International Archives of BioMedical and Clinical Research <p style="text-align: justify;">International Archives of Biomedical and Clinical Research (IABCR) is an open access, international, peer-reviewed, quarterly multidisciplinary medical research journal that focuses on communicating high quality research articles, reviews, Short communications, case reports, Letter to Editor, Drug News and updates in the field of Medical, Dental and other allied health and BioMedical Sciences. The Journal publishes 4-four issues in a year.</p> <h3>Connecting Researchers Globally</h3> <p style="text-align: justify;">IABCR offer Researchers, Academicians a better option when it comes to Open Access Journal publishing. Our platform vies to become the standard for all open access publications, irrespective of subjects or branches and aims to bring together researchers from all over the world and under a single global organization to form a community that actively creates new data and shares it with everyone with the utmost ease and simplicity.</p> <h3>Ethical guidelines for journal publication</h3> <p style="text-align: justify;">The Editor-in-Chief/Editor of International Archives of BioMedical and Clinical Research (IABCR) is responsible for determining which of the research papers/articles submitted to the journal should be printed. The publication decision is based on the recommendation of the journal's reviewers. The Editor-in-Chief /Editor may be maneuvered by the policies of the journal's editorial board and constrained by such legal requirements as shall then be in force regarding libel, copyright infringement and plagiarism. The Editor-in-Chief/Editor may consult with other editors or reviewers in getting to this determination.</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> en-US (Dr. Farhan Ahmad Khan, MD) (Mohd Waseem) Sat, 09 Oct 2021 10:18:34 +0000 OJS 60 Anosmia and ageusia in COVID-19: Updating its pathophysiology, diagnosis and treatment <p>Infection caused by the new coronavirus SARS-CoV-2 produces different clinical manifestations, including anosmia and ageusia, which can occasionally be persistent after the disappearance of other symptoms, which is the reason for the current review, with the aim of presenting the pathophysiology, diagnosis and management of these alterations in an updated manner. Through a search in scientific databases and worldwide recognized organisms in Health, evidence published since 2019 was compiled, where answers were found to new physiopathological bases that explain such disorders, such as the cofactor Neurolipin 1; and effective subjective methods for the diagnosis, as well as objective tests generally used by specialists, finally in terms of treatment there are described varieties ranging from olfactory training to the use of corticoids. In conclusion, the aspects studied related to the manifestations of COVID19 are constantly providing pathophysiological answers and therapeutic alternatives.</p> Enrique Arturo Lombana Salas, Moisés Andrés Lombana Salas, María Camila Miranda Jiménez , Michelle Bedoya Coronel, Wendy Yulieth Herazo Madera, Andrés Felipe Ducuara Hernández Copyright (c) 2021 Enrique Arturo Lombana Salas, Moisés Andrés Lombana Salas, María Camila Miranda Jiménez , Michelle Bedoya Coronel, Wendy Yulieth Herazo Madera, Andrés Felipe Ducuara Hernández Sat, 09 Oct 2021 10:12:48 +0000 Myocardial workload and fat oxidation in walking versus cycling by overweight and hypertensive adult males <p>Background: The fast-paced increase in the prevalence of obesity and hypertension in India is burdening the country with non-communicable diseases that include cardiovascular disease. Exercise is a primary intervention to manage obesity and hypertension. Treadmill and stationary cycle are the most common form or modalities of indoor exercise adapted by individuals. The modality of exercise causing higher fat oxidation at a lesser myocardial workload should be preferred. The objective of the study was to compare the rate pressure product (RPP, a correlate of myocardial workload) and respiratory exchange ratio (RER, lower value indicates a higher contribution of fat oxidation to total energy expenditure during exercise) in treadmill walk with stationary cycling. Methods: The present crossover study involved twelve, overweight, hypertensive, and physically inactive adult males. The participants exercised for thirty minutes on the treadmill and stationary cycle with a target energy expenditure of 180 Kcal. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded by an automated blood pressure monitor, and RPP in arbitrary unit (AU) was calculated as SBP×HR÷100. Respiratory gas exchange analysis determined the volume of oxygen consumed (VO2) and carbon dioxide produced (VCO2). RER was calculated as VCO2÷VO2. Student t-test was applied and P≤0.05 was considered significant. Results: SBP, HR, RPP, and RER was significantly higher in cycling (160.4±4.5 mmHg, 131.9±7.1 beats per minute, 211.4±8.6 AU, and 0.88±0.04) than the treadmill walk (158.4±4.9 mmHg, 129.6±7.6 beats per minute, 205.3±10.9 AU, and 0.86±0.03). Conclusion: Treadmill walk resulted in lesser myocardial workload and higher fat oxidation than cycling.</p> Mayank Agarwal Copyright (c) 2021 Mayank Agarwal Sat, 09 Oct 2021 10:06:09 +0000 Correlation of Basal Marker Expression in Triple Negative and Non-Triple Negative Breast Carcinomas <p><strong>Background: </strong>Breast cancer is a multifaceted disease comprising of distinct biological subtypes and various molecular features with different prognostic and therapeutic implications. Breast cancers with ER/PR negative, HER2 negative phenotype are classified as triple negative tumours and have poor prognosis and therapy response. Four basal like markers, namely CK5/6, CK14, CK17 and EGFR of which at least two should be positive to be termed as Basal-like breast cancer. Basal-like breast cancers (BLBC) are often called triple negative (TN) breast cancers<strong>. </strong>Although, a significant overlap was observed between the triple-negative breast cancer and BLBC, triple negativity should not be used as a surrogate marker for the basal-like breast cancers.</p> <p>The aim of the study is to show the importance of basal markers in diagnosis of triple negative/non triple negative breast cancers.</p> <p><strong>Materials and Methods: </strong>The study was performed for the expression of ER, PR, HER2, CK 5/6 and EGFR by Immunohistochemistry (IHC) in 48 breast carcinoma patients who underwent for radical mastectomy and cases had triple negative phenotype were correlated with basal markers for any significance.</p> <p><strong>Results: </strong>Out of 48 breast carcinoma cases, 21 were triple negative. 15 (71.4%) TN cases showed basal marker positivity as compared to 62.9% of non-TN cases.</p> <p><strong>Conclusions: </strong>Expression of basal markers was more among the triple negative breast carcinomas. However, not all basal-like cancers lack ER, PR and HER2 expression and conversely not all triple negative cancers show a basal-like expression.</p> Pawan Trivedi, Priyanka Singh, Santosh Kumar Jain Copyright (c) 2021 Pawan Trivedi, Priyanka Singh, Santosh Kumar Jain Sat, 09 Oct 2021 09:51:00 +0000 Incidence and Prevalence of Osteogenic and Non Osteogenic Bone Tumors in Western Uttar Pradesh <p><strong>Introduction:</strong> Primary bone tumors are uncommon lesions constituting less than 1% of all cancers. In these primary bone tumours benign bone tumours are common than malignant tumours. This study was conducted to determine the spectrum and demographic characteristics of bone tumors and tumor like lesions at a tertiary care centre in western Uttar Pradesh.</p> <p><strong>Material and method-</strong> This is a five year, retrospective as well as a prospective study done on a total of 200 cases of benign and malignant bone lesions. After a detailed clinical history and local examination, paraffin sections of resected specimen were studied by Hematoxylin and eosin, immune-histochemical stain and osteonectin.</p> <p><strong>Result-</strong> Benign and malignant tumour accounted for 70% and 30% of the total cases. Most common tumour in this study was giant cell tumour (22.5%) cases followed by osteosarcoma (18%), fibrous dysplasia (9%), aneurysmal bone cyst (7.5%), Osteochondroma (7%), callus formation (7%), osteoid osteoma (5%), chondrosarcoma (4.5%) and Enchondroma (4%).&nbsp; Incidence of bone tumour was more in female population.&nbsp;</p> <p><strong>Conclusion-</strong> Giant cell tumours are most common benign bone tumour and osteosarcoma is most common malignant bone tumour.</p> Sadaf Mirza, Priyanka Singh, Mohammad Kashif, Arshad Ikram Copyright (c) 2021 Sadaf Mirza, Priyanka Singh, Mohammad Kashif, Arshad Ikram Sat, 09 Oct 2021 09:47:22 +0000 Role of Hormone Receptors- Estrogen receptor, Progesterone Receptor and Human Epidermal Growth Factor Receptor 2/Neu (Her2/Neu) as a Prognostic and Therapeutic Tool in Breast Cancer <p><strong>Background: </strong>Breast carcinoma (BC) is the second most leading cancer which mostly occurs in younger age group. It is better to represent BC by the combined receptor expression pattern, as single receptor status alone will not help in treatment and management of tumor. This study aims to analyze the expression pattern of ER, PR and Her‑2/neu hormone receptors in BC patients for evaluating their clinicopathological correlation with other factors for BC development in the Southern Assam region of India.</p> <p><strong>Materials and Methods: </strong>60 number of breast carcinoma cases were studied from December 2016 – November 2018. Immunohistochemical analysis of all the samples were done. Data including age, gender, tumor size, histological grade and type, lymph node status were collected from the Pathology Dept. All the data were entered and analyzed in SPSS Software. ANOVA analysis and Pearson correlation test was done for determining statistical significance.&nbsp;</p> <p><strong>Result:</strong> The mean age was found to be 41.33 ± 9.63. The most common type of carcinoma was found to be Invasive Breast Carcinoma (Ductal), NOS Type. Grade-II was the most prevalent type followed by Grade-III and Grade-I. PR is statistically significant with age (p=0.001) and gender (p= 0.002). ER and PR are significantly positively correlated with each other (‘r’=0.323 and p=0.012) and Her2/neu was significantly negatively correlated with ER and PR expression (‘r’= -0.333, p=0.009 and ‘r’= - 0.274, p=0.034 respectively).</p> <p><strong>Conclusion:</strong> In this present study ER/PR expressions were found to be low, while Her-2/neu over-expression was higher. So, Her-2/neu, is an important predictive and prognostic marker at a very young age.</p> <p><strong>Keywords: Her-2/neu, Prognostic marker, SPSS, Breast carcinoma, Progesterone receptor.</strong></p> <p><strong>&nbsp;</strong></p> Nivedita Dasgupta Copyright (c) 2021 Nivedita Dasgupta Sat, 09 Oct 2021 10:08:25 +0000 A Study of Genotypic Characterisation (mec-A Gene & Panton Valentine Leukocidin Gene) of Methicillin Resistance Staphylococcus aureus Strains Isolated From Tertiary Care Hospital <p><strong>Background:</strong> MRSA causes globally severe morbidity and mortality. Methicillin resistance is caused by the presence of&nbsp;<em>mec</em>A gene, which has a low affinity for β-lactam antibiotics, whereas absence of the gene from <em>Staphylococcal </em>strain indicates methicillin susceptibility. Cefoxitin is a potent inducer of the <em>mec</em>A regulatory system. The PVL gene has been detected in skin associated hospital acquired infection.</p> <p><strong>Aims and Objectives:</strong> To isolate methicillin resistant Staphylococcus aureus from various clinical specimens from hospital acquired infections and study the association of mecA and PVL gene in MRSA from tertiary care hospital.&nbsp;</p> <p><strong>Materials and Methods:</strong> Processing of specimens were done according to standard bacteriological procedures and identification of bacterial isolate was done by colony morphology &amp; biochemical test and further subjected to antibiotic susceptibility testing and to Polymerase chain reaction for detection of mec A gene and PVL gene.</p> <p><strong>Results</strong>: Testing with cefoxitin disk diffusion method identified 162 isolates as MRSA, by PCR, mec-A gene was present in 162 isolates and 32 isolates of MRSA showed PVL gene and both the genes were present in 21 isolates of MRSA.</p> Vichal Rastogi, Ashutosh Rawat, Dakshina Bisht, Anurag Prasad Copyright (c) 2021 Vichal Rastogi, Ashutosh Rawat, Dakshina Bisht, Anurag Prasad Sat, 09 Oct 2021 09:59:35 +0000 Outcomes of Type-I Tympanoplasty with and without Cortical Mastoidectomy in Chronic Otitis Media- Inactive Mucosal Diseases <p><strong>Abstract:</strong></p> <p><strong>Aims: </strong>To evaluate the outcomes of type-I tympanoplasty with and without cortical mastoidectomy in patients of inactive mucosal chronic otitis media with sclerosed mastoids.</p> <p><strong>Methods: </strong>&nbsp;The study was prospective in nature and comprised of 64 patients suffering from chronic otitis media inactive mucosal disease with sclerosed mastoids. The patients were divided into two groups (Group-I &amp; Group-II) based on the patency of the eustachian tube. Further subgroups (Group-IA &amp; Group-IB and Group-IIA &amp; Group-IIB) were made into each group on the basis of intervention being done. Type-I tympanoplasty was done in Group-IA &amp; group-IIA whereas cortical mastoidectomy along with type-I tympanoplasty was performed in Group-IB &amp; Group-IIB. Evaluation was done in terms of uptake of the graft and post-operative mean audiological gain. The results of different interventions done was compared within each group.</p> <p><strong>Results: </strong>The difference in the successful graft uptake and mean audiological gain in the group of the patients with patent eustachian tube (Group-IA &amp; Group-IB) was not statically significant. There was statically significant difference in the graft uptake and mean audiological gain in the patients undergoing type-I tympanoplasty alone and cortical mastoidectomy with type-I tympanoplasty with blocked eustachian tube group (Group-IIA &amp; Group-IIB).</p> <p><strong>Conclusion: </strong>On combining the cortical mastoidectomy with type-I tympanoplasty there was no statistically significant difference in the outcome of the patients with patent eustachian tube. Whereas in the group of the patients with blocked eustachian tube the outcome improved significantly on combining the cortical mastoidectomy with type-I tympanoplasty.</p> <p><strong>Keywords: </strong>Type-I tympanoplasty; Type-I tympanoplasty with Cortical mastoidectomy; Chronic otitis media-inactive mucosal disease.</p> Aftab Ahmed, Jabir Bin Ummer K P, Satish Chandra Sharma Copyright (c) 2021 Aftab Ahmed, Jabir Bin Ummer K P, Satish Chandra Sharma Sat, 09 Oct 2021 10:10:36 +0000 Implementation of WHO Surgical Safety Checklist in Assessing Surgical Mortality, Morbidity and Length of Hospital Stay <p><strong>Background:</strong> In the era of quality assurance, strategy development to overcome avoidable human errors has become imperative. One of the most important goals for healthcare organizations is patient safety. Studying of four pillars of safe surgical care: infection prevention, anaesthesia safety, team work and communication, and measurement of surgical capacity and outcomes resulted in the development of WHO Surgical Safety Checklist (SSC) in June 2008. The present study was conducted to assess the surgical morbidity, mortality, length of hospital stay and quality of life after routine implementation of the WHO Surgical Safety Checklist on patient’s undergoing major operative procedure.</p> <p><strong>Materials and Methods :</strong> This was a prospective study which included 50 cases (Group A) on which the checklist was applied and 50 controls (Group B) on which the checklist was not applied in the Department of General Surgery at Government Medical College and Rajindra Hospital, Patiala during the period of May 2019 to December 2020.</p> <p><strong>Results :</strong> The study has shown an overall decrease in complication rates from 58% to 22% after the implementation of the checklist. Wound discharge showed a decrease from 34% to 16% whereas rates of wound dehiscence decreased by 18% after the implementation of the checklist. Surgical Site Infection (SSI), one of the most common complications seen in surgical wards showed significant decrease with p-value = 0.037. Mortality rates also showed a decrease by 2% post-implementation of the checklist. The mean hospital stay, however, showed non-significant results with stay decreasing from 9.40 days to 8.70 days post-implementation. Successful communication was observed after checklist implementation (Anaesthesiologists: 78.12% vs. 93.75%; Surgeons: 88.46% vs. 94.87%; Circulating Nurses: 70.0% vs. 82.5%)</p> <p><strong>Conclusion:</strong> It can be concluded from our study that effective implementation of the checklist improves communication and teamwork, decreases the occurrence of adverse events both intra-operatively and post-operatively and subsequently improving patient’s quality of life.</p> Parth Dhamija, Manisha Aggarwal, Rachan Lal Singla, Ashwani Kumar Copyright (c) 2021 Parth Dhamija, Manisha Aggarwal, Rachan Lal Singla, Ashwani Kumar Sat, 09 Oct 2021 10:01:37 +0000 Association of Metabolic Syndrome with Severity of Coronary Artery Disease in Patients Undergoing Coronary Angiography with the Gensini Sore: A Cross-Sectional Observational Study <p><strong>Background: </strong>Little data exists about the association of metabolic syndrome (MetS) with severity of coronary artery disease (CAD) and correlation of the extent of CAD in patients with MetS assessed by Gensini score in Indian context.</p> <p><strong>Aim: </strong>The present study explored to investigate the association of MetS and its metabolic components with severity of CAD in patients undergoing coronary angiography and to compare the severity of CAD in patients with MetS and without MetS using the Gensini score.</p> <p><strong>Methods: </strong>This was a single-center, observational and cross-sectional study conducted at tertiary health care center between July, 2020 and June, 2021. The study population included 100 consecutive patients who underwent coronary angiography and were divided into two groups based on International Diabetes Federation (IDF) criteria (1): Group I (n=56 patients with MetS) and Group II (n=44 patients without MetS).</p> <p><strong>Results:</strong> Prevalence of MetS in CAD was found in 42 patients. A higher prevalence of male patients was found in both the groups (55.4% vs. 68.2%, p=0.272) with a mean age of 55.32 ± 7.8 and 53.45 ± 10.4 years, respectively (p=0.308). Body mass index (26.80 ± 2.80 kg/m<sup>2</sup> vs. 24.08 ± 1.87 kg/m<sup>2</sup>; p&lt;0.001), BMI&gt;25 kg/m<sup>2</sup> (71.43% vs. 38.64%; p&lt;0.001), waist/hip ratio (0.93 ± 0.02 vs. 0.91 ± 0.02; p &lt;0.001), and hypertension (60.71% vs. 20.45%; p &lt;0.001) were the most common risk factors found significantly higher in group I than group II. All the components of MetS according to IDF criteria were significantly higher in group I compared to group II (p&lt;0.005), except triglycerides (p=0.285). Fasting blood glucose was the most common component of MetS followed by SBP, DBP and HDL.&nbsp; Significant correlation was found between number of vessels affected and Gensini score (p&lt;0.01) as well as between sex and Gensini score (p&lt;0.001). Group I had significant higher values of hypertension (44.47 ± 41.33 vs. 29.16 ± 22.47; p=0.020), alcohol consumption (46.71 ± 36.66 vs. 31.26 ± 30.05; p=0.031), and xanthelesma (69.25 ± 35.78 vs. 32.83 ± 30.93; p=0.002) than group II. Low levels of HDL correlated significantly with the Gensini score (p&lt;0.001).</p> <p><strong>Conclusion:</strong> Patients with CAD had a higher prevalence of metabolic syndrome thus it is associated with severity of CAD.&nbsp; Gensini score may be employed to recognize patients at a high risk for CAD.</p> Sumit Kumar Tripathi, Pradeep Kurmi, Sumit Pratap Singh Copyright (c) 2021 Sumit Kumar Tripathi, Pradeep Kurmi, Sumit Pratap Singh Sat, 09 Oct 2021 09:55:07 +0000 Role of immediate versus deferred radiotherapy in good prognostic post-operative histologically proved low grade gliomas <p>Purpose : The aim of our prospective study was to compare the role of immediate radiotherapy with delayed radiation therapy in good prognostic low grade gliomas.</p> <p>Material and methods: A total of 30 patients of low grade glioma ( grade I,II) with good prognostic features like tumor&nbsp; size &lt;5 cm not crossing midline, no neurological deficit, KPS &gt;70, young patients&lt;40 years old were divided into two groups A and B of 15 each. One group received radiotherapy immediately after surgery as post -operative adjuvant therapy and second group of patients were observed for any symptomatic deterioration and evidence of progressive disease on serial MRI done every 3 months. The data was analysed in terms of age, sex, site of tumor, tolerance, toxicity, survival and inference was drawn.</p> <p>Results : the two groups were matched in age and sex distribution ( mean age 32.6 years and 30.3 years respectively ). 86.7 % in group A and 60 % in group B were males. The chief complaints were seizures and headache in both the groups (86.7% and 80% respectively). The location of tumor in the frontal region was more common ( 26.7% in group A and 33.3% in group B). Majority of the patients were able to underwent gross tumor resection and decompression (93.3% in both groups). Both the groups were equally matched in terms of duration of symptoms &gt;6 months or &lt; 6 months (53.3% in group A and 46.7% in group B. Among the group B who were kept under observation , 5 (33.3%) patients got radiotherapy in view of progressive disease. At the end of 2 years 93.35% patients were alive in both groups. Majority of the patients tolerated radiation therapy well with mild symptoms like loss of appetite, dyspepsia,headache.</p> <p>Conclusion : our results showed that delayed radiotherapy with wait and watch concept may be an option with close monitoring in good prognostic completely resected low grade gliomas. Large randomized clinical trial with longer follow up is necessary to clarify these issues to determine a consistent policy.</p> karuna karuna; manjit kaur rana manjit, pardeep sharma pardeep, sheetal sachdeva sheetal Copyright (c) 2021 karuna karuna; manjit kaur rana manjit, pardeep sharma pardeep, sheetal sachdeva sheetal Sat, 09 Oct 2021 10:14:31 +0000 Association between the consumption of vegetables and fermented foods and COVID-19 mortality at a country level in Europe. An ecological study <p><strong>Purpose</strong></p> <p>Many foods have an antioxidant activity, and nutrition may mitigate COVID-19. Some countries with a low COVID-19 mortality have a relatively high consumption of cabbage or fermented foods. To test the potential role of fermented foods and cabbage in COVID-19 mortality in Europe, we performed an ecological study.</p> <p><strong>Methods</strong></p> <p>The EFSA Comprehensive European Food Consumption Database performed an analysis on country food consumption. Fermented foods were analysed in sub-study 1, and cruciferous and other vegetables in sub-study 2. We obtained the COVID-19 mortality per number of inhabitants from the Johns Hopkins Coronavirus Resource Center. EuroStat data were used for data on potential confounders at the country level including Gross Domestic Product, population density, percentage of people older than 64 years, unemployment rate and obesity. Mortality counts were analysed using quasi-Poisson regression models - with log of population as an offset - to model the death rate while accounting for over-dispersion. A hierarchical model was used to account for multiple data.</p> <p><strong>Results</strong></p> <p>Amoung the variables considered, only fermented vegetables reached statistical significance concerning COVID-19 death rate in sub-study 1. &nbsp;In sub-study 2, cabbage and cucumber showed significance, although, for cucumber, this was no longer the case after hierarchical assessment. Adjustment did not change the point estimate, and results were still significant.</p> <p><strong>Conclusions</strong></p> <p>The negative ecological association between COVID-19 mortality and consumption of fermented vegetables or cabbage supports the <em>a priory</em> hypothesis previously reported. This hypothesis needs to be tested in individual studies performed in countries where the consumption of fermented vegetables is common.&nbsp;</p> <p><strong>&nbsp;</strong></p> Jean Bousquet, Susana Fonseca, Xavier Basagana, Dora Romaguera, Marcos Quijal, Wienczyslawa CZARLEWSKI, Alain Vidal, Joao Fonseca, Josep Anto, Luis Cunha Copyright (c) 2021 Jean Bousquet, Susana Fonseca, Xavier Basagana, Dora Romaguera, Marcos Quijal, Wienczyslawa CZARLEWSKI, Alain Vidal, Joao Fonseca, Josep Anto, Luis Cunha Sat, 09 Oct 2021 10:17:58 +0000 Estimation of Sample Size in Biomedical Research: A Quick Guide for Postgraduate Medical Students <p>Calculation of sample size becomes a challenging task for many of the postgraduate medical students. Given the time and resource constraints, it often becomes quite overwhelming for the resident doctors to come up with a feasible sample size obtained scientifically and with a statistical validity, given that for most medical students, the postgraduate thesis work is the stepping stone to the dynamic world of medical research. While some propose very high numbers and end up collecting data from a much smaller sample, thus compromising on the study power, some state too small a sample size to draw any valid conclusion. This article is meant to serve as a quick guide for the postgraduate medical student and budding biomedical researchers to understand ways to calculate sample size.</p> Ahmad Najmi, S Balakrishnan, S. Avik Ray Copyright (c) 2021 Ahmad Najmi, S Balakrishnan, S. Avik Ray Sat, 09 Oct 2021 09:57:22 +0000