Assessment on outcome of papaya fruit on premenstrual tension syndrome among adolescent girls in selected setting.

Premenstrual syndrome is medically defined as distressing physical and psychological symptoms not caused by organic disease which appear before menstruation regress during the menstruation, perhaps a hormone imbalance, due to lack of progesterone, a poor diet and lack of exercise. Premenstrual tension syndrome is the emotional tension, insomnia, depression, irritability associated with the premenstrual week. Somatic sensations associated with the syndrome are bloating, cramping, tenderness of the breasts, swelling of hands and feet, temporary weight gain. Premenstrual disorder is a condition in which the symptoms of premenstrual syndrome are more severe and cause significant functional impairment .It has been estimated that anywhere from 3 to 9% of women suffer from this disorder (Woods, 2005). In premenstrual syndrome, symptoms can be controlled to some extent by the dietary manipulations. Studies suggest that a diet high in vitamin C, calcium and magnesium was helpful in order to reduce the level of premenstrual tension syndrome. It is advisable to take diet consisting of fruits which is rich in calcium, antioxidant, vitamin A and minerals from one week prior to menstruation. Papaya fruit is an excellent source of dietary fibre, folate, vitamin A, C and E.It also contains small amount of calcium, iron, riboflavin, thiamine and niacin. It is also very rich in antioxidant nutrients flavanoids and carotenes, very high in vitamin A and C & and also low in calorie. Premenstrual syndrome is linked to other disorders associated with inadequate calcium, iron, vitamins and minerals. Hence the researcher was interested to reduce the level of premenstrual tension syndrome by providing papaya fruit for adolescent girls. The aim of the study was to determine the outcome of papaya fruit on premenstrual tension syndrome among adolescent girls in selected setting. A Quasi experimental design was adopted. The study was conducted at selected government school, Arakonam.60 adolescent girls were selected.30 in experimental and 30 in control group. Adolescent girls who fulfilled the inclusion criteria were selected by using non probability purposive sampling technique. The demographic variables were age in years, age at menarche, weight in kilogram, body mass index and type of diet. The pretest and posttest level of PMTS was determined by modified premenstrual tension syndrome scale.75 mg of papaya fruit was provided by the researcher from the 5th day of last menstrual period in mid morning for 21 days. Data analysis was done by using descriptive and inferential statistics. The pretest and posttest level of premenstrual tension syndrome were compared and found that in pretest 6(20%)had mild level of premenstrual tension syndrome,24(80%)had moderate level of premenstrual tension syndrome ,none of them comes under severe level of premenstrual tension syndrome and in post test 27(90%) had mild level of premenstrual tension syndrome,3(10%) had moderate level of premenstrual tension syndrome, none of them comes under the severe level of premenstrual tension syndrome. Thus the study concludes that papaya fruit was effective to reduce the level of premenstrual tension syndrome. The conceptual framework was based on modified Weidenbach’s helping art nursing theory. The research hypothesis formulated for the study was “there is a significant relationship between the premenstrual tension syndrome and papaya fruit” .The outcome was proved in comparing the pretest and post test level of premenstrual tension syndrome where the result showed p<0.05 level of significance. Thus the research hypothesis was accepted. It was also found that papaya fruit have a role in reducing PMTS. This is statistically proved that research hypothesis was accepted as papaya fruit was effective to alleviate PMTS

Temporomandibular Joint Pain

Temporomandibular joint (TMJ) is a synovial articulation between mandibular condyle and glenoid fossa in the temporal bone. Any structural and/or functional changes can affect the TMJ and related structures. Temporomandibular disorder (TMD) is a heterogeneous group of musculoskeletal disorders mainly characterised by regional pain in the facial and preauricular area and/or limitations/interference of jaw movement. TMD has multifactorial aetiology, which includes biology, and environmental social, emotional, and cognitive factors. TMD is more common orofacial pain condition and nondental origin. Factors associated with TMD include other pain condition, auto-immune disorder and psychiatric illness. The clinical conditions may present with limitation in opening and closing mouth, pain and articular noise. So this chapter mainly deals with the classification of TMJ disorder, diagnosis and management particularly TENS and ultrasound therapy for TMJ disorder

Easing the excision of earlobe keloid

Earlobe keloids are commonly encountered in this era where ear piercing is routine in various traditions. Various medical and surgical methods have been tried for its management. Surgically, fillet flap surgery has better acceptability worldwide. Various difficulties are faced during keloid excision, and we hereby describe few innovative modifications (use of needle, hydrodissection, pressure dressing, bolster button) using cost-effective and simple materials (needles, dynaplast, buttons) to ease the excision of keloids. These have easy adaptability and also reduce the recurrence rate of earlobe keloids

Role of pro-297 in the catalytic mechanism of sheep liver serine hydroxymethyltransferase.

Serine hydroxymethyltransferase belongs to the alpha class of pyridoxal-5'-phosphate enzymes along with aspartate aminotransferase. Recent reports on the three-dimensional structure of human liver cytosolic serine hydroxymethyltransferase had suggested a high degree of similarity between the active-site geometries of the two enzymes. A comparison of the sequences of serine hydroxymethyltransferases revealed the presence of several highly conserved residues, including Pro-297. This residue is equivalent to residue Arg-292 of aspartate aminotransferase, which binds the gamma-carboxy group of aspartate. In an attempt to change the reaction specificity of the hydroxymethyltransferase to that of an aminotransferase and to assign a possible reason for the conserved nature of Pro-297, it was mutated to Arg. The mutation decreased the hydroxymethyltransferase activity significantly (by 85-90%) and abolished the ability to catalyse alternative reactions, without alteration in the oligomeric structure, pyridoxal 5'-phosphate content or substrate binding. However, the concentration of the quinonoid intermediate and the extent of proton exchange was decreased considerably (by approx. 85%) corresponding to the decrease in catalytic activity. Interestingly, mutant Pro-297 Arg was unable to perform the transamination reaction with L-aspartate. All these results suggest that although Pro-297 is indirectly involved in catalysis, it might not have any role in imparting substrate specificity, unlike the similarly positioned Arg-292 in aspartate aminotransferase

Acute pyelonephritis: A single-center experience

Acute pyelonephritis (APN), although a common clinical entity, still not much is known about the clinical profile in the Indian scenario. We prospectively collected clinical, biochemical, and radiological data of patients hospitalized with a diagnosis of APN from March 2014 to June 2016. A total of 296 cases were included in the study. Mean age was 53.85 ± 9.78 years. Male to females ratio was 1.93:1. Among the risk factors recognized for complicated pyelonephritis (PN), diabetes mellitus (DM) (54.4%) was the most common factor followed by renal calculi (14.4%), benign prostatic hyperplasia (6.7%), immunocompromised state (3.3%), stricture urethra and meatal stenosis (3.3%), and neurogenic bladder (2%). Urinary culture was negative in 153 (51.7%) and positive in 143 patient (48.3%). Most common organism isolated was Escherichia coli (29.7%), followed by Klebsiella pneumoniae (5.4%), pseudomonas (5.4%), Enterococcus (4.4%), and Proteus in 10 (3.4%). Serum creatinine of more than 1.5 mg/dl at admission was seen in 96.3% patients; 40% of them had underlying chronic kidney disease with DM being the most common. Multiorgan dysfunction either at admission or during the course in hospital stay was seen in 31.8% patients. Twelve (2%) had emphysematous PN. Six patients had Class II, 4 had Class III, 1 with Class I, and another with Class IV. A total of 18 deaths were noted (6.1%). Hemoglobin 1.5 mg/dl, HbA1c% >10%, and immunosuppression had statistically significant association with the development of multiorgan dysfunction on univariate analysis, but on multivariate analysis, only hemoglobin, HbA1c%, and immunosuppression reached statistical significance. Even with attributable risk of mortality, only hemoglobin, HbA1c%, and immunosuppression reached statistical significance on multivariate analysis. HbA1c% adds to the predictive parameters to recognize at-risk patients to intensify the treatment and avoid complications