National Journal of Integrated Research in Medicine <p>This is an Open access official publication of <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 (Dr. Chinmay shah) (Mr Bhavesh Bhoj) Wed, 10 Mar 2021 16:41:32 +0000 OJS 60 A Study Of Platelet Indices And Angiographic Profile In Patients With Acute Coronary Syndrome <p>Background: ISCHEMIC HEART DISEASES continues to be a major public health problem becoming an increasingly important problem in developing countries constitutes around 12.8% of total deaths (7.2 million). Objectives: To evaluate the clinical course of ACS patient’s admitted to KIMS HUBLI ICCU. Material &amp; Methods: Patients admitting to ICCU KIMS, HUBLI diagnosed as Acute Coronary Syndrome. The study included 156 patients admitted to ICCU KIMS Hubli who diagnosed as ACUTE CORONORY SYNDROME. Results: There was significant difference in the platelet indices between the three groups. The platelet Indices - mean platelet volume, platelet distribution width and platicrit were significantly higher in STEMI and NSTEMI groups when compared to the USA group and severity of CAD more in patients who were having higher platelet indices. Conclusion: The platelet indices: mean platelet volume (MPV), platelet distribution width (PDW) and platecrit are significantly higher in STEMI and NSTEMI groups when compared to USA group. [Gouda G Natl J Integr Res Med, 2020; 12(1):01-06]</p> Ganesh Gouda, Bharath G, Raghu G, Manoj Kumar B K, Umesh Rajoor Copyright (c) Mon, 01 Mar 2021 00:00:00 +0000 Uromodulin- Glycated Hemoglobin Ratio Plays The Trump In Diabetic Nephropathy Detection- A Case Control Study <p>Background: To investigate urine uromodulin as a marker for Diabetic nephropathy (DN) and its relation with glycaemic control. Material &amp; Methods: a cross-sectional comparative study on 180 healthy controls (Group I), 205 patients of Diabetes Mellitus were classified as Group II without microalbuminuria and those with microalbuminuria as Group III.Urineuromodulin, albumin and creatinine was estimated along with routine biochemistry. Results: The FBS, PPBS, HbA1c and serum creatinine were lowest in Group I as compared to groups II and III (p &lt; 0.01, &lt;0.01, &lt;0.01, 0.008 respectively). There was no difference in urine uromodulin levels among the three groups (p= 0.609) but the Uromodulin HbA1c Ratio (UHR) showed a significant difference (p &lt;0.01). UHR showed a statistically significant negative correlation with FBS, PPBS, HbA1c and urine (p= &lt;0.01, &lt;0.01, &lt;0.01 and 0.004 respectively). The Odds of having DN with UHR &gt; 8.6 was 0.49 (95% CI is 0.308- 0.78). Conclusion: The non-occurrence of a diabetic complication that is nephropathy in our study group is favourable to those diabetic patients with a higher UHR (&gt;8.6). Estimation of urine uromodulin will be beneficial along with albuminuria in detecting DN. [Sahu S Natl J Integr Res Med, 2021; 12(1):07-11]</p> Suchanda Sahu, Manish Taywade, Gautom Kumar Saharia, Balamurugan Ramadass Copyright (c) Mon, 01 Mar 2021 00:00:00 +0000 Critical Cerebrospinal Fluid Adenosine Deaminase Activity In Tubercular Meningitis <p>Background: Tuberculosis of the central nervous system accounts for ~5% of extra pulmonary cases in the United States. It is seen most often in young children but also develops in adults, especially those infected with HIV. If unrecognized, tuberculous meningitis is uniformly fatal. This disease responds to chemotherapy. Cerebrospinal fluid (CSF) evaluation is the single most important aspect of laboratory diagnosis of meningitis. Basic studies of CSF that should be performed in meningitis include measurement of pressure, cell count and differential count, estimation of glucose and protein levels, Gram's stain and culture. Objectives: To evaluate the diagnostic significance of CSF adenosine deaminase (ADA) activity in tuberculous meningitis. Material &amp; Methods: 70 Tubercular Meningitis patients who were admitted in Department of Medicine, Victoria hospital were included. The study was approved by the Ethical Committee of Bangalore Medical College and Research Institute, Bangalore. Patients were selected after fulfilling the following inclusion and exclusion criteria. Results: The mean age of the 70 patients studied was 39.82+16.48 years. The youngest patient was 18 years old and oldest patient was 70 years. The mean value of ADA activity in tubercular meningitis was 18.07±8.03IU/L. Cut-off value of ADA in our study was 10 IU/. The result was statistically significant with a p value&lt;0.001. Conclusion: The test for ADA in CSF is simple and can be carried out in a central laboratory with a rapid diagnosis, thus reducing unwarranted or harmful therapy for patients. Elevated CSF-ADA level helps in differentiating tubercular from non-tubercular meningitis. [Nipanal A Natl J Integr Res Med, 2021; 12(1):12-16]</p> Akkamahadevi V Nipanal, Nagappa H Copyright (c) Mon, 01 Mar 2021 00:00:00 +0000 Study Of Maternal And Perinatal Outcome In Patients With Abruption Placenta <p>Background: Abruption placenta is one of a serious obstetrics emergency. It is defined as partial or complete separation of normally implanted placenta after 28 weeks of gestation, prior to delivery of the fetus. Placental abruption complicates about 1% of pregnancies and is a leading cause of vaginal bleeding in the latter half of pregnancy.1 AIMS: To study maternal outcome in patients with abruption placenta. To study perinatal out come in patients with abruption placenta. Material And Methods: A prospective observational study was carried out at tertiary hospital for 6 months from September 2019 to February 2020. 30 cases of abruption placenta were enrolled in this study. Results: Maximum patients (56.6%) were from 26 – 30 year age group. (63.3%) were having second gravida. Maximum (56.6%) patients admitted were between 33 – 36 week gestational age group. Most of (60%) patients were having revealed type of bleeding. (52.3%) patients were having grade 2. Major maternal morbidities were PPH (36.6%), severe shock (23.3%) and DIC (6.6). (26.6%) babies had birth asphyxia, (16.6%) developed ARDS. Sepsis and ICH was seen in (10%) each whereas necrotizing enterocolitis and stillbirth was found in (13.3%). Perinatal death was seen in (6.6%). Conclusion: Abruption placenta is associated with poor maternal and fetal outcome. Early diagnosis and prompt resuscitative measures are essential to prevent both perinal and maternal morbidity and mortality. [Bariya E Natl J Integr Res Med, 2020; 12(1):17-21]</p> Dr. Ekta M. Bariya, Dr. Prakash B. Prajapati, Dr Pallavikumari A Patel, Dr. Ankit L. Taviyad, Dr. Hardik J Bariya Copyright (c) Mon, 01 Mar 2021 00:00:00 +0000 Role Of Diagnostic Imaging And Surgical Outcomes In Abnormal Placental Invasion Spectrum Associated With Prior Caesarian Delivery Patients: A Prospective Case Series From Western India <p>Background: The aim of our study was to explore the demographics, surgical outcomes and performance of diagnostic imaging modalities namely Ultrasound and Magnetic Resonance Imaging for predicting abnormal placental invasion spectrum in females with history of past caesarian sections. Materials &amp; Methods: We conducted a prospective study from February 2017 till December 2019 at a tertiary referral public hospital in western India. During this time-period we had 26 females satisfying our study criteria. They were subjected to imaging diagnostics to confirm abnormal placental invasion disorder in their present pregnancy. The imaging findings were compared with the final findings at the time of delivery and pathological examinations of placental specimens. Results: More than two thirds of our study patients were young and belonged to the age group of twenties (mean age 29.5 +/- 4.64). Half of them were 3rd gravidas and 77 % (&gt; 3/4 th) of them were diagnosed in their second trimester of pregnancy. Majority of them had history of single past caesarian delivery and the commonest indication for performing it was placenta praevia. Both Ultrasound and MRI were found to be fairly accurate in diagnosing abnormal placental invasion with good sensitivities. Overall, in our series MRI scored an upper hand as a diagnostic imaging modality in posteriorly implanted placentas and cases with ambiguous USG findings. Conclusion: Both diagnostic imaging modalities USG and MRI can predict abnormal placental invasion spectrum with high sensitivity in the antenatal period. These imaging modalities can have a complimentary role, although MRI was found to be superior over USG in our case series with inconclusive findings. [Bhojwani N Natl J Integr Res Med, 2021; 12(1):22-29]</p> Nisha Bhojwani, Madhvi Pandya, Akshay Rafaliya, Rashesh Patel, Sheetal Turakhiya Copyright (c) Mon, 01 Mar 2021 00:00:00 +0000 An Osteological Study Of Morphometric Variations Of Suprascapular Notch In South Gujarat Region <p>Background: The suprascapular notch is a depression in the lateral part of superior border of scapula. The suprascapular ligament bridges the notch. The suprascapular nerve passes below the ligament and corresponding artery above the ligament. Variation in size and shape of suprascapular notch is identified as one of the causes of suprascapular nerve entrapment. Aim Of Study: To study morphological variations of suprascapular notch in dry scapulae of South Gujarat (Indian) population and compare data with studies in other ethnic populations. Materials And Methods: Total 200 dry human scapulae were obtained from Anatomy departments of three medical colleges of south Gujarat. Three dimensions were defined and measured for each suprascapular notch (SSN) using classical osteometry: maximal depth (MD), superior transverse diameter (STD) and middle transverse diameter (MTD). Based on Michał Polguj’s classification SSN was classified into five types. The results of the present study were compared with previous studies in different populations. Results: The proportion of Type III SSN is highest (46.5 %) followed by Type V (26 %), Type I (16 %), Type IV (6 %) and Type II (5.5 %). For Type III SSN, proportion of subtype III c is highest (36.5 %), followed by subtype III b (6 %) and subtype III a (4 %). For Type I SSN, proportion of subtype I c is highest (8.5 %), followed by subtype I a (4 %) and Subtype I b (3.5 %).Conclusion: The suprascapular nerve entrapment syndrome, in most cases is due to morphological variations of suprascapular notch particularly complete ossification of suprascapular ligament. So the knowledge of such variations is essential for clinicians, to make a proper diagnosis of shoulder pain and to plan the most suitable surgical intervention. [Hafezji H Natl J Integr Res Med, 2021; 12(1):30-35.]</p> Hamzah M Hafezji, Deepa S Gupta Copyright (c) Mon, 01 Mar 2021 00:00:00 +0000 Prospective Study Of Efficacy And Perinatal Outcome Of Hydrotherapy In Oligohydroamnios Patients <p>Background: Oligohydramnios means a low level of amniotic fluid during pregnancy. It is defined by an amniotic fluid index that is below 5th percentile for the gestational age. It may cause IUGR, fetal anomalies, mal presentations and fetal distress in labour. Oral or intravenous fluid therapy may increase the amount of amniotic fluid and may improve perinatal outcome. Aims And Objectives: To study efficacy and perinatal outcome of hydrotherapy in patients with oligohydamnios. Material &amp; Methods: A prospective observational study was carried out at tertiary care centre for 6 months. 30 cases of oligohydramnios were enrolled in this study. Results: In present study, maximum (50%) patients admitted for oligohydramnios were between 28 – 32 weeks gestational age and 66% were having severe oligohydramnios. After giving hydration therapy, difference in AFI, was 2.57±0.13, which was statistically significant. 83.3% patients were delivered after 36 weeks and 80% were delivered by normal vaginal delivery. 53.3% babies were live healthy, whereas others needed resuscitation and admitted to NICU. Conclusion: Oligohydramnios has higher impact on perinalal outcome due to antenatal and intrapartum complication. Because of early diagnosis by ultrasonography or clinical analysis, fluid therapy is an option to increase amniotic fluid volume and so perinatal outcome may be improved. [Patel P Natl J Integr Res Med, 2021; 12(1):36-41]</p> Dr. Pallavikumari A Patel, Dr. Samipa J Shah, Dr. Naisha R Gohel, Dr. Dhruvil Damor Copyright (c) Mon, 01 Mar 2021 00:00:00 +0000 Blood Grouping With ABD PAD- Efficacy And Comparison With Standard Method – A Pilot Study <p>Background: In transfusion service, it is very important to carry out blood group with perfection. Blood grouping is a fast and easy way to ensure that you receive the right kind of blood for right patient. There are many methods we use for blood grouping like Slide method, test tube method, column agglutination method and erythrocyte magnetic technique. Test tube method is gold standard method for blood grouping. We need to verify donor blood group in blood bank or at camp site, for patients at bed side, at the time of issue of blood unit or at the time of dire emergency so to verify the blood group in Blood centres we require the results of blood grouping urgently. ABD PAD® is a new device for the quick confirmation of the ABO blood group. Materials And Methods: In this Pilot study,200 samples were taken of which 100 were donor samples and 100 were patient samples. Blood grouping was performed on the ABD PAD, and results were compared with conventional tube technique and automate platform, Qwalys 3 (Diagast) EMT technique.Results: All 200 tests performed on the ABD PAD were concordant with other standard methods, namely the Test Tube technique and automated platform, Qwalys 3 (Diagast).The results of ABD PAD were quicker(within 30 seconds) and easy to interpret.Discussion:The manual confirmation of the ABO group and RH- rhesus is a repetitive and time consuming task. It requires following a procedure handling several reagents. In this context, the ABD pad is a ready to use device using the latex technology M- TRAP, facilitating the procedure intended for the confirmation of ABO/Rh. The only drawback is that we are not able to perform reverse grouping. Conclusion: ABD PAD is very useful for blood grouping in donors in the blood bank as well as in outdoor blood donation camp and at the time of issue of blood unit when we want to re-check the blood group of the issue bag. It is easy to interpret, fast, reliable and results are comparable with standard methods. [Shah M Natl J Integr Res Med, 2021; 12(1): 42-45]</p> Dr. Mamta Shah, Dr. Nidhi Bhatnagar, Dr. Sangita Shah, Dr. Falguni Pandav, Dr. Shital Soni Copyright (c) 2021 Mon, 01 Mar 2021 00:00:00 +0000 Effect Of Proprioceptive Neuromuscular Facilitation On Selective Motor Control Of Lower Extremity In Children With Hemiplegic Cerebral Palsy: An Experimental Pilot Study <p>Background: Cerebral palsy children have limitations in motor function resulting in diminished selective motor control. Selective motor control (SMC) is essential for independent control of joint motion. Impaired SMC is interrelated to neuromuscular deficits in CP. In this study PNF approach was used with different patterns and techniques which help to evoke motor responses and improve neuromuscular control and function. Objectives: To assess the effect of PNF along with conventional treatment ,To assess the effect of Conventional treatment and To compare the effect of PNF along with conventional treatment and conventional treatment on selective motor control of lower extremity in children with hemiplegic cerebral palsy. Material and Method: Study included 22 hemiplegic cerebral palsy children which were divided into two groups. Experimental group received PNF and conventional treatment and control group received conventional treatment. SMC of lower extremity was assessed using SCALE. Pre and post treatment scores were measured. Results: There was statistically significant difference noted within group and between groups on Total SCALE score. Difference was seen greater in experimental group than control group. Conclusion: This study suggests that PNF have an effect on selective motor control of lower extremity in children with hemiplegic cerebral palsy. [Kale G Natl J Integr Res Med, 2021; 12(1):46-51]</p> <p>Abbreviations: Selective motor control (SMC), Proprioceptive Neuromuscular Facilitation (PNF), Cerebral Palsy (CP), Selective control assessment of lower extremity (SCALE), Diagonal Pattern (D1 and D2), Gross motor function classification system (GMFCS), Corticospinal tract (CST).</p> Dr. Gauri Kale, Dr. Rahul Bisen, Dr. Parag Ranade Copyright (c) 2021 Mon, 01 Mar 2021 00:00:00 +0000 A Record Based Study On Various Factors Affecting The Choice Of Intra-Uterine Contraceptive Device In Ahmedabad City <p>Background: Unplanned pregnancy may be the reason of many neonatal and maternal adverse effects. The objective is to study various factors affecting IUCD (temporary contraceptive method) preference. Material And Methods: A record based study of data of 483 couples selecting IUCD, during the one year period was collected with permission from tertiary care hospital. Result: The most common group preferring IUCD was 21-30 years (mean age- females-26 years and males-30 years).Majority having 2 children opted for IUCD while only 1 couple opted for IUCD without any child. Out of the total, 42% opted PPIUCD, 42% interval IUCD and 16% PAIUCD. Among lower age and up to primary educated groups, majority opted for PPIUCD. Among higher age and educated groups, majority opted for interval IUCD. PAIUCD proportion was higher in less educated females. Majority of Muslims preferred PPIUCD while Hindus, interval IUCD. The association of type of IUCD with age, number of children and religion was found significant while with education, it was in-significant. Conclusion: The use and type of IUCD preferred depends on various factors such as age of male and female, number of children and religion of couples. [Parikh B Natl J Integr Res Med, 2021; 12(1):52-56]</p> Bansari Parikh, Jay Parikh, Dr. Vaibhavi Patel, Aastha Nayak, Viraj Panchal Copyright (c) 2021 Mon, 01 Mar 2021 00:00:00 +0000 Ophthalmic Manifestations In HIV Patients- A Case Series Study From North India <p>Background: The ophthalmological problems occur in approximately half of the patients with advanced HIV infection when the CD4 T cell count is usually well below 50/ul and the increasing number and prolonged survival of AIDS patients means that the ocular lesions associated with this syndrome will become more frequent problem. Material And Methods: This was a case series study with no controls. All HIV positive patients were included in this study with or without ocular involvement. 50 known HIV positive cases attending OPD and/or admitted in GM and Associated Hospitals, KGMC, and who were willing to take part in study were enrolled after proper counselling. Detail history of the cases is taken including personal data, occupation, history of any risk factor, detail history of systemic disease and ocular symptom with their duration and course. Results: In our study 33 patients did not have ocular symptoms and signs and the remaining 17 patients were found to have ocular involvement. Among them 6 patients were asymptomatic, but they had ocular signs. Amongst various symptoms 7 patients presented with diminution of vision, one had headache, other visual symptoms including watering itching and foreign body sensation were found in 5 patients. Conclusion: More than half of the cases in this study were either illiterate or had attended primary schooling and mostly from rural area. In view of this there is a need to intensify primary health education programme and awareness about AIDS through mass media and education regarding adaptation of safe sexual practices. The role of Govt. program and various NGOs has become more important in this respect to restrict this 21st century epidemic. [Singh P Natl J Integr Res Med, 2021; 12(1):57-61]</p> Dr. Poonam Singh, Dr. Chandra Shekhar Tiwari, Dr. Dharmendra Uraiya, Dr. Rahul Pandey Copyright (c) 2021 Mon, 01 Mar 2021 00:00:00 +0000 An Evaluation Of The Retention Property Between Cream Type And Strip Type Denture Adhesive With And Without Salivary Substitutes: An In Vitro Study <p>Background: Patients with xerostomia complain of not only dryness of mouth but also discomfort during routine normal oral functions like speaking and swallowing. These complain is worse in individuals wearing removable intraoral dental prosthesis. In such situations, when salivary flow decreases, denture adhesives and salivary substitutes are recommended; which aid in denture retention and improve patient comfort. Material &amp; Method: A total 150 samples were prepared using heat-cure acrylic resin of 30mm×30mm×5mm. All samples were equally divided in A,B,C,D,E groups, wherein Group A was control group with salivary substitutes. Group B was denture adhesive cream without salivary substitutes. Group C was denture adhesive cream with salivary substitutes. Group D was denture adhesive strips without salivary substitutes. Group E was denture adhesive strips with salivary substitutes. The retentive force was measured for all samples using universal testing machine. Results: Data was collected and statistical analysis was done by one-way ANOVA test followed by post hoc test. The significant difference was found between the retentive forces of cream type and strip type denture adhesives with or without salivary substitutes. Conclusion: From this study, it is concluded that denture adhesive will definitely increases the denture retention. The cream type denture adhesive with salivary substitutes has the most retention than among all groups. [Shah D Natl J Integr Res Med, 2020; 12(1):62-67]</p> Dipti S Shah, Kalpesh Vaishnav, Pankaj Patel, Pratik Acharya, Zalak Patel, Dishant Chaudhary Copyright (c) 2021 Mon, 01 Mar 2021 00:00:00 +0000 Patient’s Adherence to Physiotherapist Prescribed Self-management Strategies: A Physical Therapist’s Perspective <p>Background: Few studies have been done in India about factors which can influence patient’s adherence to self-management protocol and a physiotherapist’s view on subject of adherence. Material &amp; Methods: This cross-sectional study was conducted via a self-made questionnaire consisting of 20 items. Fifty final BPT and 1st year post graduate students were asked to choose the most appropriate answer from options given. Descriptive analysis was done using Google Forms.Results:62% strongly agreed that self-management is important. Good self-management strategies should have clarity of instructions (66%), be proper and should be easy to follow (50%). 86% believed proper communication skills, strategy prescription, knowledge, monitoring and follow up by therapist will help patient adhere to strategies. Willingness to exercise (48%), Positive belief in exercise(44%) and Age(56%) were thought to influence patient adherence. Stigma associated with disability (52%), poor inter-professional relation (86%), are barriers. Properly educating the patient about his condition(96%), involving the family members(92%) were believed to be facilitators. 46% therapists agreed that a passive approach should not be used. 54% strongly disagreed they don’t have time to assess patient adherence. Conclusion: Physiotherapists agree that patient’s adherence to physiotherapist prescribed self-management strategies is essential for clinical practice. There is a need to use different approaches to increase patient adherence.[Baxi H Natl J Integr Res Med, 2020; 12(1):68-73]</p> Heta D Baxi, Megha S Sheth Copyright (c) 2021 Mon, 01 Mar 2021 00:00:00 +0000 A Prospective Observational Study to Ascertain the Role of Homoeopathic Therapy in Management of Rheumatology <p>On day to day practice most problems in all over the world is joint pain. Especially in female joint pain more common after climacteric period and old age. On these base my study of homeopathic therapeutic effect on joint pain. In my study use homeopathic medicines which are regularly use and easy availability for patient, and benefit to relive the complaint but not completely cure all joint pain. With help of homeopathic medicine improved his/her daily routine work and enjoy his/her life without pain in joint. [Shah D Natl J Integr Res Med, 2021; 12(1):74-76]</p> Dr. Denish Shah, Dr.Girish Patel, Dr.Pranav Shah Copyright (c) 2021 Mon, 01 Mar 2021 00:00:00 +0000 Homeopathic Approach In Iron Deficiency Anaemia <p>In present global worming most common disease in women is anaemia.This condition also seen in during pregnancy also. In my study also find out which miasmas are more prominent during pregnancy may be responsible for iron deficiency anaemia. [Soni A Natl J Integr Res Med, 2021; 12(1):77-79]</p> Dr Amrish Soni, Dr.Girish Patel, Dr.Pranav Shah Copyright (c) 2021 Mon, 01 Mar 2021 00:00:00 +0000 Understand The Role Of Susceptibility In Acute Disease <p>Day in and day out we come across acute diseases in our practice. It is observed in clinic practice of almost all physicians that majority of the cases are of acute origin and the rest are chronic in nature. Usually acute disease presents to us with distinct characteristic form which suggest acute remedy. In order to treat as early as possible acute cases becomes the prime need of the physician. We have noted that an organism is constantly required to adapt itself to its environmental conditions so that harmony is maintained. This process of adaptation can take lace on account of the susceptibility. To undertake such study we need to examine acute diseases. We need to understand the role of susceptibility and miasm in every case. In developing countries like India, infectious diseases are the commonest cause of mortality. Especially diseases like Typhoid fever, Acute Viral Hepatitis and Pneumonia are very frequent cause of admission and also a frequent enemy to encounter in O.P.D. [Doshi J Natl J Integr Res Med, 2021; 12(1):80-84]</p> Dr. Jignesh J Doshi, Dr. Girish Patel, Dr. Pranav Shah Copyright (c) 2021 Mon, 01 Mar 2021 00:00:00 +0000 Utility Of Pulsatilla Nigrican And Sepia In Leucorrhoea <p>Now a day with modern civilized life a report suggests that women are probably dying because incidence is increasing due to change of life style. Women’s health is compromised at practically in every step. The statement has been amplified to include the ability to lead a ‘socially and economically productive life’. Among the people the health of women requires high attention. There are several medical disorders from which women suffer, from puberty to till after menopause like leucorrhoea, painful menses, menstrual irregularities; dysfunction uterine bleeding, cancer of genital organ, cervical and endometrial polyposis etc are chief problems. Many of victims suffer from among all this, but leucorrhoea is universal problem of all women. Material &amp; Methods: Type of study: Comparative study&amp; Prospective study. Type of sampling: random sampling Conclusion: These prove when homoeopathic medicine selected on bases of Totality of symptoms, causation, constitutionally and on bases of individualization, it gives permanent improvement without recurrences. [Gupta V Natl J Integr Res Med, 2021; 10(6):85-90]</p> Dr.Vivek Gupta, Dr.Pranav Shah Copyright (c) 2021 Mon, 01 Mar 2021 00:00:00 +0000 Placenta Percreta And Its Successful Outcome: A Rare And Difficult Case Report And With Review Of Literature <p>Placenta Percreta is one of the most serious complications of placenta previa, the incidence of which has been on a rising trend and is frequently associated with severe obstetric hemorrhage usually necessitating hysterectomy. lacenta Previa complicates 0.3–0.5% of all pregnancies and is a major cause of third-trimester hemorrhage which is on the rise due to rise in incidence of cesarean sections. Significant maternal morbidity in form of increased incidence of fetal mal presentation, cesarean delivery, increased blood loss, and peripartum hysterectomy have been noted in cases of placenta previa and can lead to prolonged hospitalization in these women. Premature deliveries can occur which lead to higher admission to neonatal intensive care unit and stillbirths. (1).We present a case of placenta previapercreta in a case of previous cesarean section , managed excellently with a surgical expertise. [Katke R Natl J Integr Res Med, 2021; 12(1):91-94]</p> Dr. Rajshree Dayanand Katke Copyright (c) Mon, 01 Mar 2021 00:00:00 +0000 A Critique On Learning Theory <p>Learning in humans is an extremely complex process. Many theories have been espoused to explain the learning process. However, no single theory can fully explain how learning process occurs. There is no clear cut demarcation between the theories. Their boundaries seem to be overlapping with each other. Cognitive psychologists have explained how learning takes place from different perspectives. The major traditional schools of thought concerning learning include behaviourist, cognitivist, and constructivist schools. Socio-cultural, situated and activity theories of learning have emerged more recently through understanding the ways in which students learn, teachers can help them learn by planning the most effective way to learn. The appropriateness of any learning theory depends on the context. A blend of learning theories is suitable most of the times. [Saxena R Natl J Integr Res Med, 2021; 12(1):95-98]</p> Dr. Rajeev Saxena, Dr Umar Rashid Khan, Dr. Archna Choure, Dr. Sachin V Wankhede Copyright (c) Mon, 01 Mar 2021 00:00:00 +0000 Expecting The Unexpected <p>Report of unusual presentation of two root canals in all the mandibular anterior teeth in a single patient. Incidence of two canals in individual mandibular anterior teeth ranges from 5-37% but all six anterior teeth showing two canals is a rare finding and is seen in less then 5% of the population. We report Endodontic management of such case. Conclusion: Successful endodontic therapy of a tooth demands that a dentist should have a thorough knowledge of the root canal morphology, making it mandatory towards proper radiographic evaluation and diagnosis of the status of the pulp canals as well as periapical areas. Improper diagnostic protocol may lead to failure of Endodontic treatment. The case presented here shows successful root canal treatment of all the mandibular anterior teeth with two root canals each. The frequency of mandibular anterior teeth having two root canals varies from 5% to 37 % in different populations. Pulp space anatomy of mandibular anterior teeth shows high incidence of complexity which includes variation in canal configurations, number of canals and presence of isthmus. Thorough knowledge of root canal anatomy and morphology, additional radiographs taken at different angles and correct interpretation of radiographs is mandatory [Tagdiwala D Natl J Integr Res Med, 2020; 12(1):99-104]</p> Dr. Tagdiwala Dhagash P, Dr. Bhagwat Sumita A, Dr. Menon Leena Copyright (c) 2021 Mon, 01 Mar 2021 00:00:00 +0000 Bilateral Narrow Internal Auditory Canal With Duplication: High Resolution CT And MRI Findings <p>Inner ear malformations account for only 20 % of cases of congenital sensorineural hearing loss. A narrow internal auditory canal (IAC) with duplication is a very rare congenital anomaly that can be associated with other malformative ear abnormalities. Identification and characterization of these abnormalities will be crucial for the proper management of patients.We report two cases of bilateral duplicated internal auditory canal with other associated inner ear anomalies. [Patel N Natl J Integr Res Med, 2020; 12(1):105-111]</p> Dr. Nikunj A. Patel, Dr. Nitisha Jain, Dr. Hardik Raiyani, Dr. Meet Patel Copyright (c) 2021 Mon, 01 Mar 2021 00:00:00 +0000