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> en-US (Chinmay shah) (Dr Chinmay shah) Wed, 01 Jan 2020 00:00:00 -0800 OJS 60 Prevalence Of Periodic Limb Movement Disorder In Intellectually Disable Population <p>Abstract: Background: Periodic limb movement Disorder (PLMD) is defined as presence of repetitive limb movements during sleep, seen in 4-11% in general population. PLMD is known to cause sleep fragmentation leading to daytime consequences. Intellectual developmental disorder is a disorder known to have intellectual and adaptive functioning deficits. In case, PLMD is present in Intellectual disability then the problems faced by such population further magnify. Method: Local areas of Thane and Nasik were approached. After consent from parents 27 participants underwent nocturnal polysomnogram. Scoring of the study was done as per AASM criteria. Result: Participants positive on PLMD were 51.48%. Polysomnography findings showed TST 6hrs, sleep onset 38.35 mins, wake after sleep onset 42.23 mins, Stage 1-1.6%, Stage 2- 49.35%, REM- 17.82%, Sleep Efficiency- 77.5%. Conclusion: The paper highlights results pertaining to determining prevalence of periodic limb movement disorder in intellectually disabled population by polysomnography. The results have qualitatively improved perception of practitioners of medicine as well as parents and guardians of intellectually disabled persons with regard to physical disorders among them. [Irani N, Natl J Integr Res Med, 2019; 10(6):1-5]<br><br></p> Nushafreen Irani, Sanjay Deshmukh, Abhijit Deshpande Copyright (c) Wed, 01 Jan 2020 00:00:00 -0800 Normative Values Of Strength Of Hip Adductors In Runners Assessed By Using Pressure Biofeedback Unit <p>Abstract: Background: Muscle strength measurement is a key component of physiotherapists’ assessment and is frequently used as an outcome measure. A pressure biofeedback unit can be potentially used as a tool to assess hip isometric muscle strength. Objectives: This study was designed to establish normative adductor squeeze test (AST) values in runners and investigate strength of adductor muscles during the performance of the thigh adductor squeeze test at 0°, 45°, and 90° of hip flexion. Material And Methods: A total of 51 healthy runners aged 23-27 years participated. Each participant performed 3 trials of the thigh adductor squeeze test in the three positions at 0°, 45°, and 90° of hip flexion. Pressure biofeedback unit was used to assess the strength of hip adductor muscles. Strength of the adductors was measured as the maximum pressure that was achieved by the subject from 10 mm Hg. Result: Mean strength is 103.05 ± 23.05 mmHg at 0° hip flexion, 141.03 ± 24.31 mmHg at 45° hip flexion and 134.86 ± 22.83 mmHg at 90° hip flexion position. Conclusion: The results of the present study suggest that the 45° of hip flexion test position is the optimal thigh adductor squeeze test position. [Mehta K Natl J Integr Res Med, 2019; 10(6):6-10]</p> Krupa H Mehta, Smitul S Parmar, Dinesh M Sorani, Shesna R Rathod Copyright (c) Wed, 01 Jan 2020 00:00:00 -0800 A Prospective Observational Study Of Hyponatremia In Lower Respiratory Tract Infection In Children Admitted In Tertiary Care Teaching Hospital <p>Abstract: Background: The primary objective of our study is to evaluate the incidence and prevalence of hyponatremia in children admitted with Lower respiratory tract infection. Method: 135 patients diagnosed as clinically Lower respiratory tract infection admitted in wards were enrolled in study from &gt;1 months to 12 year of age. Hyponatremia defined on basis of serum sodium level as mild, moderate and severe hyponatremia. According to severity of Hyponatremia and severity of diseases IV fluid and correction was given. Result: Prevalence of Hyponatremia in LRTI cases was 66.6% (90/135) in this study. Among this 52.2%(47/90) were pneumonia; 25.5%(23/90) were bronchiolitis; and 22.2%(20/90) were of empyema. Out of this 42.2%were mild hyponatremia,40% were moderate and 17.7% were severe hyponatremia..Mortality among severe hyponatremia was 2.2%(2/90). Conclusion: There is a high prevalence of hyponatremia in lower respiratory tract infection. Children with pneumonia are more likely to have hyponatremia. Use of early initiation of appropriate IV fluid and correction of hyponatremia gives better outcome of patients of LRTI presented with hyponatremia. [Parekh A Natl J Integr Res Med, 2019; 10(6):11-15]</p> Dr. Alpa N Parekh, Dr. Dimpal Patel, Dr. Aditya N Parekh Copyright (c) Wed, 01 Jan 2020 00:00:00 -0800 Effect Of Antimicrobial Activity Of Herbal Medicines On Streptococcus Mutans <p>Background: Many plants or herbs exhibit potent antimicrobial activity against various microorganisms. They have no side effects and presumably act against and modulate the factors that are crucial for microbial survival or their activity. Osimum sanctum(Tulsi)is the most commonly found in households plants of India. Azadirachta indica (Neem) is perhaps most traditionally useful plant in India. As well aleo vera has also medicinal properties. Streptococcus mutans is a pioneer bacteria implicated in dental caries. This study aims to evaluate the antimicrobial activity of Tulsi, Neem and Aleo vera on Streptococcus mutans by evaluating their zone of inhibition and determining their minimum inhibitory concentration. Material And Methods: Tulsi powder, Neem and Aleo vera gel were incorporated in blood agar in which streptococcus mutans were cultivated. Antibacterial effect was studied at various concentrations of Tulsi, Neem and Aleo vera gel. Result: All three herbal medicines showed different sized zone of inhibition at different concentrations.Conclusion: Tulsi, Neem and Aleo vera gel have antimicrobial effect at different concentrations. [Shah P, Natl J Integr Res Med, 2019; 10(6):16-18]</p> Dr. Pankti H Shah, Dr Mamtha M.T., Dr. Viral Bhatt, Dr Dharti Zatakiya, Dr Shuchi H. Shah, Dr Binita Gandhi Copyright (c) Wed, 01 Jan 2020 00:00:00 -0800 Antimicrobial Sensitivity Pattern Of Salmonella Spp. Isolated From Blood Culture Of Clinical Suspected Case Of Enteric Fever <p>Background: Enteric fever is one of the most common systemic infections in developing countries. The increasing rate of resistance to the commonly used antibiotics &amp; changing trends of antibiotic susceptibility has been of great concern in the proper treatment and prevention of this disease. This study aims to investigate the current antibiotic susceptibility pattern of Salmonella typhi, Salmonella paratyphi A &amp; B. Method: This study was carried out at GCS Medical College, Hospital &amp; Research Centre in Microbiology Department, over the period of six months from March 2019 to August 2019. Blood culture samples from a suspected case of enteric fever sent in microbiology laboratory. Patients of all the age groups were enrolled during the study. Antibiotic susceptibility test of isolated Salmonella spp. was performed by the modified Kirby Bauer Disc Diffusion method and results were interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Result: Total 116 blood culture samples were found positive for Salmonella species. Out of these, 106(91.37%) were Salmonella Typhi, 8(6.89%) were Salmonella paratyphi A &amp; 2(1.72%) were Salmonella paratyphi B. Isolates were mainly from pediatric age group. Salmonella spp. shown 100% sensitivity, towards Ampicillin, Amoxicillin, Ceftriaxone, Cefixime, Cefepime, Doxycycline &amp; Cotrimoxazole. Sensitivity pattern of S.Typhi was (81%) to Ciprofloxacin, &amp; (84.90%) to Azithromycin. Conclusion: Early diagnosis and appropriate antibiotic therapy reduced the public health burden of typhoid fever. Third generation cephalosporins were found most effective &amp; can be used as an empiric choice or First-line agents for the management of Enteric fever. Nowadays Fluoroquinolone resistance in Salmonella species is rising. [Patel I Natl J Integr Res Med, 2019; 10(6):19-22]</p> Dr.Indu Patel, Dr.Urvesh Shah, Dr.Dhruvi Patel Copyright (c) Wed, 01 Jan 2020 00:00:00 -0800 Acute Toxicity Study Of An Aqueous Extract Of Dried Leaves Of ‘Gymnosporia Spinosa’ On Albino Mice <p>Background: Leaves of G. Spinosa have been used by people for treatment of jaundice. No information is available regarding toxicity studies which prompted us to carry out this work.Method: Acute toxicity study was carried out using aqueous extract of G.Spinosa leaves. for that 28 inbred Swiss albino mice of either sex were randomly divided in to 4 equal group. First group received distilled water (control). Second, third and fourth groups received single dose of drug orally as 40,120 and 240mg/100 g. of Bd. Wt. respectively. Animal were observed for various sign and symptoms. After 72 hrs blood was collected for blood counts and biochemical parameters. Liver, lungs and kidney were subjected to histo-pathological studies. Result: Throughout study there was no mortality in study except degenerative changes in the liver, other organ showed no changes. Analysis of biochemical data showed elevation of S.Alkaline phosphatase and Random blood sugar level.Conclusion: The data showed that hepato-toxicity at higher dose level which is about 100x human therapeutic dose. [Kubavat R Natl J Integr Res Med, 2019; 10(6):23-26]</p> Amita R Kubavat , Shahenaz M Malek Copyright (c) Wed, 01 Jan 2020 00:00:00 -0800 Effectiveness Of 2% Isobaric In Producing Spinal Anaesthesia In Comparison to 5% Heavy Xylocaine <p>Background: The objective of the study was to compare the effect of isobaric 2% Xylocaine with hyperbaric 5% Xylocaine in subarachnoid block in lower abdominal and lower limb surgeries. Method: This study was carried out in the department of Anesthesiology, Government Medical College and S.S.G. Hospital, Baroda during the period of 2004 to 2006. The study consisted of 60 patients of either sex of ASA grade I and II between age group 20 to 60 years, undergoing planned lower abdominal and lower limb surgeries. They were randomly assigned into the following two groups: Group X2 (n=30) - Patients receiving Inj. Xylocaine 2% Isobaric 4 ml (80 mg) intrathecally and Group X5 (n=30) - Patients receiving Inj. Xylocaine 5% hyperbaric 1.6 ml (80 mg) intrathecally. They were monitored for sensory block, motor block, vital parameters like pulse rate, blood pressure, oxygen saturation, duration of effective analgesia and peri-operative complications. Results were compared among the groups using unpaired "t" test and difference was considered significant when p value was less than 0.05. Result: There was no difference in mean age and weight of patients in both groups. The time for onset of sensory block, time to achieve peak sensory level, and time for sensory regression to LI level was not found to be statistically significant in both groups. The time for onset time of motor block, maximum Bromage score achieved, mean time to achieve this and the recovery of motor block to grade 0 was also similar in both groups. There was no significant change in mean pulse rate, mean systolic blood pressure, mean diastolic blood pressure and mean oxygen saturation in either of the groups at any point of study. The mean duration of surgery and duration of effective analgesia was also similar in both groups. No significant complications were found other than nausea in either of the group intra and post operatively. Conclusion: 2% isobaric Xylocaine can be very well used as an alternative to 5% hyperbaric Xylocaine in spinal anaesthesia for lower abdominal (infra-umbilical) surgeries lasting for less than one hour. [Prajapati H Natl J Integr Res Med, 2019; 10(6):27-32]</p> Dr Hemal Prajapati, Dr Kashmira Pander, Dr Akash Chavda, Dr M R Upadhya Copyright (c) Wed, 01 Jan 2020 00:00:00 -0800 Pharmacoepidemiological Profile Of Antidepressant Agents Prescribed For The Treatment Of Newly Diagnosed Cases Of Major Depressive Disorder <p>Background: Depression is a major public health problem in India, contributing to significant morbidity, disability as well as mortality, along with significant socioeconomic losses. Causes of depression are several, including biological, social, economic and cultural factors, which are triggered by environmental factors. Present study was designed to identify the socioeconomical factors, age and sex distribution and prescribing pattern of antidepressant agents in newly diagnosed cases of Major Depressive Disorder (MDD) in a tertiary care teaching hospital. Method: Prior approval from the Institutional Ethics Committee, permission from Head of Psychiatry department and Medical superintendent of the hospital were taken. Investigator visited OPD and wards of psychiatry department thrice weekly. Patient who met inclusion and exclusion criteria had been enrolled. All the sociodemographic details, clinical presentation as well as prescribed antidepressant agents as well as their dosage regimens were recorded in predesigned and structured case record form. Hamilton depression rating scale (HDRS) and montgomery and asberg depression rating scale (MADRS) were recorded in all study participants. Data were analyzed by using appropriate statistical tests. Result: 202 patients were divided into four groups as per the drugs prescribed (Fluoxetine: n=58; Sertraline: n=54; Amitriptyline: n=46 &amp; Desvenlafaxine: n=44). Out of total 202 patients, 109 patients were women and 93 patients were men. Maximum numbers of patients (66.34%) were aged 41 to 60 years. There were 68 illiterate patients. It was observed that the most common presenting complaint was depressed mood (94.1%), followed by loss of interest, anxiety , insomnia, fatigue, lack of concentration, somatic symptoms, guilt and suicide tendency Conclusion: Higher prevalence of MDD was reported in female, in lower socioeconomic class, in illiterate and elderly. Fluoxetine, Sertraline, Amitriptyline and Desvenlafaxine were the prescribed antidepressant agents. But socioeconomical factors, gender, age were not found to be the determinant factor for the selection of antidepressant agent. [Patel D Natl J Integr Res Med, 2019; 10(6):33-40]</p> Dr. Dhrumil S. Patel, Dr. Manish N. Solanki, Dr. Darshan J. Dave Copyright (c) Wed, 01 Jan 2020 00:00:00 -0800 Effectiveness Of Jigsaw Technique Of Interactive Learning In Physiology For I MBBS Students <p>Background: Jigsaw technique is method of collaborative and cooperative learning where students learn and teach to each other. Aim and objective was to introduce Jigsaw technique in teaching Physiology and to assess its effectiveness and perception of students. Method: Pretest was conducted. Students were divided in two groups T and J. First group T was taught by traditional lecture and Group J learned by Jigsaw technique followed by posttest. Next day crossover of groups was done and same procedure was repeated for another topic. Feedback was collected. Result: On comparing means of Pretest and Posttest scores (n=77) statistically significant (p=0.00) increase in score in both Traditional and Jigsaw method was observed. On comparing difference between two groups (T and J) increase in score of Jigsaw method was statistically significant (p=0.000) than that for Traditional method. Students and Faculty enjoyed the learning and recommended this technique. Conclusion: : Jigsaw technique is effective and enjoyable method of interactive learning. It shall be implemented for teaching. [Pande S, Natl J Integr Res Med, 2019; 10(6):41-45]</p> Dr. Mrs. S. S. Pande, Dr. Mrs. S. S. Pande Copyright (c) Wed, 01 Jan 2020 00:00:00 -0800 Effect of Cushion Height on Muscle Activation During Sit to Stand Motion in Healthy Elderly Subjects <p>Background: During 2nd phase of sit to stand motion, complex co-contraction pattern of activity at knee joint is in contrast to the flexion only of phase 1 and extension only of phase 3. In this study amplitude of activation of knee joint muscle (vastus medialis and biceps femoris) is assessed. As cushion height is an important factor in sit to stand motion, 30mm cushion, 60mm cushion and 90mm cushion on ideal chair for assessing amplitude of muscle activation during sit to stand have been used. OBJECTIVES: To assess muscle activation while using 30mm, 60 mm and 90 mm thickness cushion during Sit to stand (STS) motion in healthy elderly subjects. To compare between this 3 thickness of cushion. To correlate balance (time up and go score) with amplitude of muscle contraction during STS motion using different heights of cushion. Methods: The study included 75 healthy elderly individuals who were able to do Sit to stand motion (STS) independently. Amplitude of muscle activation of vastus medialis and biceps femoris muscle were assessed using surface Electromyography. Three times subject was told to do sit to stand motion on 30 mm, 60 mm and 90 mm cushion thickness respectively, average value of amplitude of muscle activation on 30mm, 60mm and 90mm cushion thickness was considered. Balance was assessed using Timed up and go scale (TUG). Results: There was no significant difference in the EMG activity of vastus medialis at 30 mm, 60 mm, and 90 mm cushion thickness. (p=0.442), there was significant difference in the EMG activity of biceps femoris at 30 mm, 60 mm, and 90 mm cushion thickness. (p=0.000) Friedman Test was used. There was increased electromyographic activity of biceps femoris muscle on 30 mm cushion thickness followed by 90 mm cushion thickness and less electromyographic activity at 60 mm cushion thickness during sit to stand motion. Multiple Comparisons - Bonferroni Adjusted Wilcoxon signed rank tests was used. Conclusion: This study suggests, the electromyographic activity of biceps femoris muscle during sit to stand motion was more on 30 mm cushion thickness followed by 90 mm cushion thickness and 60 mm cushion thickness. [Salvi S Natl J Integr Res Med, 2019; 10(6):46-49]</p> Sanjyot Salvi, Dr. Parag Ranade Copyright (c) Wed, 01 Jan 2020 00:00:00 -0800 A Study on Fetomaternal Outcome of Breech Presentation in a Tertiary Care Hospital <p>Background: The aim of the study was to find out the incidence, maternal and fetal outcome of breech presentation in a tertiary care hospital. Methods: The present retrospective study was carried out in the department of Obstetrics and Gynaecology in tertiary care system from 1st january2019 to 31st july2019. Total 97 cases were included in this study. The demographic data like age, parity, gestational age, mode of delivery, maternal and perinatal outcome were noted from hospital records and studied. Results: The incidence of breech was found to be 2.65% in patients attending tertiary care system. 47.42 % cases were in the age group of 20-25 years and 28.86% were in age group of 26-30 years. In the present study, primigravidas constitute 39.27%of cases. Perinatal morbidity was seen to be higher in babies delivered vaginally (25.49%) as compared to 17.39 % in cases delivered by caesarean section. Conclusion: Breech delivery is a high risk pregnancy with adverse fetal outcomes during pregnancy and labour. Though caesarean section for breech presentation is not universally recommended, caesarean section can reduce the perinatal mortality and morbidity compared to vaginal birth for term breech pregnancy, but maternal morbidity was increased because of anaesthesia and operative interference. The mode of delivery in breech presentation should be specified based on type of breech, stage of labour, fetal wellbeing and availability of skilled obstetrician. [Mehta S Natl J Integr Res Med, 2019; 10(6):50-53]</p> Shital Mehta, Vijeta Lilhare, Bina Raval, Riya Parikh, Riya Parikh Copyright (c) Wed, 01 Jan 2020 00:00:00 -0800 Evaluation Of Secondary Peritonitis A Record Based Study <p>Background: Secondary peritonitis is the most common indication for exploratory laparotomy in India. However the etiology of perforation varies from the western world. The objective of this study is to assess the etiology, presentation, management and post-op outcome of patients operated for secondary peritonitis at our hospital. Method: Hospital based retrospective study of 50 cases of secondary peritonitis during the period of 2015-2018. Pediatric patients, primary peritonitis and anastomotic leak patients were excluded from the study. Result: Maximum number of patients were in age group of 11-30 years with male: female =4:1. Out of 50 cases the most common clinical presentation was abdominal pain in all of the patients. Mostcommon site of perforation was peptic perforation (44%), followed by small bowel perforation (36%),appendicular perforation (10%) and colonic perforation (10%). Overall rate of complication was 25%. Conclusion: In our setup the major etiology of perforation was infective and presentation of patients immediately after first symptom and timely surgical intervention resulted in good prognosis and less post-op complications. Complications in our study werewound infection (22%), electrolyte imbalance (20%), pulmonary complication (12%), septicemia (12%), intestinal obstruction (2%), fecal fistula (2%), burst abdomen (2%) and mortality (16%).[Natl J Integr Res Med, 2019; 10(6):54-56]</p> Dr. Astha K. Trivedi, Dr. Astha K. Trivedi, Dr. Het B. Upadhyaya, Dr. Archana D. Dalal Copyright (c) Wed, 01 Jan 2020 00:00:00 -0800 Study Of Type 2 Dm Patients In Newly Detected Hypothyroidism <p>Background: : Present Study was carried out to study relationship between Effects of Newly diagnosed Hypothyroidism on Type 2 DM patients. Method: Observational Cross Sectional Study was conducted in Medicine wards of Tertiary care Hospital in patients matching the Inclusion Criteria, In which detailed history and examination was done. Result: Patients with FBS 206 ±84.11, and PP2BS 310 ± 106.31 developed hypothyroidism in the form of either overt or subclinical and which was also statistically significant.(p&lt;0.05). Conclusion: Overweight and Obese patients of Type 2 DM, with increasing age were at Higher risk to devlop Hypothyroidism. [Variya Dhruv Natl J Integr Res Med, 2019; 10(6):57-60]</p> Dhruv Variya, Prafful Kothari, Vandana Dhangar, Jigisha Rakholiya, Niral Shiroya Copyright (c) Wed, 01 Jan 2020 00:00:00 -0800 Prevalence Of Areca Nut And Tobacco Use Among School Going Children In Gandhinagar, Gujarat <p>Background: The habit of areca nut and tobacco chewing is prevalent among young children throughout India. Factors like easy availability, low cost, good taste have an impact on development of habit that can lead to precancerous and potentially malignant oral conditions, which is a great concern for the society and the government. Aim: To determine the prevalence of tobacco/areca nut chewing habits among school going children in Gandhinagar, Gujarat. Method: Self administered questionairres were distributed among 3590 students of government schools of Gandhinagar district. Data about their chewing habits was obtained. 1200 school children with age group of 6-15 years having the habit of areca nut chewing were included in the study. The data was subjected to statistical analysis. Result: The overall prevalence of areca nut/tobacco usage among school children was alarmingly high (32.15%). Children of 8-9 years exhibited highest (36.5%) involvement in areca nut/tobacco habit. 51% of the school children chewed areca nut/tobacco atleast once in a day. Majority of the children (70%) bought areca nut from shops nearby schools. 66.5% of the students were not aware of harmful effects of the chewing habits. Conclusion: In the current scenario, the biggest challenge is to make effective strategies to motivate young children not to initiate the habit and to create awareness among the society about potential health hazards of these substances. [Thakkar H. Natl J Integr Res Med, 2019; 10(6):61-65]</p> Dr. Hinal Jayeshkumar Thakkar, Dr. Dhara Pandya, Dr. Bhumi Sarvaiya, Dr. Birva Patel, Dr. Komal Rastogi, Dr. Meenakshi Meena Copyright (c) Wed, 01 Jan 2020 00:00:00 -0800 Does Orthopantomograph Helps In Evaluating Bone Density After Placement Of Demineralized Dentin Graft? <p>Background: Subsequent to tooth extraction a physiological phenomenon takes place with alveolar resorption and results in decreasing ridge volume and ridge contours. Therefore, preservation of 3-dimensional alveolar bone contour is mandatory with placement of graft and follow-up is essential to authenticate the subsequent formation of bone within the socket. Aim and Objective: The aim of this paper was to discuss a technique in detail for radiographic evaluation of bone formation by measuring bone density of autogenous dentin demineralized (Auto DDM) graft prepared for alveolar bone grafting immediately after dental extractions and review the literature on “Bone Density and Demineralised Dentin Graft” online PubMed database. Material And Methods: A systematic search of the literature was carried out relevant to oral and maxillofacial surgery in online data-base of the United States National Library of Medicine. Evaluation of bone density was refined with the help of standardized digital radiographs, Orthopantomograph (OPG), at immediate after extraction and placement of DDM graft, 1 month, 3months, and 6 months follow-up. Result: OPG showed favorable bony healing with excellent bone formation, which can be appreciated on measuring bone densities. Conclusion: We conclude that the availability of DDM grafts would have a strong positive effect on the clinical use of the tooth as a bone graft material in oral surgery. Further studies should be performed to confirm the osteogenic effects and biological safety of this DDM graft material. [Dhuvad J Natl J Integr Res Med, 2019; 10(6):79-84]</p> Dr. Jigar M. Dhuvad, Dr Deval Mehta, Dr Sonal Anchlia Copyright (c) 2020 Wed, 01 Jan 2020 00:00:00 -0800 An Extremely Rare Presentation Of Central Arterial Stiffness With Kartagener Syndrome In A Young Female: An Unseen Comorbidity <p>Primary Ciliary Dyskinesia (PCD) is an autosomal recessive hereditary disorder having wide range of genetical and phenotypical expression. The triad of situs inversus, chronic sinusitis and bronchiectasis is known as Kartagener syndrome (KS). We report the case of 22 year old unmarried female presented with the typical triad diagnosed as Kartagener syndrome with positive saccharine test associated with extremely rare presentation of moderate to high central arterial stiffness, recognised as previously unreported fatal co morbidity in a young age. Treatment of bronchiectasis, sinusitis as well as hypo- Vitaminosis D has been commenced with promising response in follow up. [Rana R Natl J Integr Res Med, 2019; 10(6):85-88]</p> Dr.Rishi Rana, Dr.Anad Agrawal, Dr.Kamaljeet Singh, Dr.Sunaina Kharb Copyright (c) 2020 Wed, 01 Jan 2020 00:00:00 -0800 Prolapsed Ureterocoele - A Rare Midline Mass In Females <p>Ureterocole is a congenital anomaly of the distal ureter found mostly in females . Rarely these may prolapse in the urethera and appear as a midline mass. A 19 year old female presented with difficulty in voiding with an intralabial mass . The mass was reduced into the bladder followed by excretory urography which showed a distal ureteric lesion .Cystosocpy was done which showed a ureterocoele on the left side. A transuretheral incision of ureterocoele was done . Prolapsed ureterocoele should be kept as a differential diagnosis in young females .However it should be differentiated from caecoureterocoele .Transuretheral incision is the optimal treatment modality for these patients . [Shetty M Natl J Integr Res Med, 2019; 10(6):89-90]</p> Manjunath Shetty, Anuj Mahajan, Prashanth Adiga, Vivek Pai Copyright (c) 2020 Wed, 01 Jan 2020 00:00:00 -0800