Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52411419EnglishN2022October5Healthcare Alteration of Hematological and Biochemical Parameters to Predict Severity in SARS-CoV-2 Infection   English0108Shrewastwa Mukesh KumarEnglish Acharya ViyatprajnaEnglish Aggrawal KavitaEnglish Introduction: SARS- CoV-2 global pandemic has fired the world into a notable health catastrophe, with over 187,348,181 cases and 4,044,898 deaths as of July 10 2021. Many studies have been conducted to determine the clinical, biological, and radiological characteristics of COVID-19 for better identification of infected people at an early stage and stop disease development to an advanced state. Objectives: The aim & objective of our study was to take advantage of the biochemical and hematological parameters in pre-dicting the prognosis and mortality in disease severity COVID-19 patients. Methods: This single-center retrospective, observational study was supervised to have all the admitted patients (n = 90) possessing COVID-19 Polymerase chain reaction (PCR) positive, and assessed those for prognosis and disease outcome by taking advantage of several biochemical and hematological markers. Results: Out of 90 patients, 53(58.89%) had mild to moderate disease that were included in the non-severe group; 37(41.11%) had severe to critical disease, of which 17 died and 20 survived. Advanced age, presence of comorbidities and infection were risk factors for advancement to severe disease. The existence of statistically significant abnormalities in the following parameters were strongly related with the advancement to severe disease: white blood cells (WBC, p=0.002), neutrophils (p=0.001), lymphocytes (p=0.001), C-reactive protein (CRP, PEnglish Introduction Caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), otherwise known as the COVID-19 pandemic is the largest pandemic of the century. It is an up surging disease that is spreading promptly worldwide and alarms the bio security of all countries1,2, with the number of cases outstripping 187,348,181 and death of more than 4,044,898 people. The two most overwhelmed countries are the United States of America and India, with a death toll of 622,821 in the USA and 408,072 in India as of July 10, 2021.The infection rate was 24,035 cases per million populations. The COVID-19 pandemic in Nepal is part of the worldwide pandemic of coronavirus disease. In Nepal, the first case was approved as Covid-19 positive test on 23 January 2020 when a 31-year-old student had returned to Kathmandu from Wuhan on 9 January.3It was also the first noted case of COVID-19 in South Asia.4 Nepal's first case of local transmission was approved on 4th April in Kailali District. The number of cases confirmed in the different regions of our country was 652,002 including 9,400 deaths in July 12, 2021. This alarming viral transmission and mortality have prompted the publication of many studies to determine clinical, biological, radiological, and genetic predictors for the progression to severe and fatal forms of the coronavirus disease.5Acknowledgement of these predictors would make it possible to differentiate the risk and conduct the intervention studies to triage the patients. Clinical (comorbidities, acute respiratory distress syndrome [ARDS]), Demographic (advanced age, male sex) and radiological predictors have been broadly comprehensive in many studies.5–7Biological (lymphopenia, hyperferritinemia, serum C-reactive protein [CRP] levels) predictors 5, 8 have been described but remain mainly unreported/ under-reported in western region of Nepal. A simple and potent index to evaluate the severity and decide the prognosis of new crown pneumonia is urgently needed at this stage of coronavirus disease. Lymphocytes take part in a pivotal role in maintaining the body’s immune homeostasis and inflammatory response. The knowledge regarding the mechanisms involving in changes in these blood biochemical indexes is contemplated to give an effective approach for the treatment of COVID-19. In addition, the promotion, protection and maintenance of lymphocyte counts may promote the treatment and prevention strategy regarding development of new crown pneumonia in COVID-19 patients. We retrospectively analyzed the patients admitted to Nepalgunj Medical College & teaching hospital, Kolhapur who had been cured of COVID-19 and discharged from the hospital between January 1, 2020, and August 30, 2020 because all the literature published regarding COVID-19 patients are mainly concentrated on hospitalized patients, with many patients still being under hospitalization or under treatment. We propose the prediction reliability and accuracy of this study are higher because the clinical end point has been accomplished in these patients. The main objective of our study was to report the haematological and biochemical abnormalities in Nepalese patients with COVID-19 and to determine the prediction efficacy of parameters that can help to distinguish those likely to develop severe COVID-19. We expect that the findings of this study can give helpful information for early decision-making and treatment for severe COVID-19 patients. Study design and methods A retrospective, observational and single-centre study was approved by institutional review committees of Nepalgunj medical college & teaching hospital, Kolhapur of ethical clearance letter number:743/077-078 and was planned to be conducted at Nepalgunj medical college & teaching hospital, Kolhapur which was started from 1 January, 2020 till 30 August 2020 and including all patients who were diagnosed as COVID-19 positive via on a reverse-transcriptase polymerase chain reaction (RT-PCR, Kit Maccura Biotechnology) assay using a nasopharyngeal swab specimen. A total of 90 patients were recruited which were divided into two groups: 37 severe patients and 53 non-severe patients that were randomly taken without age and gender matched. Severely ill patients were defined as those admitted to the ICU with one of the following signs: respiratory rate more than 30 breaths/min, oxygen saturation less than 93% at room air, ARDS, or requirement of mechanical ventilation.9 Non-severe patients were those with mild or moderate forms of COVID-19 according to World Health Organization criteria.9 This study reports the clinical presentation, demographic characteristics, laboratory findings, and outcomes of incident cases of COVID-19 admitted to the intensive care unit (ICU) from 1 January, 2020 till 30 August 2020.The time frame was chosen to have a minimum follow-up of 15 days for all patients. The nadir and peak haematological and biochemical parameters were taken by following patients from admission to their last blood test. Statistical analysis Normally distributed continuous variables were expressed as means ± standard deviation [SD] whereas variables not normally distributed were expressed as medians (interquartile range [IQR]); categorical variables were presented as counts (%). The Kolmogorov-Smirnov test was used to assess the normality of distribution of continuous variables. Baseline demographic, clinical, and biological characteristics were compared among severe and non-severe patients. We used the Student’s t-test (parametric distribution) or Mann-Whitney’s U test (nonparametric distribution) for continuous variables and the chi-squared or Fisher’s exact test for categorical variables to compare differences between the two groups.  Statistical analyses were performed using SPSS version 20.0 (IBM SPSS) and p-value below 0.05 was considered statistically significant for two-tailed. Result: Out of 90 PCR positiveCOVID-19 patients, 53 (58.89%) were admitted to general wardwhereas37 (41.11%) patients were severe due to corona diseases who required treatment in the ICU. During treatment of severe covid-19 patients in ICU, 20 survived and 17 died. Gender-wise, males had a higher preponderance for the disease. The age and comorbidities of the patients were statistically significant associated with disease severity (PEnglishhttp://ijcrr.com/abstract.php?article_id=4607http://ijcrr.com/article_html.php?did=4607

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52411419EnglishN2022October5Healthcare Awareness Among Parents Working in the Healthcare Sector on Screen Addiction and Its Impact on Children and Adolescents     English0916Sathyanarayana KondatiEnglish Nandhini L.English L.S. ThiruneelanEnglish Hilda SolomonEnglish Jayanthi SwaminathanEnglish Anitha Rani A.English Introduction: The digital life of our children begins at an early age as they are exposed to a variety of screens (mobile phones, TV screens, tablets and computers). It has become more important for parents to suggest appropriate screen time and type of media exposure for children in recent years. Aim: The present study aimed to understand the awareness of parents who are health care workers on their child’s screen timing and associated behavioral changes, post lockdown. Method: A cross-sectional survey was conducted among the health care workers, who are parents of child aged between 3 - 18 years at Apollo Hospitals, between December 2021 - Feb 2022. Results: A total of 105 responses were received from medical and non-medical sectors. In the study, 47.61% were fathers followed by mothers (44.76%) and guardians (7.61%). The majority of the children belong to the age group of 6 to 12 years (42.85%) and were secondary school level (29.52%). The majority of the children watch mobile phones, followed by television. The daily screen time for child was reported as 3 hours in weekdays and > 4 hours on weekends. Among behavioral changes, age groups of 3-6 years and 12-18 years showed lack of concentration, whereas in 6-12 years age group personal hygiene was reduced. Further, there is a change in eating patterns (70%) and sleeping patterns (92%), and an increase in their monthly bills (42%) towards the mobiles/ screen apps due to increased screen time. On the other hand, digital technology increases the understanding of the concept easily and improves the learning outcome. Thus, parents feel that they need to find the right balance in the usage of technology (39.4%) for the prolonged use of digital technology. Conclusion: To conclude, it is fairly impossible to provide techno free zone to children in this digital world. Thus, parents have to focus and limit the screen usage time to reduce the ill effects, further parental screen addiction awareness and co- viewing avoid the behavioral problem. EnglishScreen addiction, Digital technology, Parents, health care workers, Awareness, Techno free Introduction: The digital life of our children begins at an early age as they are exposed to a variety of screens (mobile phones, TV screens, tablets and computers). It has become more important for parents to suggest appropriate screen time and type of media exposure for children in recent years. Screen time is defined as the time spent interacting with media devices. Both its benefits as well as its harms have been subject to debate.1 Initially, screen time was found to be associated with health problems like obesity, sleep disturbances, and behavior disorders. Currently, digital literacy is being hailed as a way to further the education of children. 2 The population of India's digital consumers (nearly 41%) grew to 560 million in 2018, ranking second only to China among the largest and fastest-growing markets for digital consumers.3 As on 2019, there were about 1161.17 million cell phone users in India.4 Cell phones are known to affect an individual’s overall health.5 They are associated with sleep deprivation, inappropriate food habits, physical inactivity, being overweight, and obesity. 6,7,8 As the confusion on appropriate of screen time for children exists American Academy of Paediatrics (AAP) started updating and providing recommendations.9 AAP initially suggested the restriction perhaps later it suggested limiting the screen timing to not more than two hours per day for children greater than two years and also recommended no screen timing for children less than two years of age.10 Further in 2013 AAP recommended that pediatricians to include the two basic questions in their regular check-ups as the child has a TV in their room and the amount of time spent in front of the screen. As per the newer guideline motivating the parents to interact with their children, limit the media hours, and create a tech-free zone for their kids.11 According to WHO (World Health Organization) there should be absolutely no screen time for children less than five years and stress upon the physical activity of more than an hour to reduce sedentary activity. In recent times, researchers are focused on the association of parental mobile devices and internet usage and the association of the mobile device and decreased verbal and non-verbal interactions and support.12  Further there is an association between the mobile device. The disruption in parent-child interaction due to technology has even been labeled “technoference”.13 Although internet benefits are innumerable, it also has several negative aspects if used in an unwise manner.14,15 In the eyes of parents, the Internet provides access to the whole world and is a tool for delivering information. In fact, parents are aware of the positive and negative impacts of internet usage. To prevent and manage internet addiction, parents must know how to implement a strategic management plan. Excessive use of the internet is associated with screen time with hyperactivity, conduct and emotional problems, further, it is associated with a negative impact on academic performance.16,17 The extensive exposure of rapid screen changes and during the brain development period that is between two to six years of age, tuned the mind of the children to expect the higher level of simulations, which can ultimately lead to hyperactivity, cognitive problems, language difficulty in their real-life situation or human interaction.18 The psychological well-being to be progressively reduced from one hour per day to screen timing to greater than or equal to seven hours per day of screen timing.19 Further the viewing of television for more than three hours is associated with increased screen timing of children, it shows that parents influence the screen timing on children.20 Thus, there is a need to study the understanding of parents about the awareness of their child’s screen timing. The present study was conducted to understand the awareness among parents who are health care workers on their child’s screen timing and associated behavioral changes observed in their child/children post lockdown. Methodology: A cross-sectional survey was conducted among the healthcare workers, who are parents of child/ children aged between 3 - 18 years at Apollo Hospitals, Chennai, between December 2021 - Feb 2022. A questionnaire was prepared using Google Forms and were shared with the parents who are health care professionals’ workers at Apollo Hospitals Chennai, through various social media platforms and the data collected were analyzed. The study was approved by the Institutional Ethics Committee - BioMedical Research (AMH-DNB-085/11/21), Apollo Hospitals Chennai A 27-item structured questionnaire was used in the study to obtain the required data. The information related to parents (Father / Mother/ Guardian), details of child such as age, educational status, Types and usage of screen, weekly usage pattern, behavioral change in kids, and related health outcomes of the kids were recorded accordingly. The baseline characteristics of the participants were presented as frequency and percentages. The data was analyzed using SPSS version 22.0 (IBM). P value ≤ 0.05 was considered statistically significant for all analyses. Results:             A total of 128 participants responded, among which 105 were included in the study. The demographic characteristics of the healthcare workers was presented in Table 1. In the current study majority of the healthcare worker responders were fathers (47.61%), followed by mothers (44.76%) and guardians (7.61%). In the study population, Clinical Researchers were higher (39.04%) followed by Paramedics (36.19%), doctors (14.28%) and administrative sectors (10.47%). The daily time spent by parents with their children was 3 hours on average. The number of electronic devices at home was on an average of five devices such as TV, Mobile, desktop, laptop, and tablet) (Table 1). The children’s demographic details were presented in Table 2. The children aged between 6 to 12 (42.85%) were followed by children aged between 3 to 6 years (37.14%) and 12- 18 years (20%). In the present study majority of the child falls under the secondary school level (29.52%), followed by primary school (27.6%). On average, the child’s screen time is 3 – 3.5 hours. Parents observed that the majority of the children watch Mobile phones, followed by television, laptop, Desktop, and Tablet. The daily time spent with the child during weekdays were about 3 hours and during weekends it is more than 4 hours both parents follow the same pattern. Further, the screen time shared by parents with the child were less during the weekday and slightly more during the weekends (Table 2). The type of screen usage and duration of usage during weekdays and weekends was presented in Fig 1. In the current study, the healthcare workers reported that their child spends more hours in Online classes, followed by online videos/ movies, gaming, and social media. Likewise, during weekends children concentrates more on online videos/ movies, gaming, social media and competitive exams.  Changes observed by parents in their child’s activities: Parents' observation in changing a child’s activity was presented in Figure 2a and Figure 2b. In terms of the child’s activity about 27 % the child was engaged in sports, indoor games (27%), followed by yoga (21.3%), Watching movies, and videos, online games (21.35%), playing a musical instrument, singing and dancing, gardening (19.4%), art and craft (15.53%).In the current study Among 3- 6 yrs. age group Children were engaged in Playing games with friends and families (15.38%) and Watching movies, videos, and online games (15.38%); followed by Indoor games (12.82%) and Playing musical instruments, singing and Dancing (12.82%). Among the age group, 6-12yrs children have engaged Indoor games (28.89%), followed by Watching movies, videos, online games (22.22%) and Sports (22.22%). Whereas in the 12-18yrs age group children were engaged in Sports (71.42%), followed by yoga (57.14%), indoor games (47.61%) and gardening (38.09%) (Fig 2a). Parents observed that their child’s concentration has been reduced, followed by decreased personal hygiene, increased anger, Difficulty in problem-solving & creative thinking, lethargy, increased escapism, feeling of loneliness, decreased physical activity, increased irritability, Difficult interacting socially, Not interested in activities. The majority of the Responses were multiple responses (Fig 2b). Among 3-6 years age group, parents observed there is a lack of concentration (38.8%), Followed by lethargy (33.33%), Angry (33.33%) and reduced physical activity, reduced personal (27.77%), reduced physical activity (27.77%), difficult to interact socially (22.22%), Anxiety (22.22%), Irritability (22.22%), Difficulty in problem-solving & creative thinking (22.22%). Among 6-12 years of age group parents observed that the majority of the children have reduced personal hygiene (56.09%), Angry, and lethargy (48.74%), followed by Difficulty in problem-solving & creative thinking (46.34%). Whereas among 12-18 years age group the changing behavior was seen in lack of concentration and decreased personal hygiene (88.23%), followed by Irritability, escapism and Anxiety (70.58%).             About 70 % of the study population observed changes in their child’s eating pattern. The majority of the parents reported that their child increased their consumption of junk food (43.84%) and consumption of health food is decreased (35.62%), some children showed decreased appetite (41.10%). Majority of the children belonging to 3- 6 years of age group showed decreased appetite (38.7%), whereas in 6 – 12 years age group majority showed decreased consumption of healthy food (51.61%) and 12-18 years group showed Higher consumption of junk food (66.66%). Parents' observation on the child’s eating pattern due to excessive screen usage was depicted in Fig 3.             The sleeping pattern also changed due to prolonged use of screen timing and was presented in Figure 4. There is a significant delay in the bedtime and wake-up time (20.62%), followed by nightmares (20.62%), decreased (18.56%) or increased (16.49%) sleeping pattern, co-sleeping tendency (15.46%), disturbed wake ups (15.46%). The majority of the children belonging to 3- 6 years of age group showed co-sleeping tendency (21.62%) and nightmares (21.62%), whereas in 6 – 12 years age group majority showed significant delay in bedtime and wakeup time (23.25%) and 13-18 years group showed decreased sleep (35.29%). Parents' observation on the child’s health issue was presented in Figure 5. About 47.61% of the study population observes that their child faced some of the health issues such as eye issues (46%) headache (36%), body ache (30%) and weight loss/ gain (20%, 16%) (Table 2). Eye issues is the major health-related problem in 3-6 yrs (29.41%), 6- 12yrs (43.33%) and 12-18 (50%) years age groups respectively.             Challenges faced by parents due to excessive screen usage was presented in Figure 6. About 42% of the Parents feel that their monthly bills towards the mobiles/ screen apps were increased to on an average of 500rs per month. Nearly 30% of the study participants feels that there is no significant challenge faced by them due to child’s increased screen usage. Perhaps 70% faced issues such as they met the expenses towards frequent recharges for mobile data/ OTT platforms or downloading paid apps, followed by a demand for better gadgets and excessive online shopping and temper tantrums.  The benefits observed in children due to digital technology usage was presented in figure 7. The children were curious to learn new things followed by technological advances, understands the concepts easily, and improved learning outcomes. The majority of the parents feel that they need to find the right balance in the usage of technology (39.4%) for the prolonged use of digital technology and some parents feels that using digital technology by their child is a serious issue (32.38%). About 19.4% of the study population attend the awareness program for screen addiction in their child’s school/college. The parents think that it would be beneficial for parents to attend the awareness session for a better understanding of screen addiction and its impact on the child’s health. Discussion: In the current study majority of the healthcare workers who participated in the current study were males, in spite of the gender-based work allotment, especially in a country like India, parents there were aware of their child’s screen timing and their behavioral changes. This might be due to the shift-based system in health care workers.  The parents reported that they spent 3 hours on average with their child and they can able to spend quality time with their child at during weekdays and weekends. This helps the parents to observe the pattern and change due to prolonged screen timing of their child. As healthcare workers parents would be able to pick up the change in their child’s behavior when compared to, parents who were from the non-healthcare sector. Due to exposure to social media through different screens, it’s important to recognize the type of media child is exposed to and how that affects the child physically and emotionally.21 Younger adolescents Englishhttp://ijcrr.com/abstract.php?article_id=4608http://ijcrr.com/article_html.php?did=4608

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52411419EnglishN2022October5Healthcare Ru (III) Catalysed Oxidative Degradation of Sodium Bisulphite Derivatives of Aromatic Aldehydes by Potassium Hexacyano Ferrate (III) in Aqueous Alkaline Medium English1720Baboo RameshEnglish Introduction: The catalysed oxidation of the derivatives of aromatic aldehydes with inorganic moieties is still unstudied with an economically cheaper oxidant like potassium hexacyanoferrate (III). The catalyst like ruthenium (III) chloride is very much effective at very low concentrations for oxidation reactions. Aims: The study is carried out to observe and to get the results about the oxidative degradation of derivatives of organic and inorganic moieties. Methodology: Benzaldehyde sodium bisulphite (BSS) and substituted aromatic aldehyde sodium bi sulphite like p-chloro benzaldeyde sodium bisulphite, p-methyl benzaldehyde sodium bisulphite, etc. are dissolved in water, can be oxidized in good yield by potassium hexacyanoferrate (III) as PHF in aqueous alkaline medium in presence of ruthenium (III) chloride. Result: The process requires lesser time and probably an intermediate complex of ruthenium (III) chloride, substrate and oxidant give the products. Conclusion: Oxidative degradation of Benzaldehyde sodium bisulfite (BSS) and substituted aromatic aldehyde sodium bisulphite like p-chloro benzaldeyde sodium bisulphite, p-methyl benzaldehyde sodium bisulphite, etc. give moderate to good yield of corresponding aromatic acids in presence of potassium hexacyanoferrate (III) and ruthenium (III) chloride. EnglishPHF, Ruthenium (III) catalysis, BSS, Aromatic Acids, Intermediate complex, Oxidationhttp://ijcrr.com/abstract.php?article_id=4609http://ijcrr.com/article_html.php?did=4609 1. Jonge M. De. Organic Synthesis by Oxidation with Metal Compounds, Plenum, Newyork, 1986, 839-876. 2. Hundicky M., Oxidations in Organic Chemistry, Am. Chem. Soc., Washington, 1990, 838-840. 3. Rappoport Z., Second Eds, Synthesis of Carboxylic Acids, Esters, their Derivatives, Wiley Chichester 1991, 357-360. 4. Russel G.A., Selective Oxidation Processes. Am. Chem. Soc., Washington DC, 1965, 112-173. 5. Sonsnovasky D., In Organic Peroxides, Wiley Interscience USA, Vol. 1, Sweren D (ed) 1970, 517-560. 6. March J., Advansed Organic Chemistry, McGraw Hill Inc. 2004, 698, 1162, 1167, 1169, 1181-1182, 1191-1192 – 1196, 1200 &1235. 7. Singh M, Singh H.S, Verma M.K.; Kinetics and mechanism of the ruthenium(III) chloride catalyzed oxidation of butanone-2 and pentanone-3 by cerium(IV) sulfate in aqueous sulfuric acid medium, J. phys. Chem., 1980, 84, 3, 256-159 8. Tandon P. K., Manibala, Singh H.S., Krishna B., Mechanism of Ruthenium(III) chloride Catalysed Oxidation of Cyclopentanol, Cyclohexanol and Cycloheptanol by Cerium(IV) Sulphate in Aqueous Sulphuric Acid Medium, Z. phys. Chemie, Leipzig, 1984), 3, S. 265, 609-61 9. (a) Srisailam V., Rao M.A., Kinetics and mechanism of the ruthenium (III)-catalysed oxidation of aliphatic acids by peroxodiphosphate in acetate buffers. Transition Met Chem, (1994) 19, 257–259 (b) TeresaM., Nunez and Martin Victor S., Efficient oxidation of phenyl groups to carboxylic acids with ruthenium tetraoxide. A simple synthesis of (R)-.gamma.-caprolactone, the pheromone of Trogoderma granarium, J Org. Chem, 1990, 55, 6, 1928-1932 (b) 10. Barkowitz L.M., Rylander P.N., Use of Ruthenium Tetroxide as a Multi-purpose Oxidant, J. Am. Chem. Soc., 1958, 80, 24, 6682-6684 11. Friedman H.B., Anderson B. E., Neutral Salt Action. I. The Effect of Neutral Salts on the Velocity of the Reaction 2Fe(CN)6 ≡ + 3I-  → 2Fe(CN)6 [UNK] + I3 - , J. Am. Chem. Soc. 1939, 61, 1, 116- 118. 12. Wagner C., Der Mechanismus der Oxydation des Jodions durch Ferricyanion und Ferriion, Z Phys Chem, 1924, 113, 261-274 13. Singh H. S. , Singh R. K., Singh S. M., Sisodiya A. K., Kinetics and mechanism of the ruthenium(III) chloride catalyzed oxidation of butan-2-ol and methyl-1-propanol by the hexacyanoferrate(III) ion in an aqueous alkaline medium, J. Phys. Chem. (1977), 81, 11, 1044–1047 14. Cotton F. A., Wilkinson G., Advanced Inorganic Chemistry, 2rid Edition, 1980, 918 & 919

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52411419EnglishN2022October5Healthcare Evaluation of In Vitro Anthelmintic Activity and Phytochemical Analysis of Ethanolic Extract of Cardiospermum halicacabum Leaves     English2126C. Senthil KumariEnglish A. KamatchiEnglish K. MeghanaEnglish K. V. MridhulaEnglish T. KanimozhiEnglish S. MonishaEnglish Introduction: The infection caused by helminths is called as Helminthiasis. It is otherwise known as helminthosis, helminthiases, helminth, infection and worm infection. They often live in the gastrointestinal tract of their host, but they may also burrow into other organ, where they induce physiological damage. The different categories of worms consist of Roundworms, Pinworms, Threadworms, Whipworm Hookworm, Flatworms and Tapeworm. Objective: The present study was carried out to find the anthelmintic activity of Cardiospermum halicabum. Methods: The anthelmintic activity of Cardiospermum halicacabum was analyzed by in vitro method by using the Indian earthworms. The activity was performed and the paralysis time and death time were noted down. The anthelmintic activity of the extract was compared with that of the standard drug Albendazole. Results: The ethanolic extract at the concentrations of 100 mg/ml, 200 mg/ml, 300mg/ml showed paralysis and death time in 7, 6 and 36, 28 mins respectively. The effect increased with concentration. The extract caused paralysis followed by death of earthworms at all tested dose levels. Conclusion: The extract showed paralysis followed by death of worms at all tested dose levels. Based on the study the Ethanolic leaf extract of Cardiospermum halicacabum has potent anthelmintic activity. EnglishAlbendazole, Paralysis time, Death time, Helminthiasis, Indian Earth worm, Physiological Damage INTRODUCTION The macro parasitic disease of individuals and other creatures in which the portion of the body is infected with parasitic worms is called Helminths1. It is otherwise known as intestinal worm infestation, helminthic infestation or soil-transmitted infestation. Parasitic worms are invertebrates that characterize extended, smooth, or rounded forms. These worms get burrowed into the organs or gastrointestinal tract of the host and induce physiological damage. The different kind of worms consists of strongyloidiasis, trichinella, blood flukes, lymphatic filariasis, Hookworm, Flatworm, and Tapeworm. Female produces eggs (almost 200000 each day) that remain defecated with feces. Unfertilized eggs remain in offense, but fertilized ones are infectious after 18 days to several weeks. Infectious eggs are consumed and arrive in the gut. Mature into larvae in the intestine, and penetrate the blood vessels to enter the lungs, where they develop further. At day14, they penetrate into the alveolar walls. As they reach the small intestine and develop into adult worms. INDICATIONS For minor infections, no evident symptoms are seen. For long and heavy infections, a variety of health complications are anemia, malnutrition, growth retardation, developmental retardation, intestinal obstruction, decreasing protein loss and blood loss, less cognitive and physical growth, and inability to control motion. People with light infections usually have no symptoms. TRANSMISSION Soil-transmitted Helminths are spread by eggs that are passed in the feces of infected persons. Eggs that are attached to vegetables are ingested when the vegetables are not carefully cooked, washed or peeled. Hookworm egg hatch in the soil releasing larvae that mature into a form that can actively penetrate the skin. There is no direct person-to-person transmission or infection from fresh feces because eggs passed in feces need about 3 weeks to mature in the soil before they become infective. DIAGNOSIS Some of the diagnostic methods are Microscopy-based techniques, Egg counting Kato- Katz method, Serological assays, Endoscopy/Colonoscopy, X-ray, Magnetic Resonance Imaging (MRI) scan, Computerized Axial Tomography scan(CAT)4 PREVENTION Avoid interaction with soil contaminated with human waste, especially feces. Wash hands thoroughly with soap before taking food. The infection will be prevented by disrupting the cycle of the worm. And other preventive measures are by sanitation and hygiene, provision of safe drinking water, and wearing protective footwear. Not evacuating outside use toilets linked to current sewage discarding systems. TREATMENT Various allopathic drugs are used in the treatment of Helminthiasis. Benzimidazoles (albendazole, mebendazole, thiabendazole), piperazine citrate, pyrantel pamoate, levamisole, Tetraisole, Diethylcarbamazine citrate (dec) , Ivermectin, Praziquantel, Niclosamide 4 HERBAL MEDICINE Though Allopathic drugs produce the onset of action quickly, it produces many adverse effects. So, nowadays herbal drugs are preferred mostly when compared to that of allopathic drugs because It does not produce side effects. Some of the most widely used herbal drugs are as follows, MATERIALS AND METHODS Collection of plant: Cardiospermum halicacabum leaves were collected from Chennai. The leaves were identified, confirmed and authenticated from Siddha Central Research Institute, Arumbakkam, Chennai with reference No:117.05021903 by comparing with an authentic specimen by a botanist. Preparation of extract: Percolation is an extraction process that involves the slow descent of a solvent through a powdered substance until it absorbs certain constituents and drips out through the filtered bottom of the container. Percolation can be done by using the Soxhlet apparatus. 6 Phytochemical analysis For our present study, preliminary phytochemical studies were carried out to characterize the therapeutic active constituent from the leaf extract of Cardiospermum halicaca[8] Screening of anthelmintic activity by IN-VITRO method Indian earthworms (Pheretima Posthuma) were collected from a water-logged area of soil. The average size of each worm collected is about 14-16 cm length. They were washed thoroughly with tap water to remove the adhering dirt. Five Sterile Petri dishes were taken. In each Petri dish 6 earthworms were placed and kept in a room temperature. Distilled water was used as a control. Distilled water was poured into Petri dish containing 6earthworms (Group-1). Albendazole, the standard drug was diluted with distilled water to obtain 10mg/ml concentration and then it was poured into Petri dish containing 6 earthworms. (Group-2) Ethanolic extract of Cardiospermum halicacabum was diluted with distilled water to obtain 100mg/ml, 200mg/ml, and 300 mg/ml concentrations and it was poured into Petri dish containing 6 earthworms(Group-3,4,5 respectively The time taken for paralysis(when there was no movement of worms) were observed and the time taken for death(when there is no movement on vigorous shaking also) was noted. It was noted in terms of minutes.8,9,10 STATISTICAL ANALYSIS Values are expressed as mean ± SEM. One-way ANOVA followed by Dunnett’s test to assess the statistical significance. RESULTS Preliminary Phytochemical studies The result of preliminary phytochemical analysis of the Ethanolic leaf extract of Cardiospermum halicacabum shows the presence of Flavonoids, Glycosides, Tannins, Amino acids, Steroids, Phenols, Saponins, Carbohydrates.11 Anthelmintic activity12,13,14 The anthelmintic activity of Cardiospermum halicacabum was analyzed by in vitro method by using the Indian earthworms. The activity was performed and the paralysis time and death time was noted down. The anthelmintic activity of the extract was compared with that of the standard drug Albendazole.15 Figure 4:Graphical representation for the anthelmintic activity of ethanolic extract of Cardiospermum halicacabum (100mg/kg) showed higher concentrations compared to the standard drug (Paralysis time) Figure 5 Graphical representation for the anthelmintic activity of ethanolic extract of Cardio spermum halicacabum (100mg/kg) shows higher concentrations compared to the standard drug (Death time). DISCUSSION: The anthelmintic activity of leaf extract of Cardiospermum halicacabum was carried out on earthworms. Different concentrations of ethanolic extracts were used for the studies. The time taken for paralysis and death of earthworms was recorded in table 1. The perusal of the data reveals that the ethanolic extract at the concentrations of 100 mg/ml, 200 mg/ml, 300mg/ml showed paralysis and death time in 7,6, and 36, 28 mins respectively. The effect increased with concentration. The extract caused paralysis followed by the death of earthworms at all tested dose levels. It was observed that the ethanolic extract of Cardiospermum halicacabum is a more potent drug. The extract exhibited paralysis followed by the death of worms at all established dose levels. The extract potency was found to be inversely proportional to the time taken for the paralysis or the death of worms. CONCLUSION: From the present study we concluded that the preliminary phytochemical analysis of the Ethanolic leaf extract of Cardiospermum halicacabum shows the presence of Flavonoids, Glycosides, Tannins, Aminoacids, Steroids, Phenols, Saponins, and Carbohydrates. The Ethanolic leaf extract of Cardiospermum halicacabum has anthelmintic activity. Acknowledgement: We wish to express sincere gratitude to Dr. Meena Principal, Dr. Shanthi Vice-Principal, K.K. College of Pharmacy for their support and encouragement towards our research work. Conflict of interest: None Source of Funding:   None Englishhttp://ijcrr.com/abstract.php?article_id=4610http://ijcrr.com/article_html.php?did=4610 1. Vinay Kumar, Abull Abbas, Jon C., Astewr, Nelson Fausto, et al. Disease caused by helminths from Robbin and Carran pathologic disease. 8thedition. 2. Types of worms, Parasites: Types, in humans, worms, and ectoparasites, www.medicalnewstoday.com. [Accessed date 11th February 2021]. 3. Lifecycle of Helminths from https://www.cdc.gov/dpdx/schis tosomiasis/index.html. [Accessed date 15th February 2021]. 4. Tripathi, K.D., Essentials of medical pharmacology. 7th edition, p. 849-855. 5. Kokate, C.K., Purohit, A.P., Gokhale S.B., et al. Textbook of Pharmacognosy.Volume1&2. 6. K. Gnaneswari, Y. Padma, et al. In-vitro anthelmintic activity of Leonotisnepetiifolia(L.)R.Br., a potential medicinal plant. J chemical and pharmaceutical research,2013;5(2):345-348. 7. Working of soxhlet apparatus from https://www.slideshare.net. [Accessed date 22nd February 2021]. 8. Anujkumar., Agrahari, et al. Assessment of anthelmintic activity of Jussiaehyssopifolia 9. G. Don. Asian J Plant Sci and Res, 2011;1(4):87-91. 10. Sathish B. Kosalge, et al. Investigation of invitro anti-helminthic activity of the spesialampas(CAV). Asian J Pharmaceutical and clinical research,2009;2(2):67-79. 11. Sanghpartap, et al. In-vitro anthelmintic activity of luffa cylindrical leaves in Indian adult earthworm. J Pharmacognosy and phytochemistry, 2012;1(2):27-31. 12. G.V.N. Kiranmayi, K Ravishankar, et al. Phytochemical screening and in-vitro comparative study of anthelmintic activity of Asparagus racemosus and Cucurbita maxima. J pharmacy research,2012;5(3):1545-1547. 13. Arshad Hussain, et al. In-vitro anthelmintic activity of coleus aromaticus root in Indian adult earthworm. Asian pacific J tropical disease, 2012:1-6. 14. Amit Kumar, et al. In-vitro anthelmintic activity of lagenariasiceraria leaves in Indian adult earthworm. J pharmacognosy and phytochemistry, 2012;8(6):39-42. 15. Narsimharao, et al. In-vitro anthelmintic activity of Rhizophoramucronate leaf extract. Scholars research library,2016;8(6):32-36. 16. Gayathiri N, et al. In-vitro antihelminthic activity of hydroalcoholic extract of Martyniaannua Land pentanemaindicum, 2019;12(8):3847-38.

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52411419EnglishN2022October5Life Sciences The on-task Attention of Individuals with Autism Spectrum Disorder-An Eye Tracker Study Using Auticare     English2733Sathyanarayanan AREnglish Joanna JamesEnglish Bobin ChandraEnglish Sankaranarayana AREnglish Ajisha BhasiEnglish Introduction: Autism Spectrum Disorders (ASD) are characterized by atypical patterns of behaviors and impairments in social communication. Traditional intervention approaches often require extensive fund support and well-trained therapists to address core deficits. Hence, emerging technology such as virtual reality (VR) has the potential to offer useful technology-enabled intervention systems. In this paper, an innovative Extended reality, Artificial Intelligence, virtual reality-based skill training platform called Auticare was used. Aim/Objective: This study explores on-task attention on two virtual reality-based cognitive scenarios of individuals with Autism spectrum disorder (ASD) and typically developing (TD) groups. Methodology: 220 participants (ASD = 200, TD = 20) took part in a series of attention tests, which involved ball picking and putting in a basket and an alphabet learning scenario. We captured four eye-gaze parameters, which includes time to first fixate, first fixation duration, average fixation duration, and the sum of fixation count. The eye-tracking data were analyzed to determine the on-task attention of the user while performing VR-based cognitive scenarios. Performance data, eye tracking indices and physiological features indicated the on-task attention of the individuals with ASD. Results: In the results we observe the comparison in the eye tracking parameters of ASD and TD group. This gives insight into the attention patterns of the participants of the study in each cognitive VR scenario. Conclusion: It is concluded that virtual reality skill training is a promising medium for skill training of individuals with Autism. EnglishAttention, Auticare, Autism spectrum Disorder, Eye tracker, Virtual reality Introduction Autism Spectrum Disorder (ASD) is a spectrum-based disorder that occurs in early childhood due to neurological disorders, and its symptoms include abnormal social skills, communication skills, interests and behavior patterns (center for disease control and prevention, 2022). Currently, there are no effective drugs to treat the disease, but long-term educational intervention can gradually improve children with ASD, which prevents lifelong disability. Therefore, the development of technical tools to help and train children with ASD has been identified as a priority research domain.7 Among these, VR based systems for ASD intervention are coming to light. It is well known that tracking eye gazing information in VR intervention training will provide valuable information of the trainee’s status, such as the trainee’s attention information. With the eye-tracking embedded HMD becoming more accessible, in our current research, we aimed to develop a VR system that utilizes the eye-tracking information to conduct attention training for users with ASD. The current research study is carried out using Auticare, an Extended reality, Artificial intelligence and virtual reality based inclusive learning platform for individuals with ASD, neurodevelopmental disorders and special education.  As an emerging technology VR integrated training programs have been developing and show a positive impact on the life of ASD patients. It allows the ASD patients to be trained in a real-world which could be manipulated and the patients can be adapted to any situation, overcome their limitations based on their unique capabilities. Due to limited empirical evidence, more research and intervention models should be needed by using VR integrated technology. It is essential to prove the potential of this technology to support the life skill learning of people with ASD and it must be developed as a tool that helps them to make their own life easier.             It is important to identify activities that appeal to the special needs and ability of individuals with intellectual and developmental disabilities (IDD) for enhancing their participation level.6 A study was conducted on children with autism, to assess the performance of children on joint attention tasks using an Avatar mediated virtual reality technology.5 The study results revealed that using VR integrated technology, the performance scores and focus area of attention of participants can be measured accurately. Another case study contributed to the importance of the development of a VR tour system to explore methods of therapy for individuals with intellectual and developmental disabilities and help them in dealing with everyday social situations.1 Another study involved creating virtual environments to help IDD individuals get more comfortable with skills for independent living, enhance cognitive performance, and finally improve social skills.4 A study that involved designing a VR experience to support the cognitive development of IDD individuals.8 The participants demonstrated significant cognitive improvement in terms of their abilities to perform certain tasks. The findings of this study suggested that VR-based experiments can be used in treating IDD individuals. The developed prototype of an attention enhancement system using virtual reality technology and EEG biofeedback possesses the ability to improve the attention span of children and adolescents with behavioral or cognitive problems and help them learn to perform certain tasks.3 The immersive Virtual Reality was found to supplement the training and keep it interesting and also found that both VR EEG Biofeedback and VR cognitive training has a great effect on attention enhancement. A study conducted on sex differences in Autism spectrum Disorders which showed a significant male bias in terms of prevalence, with roughly four affected males for everyone affected female.9 The stability of this finding across time and populations clearly suggests that sex-specific biological variables play a role in ASD causation. Objectives of the study The present study aims to explore the factors affecting the attention patterns of individuals with ASD, to check the effectiveness of VR simulated Technology on measuring the attention deficits of children with ASD, to find out the effectiveness of eye-tracking studies on attention patterns of children with ASD, to find the values of AFD, SFC, TTFF and FFD of the participants, and to understand the differences in the attention patterns of individuals with ASD and TD. To find the efficacy of cognitive skills training using virtual reality for individuals with ASD, To find the relationship if any between gender and level of autism of individuals with ASD, to find the efficacy of the product Autocare for skill training. TTFF (Time to first fixate):  Measures the time it takes to look at the first Area of Interest (AOI) in the stimuli. FFD (First fixation duration):  Gives the total time of first look at AOI. AFD (Average fixation duration):  It gives the mean value of the entire fixation duration for each AOI and throws light into how each of the participants gives attention to stimuli. SFC (Sum of fixation count):  Estimates the number of looks made on each AOI throughout the viewing time  Formula Total AFD= Total duration of fixations (all AOIs) / total number of fixations (all AOIs) AFD of AOI = Sum of fixation durations of the specific aoi / sfc Purpose of the study Recognizing the eye-gazing patterns is critical. When people look at different objects, their eyes will stay on some objects for a long time. On the other hand, people’s eyes may just glide through each object. The question is how to distinguish these objects, if they attract people's attention, and how to check out people's eye patterns from these distracting objects. For autistic individuals with impaired communication, eye-tracking software is especially important for understanding how they focus on the world around them. Methodology Type of research A quantitative approach has been employed for the present study as we have focused on quantifying the collection and analysis of data. Population The participants of the study were taken from various special education institutes across Kerala. We obtained prior informed consent from the parents/guardians of all participants. A total of 220 children between the age group of 6 and 18 years participated in the study. Among these 200 children with ASD, diagnosed by clinicians and satisfied the diagnostic criteria for ASD according to the ISAA (Indian Scale for assessment of Autism) as mild or moderate were taken for the present study. And twenty of the children were TD children. We recruited TD participants from mainstream schools. Materials For the study we have used an Extended reality, Artificial intelligence and Virtual reality-based product called Autocare. Autocare is a skill training platform for individuals with special needs. Auticare comprises of both software and hardware, which includes HTC Vive pro eye kit, leap motion (hand tracking sensor), laptop and tablet. Applied Behavior Analysis and Cognitive Behavior Therapy based VR skill training activities have been applied to ASD. Virtual Reality Environment (VRE) Virtual environments are intimate and immersive for children, so they easily pay attention to the environment itself. For the present study, we have used two cognitive virtual reality-based scenarios which include ball picking and putting in the basket and an Alphabet learning scenario. The environments are designed and scripted by therapists and special educators specifically for individuals with special needs. The ball-picking scenario includes the avatar in the VRE welcoming the user to the scenario and giving instructions about the task. The scenario consists of various balls of various colors and sizes. The user has to pick each ball and put it in the basket kept nearby. The scores for each of the correct responses are coded. The Alphabet scenario involves the avatar teaching the child each alphabet along with their interaction. For both of the scenarios, the areas of interest are fixed. Hardware and Software Configurations The System hardware consists of Head Mount Display along with Eye tracking hardware which is included in the Vive Pro Eye. A tablet is provided to the therapist to remote control the hardware. Initially the therapist logs into the system and selects the patient profile which is created beforehand. Then the therapist selects a scenario for the therapy and it is launched. The Eye tracker data along with other metrics is recorded on a session that the therapist could manually start. Once started, the data will be recorded in the system and after the recording session is stopped, it is saved to the server. This data can be visualized in the Web dashboard by the therapist. The Eye data collected include TTFF, FFD, AFD of AOIs, SFCs of AOIs. Statistical Analysis For the statistical analysis, first, we used the Pearson correlation test between the factors, gender and level of autism. Second, we conducted a Pearson correlation test for the average performance score of our sample set (N =220) and the level of Autism.  We used analysis of variance (ANOVA) to compare the means of performance scores between groups (ASD and TD). Results              Below is a summary table of the surveys carried out following the guidelines corresponding to the research work: Table 1 represents the average value of eye tracker components of ASD And TD group. This table gives the average comparative value of the eye tracker components ASD and TD group. The various eye tracker components include TTFF, FFD, AFD and SFC. Table 2 Correlation Between Gender and Level of Autism Relationship between gender and level of Autism Hypothesis H0 - There is no significant relationship between gender and level of Autism. H1- There is a significant relationship between gender and the level of Autism As per the Pearson correlation test, when the obtained significance value p is less than 0.01, we will reject the null hypothesis, therefore there is a significant relationship between gender and level of Autism. Here the level of Autism involves Mild, moderate and severe categories according to the ISAA (Indian scale for Assessment of Autism) scale. The correlation test proved a significant relationship between levels of Autism and Gender. Thus, the findings prove that Males are a severe on level of Autism when compared to females. Table 3 Correlation between Average Performance Score and Level of Autism Relationship between average performance score of ASD and TD with level of Autism. Hypothesis H0- There is no significant relationship between the average performance score of ASD and TD with level of autism. H1-There is a significant relationship between the average performance score of ASD and TD with level of autism. As per Pearson correlation test, when the obtained significance value p is less than 0.01, we will reject the null hypothesis, therefore there is a significant relationship between average performance score of ASD and TD with level of autism. This means that the greater the severity in the level of Autism, lower will be the performance scores. Here the findings prove that the performance scores are greater for individuals with Mild autism when compared to moderate and severe ASD individuals. The study also proves that there is a significant difference in the average performance scores of ASD and TD group. The performance scores of TD is comparatively greater than ASD. Table 4: Tests of Between- Subjects Effect The relationship between Level of Autism and Performance Score of ASD Hypothesis Ho- there is no significant relationship between level of autism and performance score of ASD. H1- there is a significant relationship between level of autism and performance score of ASD. Significance level is less than 0.01 so we reject the null hypothesis therefore there is a significant relationship between level of autism and performance score of individuals with ASD. This proves that performance scores are higher for individuals with Mild autism when compared to moderate and severe categories. Figure 1 Represents the graph showing relationship between level of autism and gender. From the graph it is seen that males are more severe on level of autism when compared to females. Figure 2 Represents the heat map of the alphabet learning scenario. It depicts where the user is fixated the majority of the time during the task. Figure 3 Represents the alphabet learning task environment. As the user starts the session, the eye tracker data will start recording. Figure 4 Represents the ball picking task environment. As the user starts the session, the eye tracker data will start recording. Discussion This study has been carried out to understand the factors affecting attention patterns of individuals  with ASD, to check the effectiveness of VR simulated Technology on measuring the attention deficits of children with ASD, to find out the effectiveness of eye-tracking studies on attention patterns of children with ASD, to find the values of AFD, SFC, TTFF and FFD of the participants, and to understand the differences in the attention patterns of individuals with ASD and TD, to find the efficacy of cognitive skills training using virtual reality for individuals with ASD, To find the relationship if any  between gender and level of autism of individuals with ASD, to find the efficacy of the product Auticare for skill training. Two cognitive Virtual reality scenarios in Auticare: Ball picking and putting in basket The scenario begins with the user entering a virtual room. To the right of the user he/she will be able to see an avatar to the right side. As soon as the user locks eye with the avatar, the avatar starts the conversation with the user by greeting and introducing oneself. This in turn gives the child the opportunity to highly engage with avatar modeling and improving greeting behavior in social interaction. After the introduction, the avatar will be providing step wise instructions to do the respective task. In this scenario the avatar guides the child to find the different colored balls in front of them and ask them to pick and put in the basket kept nearby. The users are positively reinforced with visual reinforcements after each successful attempt and are encouraged to do better after every failed attempt by the avatar. The scores are automatically stored in the AI cloud platform, along with that the attention distribution pattern based on AOIs generated using four eye-gaze measures, TTFF, FFD, AFD AND SFC are computed. The list of AOIs range from ball, basket, toy basket, poster, roof, ceiling lamp, chair, door, floor, plant, toy, table. Scoreboard and window Alphabet learning scenario In this scenario, the avatar guides the child on each alphabet with their corresponding objects. The user is guided to interact with each object while learning the alphabets. The responses are automatically stored in the AI cloud platform, along with that the attention distribution pattern based on AOIs generated using four eye-gaze measures, TTFF, FFD, AFD and SFC are computed. The list of AOIs range from wall stickers, buzzer, window outside, wall side, wall front, door, wall design, roof, cupboard, door, table, apple. Ball, cat, dog, elephant, flower, Glass, hat, ice cream, jar, kite, lamp, mango, Nest, orange, parrot, queen, rocket, sun, Tap, Umbrella, violin, watch, xylophone, yacht, zebra. From the results, it is clear that the average time to first fixate (TTFF) for alphabet learning and ball-picking tasks for ASD is greater than the TD group. This shows that the ASD subjects take more time to first fixate on the area of interest when compared to the TD group. Thus, the study has thrown insight into understanding the on-task attention of the user. This helped to know the reaction time of the user and the total time taken to finish a particular task. The FFD, AFD and SFC average values for ASD group is less when compared to the TD group. This shows that the on-task attention for individuals with ASD is less when compared to the TD group. The Sum of Fixation counts (SFC) enabled an understanding the total amount of time fixated on each area of interest in each of the Virtual reality scenarios. These findings emphasize the potential for the use of eye-gaze measures to identify attention impairment in children with ASD. This product Auticare, thus enables to find the attention deficits and distractions of the user with ASD. Since this study also gives the eye tracking report of the TD group, it helps in a comparative analysis of performance in the VR scenarios.  From the study it is also observed that all the participants in the ASD group participated in the VR skill training. They were very enthusiastic to perform their task in the virtual reality environment. The eye tracking measures gave a detailed report of the attention patterns of the ASD group and how it varies with the TD group. The eye gaze measures of participants in the ASD group helped to generate a heat map of their eye movement and hence helped the therapist to map the progress of each individual with ASD.  Auticare, proved to be an assistive aid for the therapist to carry out the therapy sessions in a productive manner. All the performance metrics tapped were stored in each patient behavior data dashboard. This enabled the therapist to prepare an Individualized Education plan. Auticare also enabled therapy sessions to be fun and enabled parental involvement, as they could track each progress of their kid. The attention parameters received from the eye tracker system fostered adding, removing or even creating a hierarchy of virtual reality objects according to their areas of interest. This enabled them to increase their learning curve and better improve their skills in a safe immersive platform. In the results, in relation to Gender and levels of autism, it is understood that males are more severe on level of autism when compared to females. According to the Center for disease control and prevention (2021), approximately 1 in 44 children in the U.S. is diagnosed with an autism spectrum disorder (ASD), according to 2018 data. 1 in 27 boys identified with autism 1 in 116 girls identified with autism. Boys are four times more likely to be diagnosed with autism than girls. The severity of symptoms was also seen in boys compared to girls in the present study. In the results, in relation to the Relationship between average performance score of ASD and TD with level of Autism, it is evident that there is a correlation between the performance scores of ASD group and level of autism. In the results, Tests of Between- Subjects Effect The relationship between Level of Autism and Performance Score of ASD, it is understood that there is a significant relationship between level of autism and performance scores of ASD. Greater the performance scores in the cognitive VR scenarios, lower degree of autism. The participants of the ASD group with Mild autism level scored higher in ball picking and putting in basket and Alphabet learning VR scenario. Conclusion This study helped to put forward the effectiveness of the Virtual Classroom for the assessment and rehabilitation of attention deficits using Auticare. This study shows that VR can be used in the assessment of attention as well as cognitive training and can offer better predictive information regarding performance in the real environment. The subjects of the study actively participated in the two cognitive VR scenarios, Alphabet learning and ball picking and putting in basket. The present study showed the efficacy of virtual reality training using Auticare. The eye tracking parameters of ASD and TD group gave a comparative report on the attention patterns while performing each activity in Virtual reality. The reports on various areas of interest of the participants also helped to create virtual reality objects hierarchy. The preliminary results of this study are promising and show the feasibility and efficacy of Virtual reality skill training using Auticare. It is also concluded that there is a significant relationship between gender and level of autism as males tend to show higher degrees of autism in terms of its severity when compared to females. It is also concluded that the time to first fixate is considerably higher for the ASD group when compared to the TD. The on-task attention on each cognitive VR scenario was greater for the TD group when compared to the ASD. The present study thus enabled us to get a heat map on the eye data of the participants which enabled the researchers to study the attention deficits in individuals with ASD using Auticare. This study will be beneficial for future studies since it details important data about eye tracking parameters and hence do further research on other skill areas like social, self-care and behavioral scenarios. Conflict of Interest The authors declare no conflict of interest. Source of funding This research has received grant from the Biotechnology Industry Research Assistance Council (BIRAC). Acknowledgement Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals, and books from where the literature for this article has been reviewed and discussed. Author’s Contributions Joanna James: Conceived and designed the analysis, wrote the paper. Sathyanarayanan AR: Set the objectives of the study and collected the data. BobinChandra: Contributed for collecting data and analysis.   Englishhttp://ijcrr.com/abstract.php?article_id=4611http://ijcrr.com/article_html.php?did=4611 1. Shaker A, Lin X, Kim DY, Kim J-H, Sharma G, Devine MA, “Design of a Virtual 2. 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