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Hepatic edema is caused by decreased hepatic protein synthesis, a consequence of decompensated liver cirrhosis. Fluid accumulation occurs when there is an increase in hydrostatic pressure in the hepatic sinusoids and splanchnic capillaries, as well as low albumin. The first-line treatment for cirrhosis-related ascites is an aldosterone antagonist (spironolactone); however, in severe and recurring ascites, a combination of aldosterone antagonists and loop diuretics (torsemide, furosemide, and bumetanide) is preferable. Torsemide outperformed furosemide in terms of natriuretic and diuretic effects at an equivalent dose. Pharmacological features of torsemide, such as lesser hypokalemia effect, longer duration of action, higher bioavailability, and extended half-life, make it a better alternative than furosemide. In clinical studies, it is considered a safer and more acceptable choice with fewer complications., (© Journal of the Association of Physicians of India 2024.)

Omalizumab is an anti-IgE monoclonal antibody currently approved for the treatment of asthma, nasal polyps/chronic rhinosinusitis with nasal polyps, and chronic spontaneous urticaria. Omalizumab is available as an injection in a prefilled syringe (PFS) with a needle safety device (NSD). New product configurations were developed to reduce the number of injections per dose administration, improve patient convenience and treatment compliance. The objective of this randomized open-label 12-week study was to demonstrate pharmacokinetic bioequivalence between (1) new PFS with autoinjector (PFS-AI), (2) new PFS-NSD configuration, and (3) current PFS-NSD configuration. Each new configuration was considered bioequivalent to the current configuration if the confidence intervals (CIs) for the geometric mean ratios (GMR) were contained in the 0.80-1.25 range for maximum concentration (C max ), area under the concentration-time curve until the last quantifiable measurement (AUC last ), and AUC extrapolated to infinity (AUC inf ). Safety was assessed throughout the study. In total, 193 healthy volunteers were randomized at 1:1:1 ratio to omalizumab 1×300 mg/2 mL via new PFS-AI (n = 66), omalizumab 1×300 mg/2 mL via new PFS-NSD (n = 64), or omalizumab 2×150 mg/1 mL via current PFS-NSD (n = 63). Comparing new PFS-AI versus current PFS-NSD, the GMRs were: C max , 1.085; AUC last , 1.093; AUC inf , 1.100. Comparing new PFS-NSD versus current PFS-NSD, the GMRs were: C max , 1.006; AUC last , 1.016; AUC inf , 1.027. The 95% CIs for all GMR parameters were contained within the 0.80-1.25 range. Safety findings were consistent with the known safety profile of omalizumab. Single-dose omalizumab administered as the new PFS-AI or new PFS-NSD was bioequivalent to the current PFS-NSD., (© 2024 Novartis Pharmaceuticals. Clinical Pharmacology in Drug Development published by Wiley Periodicals LLC on behalf of American College of Clinical Pharmacology.)

Colonoscopy has attached great importance to early screening and clinical diagnosis of colon cancer. It remains a challenging task to achieve fine segmentation of polyps. However, existing State-of-the-art models still have limited segmentation ability due to the lack of clear and highly similar boundaries between normal tissue and polyps. To deal with this problem, we propose a region self-attention enhancement network (RSAFormer) with a transformer encoder to capture more robust features. Different from other excellent methods, RSAFormer uniquely employs a dual decoder structure to generate various feature maps. Contrasting with traditional methods that typically employ a single decoder, it offers more flexibility and detail in feature extraction. RSAFormer also introduces a region self-attention enhancement module (RSA) to acquire more accurate feature information and foster a stronger interplay between low-level and high-level features. This module enhances uncertain areas to extract more precise boundary information, these areas being signified by regional context. Extensive experiments were conducted on five prevalent polyp datasets to demonstrate RSAFormer's proficiency. It achieves 92.2% and 83.5% mean Dice on Kvasir and ETIS, respectively, which outperformed most of the state-of-the-art models., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: Modified and superficial inguinal lymph node dissection (MILD and SILD) are the 2 widely used templates for surgical staging of clinically node negative (cN0) penile cancer (PeCa); however, no previous reports have compared their outcomes. We compared these 2 surgical templates for oncological outcomes and complications., Materials and Methods: We retrospectively reviewed records of cN0 PeCa patients who underwent MILD/SILD at our cancer care center from January 2013 to December 2019. Patients who developed a penile recurrence during follow up were excluded from analysis of oncological outcomes. The 2 groups (MILD and SILD) were compared for baseline clinico-pathological characteristics. The primary outcome was the groin recurrence free survival (gRFS). Secondary outcomes included the false negative rate (FNR) and disease free survival (DFS) for both templates and also the post-operative wound related complication., Results: Of the 146 patients with intermediate and high risk N0 PeCa, 74 (50.7%) and 72 (49.3%) underwent MILD and SILD respectively. The 2 groups were comparable with regards to the distribution of T stage, tumor grade and the proportion of intermediate and high-risk patients. At a median follow up of 34 months (47 for SILD and 23 for MILD), a total of 5 groin recurrences were encountered; all of them occurred in the MILD group. The gRFS and DFS for the MILD group was 93.2% and 91.8% respectively; while that for the SILD group was 100% and 94.4% respectively. Too few events had occurred to determine any statistically significant difference. The FNR for MILD and SILD was 26.3% and 0% respectively. The overall complication rate was significantly higher in the SILD group (46% vs 20.3%, p=0.001), especially for Clavien Dindo 3A complications., Conclusion: MILD can fail to pick up micro-metastatic disease in a small proportion of cN0 PeCa patients, while SILD provides better oncological clearance with no groin recurrences. This oncological superiority comes at the cost of a higher incidence of wound-related complications., Competing Interests: Declaration of Competing Interest The authors have no competing interests to declare that are relevant to the content of this article., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Solitary fibrous tumors (SFTs) are very rare spindle cell neoplasms of mesenchymal origin with largely benign course of disease. Genital SFT's can be managed providing excellent functional and psychological outcomes by timely intervention., Case Presentation: We report the largest and possibly the second only reported case of penile SFT in a 34 year male presenting with a gradually increasing perineal mass with clinically normal appearing phallus. MRI revealed a 9.8 × 3.2 cm soft tissue mass arising from left corpora cavernosae, the mass was excised en-bloc via a perineal approach under spinal anaesthesia. Histopathology revealed spindle cell tumor embedded in myxohyaline stroma along with hyalinized vascular channels demonstrating IHC positivity for CD34 and STAT6. The patient is disease free post 2 years of resection with no sexual or urinary dysfunctions., Conclusion: Genital SFTs, although rare, should be considered in the differential diagnosis of well-circumscribed, painless, slow growing solid masses and histopathologists must be vigilant of its malignant characteristics., (© 2023. The Author(s).)

Background: Maxillofacial trauma in polytrauma settings is often associated with multiple injuries both trivial and life threatening, and their timely detection is the mainstay of definitive trauma management for preventing mortality and morbidity. Emergency management of all the patients reporting to our maxillofacial unit is either done by our center or they have been managed at the peripheral health care facility and relatively stable patient is referred to us. Anecdotally, we found inadequacies in transport methods, diagnosis, and detection of associated injuries in the patients referred to us from the peripheral health care facility. To substantiate our finding, this observational study has been planned., Objective: To identify, diagnose, and document missed injuries associated with the maxillofacial trauma., Materials and Methods: All the trauma patients referred to the maxillofacial unit directly from the peripheral health care facility during the period of October 2017 to March 2019 were included in this study., Results: We observed a total of 270 patients having both pure maxillofacial trauma and patients having documented other injuries associated with maxillofacial injuries. In our maxillofacial unit, functioning as a secondary screen, head to toe clinical examination was performed to document any previously missed out injuries. Missed injuries diagnosed by us included spinal injuries, temporal bone fractures, fractures of the styloid process, and even head injury., Conclusion: Frequent reassessment of trauma patients at all levels of trauma care and training health care personnel particularly those at peripheral health care facility and those involved in prehospital care are pivotal in managing the trauma patients in most efficient manner., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 National Journal of Maxillofacial Surgery.)

Central Asian Economies (CAEs) have diverse exchange rate policies. They have recorded higher volatility in the foreign exchange market since inception. High volatility of the transition era has drifted these economies towards partial dollarization. Monetary authorities in CAEs, (already have a challenge of maintaining monetary policy autonomy) have a gigantic task of price stability and stopping the spread of dollarization. This study is directed towards assessing the drivers and the determinants of foreign exchange market pressure in CAEs. The results, based on panel data analysis and the System GMM model, have provided useful insights about the exchange market pressure determinants particularly USD, Euro, Ruble, and Renminbi. The results show that China and Russia exchange market pressure has a negative effect on the exchange market pressure of CAEs. While the dollar index shows a positive impact on the exchange market pressure of CAEs. Overall, the findings imply that China and Russia currency appreciation results in a trade deficit across CAEs. The policy implication suggests that the floating exchange rate regime (inflation targeting regime) is not in favor of CAEs, and they must use managed-float to reduce their trade deficits., Competing Interests: Competing InterestsThe authors declare that they have no competing interests" in this section., (© The Author(s) 2023.)

Edentulism, a common problem can occur either as a congenital defect or acquired later due to dental caries, periodontitis, as a consequence of aging, maxillofacial trauma or post-ablation in tumor resections. The rehabilitation of the missing teeth can be done using dental implants. To overcome the deficiency of available bone, processes like sinus augmentation with substituted bone graft and Le Fort I osteotomy with interpositional bone graft have been described in the literature. In order to overcome the associated limitations with these procedures, implants were designed that can be placed in specific anatomical areas like zygoma. This study aims to compare two different types of surgical approaches (Intrasinus vs Extrasinus) for the placement of zygomatic implants to treat atrophic maxilla. The placement of zygomatic implant through both extrasinus and intrasinus approaches were evaluated on the basis of different parameters and it was observed that postoperative pain and swelling was significantly found in intra sinus approach as compared to extra sinus approach. However, in the intranasal approach, poor patient compliance or low satisfaction rate was observed as compared to extra sinus approach. On the basis of the results of the study and post operative evaluation based on various criteria, it was concluded that extra sinus approach has got an edge over intra sinus approach., (© 2022 Published by Elsevier B.V. on behalf of Craniofacial Research Foundation.)

Background: Coronavirus disease 2019 (COVID-19) infection in India demonstrated three peaks in India, with differences in presentation and outcome in all the three waves. The aim of the paper was to assess differences in the epidemiological, clinical features and outcomes of patients with COVID-19 presenting at a tertiary care hospital in the three waves at Jaipur, India., Methods: This was a retrospective study conducted at a tertiary care hospital at Jaipur, India. Demographic, clinical features and outcomes were compared of confirmed COVID-19 cases admitted during the first wave (16-7-2020 to 31-1-2021), second wave (16-3-2021 to 6-5-2021) and third wave (1-1-22 to 20-2-22) of the outbreak., Results: There were 1006 cases, 639 cases and 125 cases admitted during the three waves, respectively. The cases presenting in the second wave were significantly younger, with significantly higher prevalence of symptoms such as fever, cough, sore throat, nausea, vomiting, headache, muscle ache, loss of appetite and fatigue (P < 0.05). A significantly higher proportion of patients received Remdesivir in the second wave (P < 0.001). However, in the second wave, the use of low molecular weight heparin, plasma therapy, non-invasive and invasive ventilator were higher (P < 0.001). Co-morbid conditions were significantly higher in the admitted patients during the third wave (P < 0.05). Radiological scores were similar in second and third wave, significantly higher than the first wave. Lymphopenia and rise of inflammatory markers including C-reactive protein and interleukin-6 were more evident in the second wave (P < 0.001). The mean mortality, hospital stay and air-leak complications were also significantly higher in the second wave (P < 0.001)., Conclusions: The second wave was more vicious in terms of symptoms, inflammatory markers, radiology, complications, requirement of ventilation and mortality. Mutation in the virus, lack of immunity and vaccination at the time point of second wave could have been the possible causes. The ferocity of the second wave has important implications for the government to formulate task forces for effective management of such pandemics., Competing Interests: None

Context: COVID-19 caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is an emerging pandemic that is rapidly spreading with more than 114 million confirmed cases and 2.5 million deaths by far. Nasopharyngeal swab (NPS) in VTM has been used as the gold standard respiratory specimen for SARS-CoV-2 reverse-transcriptase real-time PCR (rRT-PCR) tests. But now the virus can also be detected in other clinical specimens like bronchoalveolar lavage, sputum, saliva, throat swab, blood, and stool specimens., Aims: The aim of this study was to determine the diagnostic potential of saliva as a sample in comparison to NPS for detection of SARS-CoV-2 by rRT-PCR., Settings and Design: A cross-sectional study was conducted among 256 paired samples (NPS and Saliva) received in the Department of Microbiology, SMS Medical College, Jaipur over a period of 2 months., Methods and Material: NPS from individuals were collected in a sterile tube containing Viral Transport Medium™. Before swab collection, whole saliva was collected by spitting from the suspected patient into a sterile container. Both were stored at room temperature and transferred to the diagnostic laboratory within four hours of collection where extraction was done using Perkin Elmer chemagic extractor and rRT- PCR was performed using NIV, Pune mastermix., Results: Sensitivity, specificity, PPV, and NPV of RT-PCR for the diagnosis of COVID-19 in saliva were 84.26%, 100%, 100%, and 54.05%, respectively. The accuracy of detection of COVID-19 by saliva samples compared to the routinely used NPS samples (considered as the standard reference) for RT PCR was 86.72%., Conclusions: Our results show that saliva as a reliable sample type for SARS-CoV-2 detection.

Traditional healthcare services have changed into modern ones in which doctors can diagnose patients from a distance. All stakeholders, including patients, ward boy, life insurance agents, physicians, and others, have easy access to patients' medical records due to cloud computing. The cloud's services are very cost-effective and scalable, and provide various mobile access options for a patient's electronic health records (EHRs). EHR privacy and security are critical concerns despite the many benefits of the cloud. Patient health information is extremely sensitive and important, and sending it over an unencrypted wireless media raises a number of security hazards. This study suggests an innovative and secure access system for cloud-based electronic healthcare services storing patient health records in a third-party cloud service provider. The research considers the remote healthcare requirements for maintaining patient information integrity, confidentiality, and security. There will be fewer attacks on e-healthcare records now that stakeholders will have a safe interface and data on the cloud will not be accessible to them. End-to-end encryption is ensured by using multiple keys generated by the key conclusion function (KCF), and access to cloud services is granted based on a person's identity and the relationship between the parties involved, which protects their personal information that is the methodology used in the proposed scheme. The proposed scheme is best suited for cloud-based e-healthcare services because of its simplicity and robustness. Using different Amazon EC2 hosting options, we examine how well our cloud-based web application service works when the number of requests linearly increases. The performance of our web application service that runs in the cloud is based on how many requests it can handle per second while keeping its response time constant. The proposed secure access scheme for cloud-based web applications was compared to the Ethereum blockchain platform, which uses internet of things (IoT) devices in terms of execution time, throughput, and latency., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Kirtirajsinh Zala et al.)

The COVID-19 pandemic has caused a worldwide catastrophe and widespread devastation that reeled almost all countries. The pandemic has mounted pressure on the existing healthcare system and caused panic and desperation. The gold testing standard for COVID-19 detection, reverse transcription-polymerase chain reaction (RT-PCR), has shown its limitations with 70% accuracy, contributing to the incorrect diagnosis that exaggerated the complexities and increased the fatalities. The new variations further pose unseen challenges in terms of their diagnosis and subsequent treatment. The COVID-19 virus heavily impacts the lungs and fills the air sacs with fluid causing pneumonia. Thus, chest X-ray inspection is a viable option if the inspection detects COVID-19-induced pneumonia, hence confirming the exposure of COVID-19. Artificial intelligence and machine learning techniques are capable of examining chest X-rays in order to detect patterns that can confirm the presence of COVID-19-induced pneumonia. This research used CNN and deep learning techniques to detect COVID-19-induced pneumonia from chest X-rays. Transfer learning with fine-tuning ensures that the proposed work successfully classifies COVID-19-induced pneumonia, regular pneumonia, and normal conditions. Xception, Visual Geometry Group 16, and Visual Geometry Group 19 are used to realize transfer learning. The experimental results were promising in terms of precision, recall, F1 score, specificity, false omission rate, false negative rate, false positive rate, and false discovery rate with a COVID-19-induced pneumonia detection accuracy of 98%. Experimental results also revealed that the proposed work has not only correctly identified COVID-19 exposure but also made a distinction between COVID-19-induced pneumonia and regular pneumonia, as the latter is a very common disease, while COVID-19 is more lethal. These results mitigated the concern and overlap in the diagnosis of COVID-19-induced pneumonia and regular pneumonia. With further integrations, it can be employed as a potential standard model in differentiating the various lung-related infections, including COVID-19., Competing Interests: All the authors declare no conflicts of interest., (Copyright © 2022 Deepak Kumar Jain et al.)

Introduction: Ewing's sarcoma is a Primary Neuroectodermal Tumour (PNET) commonly affecting appendicular skeleton. The involvement of axial skeleton is very rare and that too of cervical spine is rarest. We present a case of Ewing's sarcoma involving cervical spine managed surgically, and its outcome., Case Presentation: A 26-year-old male presented with 3-month history of neck pain and progressive motor weakness for 1 week. After clinical evaluation of sign and symptoms, MRI of cervical spine revealed a posterior neck mass over C2, C3 and C4. Because of mass effect and spinal cord compression, early surgical intervention was deemed necessary to stop progression of neurological deficit and make tissue diagnosis of lesion. On histopathological examination diagnosis of Ewing sarcoma was made. PET-CT showed C2 and C3 as primary site of involvement with no other site of involvement., Discussion: The Ewing's Sarcoma of the cervical spine is a rare occurrence and usually present in late and advanced stage. High index of suspicion should be present to make early diagnosis and prevent complications., (© 2022. The Author(s), under exclusive licence to International Spinal Cord Society.)

In lung cancer, tumor histology is a significant predictor of treatment response and prognosis. Although tissue samples for pathologist view are the most pertinent approach for histology classification, current advances in DL for medical image analysis point to the importance of radiologic data in further characterization of disease characteristics as well as risk stratification. Cancer is a complex global health problem that has seen an increase in death rates in recent years. Progress in cancer disease detection based on subset traits has enabled awareness of significant as well as exact disease diagnosis, thanks to the rapid flowering of high-throughput technology as well as numerous ML techniques that have emerged in recent years. As a result, advanced ML approaches that can successfully distinguish lung cancer patients from healthy people are of major importance. This paper proposed lung tumor detection based on histopathological image analysis using deep learning architectures. Here, the input image is taken as a histopathological image, and it has also been processed for removing noise, image resizing, and enhancing the image. Then the image features are extracted using Kernel PCA integrated with a convolutional neural network (KPCA-CNN), in which KPCA has been used in the feature extraction layer of CNN. The classification of extracted features has been put into effect using a Fast Deep Belief Neural Network (FDBNN). Finally, the classified output will give the tumorous cell and nontumorous cell of the lung from the input histopathological image. The experimental analysis has been carried out for various histopathological image datasets, and the obtained parameters are accuracy, precision, recall, and F-measure. Confusion matrix gives the actual class and predicted class of tumor in an input image. From the comparative analysis, the proposed technique obtains enhanced output in detecting the tumor once compared with an existing methodology for the various datasets., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Deepak Kumar Jain et al.)

The unrelenting trend of doctored narratives, content spamming, fake news and rumour dissemination on social media can lead to grave consequences that range from online intimidating and trolling to lynching and riots in real- life. It has therefore become vital to use computational techniques that can detect rumours, do fact-checking and inhibit its amplification. In this paper, we put forward a model for rumour detection in streaming data on social platforms. The proposed CanarDeep model is a hybrid deep neural model that combines the predictions of a hierarchical attention network (HAN) and a multi-layer perceptron (MLP) learned using context-based (text + meta-features) and user-based features, respectively. The concatenated context feature vector is generated using feature-level fusion strategy to train HAN. Eventually, a decision-level late fusion strategy using logical OR combines the individual classifier prediction and outputs the final label as rumour or non-rumour. The results demonstrate improved performance to the existing state-of-the-art approach on the benchmark PHEME dataset with a 4.45% gain in F1 -score. The model can facilitate well-time intervention and curtail the risk of widespread rumours in streaming social media by raising an alert to the moderators., Competing Interests: Conflict of interestThe authors certify that there is no conflict of interest in the subject matter discussed in this manuscript., (© The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature 2021.)

For the Pacific Small Island Developing States (PSIDS), climate change will greatly exacerbate their vulnerability. The PSIDS have a high ranking in the Climate Risk Index and the World Risk Index. Financial losses due to climate-induced disasters, in terms of gross domestic product (GDP), are also high in the Pacific region. While climate risk insurance solutions could play a key role in the efficient distribution of recovery resources, there are many challenges to their successful implementation. Effective climate risk insurance products for the vulnerable sections of these societies are almost non-existent in this part of the world. Among the worst climate-induced disasters to affect the PSIDS are those related to cyclones and floods. These not only adversely impact the welfare of the households affected by these disasters, but they lower the long-term development potential of the countries involved. There is also evidence to suggest that climate-induced disasters are increasing in frequency and intensity over time due to climate change. It is against this background that an inquiry into the necessity for climate risk insurance products in the context of PSIDS should take place. This paper gives a comprehensive review of the literature addressing climate risk insurance as a risk mitigation or climate adaptation tool for managing the climate-induced financial vulnerabilities in the PSIDS. The paper explores the affordability of climate risk insurance, particularly among the vulnerable sections of society, and discusses the challenges of implementing an appropriate climate risk insurance model in the region. Finally, it examines recent climate risk insurance initiatives that have been attempted by multilateral agencies, such as the United Nations Development Programme (UNDP), the United Nations' Pacific Financial Inclusion Practice (UNCDF), Pacific Insurance and Climate Adaptation Programme (PICAP), and respective local governments., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Springer Nature B.V. 2022.)

The paper projects aggregate populations of six Pacific Island countries in both pre- and post-COVID19 scenarios using a Cohort Component Method for the period 2020-2060. It uses baseline indicators resembling China and Italy's experiences and finds that Pacific countries could experience a fatality rate between 5 and 20% due to the pandemic. It also finds that most Pacific Island countries would experience higher fatalities in the older age groups, consistent with what is being witnessed in other countries around the world. The analysis also shows that while the risk escalates for people over 50 years onward in all other sample countries, in Fiji, those in the age range of 60 years or more are at higher risk. The findings also indicate that for all countries, the fatality rate for 80 years and older is about 50%. The population projections show that Fiji will be most impacted, while others will experience around 2% initial population decline. The convergence to baseline is found to be slow (except for Tonga) in most Pacific countries. Consequently, the paper suggests a cautious approach in dealing with the current crisis., (© The Author(s), under exclusive licence to Springer Nature B.V. 2021.)

The previous studies of exports performance in Fiji were carried out at the aggregate level. We conduct a disaggregated analysis of exports of three major products, namely, sugar, tourism, and gold. This analysis is useful for developing sector-based export promotion policies. The long run as well as dynamic export demand functions are estimated at the aggregate and disaggregate levels. The results identify a number of factors such as trading partner income, relative prices, productivity shocks, natural disasters, political disturbances, and the exchange rate that affect the export demand for sugar, tourism, and gold, though not in the same way. For instance, tourism and sugar enjoy the highest income elasticity. Sugar export is adversely affected by natural calamities and political upheavals. The political upheavals also affect tourism adversely in Fiji. The exchange rate affects the export of sugar more than others. The idea that devaluation will promote exports in Fiji needs careful investigation because results show that this will happen with a high cost, i.e. 5% nominal devaluation will be required to increase real exports by 1%., (© European Association of Development Research and Training Institutes (EADI) 2022.)

Over the last decade, the field of bioinformatics has been increasing rapidly. Robust bioinformatics tools are going to play a vital role in future progress. Scientists working in the field of bioinformatics conduct a large number of researches to extract knowledge from the biological data available. Several bioinformatics issues have evolved as a result of the creation of massive amounts of unbalanced data. The classification of precursor microRNA (pre miRNA) from the imbalanced RNA genome data is one such problem. The examinations proved that pre miRNAs (precursor microRNAs) could serve as oncogene or tumor suppressors in various cancer types. This paper introduces a Hybrid Deep Neural Network framework (H-DNN) for the classification of pre miRNA in imbalanced data. The proposed H-DNN framework is an integration of Deep Artificial Neural Networks (Deep ANN) and Deep Decision Tree Classifiers. The Deep ANN in the proposed H-DNN helps to extract the meaningful features and the Deep Decision Tree Classifier helps to classify the pre miRNA accurately. Experimentation of H-DNN was done with genomes of animals, plants, humans, and Arabidopsis with an imbalance ratio up to 1:5000 and virus with a ratio of 1:400. Experimental results showed an accuracy of more than 99% in all the cases and the time complexity of the proposed H-DNN is also very less when compared with the other existing approaches., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 R., Jain, Kotecha, Pandya, Reddy, E., Varadarajan, Mahanti and V.)