Innovative Journal of Medical and Health Sciences

Bhat. A. S, Aquil.H, Wani.P, Zaheer.M.T

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Usre Tams (Dysmenorrhea) is the most common of gynecologic complaints. It affects half of all female adolescents today and represents the leading cause of periodic college/school absenteeism among that population. Since ancient times, hijamat bila shurt (Dry cupping) is a method of treatment for this disease. Therefore, objective of this preliminary study was to evaluate the efficacy of hijamat bilas shurt on intensity of pain in Usre Tams by using verbal multi-dimensional scoring system. It was conducted from November 2011 to November 2012 on 40 patients in A&U Tibbia College Karol Bagh. Patients suffering from primary dysmenorrhoea with regular cycles, age group 15-40years were selected. For dry cupping, six cups of medium size were applied around the umbilicus for 10 minutes on alternate days for two cylces and pain intensity was assessed by verbal multi-dimensional scoring system for pain before and after the treatment. . Effect of cupping on pain during periods was reduced and was stastically significant. The Mean and Standard Error Mean for pain intensity before and after the treatment was 8.75 (1.06) and 3.45 (1.79) respectively with P<0.001

Randhir Vishnupant Dhobale, Yugantara Ramesh Kadam, Alka Dilip Gore, Girish Bhimrao Dhumale

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Background: Though adolescent under nutrition still remains a major health problem in rural areas of India, overweight is also alarmingly increasing.
Objective: To study pattern of BMI of school children in association with socio-demographic factors, food habits and physical activity.
Methodology: Study type: cross-sectional, Study setting: Schools from rural area, Study subject: Early Adolescent School Children. Inclusion criteria: children in the age group of 10-16yrs from 5-10 std. Sample size: 1275 students. Study period: July-NOV 2011. Study tools: Self designed, pretested Questionnaire, weighing scale, non-stretchable measuring tape. Statistical analysis: Chi-Square test, Mean and SD. and ANOVA
Results: 1275 students were included in the study. The prevalence of underweight and overweight among the students is 23.1% and 6.5% respectively. There is significant association of underweight (< 5th percentile BMI) in male students (27.6%), having lower literacy of parents (39%) . The prevalence of overweight (13.8%) seen in children who use more computer, television and video games. Also those children who consume bakery products (9.8%), kurkure (9%) and non-vegetarian diet (10%) are more prone for overweight.
Conclusion: Increase consumption of dry snacks, bakery products and non-vegetarian diet along with reduced physical activity affects BMI and hamper nutritional status

Fathia Ahmed Mersal

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Background: Diabetes is a common condition associated with increased morbidity and mortality. Non-pharmacological intervention strategies focusing on improve self care practices which are considered an important part of the treatment of individuals with diabetes. Therefore, the role of self-care is well recognized as a major focus of international clinical intervention and education. Aim: This study aimed at improving self care practice for adults with type 2 diabetes mellitus. Methods: A quasi-experimental intervention was conducted in different outpatient clinics on asample of 180 type 2 diabetic patients randomly divided into two equal study and control groups. Data were collected using interview questionnaire, Self care practice scores; self care guideline was developed and implemented on the study group. Data were collected at pre-post, and 3 months follow up phases. Results: The results showed that the health information needs were very high in both groups. At post and follow up tests, patients in the study group had statistically significantly higher percentages of satisfactory knowledge, 95.3% and 76.7% respectively (p<0.001), compared to 4.8% and 2.4% respectively in the control group. They also had significantly lower caloric intake (p<0.001), and significantly higher percentages of adequate practices (p<0.001), the rates of adequate practice were 81.4% and 98.8% at the post and follow up phases among patients in the study group, compared to 37.3% and 51.8% respectively in the control group. Study group patients had also statistically significant improvement in their self care practice regarding diabetes mellitus (p=0.001). Conclusion: In conclusion, the management guidelines protocol was successful improving self care practice for diabetic adults, so it is recommended to apply it in similar settings.

Kousalya K*, Sanjeeva Reddy N, Uma Maheswara Reddy C, Jayashree K

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The main objective of the study was to measure depression, anxiety and stress (DAS) in infertile women and to assess the impact of counseling on these depression, anxiety and stress levels. 230 women of age ≥ 18 yrs attending the infertility clinic were selected for the study. DASS21 questionnaire was used for assessing DAS. Counseling was given to the study group (115 women) once in 15 days for a period of 3 months and the impact of counseling on DAS was assessed. There were significantly reduced mean (SD) scores for DASS - depression, anxiety and stress in the study group as compared to those in the control group. Again the control group was also counseled and the effect of counseling was assessed. Counseling markedly reduces the depression, anxiety and stress in infertile women. Moreover, counseling along with regular treatment for infertility, improved the treatment outcome. The number of women conceived in the counseled group was more when compared to the uncounseled group. Counseling to reduce depression, anxiety and stress should be given to all infertile women as a regular practice along side their treatment for infertility.

Madhav Bansal*, Sushil Dalal

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Background: unintentional injuries within the home environment have not so far been recognized to the same extent as traffic and work-related injuries in India, largely because they have not been effectively counted. This study took place in Fanda block of district Bhopal, India aiming to determine the profile of unintentional injuries. Methods: All the inhabitants of randomly selected 11 villages of Fanda block formed the study population (13,587). One family member preferably the head was interviewed about their experience of injury in the preceding three months by trained personnel. Results: 487 persons had a total of 543 new injuries during three months prior to the interview. Only 292/543 (53.7%) of the recorded injuries received medical care at health facilities. Home and road traffic injuries constituted the most common injuries with incidence rates of 27 and 24, respectively. Home injuries were most common among young children and the elderly. Majority of the injuries were attributed to ‘‘cutting and crushing’’. Falls were the leading cause among the young (v15 years) and the old (above 60 years). Conclusion: The findings suggest that greater attention needs to be directed toward the prevention of injuries occurring in the home. A larger study in terms of size as well as duration (at least one year) is needed to characterize the patterns of unintentional injury in more detail, including any seasonal variation.
Key words: community-based, surveillance, unintentional injury, India.

Pooja Batra *, DO Gupta, Ravi Batra, Ruchi Kothari, Pradeep Bokariya

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Aim: To study the pattern of soft tissue tumours in a rural population of Central India.
Method: This was a prospective study, carried out in the Department of Surgery, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha. A total of 157 patients of soft tissue tumours who attended Surgery OPD were included in the study with informed consent. The main stay of diagnosis was clinical followed by ultrasonography and FNAC. The diagnosis was confirmed by Histopathological examination if operated and by Tru Cut biopsy if inoperable.
Conclusion: The incidence of benign soft tissue tumours in the study was 89.2% and malignant tumours were 10.8%. Males outnumbered females in both the categories i.e. benign and malignant tumours. Male: Female for benign tumours was 2.1:1 while for malignant tumours it was 1.8:1. The most common site for occurrence for benign tumours was upper limb followed by head, neck and face. Lower limb and back were the most common sites for malignant tumours followed by chest and abdominal wall and head, neck and face.

Sandeep Gupta*

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Introduction -The treatment of renal calculi is based on various factors such as size, location, composition of stones, and associated anatomical abnormalities. Stone burden (size and number) is perhaps the single most important factor in determining the appropriate treatment modality for a patient with kidney calculi. In the kidney, for stones up to 20mm in diameter, ESWL is the recommended treatment. For stones >20mm in diameter, percutaneous nephrolithotomy (PCNL) is the first-line treatment. This is due to the higher retreatment rates and lower likelihood of achieving stone-free state with ESWL in comparison of PCNL. Most prefer to do pre-treatment prophylactic DJ stenting while treating larger renal stones (>2 cm) with ESWL due to fear of having complications.
Aims and Objectives: To evaluate the outcome of extracorporeal shock wave lithotripsy (ESWL) as monotherapy for solitary renal stones larger than 2 cm without ureteral stenting.
Materials and Methods: This was a retrospective study conducted in our department from September 2010 to February 2012.The study population were patients with nephrolithiasis with stone size more than 2 cm treated with Dornier Compact S – lithotripter (N= 208). The Study variables were age, sex, location and size of the stones. Pre-treatment KUB plain films, etc performed in all patients. Routine investigations performed. Post-treatment follow-up USG, KUB plain films were used to monitor the fragmentation and clearance of fragments. Stone size was calculated by measuring the maximum dimensions of the stone. Complete clearance defined as having no stone fragments at 3 months radiologically. Incomplete clearance was defined as having stone fragments of 5 mm or more in size. Clinically insignificant residual fragments (CIRFs) were defined as having stone fragments of 4 mm or less. Successful outcome was defined as being stone free or having CIRF at 3 months.
Results: The mean age of the patients was 43.8 years. More than 70 percent of the patients were in the age group of 30 - 60 years. The male to female ratio was 1:1.2. One hundred nineteen patients had stones on the right kidney and eighty-nine patients had on the left kidney. 24.04% patients developed skin bruises at the site of entry of shock waves which subsided themselves over few days. Mild transient hematuria was observed in 110 patients. Two (0.96%) patients developed perirenal hematoma after the fifth session. Steinstrasse was observed in 81(38.94%) patients. The overall success rate was 67.31%. There were 8 (3.85%) cases of failure to fragmentation and 60 cases of incomplete clearance.
Conclusion: With this small population, we were able to achieve the success rates comparable to larger series. A comparison study between PNL and ESWL for larger renal stones comparing stone-free rate, retreatment rate, economics of treatment, and complications after standardization of treatment schedule is needed. But in patients who are not fit for invasive surgeries like PCNL and open surgery, ESWL can be considered as a treatment option

Manisha M. Chadotra, Mehul. D. Jani, Vaibhav Sharma

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Aim: To present a case of adenoid cystic carcinoma of mandible manifesting as post extraction lesion.
Summary: A 56 years old female patient came with chief complaint of pain and cheek bite in right posterior teeth region of mandible since last 2 Months. She has undergone extraction of lower right 3rd molar before 1 year. Intra oral examination reveals a soft fibrous growth distal to right lower 2nd molar. A radiograph shows radiolucency distal and apical to distal root of right lower 2nd molar. A soft tissue at the site of extraction was excised and sent for histo-pathological report , which reveals adenoid cystic carcinoma.
Key learning points:
• Adenoid cystic carcinoma affecting the mandible may mimic a periapical lesion. Proper diagnosis of such a lesion is dependent on thorough clinical, radiographic and microscopic examinations.
• Such a case highlights the benefits of biopsy and histological examination of collected tissues.
• Diagnosis of lesions in the mandible should include salivary gland tumours.