Role of postpartum Kegel exercises in the prevention and cure of stress incontinence

Background: Urinary incontinence in the post partum is a significant health problem in women with serious physical, psychological, and social consequences. The objective of this article is to educate women the correct method to do Kegel exercises, to assess their improvement and to introduce Kegel exercise regimen in every women in the postpartum period.Methods: 72 women in postpartum period with genuine stress incontinence (GSI) included in the study from January 2012 to July 2014 in the department of Obstetrics and Gynecology of VCSGGMSRI Srinagar, Pauri Garhwal, India. Women divided into 2 groups, first group of supervised Kegel exercises and second group was of women doing pelvic floor exercises at home. To monitor improvement, monthly assessment of pelvic floor function (vaginal palpation and observation) and measurement of PFM strength (vaginal squeeze pressure) by physician and patient both, done in the 2 groups.Results: The women were in the age group of 18-39 years. There were 15 % patients in dry category, 52 % had good improvement and 21 % had fair results. In the supervised exercise group the patients with good clinical response were 80% in the cured and borderline responder category. In the non-supervised group patients in the cured and borderline responders group were (6) 16% and (12) 33% respectively.Conclusions: The high cure rate depends on the factors like how correctly the Kegel exercises were instructed, how correctly the patients learned and performed them

Effectiveness of transabdominal ultrasonography in assessing benign versus malignant nature of prostatomegaly

Background: Benign prostatic hyperplasia is closely related with ageing. The present study was conducted to assess the ability of transabdominal ultrasonography in diagnosing benign and/or malignant hypertrophy of the prostate.Methods: An observational study was done in the Department of Radiology, Bharati Vidyapeeth Medical College and Hospital (Deemed to be University), Sangli, Maharashtra, India of patients who had prostatomegaly on transabdominal ultrasound examination and underwent histopathological confirmation of the lesions from 1 October 2018 till 31 December 2018. The prostate gland was assessed for volume, echotexture, morphology, focal lesions and median lobe.Results: Out of 155 patient’s benign prostatic disease was diagnosed in 116 patients, while malignancy was detected in the rest of the 39 cases. Prostate specific antigen levels were significantly higher among malignant cases (18.39±7.44 ng/ml) as compared to that of benign cases (7.51±3.22 ng/ml), p value <0.01. Benign lesions were predominantly inner glandular, while malignant cases were mainly peripheral. Moderate vascularity was found in 76.9% of the malignant cases. Focal vascular asymmetry was found in 74.4% of the malignant cases and only 12% of the benign cases. Sensitivity of transabdominal ultrasonography in diagnosing malignant prostatic lesions was 94.8%, specificity was 75% with an overall accuracy of using transabdominal ultrasonography in the diagnosis of malignant prostatic lesions in this study population was 80%.Conclusions: Transabdominal ultrasound evaluation of prostate is a simple, economical, non-invasive technique of choice due to its high accuracy in detecting size, nature of pathology as benign or malignant with fair accuracy

Role of neurosonography in neonates with clinically suspected intracranial pathology

Background: Preterm neonates have a higher mortality and morbidity because of their greater risk for intracranial hemorrhage (ICH), hypoxic ischemic encephalopathy(HIE) which can lead to poor neurodevelopmental outcomes. The present study was conducted to evaluate neonates with clinically suspected intracranial pathology by neurosonography.Methods: Included neonates were those with clinically suspected intracranial pathology admitted to neonatal intensive care unit of the Bharati Vidyapeeth Medical College and Hospital (Deemed to be University), Sangli from October 2018 till December 2018. First cranial neurosonography was done between first and third day, second between 7th and 10th day of birth. HIE also known as Periventricular leukomalacia (PVL) grading was done using the De Varies et al, grading. Severity of ICH was graded according to Papile and Burstein classification(1978).Results: Of the total 60 neonates, 61.7% were preterm and rest at term. Mean APGAR score at 1 minute was 8.6 (range 5 to 10) and at 5 minutes was 9.58 (range 8 to 10). Mean ventricular index at the first assessment was 26.78% and 26.89% at the second assessment. Grade 1 HIE was found in 17 neonates on first assessment, and two had grade 2 HIE. Second assessment revealed grade 1 HIE in 20 neonates and grade 2 in two. First assessment revealed two neonates with grade 1 and grade 2 ICH, out of which one grade 2 ICH worsened to grade 3. Two neonates were found to have corpus callosal agenesis.Conclusions: Transcranial neurosonography stands as an excellent and reliable investigation of choice for neonates to detect HIE,ICH and intracranial congenital anomalies

Prevalence of different components of the metabolic syndrome in type 2 diabetics attending tertiary care hospital in Himalayan region

Background: There are enormous studies on various aspect of Diabetes and Metabolic syndrome, majority of studies are on urban population, few in rural area but very few for the population living in far flung hilly region of Himalaya. The aim was to find the prevalence of different components of metabolic syndrome in Type 2 diabetics living in the hills of Himalaya and to find correlation with obesity.Methods: All the Type 2 Diabetic patients age 35 years and above attending the inpatients and out patient’s department of V. C. S. G. G. M. C and RI Srinagar, Uttarakhand from October 2012 to March 2013 were enrolled and were evaluated for metabolic syndrome by IDF (International Diabetes Federation) criteria.Results: 128 diabetics were enrolled (76 males and 52 females), the prevalence of obesity in patients of type 2 diabetics was 45.3%. There was poor correlation between obesity and type 2 diabetes (correlation coefficient 0.08) The prevalence of metabolic syndrome was 40.6 % and high percentage (62%) had all five components of the syndrome.Conclusions: The prevalence of obesity and Metabolic syndrome is relatively lower in Type 2 Diabetics of Shivalik range of Himalaya (Uttarakhand)

ANALYSIS OF ARTAVA (MENSTRUATION) IN CONTEXT OF SHARIRA RACHANA

The proper understanding of terminology is vital for a systematic knowledge of any structure especially in context of Sharira Rachana. A term is a structured set of concepts and their designations in a specific field. The proper terminology is concerned with relationship between the concepts and also makes a fundamental pillar. The aim of present article is to compiled, critically analyze the terminology related to Artava i.e. Raja, Artava and Shonita and elaborate the fundamental concepts behind those terminologies in various classics of Ayurveda. Presence of Raja, Artava since childhood, concept of Raja, Shonita, character of Artava and difference between Artava and Shonita are mentioned as reviewed literature. About one month of time period is needed in the formation of Artava in adult female’s means to reach the Artava from its originating place to destination place or from Yakrita and Pleeha to Garbhashaya (Yoni) and this makes complete passage of Artava. Artava have Agneya Pradhana nature as source of Agneyatattva for Garbha while Anushanasheeta composition of Rakta Dhatu laid the foundation of Dhatu for body. Raja is the flowing constituent of Artava and Beeja as constituent of Artava is the source of Garbha. Both Artava and Rakta Dhatu are formed from Rasa Dhatu by Ranjanakriya. This process converts the Saumyabhava to Agneyabhava. This article can be helpful to understand the various terminologies related to the Artava

Comparing retrograde urethrography readings with intraoperative findings in urethral stricture

Background: Urethral strictures are relatively common in men with most patients acquiring the disease due to injury or infection. The present study was conducted to assess the accuracy of retrograde urethrography (RGU) in diagnosing urethral strictures in patients presenting with lower urinary tract symptoms.Methods: All male patients presenting with lower urinary tract symptoms and referred for retrograde urethrogram to the Department of Radiodiagnosis, Bharati Vidyapeeth Medical College and Hospital (Deemed to be University), Sangli from November 2018 till January 2019 were included. The parameters of RGU were compared with intra-operative findings as gold standard to calculate the operating characteristics of RGU.Results: The present study included 42 patients, mean age 54.9±11.2 years. Grade I urethral stricture was observed in 42.8% and 26% had grade II stricture. Bulbar stricture was the most common location. The common presenting complaints were increased frequency (50%) and dribbling micturition (40.4%). Approximately one tenth of all patients had a history of trauma. RGU was 100% sensitive and 66.7% specific in detecting strictures of less than 2 cm. Overall accuracy of RGU in detecting urethral strictures of less than 2 cm was 83.3%.Conclusions: RGU is a reliable means for establishing the diagnosis of a suspected urethral stricture and also provides accurate staging information with regard to stricture number, length, location, and coexistent urethral pathology

Awareness and Attitude of Physicians in Academia towards Human Stem Cell Research (HSCR) and Related Policies in Rajasthan, India

Introduction: In India, several science agencies are promoting Stem Cell Research (SCR). There is paucity of studies which document the perception of doctors about SCR, especially physicians in academia. This study was carried out to assess perception of physicians in academia towards Human Stem Cell Research (HSCR) and related policies in India. Methods: We interviewed 200 doctors from three different government medical colleges of Rajasthan. A semi-structured questionnaire was used to discern their awareness, attitudes towards utilization of SCR and their knowledge of related international and ethical policy issues. Results: Though mostly 177 (96.2%) physicians acknowledged the public health benefits of promoting stem cell research in India, but 166 (66.2%) were not aware of the stem cell research policy of the Government of India and 111 (60.3%) were not aware of the ICMR guidelines for Human Stem Cell Research in India. There was a strong desire among academic physicians 152 (82.6%) to incorporate a course on SCR to the students in the near future. Discussion: Physicians in academia have views that SCR should be encouraged to treat clinical diseases and this technology should be brought into India in a big way. They seem to believe that one of the ways to promote the benefits of SCR would be to raise awareness by publishing success stories in widely read Indian Medical Journals, giving updated information regarding its uses in clinical practices and its inclusion as a part of the curricula for health professionals