To develop and validate an Integrated Yoga Module for Tennis Players

Tennis athletes need a combination of low-intensity and high-intensity aerobic and anaerobic capabilities. Sports related fatigue, injury, stress and anxiety reduce the sports performance of a player. The main objective of any sports training should be to refrain from the onset of fatigue, stress and anxiety during competition and training. Integrated Yoga has been researched extensively. It shows that yoga helps improve psychophysiological components such as aerobic and anaerobic capacities, cardiovascular fitness, while reducing fatigue, competitive stress and anxiety. Yoga also improves relaxation and mindfulness, hence, improving performance. However, a valid yoga module is unavailable for tennis sports athletes. IYM for tennis players is developed based on ancient yogic text and previous research evidence. The yoga module was presented to 30 SMEs to evaluate and validate a total number of 82 practices included in the proposed module based on a three-point scale. The content validity has been calculated by applying Lawshe’s formula of content validity ratio (CVR). According to Lawshe’s formula, 0.33 is the critical value of CVR required for validation with 30 SMEs. Data analysis shows that out of 82 yogic practices, 41 yogic practices showed significant content validity (p<0.05). Results show that, among the 82 practices, 41 were found to be essential (CVR ≥0.33) and 41 were found to be not essential (CVR <0.33). However, the feasibility and efficacy of the Integrated Yoga Module for tennis players need to be determined by future studies

To develop and validate an Integrated Yoga Module for Basketball Players

Basketball sport required high-level of fitness-related components, heart rate, blood lactate, aerobic capacity, anaerobic power and psychological demands from an athlete. From scientific evidence it has been observed that yoga helps in develop the entire psycho physiological component without giving physical stress to the body if it is practiced in proper manner. However, a validated Yoga module for basketball player is unavailable. The IYM for basketball players is prepared after doing detailed and systematic review of classical and contemporary yogic texts and earlier research evidence. The content validity of IYM for basketball players was presented to SMEs and evaluated by an experienced panel comprised of 30 yoga experts who satisfied the inclusion criteria. Data analysis exhibited that out of 85 yogic practices, 45 yogic practices showed substantial content validity. According to lawshe’s method, 0.33 is the critical value of CVR (minimum CVR value) required for validation with 30 SMEs. The current study proposes that the IYM for Basketball players is valid with good content validity. However, future research studies must determine the efficacy and feasibility of the developed module

Prediction of caesarean section for arrest of descent during the second stage of labour

Background: Friedman described the normal progress of labor in different curves for nulliparous and multiparous women in 1954. Any deviation from these curves during the second stage of labor is considered as failure to progress in the second stage of labor. The aim of the study is to define obstetrical risk factors for arrest of descent during the second stage of labour.Methods: All singleton, vertex, term deliveries with an unscarred uterus, between December 2013 to November 2016 (3 years) were included. Univariable and multivariable analysis were performed to investigate independent risk factors associated with arrest of descent during the second stage of labor.Results: The study included 7260 deliveries, of these 163 (3.3%) were complicated with arrest of descent during the second stage of labor. Using a multivariable analysis, the following obstetric risk factors were found to be significantly associated with arrest of descent: primigravida (RR=7.8, 95% CI=6.9-8.7, p3.5 kg (RR=2.2, 95% CI=2.0-2.4, p<0.001). Deliveries complicated by arrest of descent resulted in cesarean section in 67% and 34% vaginal delivery.Conclusions: In this era of increased public awareness and medicolegal events it is very crucial to assess and evaluate every woman in labor and to identify in advance the possibility of arrest in advanced labor so that a timely obstetric intervention possibly Cesarean section can prevent unnecessary maternal- fetal complications

Clinical analysis of post sterilization failure cases in a tertiary hospital

Background: The most common permanent method of family planning accepted in India is female tubal sterilization as it has a very low failure rate of 0.1-0.8% in the first year and overall pregnancy chances of 1 in 200. It can be done by open method but laparoscopic method has now gained wide popularity.Methods: Ours was a retrospective study of post sterilization failure cases admitted to Department of Obstetrics and Gynecology, Mahatma Gandhi medical College and Research Institute, Pondicherry within a 3 year time period between May 2014 to May 2017.Results: Within a 3 year period, 3 patients presented with intrauterine pregnancy whereas 28 presented as ectopic pregnancy following sterilization. Majority of patients belonged to 26-30 year age group and had 2 children. 35.7% of ectopics presented at 7-8 weeks gestational age. Over 70% of sterilization failures were done by open method and around 43% were done during caesarean section. Around 71.4% sterilization failures were seen within 5 years of sterilization but 1 patient presented as late as 17 years post sterilization.Conclusions: Female sterilization may result in failure even after years of sterilization. In present study, open sterilization had a higher failure rate than laparoscopic sterilization. The most common mode of sterilization failure was ectopic pregnancy. Therefore, patients undergoing sterilization must be counseled about chances of failure; even though it is a permanent method, and to consult immediately if missed period else at a later stage they may go in for rupture ectopic leading to high maternal morbidity and mortality

Comparative analysis of continuous and interrupted suturing techniques for repair of episiotomy or second degree perineal tear

Background: Perineal trauma is a serious and frequent problem after childbirth which is experienced by millions of women worldwide and the type of perineal repair may have an impact on pain and healing. The objective of this study was to assess the effects of continuous subcuticular versus interrupted transcutaneous sutures on women following episiotomy or second degree perineal repair following childbirth.Methods: A prospective comparative study comprising 141 women who had undergone vaginal deliveries with episiotomies or second-degree tearing of the perineum between August 2015 and July 2016Two groups were made among which one group was repaired with continuous, nonlocking sutures involving the vagina, perineum, and subcutaneous tissues and the other group had continuous, locking sutures of the vagina, interrupted sutures in the perineal muscles, and interrupted transcutaneous sutures. The threads used for stitching were identical in both groups i.e. rapidly absorbed polyglactin 910 suture material.Results: On the 2nd day after delivery, the perineal pain scores during lying, sitting and walking in the continuous technique(CT) group was less compared to the interrupted technique(IT) group(p value 0.009). On 10th day after delivery the perineal pain score during sitting and walking were statistically less (p value 0.027) in the CT group.  On 42th day there was no difference in pain score between both the groups. The amount of suture materials consumed in CT group was statistically less than IT group(p<0.001). There was no difference in incidence of wound dehiscence (p value 0.301) but superficial dyspareunia is more in IT group which is statistically significant.Conclusions: The episiotomy and perineal tear repairs with continuous suturing associated with lesser incidence of short or long term pain, lesser requirement of suture material without an increase in complication than interrupted suturing

Conjoined twins: report of two cases and review of literature

Two pairs of conjoined twins were encountered at the SCB medical college cuttack, Odisha, India during the past 3 years. In the first set the prenatal diagnosis was not established and the case was referred to us from other hospital with diagnosis of twin pregnancy and prolonged second stage of labour. Emergency caesarean section done and a pair of thoraco-omphalopagus twins delivered. Both babies died soon after birth. In the second case the conjoined twins were diagnosed prenatally at 20 weeks of gestationon in routine anomaly scan as thoraco-omphalopagus twin with fetuses were positioned face-to-face and fused from sternum to umbilicus. Fetuses were found to have separate hearts, a fused liver and separate upper and lower gastrointestinal tracts. Each twin had two normal appearing kidneys and a urinary bladder. The couples were counselled about the various management options and referred to higher centre. But she was admitted at 34 weeks of gestation with preterm labour and emergency caesarean section done and a pair of male thoraco-omphalopagus twins delivered. Both babies were alive and referred to higher centre for further management. The prenatal identification of conjoined twins is of cardinal importance for the planning of delivery and possible separation

Pregnancy of unknown location (PUL): a case report and review of literature

While most pregnancies are obviously within the uterus, Pregnancy of Unknown Location (PUL) is used to describe cases where, there is a positive pregnancy test but no sign of a pregnancy inside or outside the uterus, on transvaginal ultrasound or even at laparoscopy. We report a case of multigravida with history of disturbed tubal ectopic pregnancy in previous pregnancy presented with lower abdominal pain and spotting per vaginum following 6 weeks amenorrhoea. The patient was clinically stable with no evidence of intrauterine or extrauterine pregnancy in transvaginal sonography with serum beta human chorionic gonadotropin (beta-hCG) above descriminatory levels. Provisional diagnosis of Pregnancy of Unknown Location (PUL) was made and serial beta-hCG levels shows increasing levels. Endometrial curettage done with histopathology report showed product of conception following which there was a fall in serum beta-hCG. She was finally diagnosed as a case of silent miscarriage. Expectant management has been shown to be safe and effective in reducing the need for surgical intervention but does require close surveillance of patients who present with PUL

A prospective comparative study between interlocking nail and locking compression plate for management of diaphyseal fractures of the humerus

Background: The aim of this study was to compare the outcomes between open reduction and internal fixation by locking compression plate (LCP) and closed reduction and internal fixation with anterograde interlocking nail (ILN) for the treatment of diaphyseal fractures of the humerus.Methods: This is a prospective comparative study, with diaphyseal fractures of the humerus treated by LCP in 30 patients and with ILN in 30 patients. Patients were followed up to 18 months. The clinical and radiographic outcomes were assessed in terms of union, complications, reoperation rate and functional outcome using the American shoulder and elbow surgeons’ score (ASES) and Stewart and Hundley’s criteria.Results: Union was achieved in 93.3% of patients in LCP group and 90% in ILN group. The mean blood loss in LCP group was 280±22.10 ml (160-400 ml) and in ILN group was 110±17.62 ml (70-150 ml) (p=0.001). The ASES score was 42.47±5.532 in LCP group and 40.93±6.330 in nailing group (p=0.320; p&gt;0.05). Stewart Hundley criteria showed excellent and good results in 26/30 and 17/30 patients in LCP group and ILN group respectively (p=0.070; p&gt;0.05). Complications and re-operation rate were higher in ILN group.Conclusions: Our study concludes that LCP can be considered a better surgical option for the management of diaphyseal fractures of the humerus as it had lower incidence of complications, less re-operation rate and better union rate. However, there is no difference between the two groups in terms of union time and functional outcome

Caesarean section scar endometriosis: a case report and review of literature

Endometriosis is described as the presence of functioning endometrial tissue outside the uterine cavity. Scar endometriosis is a rare event which usually develops after pelvic operations involving the uterus and fallopian tubes. The symptoms are nonspecific, typically involving abdominal wall pain at the incision site at the time of menstruation. Its diagnosis can sometimes be difficult and may be confused with various other surgical conditions. We present here a case of abdominal wall scar endometriosis in a woman who has undergone caesarean delivery three years prior to her current presentation. The epidemiology, pathogenesis, clinical features, diagnosis, treatment and methods of prevention of this somewhat rare condition are discussed