, preparedness and impact of COVID-19 pandemic among family medicine residents in Makkah 2020. Subjects and methods: A cross-sectional study was conducted in Makkah city, Saudi Arabia among all joint program of family medicine resident physicians, levels two, three and four on September 2020 (n=120). A self-administered electronic questionnaire was used in this study. It includes sociodemographic data, COVID-19 knowledge related questions, questions regarding basic Infection control skills and the overall impact of this pandemic on resident well-being. Results: A total of 104 family Medicine residents participated in the study out of targeted 120 with a response rate of 86.7%. Most of them (75%) aged below 30 years. The total Covid-19 knowledge score ranged between 0 and 7. It was abnormally distributed (p-value of Shapiro-Wilk test was<0.001). The median and interquartile range (IQR) were 5 (4-5). Females were more knowledgeable about Covid-19 pandemic than males, p=0.047. Majority of the family medicine residents reported receiving of COVID-19 vaccine (98.1%), formal training for hand hygiene in the last two years and on wearing and removing personal protective equipments (94.2%), and participated in COVID-19 duty (92.3%). 14.4% of the residents tested positive for Covid-19 whereas 12.5% did not perform the test. Majority of them (85.6%) thought the lockdown has negatively affected their family medicine training and theoretical learning/classroom training (78.8%). Almost half (51.9) of physicians mentioned that their exam result was negatively affected by the pandemic. Most of them (72.1%) thought that the COVID-19 lockdown has increased their stress levels. Conclusion: Overall, knowledge of family medicine residents in Makkah, Saudi Arabia about Covid-19 pandemic was satisfactory; they were adequately prepared for the Covid-19 pandemic. However, majority of them thought the Covid-19 lockdown has negatively affected their family medicine training and theoretical learning/classroom training.

  20. Dr. Rodalin N. Asenas

    This study aimed to analyze the importance of National Competency Based Teacher Standard Model in reducing the impact of pandemic in the attainment of an effective teaching. The core in every reaction to mediation rests in the utilization of National Competency Based Teachers Standard (NCBTS) instructional processes, the main basis in proposing it. Appraisal survey is being used in descriptive research like this study. The respondents were comprised of two hundred seventy-six (276) purposely selected overseas Filipino teachers/faculty members. Factual rankings centered on five-point level were used together with illustrative figures employing rate of recurrence allocation, ratio, standard, regular variation and averaging while Regression Analysis was used for inferential statistics. Results of the Regression run reveal that the occurrence of pandemic has significant effect on effective teaching related to curricular and extra-curricular activities. The positive coefficient (.000b) indicates incremental effects on the point of curricular and extra-curricular activities of students and their variables can be considered significant predictors on the level of effect of the occurrence of pandemic. It is therefore necessary to carefully examine the possible impact of our actions in the future through the study of various alternatives and be more motivated and directed after knowing the relevant effect of our actions in providing instructional interventions.

  21. Swati Gupta and Poonam Mahrotra

    Biomass has been considered as one of the primeval resources of energy and among the most fovoured matter utilized by mankind since over 5 lac year. Fuel wood is one of the commonly used sources of domestic energy in the rural areas of many developing nation. The primary source of fuel wood is cutting down of dry and diseased tree, collecting fallen wood scraps or by lopping branches. Jhansi district falls under the backward areas of the country in terms of standard of living. According to a survey more than 70% of the rural population is dependent on fuel wood for cooking and other domestic purposes which in turn causes inauspicious impact on our forest resources which is already a limited resource. The extension of demand of fuel wood is seen as one of the reasons for biodiversity degradation and the quality of Mother Nature. The study reveals that felling of tree for fuelwood is far greater than the rate of vegetational growth. Collecting large quantities of dead wood from forests for one’s own use is one of another way of degrading forest ecosystem.

  22. Pandey, J.D., Tripathi, S.B., Soni, N.K. and Singh, V.K.

    The binding energy and dissociation energy of fourteen first and second row diatomic molecules (twelve hydride molecules and two hydrogen halide molecules) have been computed using Börn-Mayer, Gaussian, Woodcock and Logarithmic (L_5) potential models. The Woodcock and Logarithmic models are also used to compute the electron affinity of halogen atoms and hydrogen atom. The estimated values are compared with the experimental findings. The Logarithmic (L_5) and Woodcock models provide the better results in comparison to other proposed models.

  23. Suchethana, H.C.

    Visual cryptography is a secret sharing scheme as it breaks an original image into image shares such that, when the shares are stacked on one another, a hidden secret image is revealed. The Visual Cryptography Scheme is a secure method that encrypts a secret document or image by breaking it into image shares. A unique property of Visual Cryptography Scheme is that one can visually decode the secret image by superimposing shares without computation. Even to make the visual cryptography image shares more secure, public key encryption scheme is applied. Public key encryption technique makes image shares so secure that it becomes very hard for a third party to decode the secret image information without having required data that is a private key.

  24. Dr. Avinash Aravind, Dr. Ajay Kumar B and Dr. Sreejayan, M.P.

    Background and Objectives: The annual incidence of diabetic foot ulcer in diabetic patients is known to be about 2% to 5% and the lifetime risk ranges from 15% to 20%. The main objective of this studyis to determine the most prevalent pathogens involved in diabetic foot ulcers and its antibiotic susceptibility. The predominant organism related to the different Wagner grades were also assessed as part of this study. Methods: The present study was a hospital-based descriptive study conducted on patients admitted with diabetic foot in the department of General Surgery at Government Medical College, Kozhikode, Kerala during the period from August 2019 to July 2020. Tissue or swab culture was taken from the ulcer and the antibiotic sensitivity was tested by Kirby-Bauer Disk Diffusion Susceptibility Test. Results: At the time of presentation more than 50% of ulcers were of Wagner’s grade II and III. The predominant organism isolated from diabetic foot infections were Klebsiella (32.98%) followed by Pseudomonas (24.47%). Multi-drug resistance was seen in 12 out of 62 samples that yielded Klebsiella, 2 out of 46 samples that yielded Pseudomonas, 4 out of 22 samples that yielded E. Coli and MRSA was seen in 8 out of 22 samples that yielded Staph. Aureus. Discussion and Conclusions: The predominant organisms isolated were Klebsiella and Pseudomonas species and were mostly sensitive to Piperacillin/Tazobactam, Meropenem, Ciprofloxacin and Amikacin. Hence it is advisable to start patients on empirical therapy with these drugs for better outcome. Proper assessment of ulcer and targeted antibiotics against these organisms can aid in early healing and avoidance of diabetic foot related complications.

  25. Dr. Goutham Vinod P. C., Dr. Ajay Kumar B and Dr. Sreejayan, M.P.

    Introduction: Injuries to the liver remain a major obstacle for the successful treatment of blunt abdominal trauma. In the early part of the 20th century, aggressive operative treatment was popular. However, following World War II, this was replaced by the use of non-operative strategies. Objectives: • To study the outcome of non-surgical management of liver injuries in blunt abdominal trauma. • To study the percentage of conservatively managed blunt trauma liver cases which had to be managed surgically later. Methods: This is a cohort study done in the department of general surgery, Govt Medical College, Kozhikode, where 100 patients of isolated blunt trauma liver was monitored and followed up for two to three weeks. The number of cases that has been successfully managed by conservative or surgical methods will be analysed and the percentage of cases that was managed surgically while on non-operative approach would also be assessed. Results: Of all 100 patients, 96 patients were managed non operatively out of which 2 patients had to be converted to laparotomy later. 94 patients who were managed by non-operative approach was successfully discharged with no mortality, however the 2 patients where non operative approach failed had expired in the postoperative period. 4 patients were hemodynamically unstable at presentation hence had to be managed by surgical means and here only 1 patient was discharged successfully wherein the other three patients had expired in the post-operative period. Conclusion: Non-operative approach should be the preferred method for managing hemodynamically stable patients and it is associated with a good prognosis and minimal mortality.

  26. Waad Ahmed AlMajnoni, Khalid Abdullah Almasaodi and Saud Hasan Surbaya

    Background: Breast cancer (BC) has many risk factors that lead to its diagnosis in premenopause and more common in postmenopause; most of these factors are modifiable; including anthropometric factors and reproductive factors. Objectives: To assess knowledge and its associated factors among physicians in primary healthcare settings in Makkah city about the modifiable risk factors of breast cancer. Subjects and methods: A cross-sectional study was conducted in Makkah Al-Mukarmah city, western area of Saudi Arabia among a sample of primary healthcare physicians working at the PHC centers, belonging to the internal PHC sectors inside the city. A self-administered questionnaire was utilized in the present study. It includes two main sections; background information of the physicians and assessing the knowledge of the participants regarding modifiable risk factors for breast cancer (Contraceptive history, obesity/physical activity, smoking and diet). Results: A total of 150 primary healthcare physicians have participated in the study. More than half of them (58.7%) aged between 20 and 30 years, and 56% were females. The knowledge score ranged between 16 and 30 with a mean±SD of 23.71±3.16. Almost two-thirds of the physicians (68%) had high level of knowledge. Among studied sociodemographic factors, only the degree of job of the participants was significantly associated with knowledge level about BC as the highest score was observed among residents (25.46±1.98) and the lowest among general practitioners (22.27±3.39), p<0.001. Conclusion: most of primary healthcare physicians in Makkah had good level of knowledge regarding breast cancer modifiable risk factors, resident physicians. Their main source of information was the Internet, followed by books and guidelines.

  27. AYOLIE Koutoua, SORO Sibirina, SORO Dogniméton, KOUAKOU Koffi Abel and KOUADIO Yatty Justin

    The annual world production of wheat is approximately 758 million tons. In Côte d'Ivoire, the quantity of wheat imported is more than 550 000 tons. Wheat thus occupies an important place in the Ivorian diet. However, its cultivation is struggling to take off in the country because of climatic conditions unfavorable to its productivity. A study was initiated with the main objective of evaluating the agronomic characteristics of five wheat accessions and their resilience to climate change in west-central Côte d'Ivoire. Five wheat accessions, including three from Morocco obtained in Marrakech (AM), Tanger (AT) and Safi (AS); two from Nigeria (AN) and Côte d'Ivoire (AC). A completely randomized design was used with pots. Three treatments (T0, T1, T2) were applied to the 5 different accessions. The seedlings were sown on the same day in 5 dm3 pots, filled with a substrate composed of soil and chicken droppings. The control pot (T0) was filled with 100% soil. T1 is filled with 20% chicken droppings for 80% soil. T2 was filled with 40% chicken droppings and 60% soil. The different organic manures of treatments T1 and T2 significantly increased the vegetative and production parameters of wheat. The effect of different treatments on grain production of wheat accessions showed significant difference with T2 treatment. Accession Nigeria had the highest number of spikes per plant (5.4) and spikelets per spike (27.5). It had the highest number of grains per spike (19.0). The highest grain filling rate (74.6%) of wheat was also observed with the same accession Nigeria for the same treatment T2. The effect of different treatments on grain production of wheat accessions was very highly significant (p<0.001). Of the five accessions evaluated (AM, AT, AS, AN and AC), only the AN accession was the most productive.

  28. Georgios Meimaris, Ioannis Stamatatos, Makis Kritikos, Marigo Theodorou, Efstathios Metaxas, Georgios Anagnostopoulos, Basilis Mpoumis and Athanasios Rogdakis

    Synchronousmultiplecolorectal cancers are defined as multiple malignant tumors of the colon and rectum, occur simultaneously, are distant from each other and are not a result of metastasis. We present a case of a 76 years old male who was admitted to our hospital complaining of diffuse, mild abdominal pain started a month ago, associated with diarrhea, fatigue and body weight loss. Computer tomography revealed a mass at the splenic flexure. Colonoscopy confirmed the finding of the tumor at the splenic flexure obstructing the lumen of the colon, not allowing the examination to be completed. Furthermore, a second tumor was found at the boundary between descending and sigmoid colon, narrowing the lumen at approximately 75%. Virtual colonography under CT reconstruction illustrated the previous two lesions and revealed an additionally mass at the hepatic flexure. The patient underwent an exploratory laparotomy the day after and all the above findings were confirmed intraoperatively for which he received a successful extended colectomy.

  29. Carolyne A. Owuor, Enose M.W. Simatwa and Maurice A. Ndolo

    Studies worldwide have established that parents have significant influence on their children’s academic performance. Studies in some parts of Kenya have indicated that parental factors like income level, parental age, and parental marital status do influence students’ academic performance. Notwithstanding these assertions, students’ academic performance in Homa Bay Sub county had been relatively lower for the last three years as follows, 2016-2018 respectively; Rangwe 3.6278; 3.4647 and 5.0251, Rachuonyo South 3.6265; 3.3311 and 4.6163, Rachuonyo East 3.7384; 3.4940 and 4.6372 and Homa Bay Town3.8197; 4.2920 and 4.4860. The objective of this study was to establish the influence of parental occupation on student academic performance in public secondary schools in Homa Bay Sub County, Kenya. A conceptual framework based on Urie Bronfenbrenner’s Ecological Systems Theory showing the relationship between the independent (Parental influence) and dependent variable (Academic performance) was used to guide the study. The study established that parental occupation highly influenced students’ academic performance with a mean rating of 3.55. It is therefore recommended that parents should serve as good role models to their children in their respective occupations so as positively influence students’ academic performance. Schools should also strengthen surrogate parenting in schools to help students find the good role models in their teachers. The findings of this study are significant to the Ministry of Education, Teachers Service Commission, teachers and parents in formulation of guidelines involving parental occupation in enhancement of student academic performance in secondary schools.

  30. Maurice A. Ndolo and Enose M.W. Simatwa

    Drug abuse is becoming increasingly problematic in Kenya. Studies done outside Vihiga and Sabatia Sub-counties have shown that students abuse drugs. The foremost concern was the number of these students that would form an addiction to serious substances, jeopardizing their own health and safety and creating difficulties for their families and the public at large. Preliminary survey in five schools revealed that students in Vihiga and Sabatia sub-counties were abusing drugs. In Vihiga and Sabatia sub-counties, cases of indiscipline had been experienced. For instance, 4(80%) were found doing examination under the influence of alcohol, 4(80%) stealing and 5(100%) students fighting. It was alleged that most of these incidences involved students who abused drugs. What was not known was the influence of drug abuse on student discipline in secondary schools in Vihiga county. The objective of the study was to establish the influence of drug abuse on student sexual harassment in secondary schools in Vihiga county. A conceptual framework showing influence of drug abuse on student sexual harassment in secondary schools was used to guide the study. The study established that with regard to influence of drug abuse on student sexual harassment principals' rating was moderate (M =3.04) while Guidanceand Counselling teachers' was high (M = 3.61). The findings of this study are useful to the managers of schools in Kenya in understanding the issues related to substance abuse among students in their schools and to come up with strategies to be used in addressing substance abuse related issues.

  31. Saripalli Sirisha and Prof. Jaladi Ravi

    Marketing refers to company activities to market the buying or selling of a product or service. Marketing involves advertising, selling, and delivering products to consumers or other businesses. Some marketing is completed by affiliates on behalf of a company. Very often the success or failure of a corporation may be a direct result of an efficient or not so effective marketing strategy. Therefore, choosing a marketing strategy that matches the corporate product is of important importance. At its most initials, marketing seeks to match a company's products and services to customers who want access to those products. The matching of product to customer ultimately eventually ensures profitability. Technology is revolutionizing how consumers shop. Every retail marketer must be prepared to regulate their marketing and customer experience strategies consistent with the newest trends while gearing up for upcoming developments. The Internet marketing plan will help define specific e-marketing objectives and develop strategies to make sure that resources are deployed to require advantage of the marketing opportunities provided by the web and to counter its threats. The study is through all the variety of marketing corners from content and social marketing to marketing technology, analytics and organizational transformation, to find and establish the ultimate summary for marketing trends. This study tries to know about current trends of digital marketing, awareness levels of consumers on digital marketing in Visakhapatnam city. Interest and curiosity to gain more knowledge in the field of digital marketing have been the main ground for selecting the topic of digital marketing for the research purpose.

  32. Ruth Anyango Onywany, Rosemary Ogada and Enose M.W. Simatwa

    The right to education for Persons With Disabilities (PWDs) is globally acknowledged as a basic human right. Education is regarded as the means by which economically and socially marginalized persons can break vicious cycle of poverty. In Kenya, the right to education is provided for in article 53(b) of Kenya Constitution, which advocates for the right to free and compulsory basic education for every child. Article 54 of the Constitution of Kenya emphasizes the need to enhance education for persons with disabilities. The Government of Kenya recognizes the importance of Special Needs Education as a crucial sub sector for accelerating the attainment of Education For All, Millennium Development Goals and Sustainable Development Goals. The objective of the study was to establish learner based opportunities and challenges influencing education for the mentally challenged learners. The study established that learner-based opportunities are learners’ attitude and existence of mentally challenged learners. The learner-based challenges are; learners’ attitude, drop out and enrollment. It was concluded that learners are accorded various opportunities to participate in learning but there are challenges too. The study recommended that school management and the Ministry of Education should establish strategies to ensure that learners and teachers are motivated and facilitated to foster quality education for the mentally challenged. These findings are valuable in formulation of policies that facilitate promotion of special education in Kenya.

  33. Ruth Anyango Onywany, Enose M.W. Simatwa and Rosemary Ogada

    The right to education is globally acknowledged as a basic human right. Education is regarded as the primary vehicle by which economically and socially marginalized persons can break vicious cycle of poverty. In Kenya, the right to education is provided for in article 53(b) of Kenya Constitution, which advocates for the right to free and compulsory basic education for every child. Article 54 of the Constitution of Kenya emphasizes the need to enhance education for persons with disabilities. The Government of Kenya recognizes the importance of Special Needs Education as a crucial sub sector for accelerating the attainment of Education For All, Millennium Development Goals and Sustainable Development Goals. The objective of the study was to establish teacher based opportunities and challenges influencing education for the mentally challenged learners. The study established that teacher-based opportunities influencing education for the mentally challenged learners are: qualified teachers, teacher’s attitude, special school allowance for teachers, teacher-pupil ratio, teachers’ skill, motivation, gender and teachers’ experience. Teacher-based challenges include: level of retardation of learners, availability of qualified teachers, teacher’s attitude, special school allowance for teachers, teacher-pupil ratio, teachers’ skill, motivation, teachers’ experience. It was concluded that learners are accorded various opportunities to participate in learning but there was an array of challenges too. The study recommended that school management and the ministry of education should establish strategies to ensure that learners and teachers are motivated and facilitated to foster quality education for the mentally challenged. This information is valuable to policy makers with regard to promotion of special education in Kenya.

  34. Anatolii Pavlenko

    The article is intended for people interested in research in such areas as physics (engines for interplanetary travels, interplanetary flights, torsion field, quantum correlation, cavity structures). This article does not contain many complex mathematical formulas and technical terms, because it is very difficult to describe the state of the Physical Vacuum and the behavior of virtual particles. Roger Penrose, Nobel Prize laureate , points out that this new, as yet absent theory, must be "uncomputable". It is believed that quantum particles are objects in much the same way as classical ones. This similarity provides an important continuity between classical and quantum physics. We believe that there is value in making research accessible to specialists in various fields - which is really the point of our publication. It is intended for readers with a college degree.

  35. Noemi F. Formaran, Ed.D, Bambalan, John, Barles, Gabriel, Caraig, Audre, Recel, Ralph, Aporto, Edzhelle, De Ocampo, Jazylei, Lardizabal, Enya and Racela, Nadeen

    The Philippine educational system currently follows the K to 12 Program, covering ten years of basic education and two years of Senior High School (S.H.S.). During the last two years of this program, students have to select a specific strand that will aid in preparation for higher education. However, it is not always that the students’ chosen strand will align with their college course. This qualitative paper uses a phenomenological research design to answer the question "How do Filipino college students adapt to the challenges of strand mismatch?" and to raise awareness of the lived experiences of these college students. The set of data was gathered through semi-structured interviews and was analyzed using inductive reasoning in theme development. Four themes were extracted from the verbal musings of the participants. These are: (1) Crucial Circumstances which include Decisive Factors, Restrictive Hindrances, and Reflective Insights; (2) Receptive Response which encompasses Social Support, Exerted Effort, and Adaptive Action; (3) Individual Impact which pertains to Personal Convenience, Relational Indifference, and Emotional Encumbrance; and (4) Acquired Abilities which involve Cognitive Capacity, Progressive Proficiency, and Environmental Expertise. While strand mismatch has made college transition more challenging for most students, there is no fixed way of coping with it. The study reveals that strand mismatch has opened a door of opportunities for personal growth and development amongst college students after facing the adversities that came along with this experience. The researchers recommend further exploration of the perspective of college students who have taken non-academic strands and are also experiencing strand mismatch, the implementation of mixed methods research design to reinforce further the study results, and the impact of strand mismatch to outcome-based education (OBE).

  36. Dr. R. Rajkumar M.S., M.Ch.

    Background: Road traffic accidents are common cause of head injuries followed by fall and combat injuries nearly 20 percent of traumatic brain injury patients develop seizures ,which may be early onset or late onset. Materials & Methods: Retrospective comparison of role of antiepileptics to control seizures in traumatic brain injury in a tertiary care centre the effectiveness to control seizures in traumatic brain injury patients admitted in rajiv Gandhi government general hospital either prophylactically or treatment is analysed. Results and Principle Conclusion: Phenytoin is drug of choice for early onset seizures in traumatic brain injury patients levetiracetam is a viable alternative, carbamazepine and sodium valproate are used as second line drugs.

  37. Balalis, K., Daskalakis, I., Balalis, M., Kastanis, G., Pantouvaki, A., Sperelakis, I., and Dimitriou, R.

    Stenosing tenosynovitis or trigger finger is a common cause of hand pain and disability.Its prevalence is higher in the diabetic population. The mainstay of treatment consists ofsurgical release of the A1 pulley, either open or percutaneous. The present study attempts to compare the outcomes and complications of conventional open versus percutaneous release, in patients with diabetes mellitus. Material and Methods: In total, 69 patients (69 digits) withchronic diabetes mellitus (38 insulin- dependent and 31 non-insulin dependents, with an average age 48 years old) were treated for trigger finger between 2014-2019). The mean duration of symptoms was 6 months. All patients had failed conservative treatment. The digits were graded accordingto severity of symptomsby using the Quinnel classification. There were 22 grade IIfingers(31,9%), 28 grade III fingers (40,6%), and 19grade IV fingers (27,5%) [8 locked in extension and 11 in flexion]. Thirty-seven patients were treated with the open technique and 32 with the percutaneous technique. Postoperatively, the patients received follow-up visits at 2 weeks and 6 months. Results: The outcome was assessed using the questionnaire of Gilberts and Wereldsma and documenting the complications and satisfaction rate. The overall complication rate was 16.2% in the open technique group and 15.6% in the percutaneous group, with the most commoncomplications in both groups being postoperative pain on the surgical site. In the open technique group, 21 patients were very satisfied patients after treatment (56.76%), 13 were satisfied (35.14%) and 3 patients (8.1%) were unsatisfied with the surgical result. Inthe percutaneous technique group, there were 19 very satisfied patients (59.37%), 11 satisfied (34.37%), and 2 dissatisfied (6.26%). Conclusion: This study highlighted the effectiveness of both techniques; however, the percutaneous technique has the advantages of lower cost and the avoidance of wound complications.

  38. Dr. Vidya P Hiremath, Dr. Snehal Bonde Chaurasia and Dr. Sonali Tamboli

    Background and Objective: Objective of this study was to identify the risk factors for corneal graft failure and isolate microrganisms associated with graft infections after penetrating keratoplasty . The present study was conducted in the Department of Ophthalmology at tertiary care centre in central India. Methods: The present study was a case control study conducted in the Department of Ophthalmology at tertiary eye care from November 2018 to October 2020. Patients operated for optical penetrating keratoplasty attending eye OPD were examined. Results: Preoperative risk factors- adjusted risk associated with donor’s age > 60 years was 8.798 with p-value 0.001, indicating significantly higher risk of graft failure as compared to donor’s age < 60 years. Presence of corneal vascularity had a significantly increased adjusted risk i.e. 7.542 with a p-value 0.002, as compared to those without corneal vascularity . Perioperative risk factors: the graft size > 8.5mm has significantly higher adjusted risk of graft failure with estimate of 15.296 with a p-value of 0.013, as compared to the reference category 8.0 – 8.5mm. Postoperative risk factors: The presence of raised IOP had significantly higher adjusted risk of graft failure with estimate 10.26 with a p-value 0.011, as compared to those with normal IOP. Adjusted risk estimate corresponding to epithelial defects was 8.464 with a p-value 0.014, suggesting increased risk as compared to those without the defect. The likelihood of graft failure corresponding to graft rejection was also significantly higher as indicated by adjusted estimate of 5.688 (95% CI: 1.048 – 30.869) with a p-value 0.044, compared to those with no graft rejection. Interpretation and conclusion: Pre-operative risk factors for graft failure: 2 or more quadrant corneal vascularisation, peripheral anterior synechiae and older donor age (>60 years). Peri-operative risk factors: repeat keratoplasty and larger donor graft size >8.5mm. Post operative risk factors: elevated IOP, suture problem, epithelial defect, graft rejection, post penetrating keratoplasty infection were postoperative risk factors for graft failure. As per multiple logistic regression Pre-operative risk factors were Corneal vascularization and Donor age of >60 years Peri-operative risk factors were Graft size of >8.5mm Post operative risk factors were raised IOP, epithelial defect, graft rejection. Although other factors indicated increased risk in univariate analysis, evidence was statistically insignificant in multivariate analysis.

  39. Sudhir Turi, Apneet Walia and Shri Ram Saini

    The novel corona virus (SARS-CoV-2) infection, which first appeared in Wuhan, China in December 2019, has now spread to over 222 countries and territories. The ever-growing list of patients with corona virus-19 disease (Covid19) has demonstrated the high rate of transmission among humans. To avoid or survive a Covid-19 pandemic, one will need a lot of good immunity. Ayurveda explains to us how to evolve our physiological responses in order to strengthen our immune system. In Ayurveda, the preventive aspects of pandemic situations are defined in sufficient details. They must be researched scientifically and fine-tuned for precision. As prevention is always better than cure, the Ayurveda ways can be considered for future strategies to avoid pandemics such as Covid-19. Ayurveda has described many herbal and compound drugs for improving the immunity like single herbs guduchi, marich, ashwagandha, yashthimadhu, rasona and compound medicines like chyawanprasa, chitraka haritaki, agastya haritaki rasayana, giloy ghanvati, kanakasava, kantakary avaleha, haridra etc. In this pandemic scenario, this conceptual study shows how immunity can be strengthened as a preventive and curative measure.

  40. Muna Al-Huthali, Esraa Bahattab and Jehad Alqurashi

    Background: Menopausal women are an increasing population that needs more attention and care. Providing counseling and management of menopausal symptoms effectively are one of the roles of primary healthcare (PHC) doctors. Thus, they need to be up to date in menopause management. Objectives: To explore the knowledge, attitude, and practices of family medicine residents towards the management of postmenopausal symptoms. Subjects and methods: Analytic cross-sectional study was performed among all family medicine residents registered at the joint program of family medicine in Makkah Al-Mukarramah city, 2021. A self- administered online questionnaire including questions about sociodemographic data, knowledge, attitude and practice of menopausal management among the participants was applied for data collection. Results: The study included 118 Family Medicine resident physicians. Majority (94.9%) aged <30 years and females represented 51.7% of them. History of ever attending courses or workshops about menopause and its management was mentioned by 18.6% of the respondents. Overall, sufficient knowledge was reported among 44.9% of them. Attending training courses was borderline insignificantly associated with knowledge level, p=0.050. Majority of the physicians (97.5%) expressed positive attitude towards menopause and its management, however, only 33.1% had good practice, with no difference between the participants according to sociodemographic characteristics and history of attending training courses. The most frequently reported barriers facing family medicine resident physicians in managing menopausal symptoms were lack of training in the management of menopause (58.5%), lack of knowledge about menopausal management (48.3%), unaware of existing guidelines (42.4%) , lack of skills (24.6%) and lack of effective referral system (24.6%). Conclusion: Insufficient knowledge and poor practice of menopause management were noticed among family medicine residents. However, positive attitude was expressed by majority of them towards menopause and its management.

  41. Dr. Mushtaq Chalkoo, Dr. Aizul Khursheed Wani, Dr. Tajamul samad and Dr. Mehraj-ud-din Ganaie

    Bochdalek Hernia (BH) is a rare variety of Diaphragmatic hernia. It’s non- specific presentation delays its diagnosis and makes patient vulnerable to potential risk of complications. The presenting symptoms include Abdominal, 62 percent, Respiratory, 40 percent, Obstructive (vomiting/abdominal distension) 36 percent, Strangulation, 26 percent; 14 percent of them are asymptomatic. They are managed by surgical intervention; surgical approach involves laparotomy, thoracotomy, and combined thoraco-abdominal approach. However, Laparoscopy and Thoracoscopy have yielded promising results and better short term outcome. Here in, we present a case report of 25 yr old man presenting with intestinal obstruction without any chest symptoms managed successfully with Laparoscopic repair and mesh placement with a good result and short hospital stay associated with minimal morbidity and mortality.

  42. Mrs. Manisha Thakur, Ms. Sarabjit Kaur, Dr. Manuja and Dr. Amrita Chaursia

    Background: COVID-19 has become a great public health concern in the world and has been declared a pandemic. It is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS CoV 2 is a positive-sense single-stranded RNA virus. COVID 19 pandemic has posed a major challenge to the health- care systems across the world. During this acute phase of the pandemic, health care workers have been working day and night to meet the need of the hour and fulfil the requirements of the covid patients and they have been facing various challenges during this pandemic. A study was done to find out the various difficulties faced by nurses anf the possible ways to cope up with the problems. Methods: A descriptive research design was used to identify the challenges faced by Indian nurses by using an electronic web-based questionnaire for data collection by using Google forms, with a consent form appended to it. The questionnaire was available to the participants through social media (Whats App, Facebook and Instagram). Study participants included 100 nursing officers of India working in the hospitals dedicated to the admission and hospitalization of COVID-19 patients. Results: Findings revealed that 42 nursing officers faced severe challenges while caring for covid-19 patients followed by moderate challenges by 34 nursing officers and mild challenges by 24 nursing officers. Conclusion: The study concluded that maximum nursing staff faced severe challenges while serving Covid-19 patients.

  43. Thiago N. ROCHA, Jéssyca R. e SILVA, Marcelo H. de S. e S. MARTINS, Thiago BLANCO-VIEIRA and Sérgio C. FILHO

    Background: In January 2020, the World Health Organization declared the Severe Acute Respiratory Syndrome Coronavirus 2 to be a pandemic. Since then, studies have demonstrated the potential of this virus to cause changes in the central nervous system and psychiatric symptoms. Some reports associating the Severe Acute Respiratory Syndrome Coronavirus 2 infection and manic symptoms have been published. Objective: Present the characteristics of manic syndrome after the Severe Acute Respiratory Syndrome Coronavirus 2 infection and provide ways to better prevent risks and identify this syndrome. Methods: Data from multiple sources of information, including reviews of medical records, direct examinations of the subjects and interviews with patients and their families, were collected and analyzed. Results: Six cases of Covid-19 infection with a first manic episode and no previous psychiatric history were reported. Conclusion: The findings of this study suggest that for mild symptomatic cases, the use of corticosteroids should be disregarded due to the risk of inducing a manic episode. The use of anticoagulation in severe conditions is reinforced by the finding of microlesions of probable microvascular etiology in one of the patients. All patients in the study had psychotic symptoms with symptom onset within the first 30 days of infection.

  44. Dr. Sonali Tamboli, Dr. Kavita Dhabarde and Dr. Vidya Hiremath

    Background & objectives: The main objective of this study was to determine microbiological profile and its association with visual outcome. The present study was conducted in the department of ophthalmology at tertiary eye care centre in central India. Methods: The present study was a hospital based prospective observational and Interventional study conducted in the department of ophthalmology at tertiary eye care centre during the period from November 2018 to Octomber 2020. After collection of aqueous or vitreous sample from all patients they received intravitreal antibiotics with or without vitrectomy and the management was based on microbiological analysis of the vitreous fluid. Results: Post operative endopthalmitis was found in 35 (45.5%) cases, post-traumatic endophthalmitis was in 31 (40.3%) cases and 11 (14.3%) cases of endogenous endophthalmitis. Males were predominant in all three types of endophthalmitis. There were 22 patients with only culture positive findings and 10 cases with both smear and culture positive finding. 24 culture samples were positive for bacteria and 8 were positive for fungi. Postoperative endopthalmitis was most common among all types. All Gram-positive bacteria were susceptible to vancomycin and all gram negative bacteria were Susceptibile to ceftazidime. Visual outcome of fungal endophthalmitis cases was poorer compared to bacterial endophthalmitis. Post-interventionv Best corrected visual acuity (BCVA) was better when the vitreous samples was negative in culture. Interpretation & conclusions: The outcome of infectious endophthalmitis and spectrum of infection in central India was similar to other parts of the country. Compared to bacterial endophthalmitis, the visual outcome of fungal endophthalmitis cases was poorer. Empirical use of standard intravitreal therapy is recommended while emphasizing on vitreous biopsy for culture and sensitivity whenever possible.

  45. Tovi, W. M. O., Komenan, E. O. P. K., Irie BI, B. B. and Kouakou, K.

    Objective: Alliumcepa is often used in traditional African medicine for the management ofmany pathologies. Therefore, our objective was to study the anti-histaminic effect of the aqueous extract of Alliumcepa in mice. Material and Methods: Allergy was previously induced in mice by administration of an allergic solution (0.15 ml egg white, 0.05 ml maalox and 0.05 ml NaCl) intraperitoneally. The antiallergic effect of the Total Aqueous Extract (TEA) of Alliumcepa leaves was evaluated by observing the number of scratching in allergic mice treated orally with different doses (250 and 500 mg/kg of body weight) of this extract. Results: The phytochemical study revealed the presence of polyterpenes, sterols, polyphenols, flavonoids, tannins, quinone and alkaloids but also the absence of saponosides. The acute toxicity study at the single dose of 2000mg/kg CP orally revealed that the aqueous extract of Alliumcepa is not toxic and would have an oral LD 50 greater than or equal to 5000mg/kg CP. After oral administration of the extarit, we observe a reduction in the number of scratching in allergic mice. Conclusion: These results show that Alliumcepa bulbs have an anti-allergic activity, which would justify its use in African traditional medicine to prevent or treat allergy.

  46. Ioannis Stamatatos, MD, MSc

    Background: Infected aortic aneurysm is one of the major clinical challenges vascular surgeons are facing, with high incidence of morbidity and mortality. In this study we present the advantages of endovascular treatment in patients with infected aortic aneurysms and clarify the factors that determine favorable outcome of these patients. Material and Methods: A comprehensive systematic retrospective study (PubMed, Medline, Embase, Google Scholar and Scopus) according to the recommendations of the PRISMA statement for administrative dataset registries reporting outcomes after patients treated endovascularly for infected aortic aneurysm and a thorough evaluation of references. Results: Endovascular treatment of infected aortic aneurysms may reduce the early and mid-term mortality. Prolonged fever, fatigue, aortic rupture, aortoenteric, aortobronchial and aortoesophageal fistulas greatly increase the rates of reintervention, morbidity, and mortality. Survival rates in patients without fistulae even reached 94% at 2 years. Conclusion: In treatment of infected aortic aneurysms, the use of endovascular aortic graft provides an alternative, to open repair method, and simplifies the management of patients who are in this critical condition. Endovascular treatment of infected aortic aneurysms is feasible both as a temporary measure and the preferred definitive treatment in selected patients.

  47. Dr. Rohit Balas, Dr. Tajgna Kadia and Dr. Kamlesh Patel

    Background: According to the WHO-2020, a quarter of the world’s population will suffer from a mental disorder due to substance abuse are projected to account for 15 % of the global disease burden. AUDs can be categorized as harmful use, hazardous use or dependence. Depressive and anxiety disorders as well as alcohol use disorders are among the most common psychiatric disorders in the general population that alarming as these disorders have a serious impact on a person’s physical, social and occupational functioning and constitute a large economic burden to society. Methods: Cross-sectional study was conducted at tertiary care hospital in Department of Psychiatry. 90 Patients diagnosed with AUD andtheir 90companion who fulfilled inclusion criteria were included in study. Participants were subjected to social-demographic details, alcohol consumption details, AUDIT, HAM-D and HAM-A. Results: Of 90 AUD patients, 5(5.6%)-low, 14(15.6%)-medium, 42(46.7%)-high and 29(32.2%)-veryhigh AUDIT score. In AUD patients 27(30%) were depressed and 27(30%) were anxious & suggests that possible association with demographic variables(age, occupation and age of onset) and depression & with demographic variables(age, SEC and age of onset) and anxiety.In Companion, 21(23.3%) were depressed and 8(8.89%) were anxious & suggests that possible association with demographic variables(education, occupation,social economical status and duration of living with AUD patient) and depression with demographic variables(education, occupation, SEC and duration of living) and anxiety. Conclusion: This study indicated that AUD patients showed severe levels of depression and moderate levels of anxiety & companion had severe levels of depression and moderate levels of anxiety.

  48. Dr. Sanjay Prasad Gupta and Iliyas Ahmed

    The selection of the appropriate adhesive and filler is always an important issue in conservation of wooden artifacts of Cultural Heritage. A poor adhesive can cause further and sometimes irreversible damage, both aesthetically and mechanically to an already deteriorated object. Hence, before selecting a potential adhesive, its performance is assessed by several criteria including i) long term stability ii) reversibility iii) characteristics after curing such as colour, hardness, brittleness and sensitivity to relative humidity (RH) and temperature (T) iv) bond strength v) physical characteristics such as open and closed time, viscosity, concentration vi) health and safety issues and vii) cost and ease of application11-14. The functional requirements of gap-filling adhesive for use in the structural conservation of Dharumavantha Rasgefaanu Mosque impose considerable constraints on the choice of material for this purpose. Some degree of flexibility in the adhesive is considered an important material characteristic. Adhesive types considered include natural and synthetic, water based materials such as acrylic and polyvinyl acetate. The paper presents an evaluation, based on accumulated personal experience from the practice of wood conservation and performance of a range of adhesive systems for gap-filling application.

  49. Dr. KOSSOUGBETO Briac Kevin Patrick, Dr. YESSOUFOU Moukadamou Joslin, Dr. HOUEHANOU Ernesto Cabral and Dr. OUSSENI AROUNA

    The use of a tacheometer (total station) during precision surveying makes it possible to combine the altimetry and planimetric components for the rapid execution of the work. Tacheometers offer the advantage of defining with enough precision the position of the points in the plane. But for a comparison of the altimetry component to the results of a direct leveling it is desirable to take into account certain factors in order to improve the accuracy of the measurements. The evolution of technology gives the possibility not only to carry out certain works quickly but also with the necessary precision. The tacheometer makes it possible to make a tacheometric survey (detail survey) simultaneously in planimetry and altimetry. This avoids performing this task first with the theodolite for the planimetric component and then with the level for the altimeter component. The section of the railway adjaha crossroads "Commune of Cotonou" – Pahou crossroads "Commune of Ouidah" was chosen in order to be able to compare the results of the measurements on different ranges. The fieldwork was divided into two stages. The first is based on the use of theodolite for planimetric measurements and the level for altimetry. For the second phase the tacheometer was used for a combination of the two measurements (altimetry and planimetry). For ranges greater than 150m it is recommended to evaluate the joint influence of refraction and curvature of the earth in order to improve the altimetry component of the measurement.). The study focuses on the methodology and content of geodetic engineering work on railways (Carrefour Adjaha – Carrefour Pahou). It gives an analysis of existing methods and describes the characteristics of the work using electronic tacheometers.

  50. Kaza Swarajya Lakshmi and Dr. Santhi Sri, K.V.

    It is estimated that 50% of Indian women are 15 to 49 years old. India has been struggling with malnutrition and undernutrition for many years. Poor nutritional and dietary habits, low spending capacity, and inability to afford a good quality diet. Central and state governments have taken many initiatives to improve the status. Hemoglobin is a very crucial parameter for pregnant ladies. Pregnancy is a significant face in women's life. One of the fundamental problems pregnant women faces is Iron deficiency anemia. Anemia may cause premature birth of babies, low birth weight, and maternal mortality. NITI Aayog and National Institute for Transforming India have indicated a strong focus on essential nutritionfor pregnant and lactating women and children during the first 1000 days of a child's life. A mother's diet is the primary source of the overall well-being of the mother and infant. Iron deficiency anemia is widespread in pregnancy. Iron and folic acid are essential minerals before and during pregnancy. Red cell mass will increase in the pregnancy. Many factors will cause the condition of anemia.To deal with anemia during pregnancy Andhra Pradesh Government implemented Integrated Child Development Services Scheme (ICDS), a universal scheme is being implemented to deliver Nutrition, Health Care through the sampoornaposhana scheme.The present study evaluates the scheme's benefits and its impact on improving the hemoglobin level in pregnant ladies in three trimesters.

  51. Eleonora Alexandrovna Yurieva, Maria Vasilievna Kushnareva, Vladimir Viktorovich Dlin, Ekaterina Alexandrovna Popova, Ekaterina Sergeevna Vozdvizhenskaya and Ekaterina Igorevna Shabelnikova

    The generalized data of publications on coronavirus infection in children, including neonatal and subsequent age periods, are presented in the review. Children are less likely to get sick than adults, but they are more often asymptomatic carriers of infection. The similarities and differences in the course of infection in adults and children are shown. A rarer incidence and a mild course of infection can be associated with the peculiarities of the activity of the immune system in children due to frequent age-related vaccinations and more frequent "contact infections". In addition, the difference in the expression sites of the APF2 receptor may play a role, facilitating the penetration of the pathogen of CoV-19 into the cell (in children - in the intestine, in adults - in the respiratory tract). Children develop gastrointestinal tract pathology more often than adults when infected with SARS CoV-2, typical and atypical manifestations of Kawasaki disease are found. The main recommendations of the Ministry of Health of the Russian Federation on the treatment and prevention of coronavirus infection are presented.

  52. Atul Samiran and Gopal Roy

    It has been reported that, hyperglycaemia is more common in patients with coronavirus disease 2019 (COVID-19). COVID-19, which triggered by the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), can cause extrapulmonary symptoms such as diabetes mellitus (DM) and hyperglycaemia, which both indicate a poor prognosis and a higher chance of death.SARS-CoV-2 infects the pancreas through angiotensin-converting enzyme 2 (ACE2), which is abundantly expressed in the pancreas relative to other organs, causing pancreatic damage, insulin secretion impairment, and hyperglycemia in non-DM patients. Thus, the present study provides an overview of the potential association or relation or linkage between COVID-19 and hyperglycemia as a risk factor for the development of diabetes mellitus in relation to diabetes pharmacotherapy.

  53. Chhaya D. Badnakhe

    The synthesis, spectral analysis and biological activities of 5-phenyl-2- hydroxy-chlorosubstituted-2-amino-1,3 thiazoles have been carried out. In this case 5- (2’-hydroxy-3’,5’-dichlorophenyl)-4-(heptan-1-one)-2-phenyl amino-1,3-thiazole (K) has been screened. The compound K was synthesized from 1-(2’-hydroxy-3’,5’- dichlorophenyl)-2-bromo-1,3-nonanedione (a4) by the action of phenylthiourea. The nanoparticles of the compound K has been prepared by using ultrasonic technique. The titled compound and its nanoparticles were assayed for antipathogenic impact against some common crop pathogens viz - Aspergillus niger, Pseudomonas lachrymans, Fusarium oxysporum and Fusarium solani.

  54. Yambem Salina Khuman, Shashirani Pangambam and Karma Doma Bhutia Sikkim Manipal

    Introduction: Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. The American Pain Society (APS) has officially declared pain as the fifth vital signs. Intramuscular (IM) injection is a common procedure that nurses frequently carry out and observe pain and distress to the recipient. The aim of the study was to compare the effectiveness of ice cube and vapocoolant spray as an anesthetic pre-treatment for IM injection among patients in selected hospital, East Sikkim. Method: A quantitative factorial design study was conducted on patients, receiving intramuscular tetanus toxoid injection at Central Referral Hospital, Gangtok, East Sikkim. Total 50 participants were selected using simple random sampling technique. The demographic data of the patients were collected using structured questionnaire and a Standardized Numerical Pain Rating Scale was used to assess the pain level after the administration of intramuscular tetanus toxoid injection using ice cube and vapocoolant spray as an anesthetic treatment. Result: The study findings highlights that the mean and SD for intensity of pain in ice cube group was 1.84±1.313 and in vapocoolant group was 2.92±1.470 with mean difference was 0.157 and (t=2.740 and p=0.009) and p<0.05 level of significance which was statistically significant and indicates that ice cube was more effective than vapocoolant in reducing the intensity of pain among patients as an anesthetic pre-treatment for IM injection. The findings also revealed that there is no association between the level of pain with selected demographic variables. Conclusion: The study found that ice cube was more effective than vapocoolant spray to reduce the level of pain while administering IM injection. The study intervention would help the health care professionals mainly the staff nurses to execute the practice of using ice cube before IM injection to reduce pain.

  55. Prof. Nizamuddin Khan, Prof. Iftekhar Ahemmed and Dr. Syed Kausar Shamim

    WHO defines disaster as a sudden ecological phenomenon of sufficient magnitude to require external assistance; thus they have a greater impact on habitat, usually changing the landscape of an area. Disaster management deals with the human, material, economic or environmental impacts of said disaster in the form of grim distraction to the operative part of a community that surpasses its capability to cope with. Disasters affect the substantial numbers of people who are exposed to life-threatening events to which they are susceptible, causing injury and loss of life, frequently pooled with destruction to property and livelihoods. Hazards brings about the emergency situation leading disastrous impact cannot be controlled but their impacts may be reduced. The present study is based on descriptive research analysis of disaster management with the help of published material on the subject matter as well as religious text especially Islamic treatise Holy Quran and Hadith. It also aims to explore the role of religious thoughts and public opinion based these established religious opinions to manage these disasters. The study reveals that the religious knowledge and are not solely responsible to control the though making process and have limitations as compared to scientific explanations pertaining to the genesis and warning of occurrence of disasters, however these religious writings and explanations can be of much importance to provide the strong base to the scientists for further exploration. It has also been revealed that all kinds of occurrence of natural disasters have hidden scientific systems to be reconnoitred. The most important components being the preparedness followed by response, recovery and rehabilitation would be optimally and rationally managed with the inspiration and inducement of religious leaders, institutions and organisations irrespective of their location. It is suggested that the society and community should be prepared in such a way that can represent the resilience whether using top-to-bottom or bottom-to-top approach in dealing with the impact on these natural disasters considering an integrated approach keeping in view the knowledge and expertise of local indigenous traditions, perception, rituals, religious education besides government policies and framework to entrust with the scientific temperament of the subject matter.

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