Online ISSN: 2515-8260

Current Issue
Volume 8, Issue 4

Volume 8, Issue 4, Summer 2021

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

Indu Sharma, Pankaj Kumar

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Quantum Cryptography helps to enhance on security issues

Mr.BGiridhar .

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

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

Effect OfYoga Practice On Anxiety During The COVID-19 Pandemic

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

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

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


Priyanka Sambyal, Reem Imtiaz, Paras Singh, Mustafa Imtiaz

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

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

SOX 2as A Prognostic Marker in Malignant Epithelial Ovarian Tumors

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

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

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

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

Jashashya Borah

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

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

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

Salah Elsayed, Muath Othman

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

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

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

Abidah Ismail Lubis, Destanul Aulia , Siti Saidah Nasution

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

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