National Journal of Integrated Research in Medicine <p>This is an official publication of&nbsp;<strong>"</strong><strong>Association of Health Professionals and Health Educators".&nbsp;</strong> National Journal of&nbsp; Integrated Research in Medicine&nbsp; will publish article of research in various type of therapy for the benefit of mankind i.e. allopathy, ayurvedic, Homeopathy, Sujok therapy, Unani and Siddha Medicine. All the Content of Journal are Open Access and <strong>can be accessed by all without login or payment . We follow Creative Commons license CC BY-NC-SA for access of article.</strong></p> Association of Health Professionals and Health Educators en-US National Journal of Integrated Research in Medicine 2230-9969 Autonomic Function Test In 72 Hours Post-Myocardial Infarction Patient <p>Background: Survival after a Myocardial Infarction (MI) is determined by both left ventricular ejection fraction and ventricular arrhythmias which is tightly linked to autonomic dysfunction. Non-invasive autonomic function assessment in post infarction patients can be used for critical risk stratification among the same. Materials and Methods: This pilot case control study was conducted at department of Physiology and Cardiology of SRH University after approval from the institutional ethical committee. 30 post MI patients (72 hrs.) cases from department of cardiology &amp; equal numbers of clinically healthy controls of similar age and gender were recruited following inclusion &amp; exclusion criteria after written informed consent. Both the groups were interviewed for demographic, clinical, medical history, measured for anthropometry &amp; investigatory parameters of Blood sugar &amp;Serum creatinine. Later they were subjected to measurement of heart rate variability by polygraph using standard recording procedure. Data recorded was subjected descriptive and comparative analysis with p&lt;0.05 as significant. Results: Significant sympatho-vagal imbalance (p=0.009)&amp;decreased Parasympathetic system activity (HF) (p=0.02) was observed in Post MI cases as compared to controls. Conclusion: Reduced anti fibrillatory effect (Decreased parasympathetic activity) persisted past 72hrs of stable MIin adults (age &lt; 65 yrs)and may be arisk factor for sudden cardiac death in such patients. [Mittal M Natl J Integr Res Med, 2020; 11(2):03-07]<br><br></p> Mittal Muskan Saxena Yogesh Copyright (c) 2020-03-01 2020-03-01 11 2 03 07 Electroencephalographic Changes And Cognitive Function In Elderly Type 2 Diabetes Mellitus Patients <p>Background: In elderly Type 2 Diabetic patients cognitive function may get adversely affected. Diabetic patients are more prone to develop memory loss. Material &amp; Methods: 30 Type 2 Diabetic patients and 30 normal healthy individuals whose age and sex matched with the cases were selected for the study. EEG recordings were done using Neuromax 64 channel instrument by MEDICAID systems and cognitive function was assessed using Mini mental status examination scores. Results: Elderly Type 2 Diabetes Mellitus patients have decreased cognitive function (MCI - Mild Cognitive Impairment). Slow wave activity is increased in type 2 diabetic patients compared to controls. Theta and Delta wave activity is also increased in cases compared to controls. EEG also showed increased alpha 2 wave activity and decreased alpha 1 wave activity among cases compared to controls. Conclusion: Various pathways of glucose metabolism in hyperglycaemia may be the main reason behind Mild cognitive impairment and abnormal EEG findings. [Amin R Natl J Integr Res Med, 2020; 11(2):08-10]<br><br></p> Dr. Rajendra A.Amin Dr. Narendra R Pathak Dr. Rahil Shah Copyright (c) 2020-03-01 2020-03-01 11 2 08 10 FFR Guided Coronary Intervention In Intermediate Coronary Artery Disease: Acute and Intermediate Term Results <p>Background: Fractional Flow Reserve (FFR), a diagnostic test, is a physiological test to determine the functional significance of any stenosis in coronary artery. It is a pressure-derived ratio that estimates blood flow through a stenotic lesion at maximal hyperemia. FFR is objective measurement of stenosis in comparison to traditional visual interpretation of angiography. The objective of this study was to plan the treatment course of patients on the basis of FFR estimation in intermediate coronary artery disease and follow them up for the acute and intermediate term results. Material and Method: The study was performed on suitable identified patients of VS general Hospital, Ahmedabad. First, the diagnostic angiography was done. If angiography result showed intermediate lesion, FFR was measured with sensor wire and decision of management of the patient was taken according to the result of FFR. The results were compared with the results of management of patients by conventional angiography guidance. Results: When management of the patient was based on FFR result, event free survival rate was better with less number of major adverse cardiovascular events than traditional way of patient management based on angiography alone. Conclusion: It could be concluded that the addition of coronary physiological measurements like FFR complements traditional angiographic information and is essential for accurate clinical decision-making. It is cost-effective and prevents unnecessary Per-cutaneous Coronary Intervention (PCI). [Patel K Natl J Integr Res Med, 2020; 11(2):11-16]<br>&nbsp;</p> Dr. Kartik Patel Dr. Neeraj Mahajan Dr. Tejas Patel Copyright (c) 2020-03-01 2020-03-01 11 2 11 16 A Clinical Study Of Cholelithiasis Presentation And Management In Tertiary Care Hospital <p>Background: Gallstones are the major cause of morbidity and mortality throughout the world and at least approximately &gt;10 % of the adults have gallstones with a recent rise in the incidence due to change in the dietary factors. This study intends to know its various modes of presentation, treatment and outcome. Materials and Methods: 100 patients with symptoms and signs of cholelithiasis admitted in department of general surgical units of GCS medical College - A Tertiary care hospital, Ahmedabad, Gujarat. from period of January 2018 to October 2019, were included in the study, clinical profile, investigation, treatments and outcomes were analysed. Results: The highest age incidence of cholelithiasis was in the 5th decade, more common in females. Pain abdomen was the most common symptom. Ultrasonography showed gallbladder stones in all patients and 15% of patient undergone open cholecystectomy, 85% of patient undergone laparoscopic cholecystectomy. The conversion rate of lap to open cholecystectomy was 4%. The total operation time and the length of post-operative hospital stay were 100 min and 9 days in open cholecystectomy and 55 min and 3 days in laparoscopic cholecystectomy. Conclusions: The result showed cholelithiasis was more common in females, 5th decade, presented most commonly with pain abdomen. Ultrasonography was the most common investigation. Laparoscopic cholecystectomy reduces the total days of hospital stay, pain and disability [Bagdai A Natl J Integr Res Med, 2020; 11(2):17-20]<br><br></p> Dr. Ankitkumar Bagdai Dr. Akshay Sutaria Copyright (c) 2020-03-01 2020-03-01 11 2 17 20 Mammographic Classification Of Breast Lesions Among Women Presenting At A Tertiary Hospital In Western India <p>Background: This study aims at mammographic classification of breast lesions amongst 132 women presenting at our tertiary hospital,Ahmedabad. BIRADS grading system recommended by American college of radiology has been used to classify the lesions. Materials and Method: Electronic medical records of 132 womenaged between 22-75 years presenting with breast lesions during the year 2019 were reveiwed retrospectively. Data reviewed included demographics, indication for mammography, distribution of breast lesions and BIRADS category. Result: Mean age of women with breast cancer in our study was 46.7years.Majorityof patients diagnosed with BIRADS grade 4 and 5 fell in the age group of 41-50 years. Breast lump followed by mastalgiawere the leading indications for performing mammograms. Left breast and upper outer quadrant was found to harbor maximum number of breast lesions. Conclusion: Mammography combined with BIRADS grading is highly sensitive, accurate and cost-effective diagnostic tool for the screening and detection of breast cancer. [Bhojwani N Natl J Integr Res Med, 2020; 11(2):21-26]<br><br></p> Nisha Bhojwani Rajas Thaker Akshay Rafaliya Sheetal Turakhiya Copyright (c) 2020-03-01 2020-03-01 11 2 21 26 Study Of Autonomic Functions In Male Current Tobacco Smokers And Non Smokers <p>Background: Smoking is the third top risk for health loss in India, leading to nearly one million deaths each year in the country. The study aims To investigate interrelationship of parameters of Autonomic Function between current smokers and non smokers. Material And Methods: The Study was conducted at Physiology Department , Medical college, Vadodara. All patients were enrolled applying inclusion and exclusion criteria.The study compared the autonomic function test data of two groups of subjects. Asymptomatic male aged 19 - 44 yrs in current tobacco smokers as cases and healthy non smokers as controls. History, Anthropometric measurements, clinical examination, Vital Parameters( like Heart rate, SBP and DBP ) and ECG recorded in lead 2 for R-R interval . Autonomic functions Tests like Expiration: inspiration ratio, Valsalva ratio, Change in DBP in sustained hand grip test Development of orthostatic hypotension on standing, Heart rate response to standing (30:15 ratio) were Recorded. Results: Maximum incidence was seen in &gt;31 yrs of age(majority 31-40 age gp) The mean height in smokers was lower than in non smokers(161.98 ±13.011vs 170.7 ± 6.011) cms. The Weight of Cases and Controls were 70.21± 8.46 and 75.43±8.00 kg respectively. BMI of Cases and Controls were 27.45 ± 6.52 and 25.96 ± 3.20 respectively. Mean resting SBP is 132.23 ± 10.45 vs 121.33 ±7.46 mmHg ; Mean resting DBP is 81.26 ±4.87 vs 78.33 ± 8.1 mmHg and Mean basal HR is 84.36 ±7.83 vs 79.86 ± 9.43 per minute. The mean value of HR response to E: I ratio in cases and controls are 1.11 ± 0.15 and 1.55 ± 0.24 respectively. The mean values of valsalva ratio in cases and controls are 1.086 ± 0.085 and 1.713 ± 0.312 respectively(p&lt;0.0001). The mean values of increase in DBP (mmHg) during sustained handgrip test in cases and controls are 10.8 ± 4.78 and 23.43 ± 6.06 mmHg respectively( p&lt;0.0001). The mean values of decrease in SBP (mmHg)during postural change from lying to standing in cases and controls are 15.26 ± 5.27 and 4.3 ± 2.53 mmHg respectively with statistically highly significant difference(p&lt;0.0001). Mean values of 30:15 ratio in cases and controls is 0.947 ± 0.165 and 1.045 ± 0.042 respectively. The mean difference in E: I ratio is statistically significant (p&lt;0.0026).Conclusion: Smoking is so debilitating that immediate cessation of habit is always the first step of program to improve one's health. Clinical symptoms of autonomic failure may appear late in the course of disease. Early assessment of degree of autonomic dysfunction can prevent hazardous complications related to Smoking. [Vagadiya A Natl J Integr Res Med, 2020; 11(2):27-33]</p> Asha Vagadiya Vaishali Patel Copyright (c) 2020-03-01 2020-03-01 11 2 27 33 A Hospital Based Study On Intracranial Atherosclerosis- Correlation With Extracranial Atherosclerosis And Risk Factors In North India <p>Background: The burden of intracranial atherosclerosis has been reported to be high in Asian population. Intracranial atherosclerosis besides being a common cause of stroke in many populations, it’s not being studied well. Therefore we planned to conduct a study in stroke patients in our hospital to diagnose intracranial atherosclerotic disease using TCD and correlate with carotid artery disease and its risk factors. Materials &amp; Methods: We enrolled all patients presenting with anterior circulation and lacunar stroke after talking informed consent. Institutional ethical clearance was taken for the same. Patients with posterior circulation stroke, hemorrhagic stroke, cardioembolic stroke and critically ill patients were excluded. Results: 55 patients were enrolled for the study, out of which 21 (38.2%) were female patients and 34 (61.8%) were male patients. Hypertension, diabetes, CAD, past stroke, substance abuse was found to be common risk factors. Intracranial atherosclerosis was found in 54.5 % patients, with involvement of ACA being in 21 (38.2%) patients and MCA in 16(29.1%). Conclusion: Intracranial atherosclerosis was found in more patients as compared to extracranial atherosclerosis. ACA was the most prevalent site of stenosis, followed by MCA which was found to be related with ICA stenosis. [Singla M Natl J Integr Res Med, 2020; 11(2):34-39]</p> Monika Singla Sandeep Chhabra Rohit Bakshi Rajesh Mahajan Narinder P. Jain Copyright (c) 2020-03-01 2020-03-01 11 2 34 39 Improving Medical Students’ Critical Thinking And Observational Skills For Learning Human Gross Anatomy: A Study At School Of Medicine And Health Sciences Of University For Development Studies, Tamale, Ghana <p>Background: To investigate students’ percept on whether visual art-based interventions would improve their observational skills, as well as to investigate how visual art-based interventions can improve medical students’ critical thinking and observational skills for learning of Anatomy.The ability to critically think, observe and analyse physical features of disease conditions on the human body is an essential skill medical students need to develop in order to conduct physical examination of patients effectively. This study aimed at investigating how visual art-based interventions can improve 3rd and 4th Year undergraduate medical students’ observational skills to facilitate learning of Anatomy. It was important to conduct this study because the results will trigger a dialogue among experts of Medical education and Art education on how to explore and incorporate visual art-based interventions into the pedagogy of the medical school as an alternative scientific approach to enhance medical students’ critical thinking and observational skills for learning of Anatomy as well as for practice. Material and Method: The study employed the post-test only experimental design. The target population was 349 students comprising 211 third year and 138 fourth year students. The study was conducted in the second semester of the 2017-2018 academic years. A randomized sample of 66% on each year group was proportionately chosen for the study. This comprised 139 and 91 third year and fourth year students respectively. The students were divided into two groups: Experimental and Control groups. The experimental group was given specific instructions on how to apply Visual Thinking Strategies (VTS) in analysing visual details of images. Four images of two-dimensionality were distributed to the students to critically observe and analyse its visual details. A scoring scheme was developed to guide in scoring the students’ performance. A questionnaire of 23 items with four five-point Likert scale feedback questions and four Visual Thinking Strategies questions were distributed to the participants. It took about 1 hour 30 minutes to complete the exercise. Statistical analysis of responses from the questionnaire and experiment was done using the Software Package for Social Sciences. The results were presented in inferential statistics with mean, standard deviations, p values and Cronbach’s Alpha. The study used 99% confidence interval and Cronbach’s alpha of .9 reliability coefficient for determining internal consistency of the feedback questions. Results: The experimental group scored significantly with mean and standard deviation of 18.56±8.42 on knowledge score than the control group that scored mean and standard deviation of 11.81±6.70. The overall impact was significant with p = 0.0001. Students’ responses via the questionnaire indicated awareness that visual art-based interventions can improve their critical thinking and observational skills for learning of Anatomy. Conclusion: This study concludes that visual art-based interventions with Visual Thinking Strategies used as alternative scientific approach for training medical students would complement the Skills Coordinators’ efforts in improving the students’ critical thinking and observational skills. [E Mani Natl J Integr Res Med, 2020; 11(2):40-46]</p> Mani E Tachie-Menson A Essel BH Abass H Ameade EPK Femke F Copyright (c) 2020-03-01 2020-03-01 11 2 40 46 Comparative Study Of Laparotomy Incision Closure With Absorbable (Polyglactin) And Non-Absorbable (Polypropylene) Suture Materials : A Study Of 50 Cases <p>Background: Laparotomy incision closure can be done using different suture materials and techniques. These factors affect the incidence of post operative wound complications such as wound dehiscence, surgical site infection, stitch granuloma, incisional hernia. Material &amp; Methods: Study included 50 patients who underwent laparotomy from January 2019 to October 2019. Equal number of cases(25 each) were studied for closure with two suture materials; Polyglactin and Polypropylene. The patients were followed–up at 1 week, 2 weeks , 1 month and then 3 months after surgery. Result: The incidence of wound infection was higher in Polyglactin (12%) compared to Polypropylene (8%) whereas incidence of stitch granuloma is 3 (12%) in Polypropylene as compared to 1(4%) in Polyglactin group. Wound dehiscence incidence was more in polyglactin (12%) as compared to polypropylene (4%) group. None of patients developed incisional hernia upto 3 months of follow up visits. Conclusion: Suture materials like polypropylene, polyglactin, PDS, nylon can be used for laparotomy incision closure. Use of absorbable suture material is more related to development of post operative surgical site infection, wound dehiscence, incisional hernia whereas stitch granuloma is more related to use of non-absorbable suture material. Overall ,polypropylene has higher merits over polyglactin for laparotomy mass closure in present study. [Rabari M Natl J Integr Res Med, 2020; 11(2):47-50]&nbsp;</p> Dr. Mayur G. Rabari Dr. Akash M. Shah Dr. Riddhi G. Muni Copyright (c) 2020-03-01 2020-03-01 11 2 47 50 Dermatoglyphics and Rugoscopy: A Diagnostic Tool for Periodontal disease or just a Forensic Aid? <p>Background: Forensic sciences, a well‑established branch in the field of medicine and dentistry always aids in uncovering individual personality by different strategies. Each person has unique set of fingerprints and palatal rugae patterns which is characteristic and may be used to identify them. Periodontal disease initiation and propagation is through an imbalance of the commensal oral micro biota but can also occur due to environmental factors as well as due to genetic susceptibility of the individual. Aim: To determine the uniqueness of fingerprint pattern and palatal rugae pattern in Greater Noida population and to assess the relationship between finger prints, rugae pattern and periodontal diseases among males and females. Materials &amp; Methods: 120 patients with age group between 20-50 years were equally divided into 4 groups of 30 patients each. Groups were characterised based on diagnosis of Group 1: periodontally health group, Group 2: gingivitis, Group 3: chronic periodontitis, Group 4: aggressive periodontitis. The fingerprint patterns of the participants were recorded with a rolling impression technique using duplicating ink on A4 sheet paper. Maxillary impressions cast in dental stone were made. Results: Among the fingerprint pattern arch pattern was found to be more common among Group 1, radial pattern among group 2, whorl pattern among group 4 and ulnar pattern among group 4. The most prevalent rugae shape among group 1 was point, in group 2 was sinuous and among group 3 was sinuous and among group 4 was angle. Mean rugae pattern was more prevalent in group 1 as compared to other groups. Conclusion: Dermatoglyphics and rugae pattern may act as prognostic and diagnostic tools for early prevention &amp; intervention of periodontal diseases.[Abrol S A Natl J Integr Res Med, 2020; 11(2):51-59]<br><br></p> Dr. Subarbie Abrol Dr. Shivjot Chhina Dr. Sachit Anand Arora Dr. Neetika Gupta Dr. Jyoti Chand Copyright (c) 2020-03-01 2020-03-01 11 2 51 59 An Anatomical Study Of Femoral Sulcus Angle On Dry Bones <p>Background: The distal end of femur has immense importance from the anatomical, functional and clinical point of view. The femoral sulcus angle is formed by two lines joining the highest points on the medial and the lateral condyles which meet at the lowest point on the intracondylar groove of the femur. Aim: This study aims to determine the size of femoral sulcus angle in local population. Due to difficulty in the determination of the gender of the femur we have limited our study to left and right bones. Material and Methods: Attempts are made to measure the sulcus angle of the femora. Study was carried out in the anatomy department of Smt. NHL Municipal Medical College, Gujarat state. Total 150 dry femora were analyzed and statistical analysis was done by using appropriate software. The femora were placed in a supine position on a flat table and with a goniometer the measurement was performed. To avoid faulty measurement and error, all the femoral angles were calculated by a single researcher. Result: Our results show the mean value of sulcus angle in right femora is 143.625 and left is 143.39. The standard deviation is 9.269 in right and 8.9919 in left femora. The result of unpaired t test is 0.7519. The p value is 0.98 which is insignificant. Conclusion: There is no significant difference in the value of sulcus angle between right and left femora. This study gives us an idea about the mean size of the femoral sulcus angle in population. [Kathayat P Natl J Integr Res Med, 2020; 11(2):60-63]</p> Priyangi M. Kathayat Mandar K. Shah Dr. Swati D. Shah Copyright (c) 2020-03-01 2020-03-01 11 2 60 63 Digitization Of Dental Records And Its Application In Forensic & Legal Perspective: Knowledge, Attitude And Practice Among The Dentists In West Bengal <p>Background: Stepping into the twenty-first century, the computer technology has become an integral part of the clinical practice of dentistry. Dental practitioners should have thorough knowledge of dental records as it has a legal and forensic implication with respect to identification of missing and deceased individuals, settlement of insurance claims, etc. Aim: The aim of the present study is to assess and evaluate the knowledge, attitude and practice of accurate dental records and the need of digitization among the dentists. Materials and Methods: A cross-sectional survey was conducted among 242 dentists from West Bengal with relevant questions focusing on awareness of dental record maintenance, its importance and its need for digitization. The data were summarized and were subjected for descriptive statistical analysis. Results: Only 65.7% of dentists maintained dental records regularly in their clinical practice. 37.2% were aware about the time-period for maintaining dental record and 64.9 % were aware that they have a professional and a legal obligation to maintain clinically relevant, accurate dental records of patients. Lastly, 82.6% preferred in digitizing &amp; archiving dental records. Conclusion: The study demonstrates a need of proper awareness of dental records &amp; its maintenance among fellow dentists. Also, it demonstrates the trend towards increased adoption of digital platforms for dental record management. [Kundu A Natl J Integr Res Med, 2020; 11(2):64-69]</p> Arjun Kundu Lakshmi Sai Sneha Nedunuri Avaish Chand Abraham Johnson Copyright (c) 2020-03-01 2020-03-01 11 2 64 69 Designing Of An Integrated Team Based Learning Module To Teach Undergraduate Students- Tuberculosis <p>Background: Medical curriculum has been revised and proposed to be competency based medical education. The curriculum proposes integrated teaching sessions. An integrated training module where in all the faculty would contribute to active learning and bring about the integration of the knowledge. The module was designed with the aim that students should illustrate the steps in clinical and laboratory diagnosis of pulmonary tuberculosis, and would demonstrate their competency by scoring more than 80% in a post test multiple choice questions based assessment. Materials &amp; Methods: The committee of faculty from microbiology, pathology, pharmacology, respiratory medicine, anatomy, physiology was constituted to design and validate the multiple choice questions, application exercises. The faculty were trained by the expert on team based learning methodology. Team based learning was conducted on a batch of 64 students, whose perception and performance was assessed. The module was redesigned, as per student’s feedback recommendations. The module was re-administered on another set of 62 students. The perception and performance of the students was analysed. The faculty feedback was gathered. Results: An integrated module was designed wherein the students were able to illustrate the steps of clinical and laboratory diagnosis of a case of tuberculosis, with 80% accuracy. And 95% students scored ≥80% marks on a multiple choice question test(paired t-test=9.122 p &lt;0.001). Faculty feedback was encouraging to implement the module. Conclusion: Integrated module can be designed on other topics adopting principles of Team based learning [Harakuni S Natl J Integr Res Med, 2020; 11(2):70-73]</p> Dr. Sheetal Harakuni Dr. Reshma Davanageri Dr. Netravati A B Dr. Bhagyashri Patil Dr. Jayasheela Bagi Dr. Shilpa Bhimalli Copyright (c) 2020-03-01 2020-03-01 11 2 70 73 Knowledge, Attitude And Perceptions Of Interdental Aids Usage Amongst Dental Students And Professionals: A Questionnaire Based Survey <p>Background: Dentists play a very important role in the public’s oral health improvement. Acquiring knowledge and attitudes related to dental health and prevention of oral diseases is very important during future dentist’s training period. Aim of the study is to evaluate the KAP (knowledge, attitude and practice) among the dental students and professionals , towards the interdental aids. To check whether increasing dental education improve the Knowledge, Attitude and Practice of interdental aids among the dental students and professionals. Materials &amp; Method: A cross-sectional study was carried out among the Dentists in Greater Noida . A self-constructed questionnaire including 16 multiple choice questions was presented to them. A total of 500 dentists (students and faculty) were selected. 5 groups were made. Group I: First and second year B.D.S. Group II: third and final year B.D.S. Group III: Interns B.D.S. Group IV: PG and Faculty (Department of Periodontics and PHD) . Group V: PG and Faculty of all other Dental departments. Results: The dental attitude became more positive and improved with each advancing year of education. Conclusion: The oral health attitude and behavior of the dental students improved with increasing level of dental education. Preventive courses providing apt information on proper techniques of plaque control must be included in the first and second year curriculum of the dental students. [Gupta N A Natl J Integr Res Med, 2020; 11(2):74-79]</p> Dr. Neetika Gupta Dr Sachit A. Arora Dr Shivjot Chhina Dr Jyoti Chand Dr Subarbie Abrol Copyright (c) 2020-03-01 2020-03-01 11 2 74 79 Electrocardiographic Changes In Primary Hypothyroid Patients <p>Background: Slight change in level of thyroid hormones can lead to vast effects on very sensitive cardiovascular system. This study was done to assess the changes in electrocardiographic parameters in newly diagnosed primary hypothyroid patients. Materials &amp; Methods: The present study included 50 patients and 50 controls , and it was conducted at B.J. Medical college, Ahmedabad. Patients under the study were investigated for Thyroid function tests, Lipid profile and Electrocardiogram. A 12 lead resting ECG was recorded via the ECG machine (Allengers Pisces A-103i) of all patients and control group. Hypothyroid patients with major ECG changes who were symptomatic for any Cardiovascular diseases were subjected for further investigations. Results: In hypothyroid patients, ECG changes observed were Sinus bradycardia in 40%, Low voltage complexes in 18%, T Wave inversion in 12%, RBBB in 6%, ST depression in 4% , PR interval prolongation in 8% and QTc prolongation in 18% cases. Conclusion: ECG during routine investigations of hypothyroid patients is very much important for early detection of cardiovascular complications, so further measures can be taken to reduce it. [Amin R Natl J Integr Res Med, 2020; 11(2):80-82]</p> Dr. Rajendra A Amin Dr. Narendra R Pathak Dr. Rahil Shah Copyright (c) 2020-03-01 2020-03-01 11 2 80 82 Evaluation Of Integrated Teaching Method For Phase I MBBS, Using Kirkpatrick’s Evaluation Method <p>Background: An integrated teaching allows students to engage in purposeful, relevant learning. We were conducting horizontal &amp; vertical integrated teaching for the first year MBBS since last 5 years at our institute. We planned the evaluation of integrated teaching method; using Kirkpatrick’s evaluation method to assess students’ satisfaction, their learning and change in their behaviour as an impact of this method. Material and Methods: Kirkpatrick’s model involves four levels of criteria – Reaction, Learning, Behaviour, and Results. In present study, the evaluation of integrated teaching method was done up to its 3rd level only. Standard questionnaire for students’ feedback, pre and post tests scores for assessment of knowledge, and application of this knowledge assessed through university examination results; were the tools used for evaluation.Result: 75% – 90% of the students rated good, better, best, for their perception about teaching &amp; learning by integrated teaching; while 10%-25% students rated poor &amp; satisfactory for their perception about teaching &amp; learning by integrated teaching. Students’ performance was significantly raised in all the three post tests than those of the pre tests. (p&lt;0.000) Conclusion: This evaluation is helpful for us to ascertain achievement of intended objectives from the integrated teaching method.<br>[Dhonde S Natl J Integr Res Med, 2020; 11(2):83-89]</p> Dr. Sushama Dhonde Dr. Gajanan. J. Belwalkar Dr. Pratap. E. Jagtap Dr.Mrs. Yugantara. R. Kadam Dr. Mrs. Meena Parekh Dr. Nitin Mudiraj Dr. Mrs. Pankaj Palange Copyright (c) 2020-03-01 2020-03-01 11 2 83 89 Prevelance Of Gingival Recession And Its Association With Gingival Biotype In Mandibular Anterior Teeth <p>Background: In the current era of aesthetically focused dentistry, it is of utmost importance that clinicians must consider how the soft tissue will respond to the various, prosthetic, restorative and periodontal procedures. The gingival morphologies which were identified according to their facio-palatal dimensions were earlier named as the scalloped and thin or flat and thick gingiva. A more specific term “Periodontal Biotype” was later introduced to classify the gingiva into ‘thick‑flat’ and ‘thin‑scalloped’ biotypes. Currently, the term “gingival biotype” has been widely used by the clinicians to categorize the thickness of the Gingiva. Aim of Study: The aim of this study is to determine whether Gingival Biotype has any correlation with the Age, Gender, occurrence and the severity of gingival recession in six mandibular anterior teeth. Material and Methods: A total number of 100 patients were examined , biotype was assessed with the help of two methods probe transperancy(PT) and transgingival probing(TP) methods and its association with the age, gender and recession defects (recession depth &amp; width) in mandibular anterior teeth was statistically analysed with the help of ANOVA, unpaired-t test &amp; post-hoc test. Result: Prevelance and severity of gingival recession in lower anteriors is likely to be seen more commonly in left central incisors(21%) and left canines(21%) , among the participants majority of the females subjects(76%) were shown to have thin biotype, with no significant age related difference in the gingival biotypes in both genders. Conclusion: Prevelance and severity of gingival recession was more common in females due to the presence of thin biotype when accessed with both TP and PT methods with no age related difference in the biotype. [Chand J Natl J Integr Res Med, 2020; 11(2):90-96]</p> Dr.Jyoti Chand Dr.Sachit A. Arora Dr.Shivjot Chhina Dr.Subarbie Abrol Dr.Neetika Gupta* Copyright (c) 2020-03-01 2020-03-01 11 2 90 96 Attitude And Preference For Replacement Of Missing Teeth In Completely Edentulous Patients Visiting Department Of Prosthodontics At Goenka Research Institute Of Dental Science, Gandhinagar, Gujarat; A Cross Sectional Survey <p>Background: The purpose of this study was to assess the attitude towards replacement of teeth among patients who reported to the department of prosthodontics in Goenka research institute of dental science, Gandhinagar, Gujarat. Material and Method: A ten-item, closed-ended questionnaire was completed by 120 volunteer patients who were completely edentulous. Collected data were analyzed. The age of the subjects selected were more than 30 and divided into three groups. Results: Among these 120 patients, 35.83% of the patients gave financial constraints as the reason for not replacing teeth; 20% reported that they lacked the time to have teeth replaced; 28.33% had low felt needs; and 15.83% indicated they did not know that teeth could be replaced. The findings indicate that awareness needs to be increased regarding the other functions of teeth like esthetics and phonetics because many subjects in this study were aware of the function of mastication performed by teeth. Results shows 65% patients were illiterate, 23.33% patients got primary education, 11.66% patient studied till high school and no patient got higher education. Conclusion: Attitudes of patients should be taken into consideration to improve patient compliance with and acceptance of prostheses. [Shetty M Natl J Integr Res Med, 2020; 11(2):97-100]</p> Kinjal Shah Shweta Kumarswami Deval Shah Rujuta Mehta Aumkar Trivedi Adit Shah Copyright (c) 2020-03-01 2020-03-01 11 2 97 100 Comparative Evaluation Of The Efficacy Of Dexmedetomidine And Dexamethasone As An Adjuvant To Combination Of Levobupivacaine And Lignocaine In Supraclavicular Brachial Plexus Block Using Nerve Stimulator <p>Background: Adjuvants when added to local anaesthetics hasten the onset and prolong the duration and quality of neuraxial and peripheral nerve blocks. In this prospective, observational, comparative study we compared dexmedetomidine and dexamethasone as an adjuvant to combination of levobupivacaine and lignocaine in supraclavicular brachial plexus block with respect to onset and duration of sensory and motor block, duration of analgesia and total requirement of rescue analgesics in first 24 hours. Material and Methods: 60 patients of ASA class I and II in the age group of 18 to 70 years divided in to 2 equal groups 1 and 2.Group 1 received dexmedetomidine 50μg and group 2 received dexamethasone 8mg along with levobupivacaine (0.5%) and lignocaine (2%). Results: Onset of sensory and motor blockade was14.25±4.01 min and 16.85±4.74min in group 1 and 16.11±5.49min and 20.37±4.89 in group 2.Onset of sensory blockade was statistically not significant (p&gt;0.05) while onset of motor blockade was statistically highly significant(p&lt;0.001) between two groups. Duration of sensory and motor blockade was 586.66±88.44min and 488.88±102.89min in group 1 and 617.77±62.85min and 528.88±74.89min in group 2, respectively (p&gt;0.05) Duration of post operative analgesia in group 1 was 1028.88±252.29 min while in group 2 it was 1278.29±137.70min (p&lt;0.001). Conclusion: After comparing dexmedetomidine and dexamethasone we concluded that dexamethasone is better, safe and effective alternative to dexmedetomidine. [Bhajikhau K Natl J Integr Res Med, 2020; 11(2):101-106]</p> Dr. Kruti Bhajikhau Dr. Bansari Naresh Kantharia Copyright (c) 2020-03-01 2020-03-01 11 2 101 106 Case Report: Split To Strengthen: Modified Cast Post To Rehabilitate The Multirooted Teeth <p>The replacement of missing tooth structure and rehabilitate the destructed part of teeth has been practiced by various cultures for thousands of years. Restoring grossly decayed teeth are always challenging for endodontist, especially in case of multi rooted teeth with or without divergent roots. A tooth with extensive coronal destruction due to carious process, sometime poses difficulty in fabrication of FDP, The post core is often required to gain support from the remaining tooth structure. In a multirooted tooth where more then one root were used as support the path of insertion of post is difficult, those cases can be saved by using split cast post and core. Endodontically treated tooth with total loss of coronal tooth structure and loss of cavity walls, multiple posts in both the roots appear necessary so as to achieve proper retention for the core material. This is a simple and scientific multidisciplinary approach towards management of grossly decayed tooth. Cast post and cores have many advantages, especially the retention and resistance they provide and strength to already weakened tooth structure. Cast post with cores should not bind within the root canal. This technique has been used for a long time and with positive results recognized by many authors. In this clinical case report restoration of an root canal treated carious mandibular first molar, directly restored and rehabilitated with split-cast post and core. [Attur K Natl J Integr Res Med, 2020; 11(2):107-110]</p> Kailash Attur Shruti Patel Kamal Bagda Chinmay Patel Copyright (c) 2020 2020-03-01 2020-03-01 11 2 107 110