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 Jul 2020 00:00:00 +0000 OJS 60 Correlation Of Hematological And Radiological Parameters With Functional Outcome In Patients Of Acute Ischemic Stroke <p>Background: Stroke in developing countries is reported to have a younger mean age at onset as compared to developed countries. Objectives: To correlate hematological and radiological parameters with functional outcome in patients of acute ischemic stroke. Material &amp; Methods: This study was undertaken in the Department of Medicine in collaboration with the Departments of Radio diagnosis and Pathology, Jawahar Lal Nehru Medical College and Hospital, AMU, Aligarh from January 2017 to November 2018. By convenience method for sampling, 102 patients who were admitted with the diagnosis of acute ischemic stroke to IPD of JNMCH, Aligarh, on clinical as well as radiological grounds were taken into study. Results: There was a positive correlation between serum cortisol and functional outcome according to m RS. As serum cortisol increased, m RS grade also increased with a correlation coefficient of 0.812 and the result was statistically significant (p &lt;0.01). There was a negative correlation between serum albumin and functional outcome according to m RS. As serum albumin increased, m RS grade decreased with a correlation coefficient of -0.659 and the result was statistically significant (p &lt;0.01). There was no correlation between CCA-IMT and functional outcome (r=0.091) and neither was the result statistically significant. Conclusion: Serum cortisol level was found to have a significant positive correlation with radiological parameter and worsening functional outcome. Serum albumin was found to have a neuroprotective effect. [Saman F Natl J Integr Res Med, 2020; 11(3):1-6]</p> Saman Fatima, Ruhi Khan Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 The Role Of Non-Modifiable Risk Factors For Peptic Ulcer Disease In Patients Attending A Tertiary Hospital In Enugu, South East Nigeria <p>Background: To determine the role of non-modifiable risk factors associated with peptic ulcer disease in patients attending a tertiary hospital in Enugu, South East Nigeria. Material And Methods: A total of 240 patients comprising 120 cases and 120 controls attending the outpatient clinic of the Enugu State University Teaching Hospital, GRA, Enugu were seen within the period February and August 2017. Their age, sex, educational and income levels were taken. Their medical history which centered on knowledge of peptic ulcer disease (PUD), family history of PUD, history of chronic illness and diagnosis of PUD were assessed. The prevalence of these non-modifiable risk factors in the cases and controls were compared. Result: There was no significant difference between the age distribution and sex distribution of cases and controls (P-value= 0.103 and 0.07 respectively). Similarly, there was no significant difference between the educational levels (P-value= 0.683) and the monthly income levels (P-value= 0.490) of cases and controls. Conclusion: Factors such as age and sex were found to be of little or no influence. However the cases with higher educational level had a higher prevalence of PUD while those with lower monthly income had the same higher prevalence, thus showing that the higher the educational attainment, the lower the monthly income. From the above findings, emphasis should be laid on a policy aimed at massive employment/ empowerment of the youths and young adults so as to improve their monthly income and reduce the observed inequality. [L.U.M, Onoh Natl J Integr Res Med, 2020; 11(3):7-10]</p> Onoh, L.U.M Copyright (c) 2020 Wed, 01 Jul 2020 00:00:00 +0000 Assessment Of Carotid Sonographic Parameter Pulsatility Index Associated With Stroke Risk Among Hypertension With Diabetic Stroke Patients Compared To Hypertension With Diabetic Controls <p>Background: Stroke is major public health problem leading to increased morbidity and mortality. Stroke is one of the leading causes of death and disability in India. Carotid sonographic hemodynamic parameter Pulsatality Index by using carotid Doppler Ultrasound is associated with the future risk of development of cerebrovascular stroke. Material And Methods: The present cross sectional study was conducted on 25 hypertension with diabetes stroke (Group A) and 30 hypertension with diabetes controls (Group B). CCA peak systolic velocity, end diastolic velocity and Pulsatility Index were assessed in each group by Doppler ultrasound machine. BMI and W/H was measured according to WHO protocol. Blood pressure was measured by sphygmomanometer. Biochemical analysis like Lipid profile and HbA1c were done by autoanalyser machine. Result: CCA PSV in Group A was found to be 65.50±21.58 and 69.75±15.51 in left and right side respectively &amp; 70.51±16.70 and 68.64±13.73 in Group B. CCA EDV in Group A was found to be 13.56±2.78 and 11.53±4.65 in left and right side respectively &amp; 20.32±4.54 and 18.17±4.39 in Group B . The data was highly significant (p&lt;0.0001). CCA MV in Group A was found to be 39.53±11.72 and 40.64±9.25 in left and right side respectively &amp; 45.41±9.39 and 43.40±7.70 in Group B (p=0.04 &amp; p=0.23 left and right side respectively). CCA PI in Group A was found to be 1.28±0.15 and 1.44±0.22 in left and right side respectively &amp; 1.05±0.23 and 1.14±0.16 in Group B . The data was highly significant (p&lt;0.0001).Age in Group A and B was found to be 62.20±9.60 and 54.66±9.01 respectively (p&lt;0.004). BMI in Group A and Group B was found to be 28.27±1.17 and 26.35±1.45 respectively (p&lt;0.0001).W/H in Group A and Group B was 0.88±0.04 and 0.86±0.02 respectively (p=0.01). Systolic and diastolic blood pressure in both the groups was found to be 148.16±15.21 &amp; 138.72±6.91 and 87.60±5.94 &amp; 83.86±6.23 which was statistically significant with p=0.003 &amp; p=0.02. The difference between mean of two groups for HbA1c, HDL , LDL , total cholesterol and triglyceride in both the groups were 8.6±0.82 &amp;7.45±0.56, 39.04±5.85 &amp; 49.97±8.34, 143.20±6.40 &amp;113.26±17.09, 226.28±8.28 &amp; 201.90±21.83 &amp; 195.68±9.69, 201.03±55.82 respectively in which HbA1c, HDL, LDL, Total cholesterol were statistically very significant(p&lt;0.0001) and triglyceride was not statistically significant. Conclusion: In conclusion, among hemodynamic parameters that are measured by carotid Doppler ultrasound, Pulsatility Index may play a role for predicting cerebrovascular stroke in hypertension with diabetic patients. In this sense, we concluded that Pulsatility Index examination should be carried out in hypertension with diabetic patients by carotid Doppler ultrasonography. These findings need to be confirmed by a prospective study. [Gadhvi H sain A Natl J Integr Res Med, 2020; 11(3):11-14]</p> Hina J. Gadhvi, Manisha B. Makwana, Vilas J. Patel Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 Comparison Of Three Methods Of Syphilis Testing In Blood Donors-RPR, TPHA & ELISA <p>Background: syphilis can be transmitted through blood, so it is significant to choose a method with high specificity and affinity to test syphilis when do the blood screening. The goal of this study was to compare the performance of three commercially available treponema-specific assays using 58,969 serum samples collected in our blood bank. Material And Methods: Serum samples collected in our blood bank were tested with the 3 treponema-specific assays described below. each sample was tested with an RPR, TPHA and ELISA to assess potential recent infection. 58,969 serum samples were collected over the period of 1.5 year and tested for syphilis in our blood bank. blood units showing reactivity in any one of the tests, were discarded as per NACO strategy I for blood bank. Result: The total samples of three methods are 58,969.Among the total samples studied, 125(0.22%) were reactive by the RPR technique, while 331 (0.56%) samples, were reactive by the ELISA &amp; TPHA techniques, So there were 125 samples which were reactive by all 3 methods. However, the 206 samples which are negative through RPR and are tested positive in ELISA and in TPHA. Conclusion: data suggest that each method has limitations. It is important that health care providers must perform a thorough review of each patient's clinical and treatment history when interpreting the results of syphilis serology. There are statistical differences on positive rate when the 206 blood samples are tested through syphilis RPR, TPHA and syphilis ELISA. Compared with the results of TPHA and ELISA, RPR have both false positivity and false negativity but the results of TPHA and ELISA just have false positivity. In addition, detection capability of syphilis ELISA and of TPHA is stronger than RPR syphilis and it also be more fitting to blood screening. So in comparison of methodology and practical operation RPR are not fit for the large-scale blood screening while syphilis ELISA and TPHA is the one which can be applied to a large-scale blood screening. [Shah M Natl J Integr Res Med, 2020; 11(3):15-18]</p> Dr. Mamta Chintan Shah, Dr. Nidhi Bhatnagar, Dr. Nirali Patel, Dr. Maitrey Gajjar, Dr. Sangita Shah Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 A Comparative Study Of Cardiovascular Autonomic Function Test In Diabetes Mellitus Subjects And Controls <p>Background: Autonomic neuropathy is the most common complication of diabetes, whose severity is related to duration of diabetes and the degree of the metabolic control. The degree of loss of autonomic functions can be assess by series of autonomic tests. The aim of the present study was to find out the effects of diabetes mellitus on autonomic functions and the sensitivity of sympathetic tests in the early detection of autonomic dysfunction in Type 2 diabetics. Material and Methods: In this cross sectional study, 30 diabetics subjects were compared with 30 non-diabetics controls (plasma glucose level between 80-120 mg %) for their autonomic functions. Each subject was evaluated for cardiovascular autonomic neuropathy by isometric hand grip test &amp; Blood pressure response to standing. Statistical analysis was performed using t test. Result: In Sustain hand grip test the mean difference in diastolic blood pressure was statistically significant p&lt;0.01 &amp;Lying to standing blood pressure test has shown significantly altered autonomic functions amongst diabetics than non-diabetics. Conclusion: Diabetes mellitus is one of the systemic disease which leads to autonomic dysfunctions when compared to non-diabetes which may be because of increased blood glucose. [Selot B Natl J Integr Res Med, 2020; 11(3):19-22]</p> Dr. Bhavna A. Selot, Dr. Bijal Mehul Shah, Dr. Pankaj P. Taviad Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 Fine Needle Aspiration Cytology In Evaluation Of Cervical Lymphadenopathy In Paediatric Age Group <p>Background: Lymphadenopathy is common problem in children. The aim of present study is to evaluate the role of FNAC as a diagnostic procedure in paediatric patients with cervical lymphadenopathy. Material &amp; Methods: The present study was carried out on total 148 children up to 12 years of age; who presented with palpable cervical lymphadenopathy at V.S. General Hospital during the period from July 2014 to October 2016. FNAC was done by standard procedure and slides were wet fixed and stained with<br>H &amp; E stain. ZN stain was performed whenever required. Result: Most of patients were in age group of 10 to 12 years (65.54%). The male to female ratio was 1:1.17. The frequency of inflammatory and neoplastic lesions was 96.62% and 3.38% respectively. Among the inflammatory lesions, granulomatous/ tuberculous lymphadenitis [68 cases (45.94%)] was the predominant lesion, followed by reactive lymphadenitis [64 cases (43.24%)] and acute suppurative lymphadenitis [11 cases (7.43%)]. Among the neoplastic lesions, 4 cases were of Hodgkin’s lymphoma and one case was of Non- Hodgkin’s lymphoma. Female preponderance was noted for granulomatous lymphadenitis while male preponderance was observed for reactive lymphadenitis and lymphoma. Conclusion: FNAC is found to be safe, simple, reliable and cost effective method for rapid diagnosis of cervical lymphadenopathy in paediatric patients. [Parikh S Natl J Integr Res Med, 2020; 11(3):23-27]</p> Dr. Swati Parikh, Dr. Milap Shah, Dr. Biren Parikh, Dr.Purvish Darji Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 Short Term Outcome Evaluation Of Conservative Versus Operative Treatment Of Fracture Clavicle A Prospective Observational Study <p>Background: Clavicle fracture is a common condition mostly treated conservatively. Newer operative modalities have come up to obtain early fixation. Accurate reduction and fixation is important for complication-free management of clavicle fractures. However, there is still doubt amongst orthopaedic surgeons regarding the choice of management for clavicle fractures. Study aimed at analysis of the outcomes and complications of the operative management and its compare with conservative modality.Material And Methods: Ethics committee permission was taken and 30 patients with middle-third clavicle fracture were included in this study. The affected limb was treated either conservatively (Figure of 8 brace and sling) or operatively (OR+IF using recon plate or AO pre-contoured plate or TEN). Regular follow-up till 1 year post-treatment was done. The functional outcome was assessed by Constant and Murley score. Descriptive statistics and Chisquare test were applied for analysing the data.Result: 15 patients were treated conservatively while 15 operatively. 23 (69.7%) had excellent or good functional outcome at 4 weeks irrespective of the treatment. The patients in the operative group who showed excellent results were significantly more than that in the conservative group (p = 0.0324). Average union time in the conservative group was 9.4 weeks, more than the 7.8 weeks seen in the operative group. Mal-union was present in 7 of 17 patients treated conservatively. Superficial infection, implant failure and keloid formation were seen in one patient of operated group. Conclusion: Clavicle fractures managed operatively had better functional outcome with lesser post-operative complications. [RK S Natl J Integr Res Med, 2020; 11(3):<br>28-32]</p> Dr. Sagar RK, Dr. Pinakin I Vora Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 A Comparative Study To Determine The Effectiveness Of Low Level Laser Therapy And Strong Surge Faradic Current On Trapezius Spasm <p>Background: This study was designed to determine and compare the effect of low level laser therapy and strong surge faradic current on trapezius spasm. Material And Methods: Group A consisted of 15 subjects who received Low Level Laser Therapy and Group B consisted of 15 subjects who received Strong Surge Faradic current. On the 1st and 5th day Numerical pain rating scale (NPRS) was taken to measure pain intensity, Hubbard’s “Tenderness grading scale” was used for assessment of soft tissue tenderness and Cervical side flexion and rotation range of motion was measured using universal goniometer. Result: The t-value for NPRS, tenderness, cervical side flexion and rotation were 12.52, 11.05, -7.28 and -8.76 respectively. So, there was significant difference in all the outcome measures between Group A and Group B at level of significance p=0.00. Conclusion: The results of this study demonstrated that LLLT and SSF current both the interventions are effective for treatment of trapezius spasm. But SSF current is more effective than LLLT in improving cervical rotation range of motion. [Mehta K sain A Natl J Integr Res Med, 2020; 11(3):33-38]</p> Krupa H Mehta, Rinkal S Adodariya, Dinesh M Sorani Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 Optical Coherence Tomography Analysis Of The Macula After Scleral Buckle Surgery For Retinal Detachment: A Diagnostic And Therapeutic Advantage <p>Background: To study the different structural alterations in macula after scleral buckling surgery on Optical Coherence Tomography and corelate with postoperative visual acuity. Material And Methods: Total 50 patients with Rhegmatogenous retinal detachment who underwent scleral buckling surgery were included. The study has been approved by ethics committee. Clinical examination and Preoperative oct and postoperative oct on day 7, 1 month 3 month and 6 months were done. Result: After Scleral buckling Surgery post operatively after 1 week(38%),1 month(20%),3 month(8%),6 month(4%) in male and 1 week(20%),1 month(16%),3 month(6%) and 6 month(2%) in female had Persistent Subretinal fluid .Pre operative eyes with subretinal fluid Mean LogMAR VA was 2.21 which was improved to 1.60 on post operative 6 month period. p value 0.033(p value&lt;0.05) was clinically significant suggested that resolution of subretinal fluid during 6 month period significantly improved Visual Acuity. Inner segment/Outer segment (IS/OS) junction of photoreceptor was disrupted in 23(46%) eyes with 21 eyes (54%) in macula off and 2(18%) eyes in macula on. In our study ELM was intact in 23(46%) eyes with 91% in macula on and 13% in macula off eyes. The Mean LogMAR VA in Eyes with Intact ELM was 1.71 and 1.91 in disturbed ELM signified that visual outcome depends on intactness of ELM. Conclusion: IS/OS disruption, Intact ELM and subretinal fluid may be important predictors of visual outcome after anatomically successful RRD surgery.<br>[Shah S Natl J Integr Res Med, 2020; 11(3):39-43]</p> Sonali Shah, Somesh Aggarwal, Puja Negi, Bhargavi Parth Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 Study Of Early Postoperative Complications After Thyroidectomy <p>Background: Thyroidectomy is an operation that involves the surgical removal of all or part of thyroid gland .Having proper knowledge about the anatomy of neck structures during thyroidectomy is very important as any damage to any structure can lead to dreadful consequences in early postoperative period. A surgeon should be aware about the postoperative complication after thyroidectomy and its management. Aims And Objectives: 1) To study age wise incidence of different thyroid pathologies. 2) To study the type of thyroidectomy preferred for different thyroid pathologies. 3) To study early postoperative complication after thyroid surgery in relation to type of thyroidectomy, and thyroid disorder,4)To study prevention and management of early complications after thyroidectomy. Material And Methods: This study is a retrospective study conducted on 47 patients who underwent thyroidectomy between June 2017- January 2019 in General Surgery and ENT Department of S.V.P. Hospital Ahmedabad. A detailed history was taken from all the patients. Result: In this study the various postoperative complications following thyroid surgeries which occurred in 47 patients who underwent thyroidectomy in the Department Of General Surgery and ENT at S.V.P. Hospital Ahmedabad were analyzed. Patients between 11 to 70 years were included in this study. 47 patients underwent thyroidectomy 25 hemithyroidectomy, 22 total thyroidectomy. Benign pathologies include – colloid goiter, solitary nodule, multinodular goiter. Malignant pathologies include – Papillary Carcinoma, Follicular Carcinoma, Hurthle Cell Carcinoma, Lymphoma. The only three complications noted in these 47 patients were Hypocalcemia In 6 Patients, Laryngeal Nerve Palsy In 2 Patients, Traumatic Vocal Cord Paresis in 1 patient. No case of permanent Bilateral Recurrent laryngeal nerve paralysis occurred in this study. Other complications like wound infection, wound hematoma and hemorrhage were not noticed in our study. Conclusion: This study was conducted to study the outcome of thyroid surgeries. It can be concluded that incidence of complication was not related to age of the patient, Complication rate depends on the experience of the surgeon, type of thyroidectomy, and thyroid pathology. Good understanding of thyroid gland anatomy, improved techniques in hemostasis, RLN dissection, preservation of parathyroid glands and postoperative monitoring are the best way to prevent complications. Appropriate postoperative care with early identification of complications and prompt institution of corrective treatment plays an important role in reducing the duration of postoperative hospital stay and limiting patient morbidity. [Rabari M Natl J Integr Res Med, 2020; 11(3):44-48]</p> Dr. Mayur G. Rabari, Dr. Parixit S. Malaviya, Dr. Sandip D. Patel Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 “5 Minute Insight” As Method Of Reflective Learning And Student Assessment Technique: A Quasi Experimental Study <p>Abstract: Background: Competency based medical education aims in higher order learning Critical thinking in medical education. Cognitive skills are needed to rise above recall based to conceptualization, interpretation, analysis, synthesis and evaluation for skilled judgment in medical students. Thus consolidation of learning is necessary for improvements in student’s academic performance. Not only teacher directed learning but also students self directed and controlled learning are identified need for time. For students to be successful in self-directed learning, they must be able to engage in reflection and self-evaluation of their learning goals and progress in a unit of study. Objective: To evaluate the effectiveness of “5 Minute Insight” (5MI) as formative Classroom assessment technique of medical students. Material And Methods: A Quasi experimental descriptive study undertaken in 70 voluntary participating 1st phase MBBS students in department of physiology. After 45 minute traditional interactive lecture session the students had “5 Minute Insight” as reflection of learning and classroom assessment. 5MI formative classroom assessment technique was designed to create an insight statement. The 5MI was based on understanding of lecture session by student based on statements on competency to achieve, What he knew, now he knows, whether he knows all, why not and why does. Quantification of learning was scored using application based 10 single response multiple choice questions on physiology topic, before and after 5MI formative assessment. Correct response was scored one for each question. Data was analyzed using for difference in proportion or correct responses using Chi square test and paired difference in mean score by Wilcoxon Sign Rank test. Result: Correct responses before 5 MI for Q1 to Q10 were within 7.1% to 85.7% which after the 5MI were within 35.7% to 92.9% range. Improvement in correct responses after 5MI was found for Q1 to Q3, Q5 to Q7 and Q10 was statistically significant (p&lt;0.05). Mean 38.9% students had correct responses before the 5MI which increase to 61.6% and was statistically significant (p=0.012). Mean total score before 5MI was 3.9 which increased to 6.2 with mean improvement of 2.3 (p&lt;0.001). Conclusion: ‘5 Minute Insight’ formative assessments caused improvement of correct response in students thus indicating better learning. ‘5 Minute Insight’ type of formative assessment technique is as if learning by self-assessment by students. [Patil P A Natl J Integr Res Med, 2020; 11(3):49-53]</p> Dr. Prashant J Patil, Dr. Girish V Thakare, Dr. Amita R Ranade, Dr. Alka T Rawekar Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 Respiratory Health Status Of Traffic Police Personnels In Ahmedabad, Gujarat <p>Background: To evaluate an association between vehicle exhaust and its effect on pulmonary functions of traffic police personnel and to assess the extent of impairment in the lung function of traffic police personnel compared to unexposed healthy control group. Material And Methods: In this comparative, observational study pulmonary function parameters were recorded in age- and BMI – matched 60 traffic police personnel (active in the field as study group) and 30 traffic police personnel (performing back office work as control group) of both genders. PFT parameters were compared between the study group and control group by using electronic (computerized) spirometer available in Department of Medicine, Smt.NHLMMC &amp; VSGH. Blood oxygen saturation levels (SpO2) and Perfusion Index (PI) were recorded using Dr.Trust Professional series Fingertip Pulse Oximeter. Result: No difference was found in case of Systolic Blood Pressure, Blood oxygen saturation levels (SpO2) and Perfusion Index (PI) in both groups. Diastolic Blood Pressure was significantly (P&lt;0.05) higher in study group (75.4 ± 8.03) in compare to control group (72.13 ± 6.02). There was a significant decrease in FVC (P&lt;0.0001), FEV1 (P&lt;0.00001), FEF25-75% (P&lt;0.0001), PEF (P&lt;0.001), FEF0.2-1.2 (P&lt;0.001), FEF25% (P&lt;0.001), FEF50% (P&lt;0.0001) and Inspiratory capacity (P&lt;0.05) in study group compared to the control group. Conclusion: These changes suggest obstruction and narrowing of the airways in study group traffic police personnel compared to the control group. It may be due to exposure to vehicle emission for several hours in a day, which decreases their lung capacity. Abbreviations: BMI: Body Mass Index (Kg/m2), PFT: Pulmonary function test, FVC: Forced Vital Capacity, FEV1: Forced Expiratory Volume in first second, FEF25-75%: Forced Expiratory Flow at 25-75% of FVC in litres per second, PEF: Peak Expiratory Flow in litres per second, FEF0.2-1.2: Forced Expiratory Flow between 200 and 1200 ml of FVC, FEF25%: Forced Expiratory Flow at 25% of FVC in litres per second, FEF50%; Forced Expiratory Flow at 50% of FVC in litres per second, FEF75%: Forced Expiratory Flow at 75% of FVC in litres per second.[Shukla P Natl J Integr Res Med, 2020; 11(3):54-57]</p> Pranav Shukla, Dr. Hina Mod, Dr. Anita Verma Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 Perceptions Related To Tobacco Cessation Among Health Professionals, Policy Makers And Patients In Ahmedabad, Gujarat <p>Background: Tobacco usage is a global concern and it is essential to curb its usage and increase awareness among patients. Health professionals’ contribution in tobacco cessation will definitely make a stark difference. Aims: To assess the perception of tobacco cessation activities among health professionals, policy makers and patients. Material And Methods: A mixed method study was conducted. A total of 250 patients from Gujarat Cancer and Research Institute, Ahmedabad were interviewed using structured questionnaire. The questionnaire comprised of demographic characteristics, tobacco usage and patient’s response about tobacco cessation activities. An in-depth interview for the health professionals and policy maker was carried out. Result: Out of 250 participants, 50.4% of them were found to be belonging to the age group of 25-44 years and 94.4% of them being males. Majority of the patients used gutka (34.8%), pan masala (34%), bidis (14%) and cigarettes (9.2%).Patients had positive attitude towards tobacco cessation activities. Policy makers perceive lack of follow up leading to non compliance of the treatment as one of the barrier in successful implementation of tobacco control policy and program. Inadequate time, lack of training on tobacco cessation activities in the curriculum, non compliance to follow up by the patients, lack of support and motivation from their own family members and fear of losing the patient due to counselling were the important barriers faced by health professionals. Conclusion: Based on the findings above, it is seen that patients are comfortable with receiving advice about quitting tobacco use, from the health professionals. There is also evidence that health professionals can successfully assist individuals to quit tobacco use. Likewise, integrating the tobacco control program into broader national health plans will be done. [Joseph S Natl J Integr Res Med, 2020; 11(3):58-64]</p> Sandra Ernest Joseph, Navya Vyas, Janmesh Shah, Abraham Johnson Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 Usefulness Of Homoeopathic Medicines In Case Of Gastro-oesophgeal Reflux, Acid Peptic Disorder, Irritable Bowel Syndrome: A Retrospective Study <p>Background: When the cases attending the college OPD were screened for the diagnosis, it was observed that 11% of them were suffering from the gastroentrological problems especially GERD, ACID- PEPTIC DISORDER or IBS. Hence the retrospective study of these cases were undertaken to assess the usefulness of homeopathic medicines in these cases. Material And Methods: Study Population: Subjects attending the OPD of Dr. V.H. Dave Homoeopathic Medical College. Study design: Retrospective randomized study. Sample size: 100 subjects suffering from GERD, APD or IBS were selected randomly from the subjects attending the OPD of Dr. V. H. Dave Homoeopathic College irrespective of age, gender and associated disease. Subjects under allopathic treatment for either of the disease were excluded from the study. The cases were analysed for the diagnosis, age, gender, symptoms of the disease and indications of prescribed medicines as well as subjective improvement status. The improvement was graded as Significant improvement if symptom score reduce by 75-99%, moderate improvement if score reduced by 50-74% and mild improvement if score reduced by 25-49%. Result: The subjective improvement was observed in all the three diseases i.e. 70% of cases improved in GERD, 63% cases improved in APD while 66.6% cases improved in IBS. The males were more affected than the females in case of GERD &amp; APD while females were more affected in cases of IBS. Conclusion: The retrospective study of the cases of gastroenterology concluded that out of 100 cases 40 were suffering from GERD while 30 cases each were suffering from APD and IBS. Ars. Alb. was an indicated medicine in 52.5% cases of GERD. Kali bich. was found to be indicated in 33.3% cases of APD while Arg.nit. &amp; Colocynth was commonly indicated in cases of IBS. Homoeopathic medicines were found to be useful in cases of GERD, APD &amp; IBS subjectively improving the cases. [Dhinge L Natl J Integr Res Med, 2020; 11(3):65-68]</p> Dr. Leena Dighe Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 To Study The Role Of Homoeopathy In Management Of Acute Summer Diarrhoea In Children <p>Background: In summer due to heat there may occur shortage of water so people try to get water from anywhere, even purification system is weak due to water shortage causing chance of water getting infected from various bacilli causing water borne diseases like Diarrhoea, Dysentery, Cholera, Typhoid etc. Some other factors like eating ice-creams, ice-gola, out-side unhygienic food, swimming in unclean swimming pool plays important role in development of acute diarrhoea. This study has been done in order to study role of homoeopathy in reducing duration, intensity and frequency of summer diarrhoea and arriving at a group of remedies indicated in such cases so that morbidity due to summer diarrhoea as well as general condition of the patients can be taken care of effectively ,gently in a cost-effective manner.Material And Methods: This study is a prospective, clinical, interventional study .Sample of 30 cases had been selected by simple randomized method from Bhavnagar district from Swami Vivekananda homoeopathic medical college and hospital as well as my private OPD. Result: In this study age group of 0-3 and 3-6 are found more liable to get summer diarrhoea .As far as sex distribution is concern male: female is almost same. Cold food, cold drink, ice gola, out-side food, drinking impure water and swimming are found as major causative factors . As far as miasms are concern more cases (almost 60%) are found to have psora in background. A group of remedies like Arsenicum album, Bryonia, Podophyllum ,Veratrum alb, Aloe socotrina, Croton tiglium, Camphora are Found to be effective in cases of summer diarrhoea. These remedies have found to improve almost 90% of cases by means of reducing intensity, duration and frequency of cases of acute summer diarrhoea. Conclusion: There is a better scope in Homoeopathic for the treatment of summer diarrhoea, since the treatment is based on holistic and individualistic approach. A homoeopathic remedy not only annihilates the disease but also prevents the complications associated with it. [Oza N Natl J Integr Res Med, 2020; 11(3):69-71]</p> Dr. Nrupa Oza, Dr.Pranav Shah, Dr. Girish Patel Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 Understanding The Role Of Miasms In Recovery Through The Study Of Three Cases Of Chronic Renal Failure: A Retrospective Purposive Case Study <p>Background: The chronic Renal Failure is the disease which requires constant monitoring of patient with conservative treatment ultimately leading to either renal transplantation or death of the patient. Its causes include from uncontrolled hypertension to diabetes mellitus, iatrogenic and hereditary. Homoeopathy treats patient as a whole and deals with the cause of the disease rather than giving symptomatic treatment of the disease, basically considering the miasm, diathesis, patho-physiology of the disease and susceptibility of the patient. This study of the three cases, shows that if we consider all the factors mentioned above we can give quality life to the patient helping him not only physically but also by reducing his economic burden. Material And Methods: Retrospective purposive study. Case reports of the subjects attending the OPD. The three cases diagnosed to be suffering from chronic renal failure and were not undergoing dialysis with regular follow ups along with repeated investigations were selected for retrospective study at least for a year. The cases were analysed for the expression of miasm, susceptibility and pathology of chronic renal failure in particular case. The conclusions were drawn from the understanding of pathophysiology of medicine, pathology present in the case, susceptibility of the patient and final result the patient had after homoeopathic medicine. Result: In the three cases studied, the miasms that were present were Syphilis, Psora+Syphilis and Sycosis+Syphilis. The case of Syphilis was palliated, the case with Psora+Syphilis could be reverted and one with Sycosis +syphilis could be maintained at the pathology presented at the entry level. Conclusion: This retrospective study reflects that the application of knowledge of Organon to the pathology of the case and prescribing the remedy as per the pathology along with the characteristics symptoms of the case can revert the clinical presentation of the case. [Dave P Natl J Integr Res Med, 2020; 11(3):72-76]</p> Dr. Pankaj C. Dave Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 Understanding COVID-19: An Analogy to SARS and MERS <p>Background: To provide a comprehensive outlook of three deadly corona viruses global epidemics, their similarities and differences which will help provide critical assessment of modifiable risk factors and preventive measures for containing their spread in future as well as utilize the lessons learned from earlier two corona virus epidemics to help control the spread and end the recent epidemic of SARS-CoV-2. Material And Methods: Utilizing comprehensive review from PubMed database and WHO bulletins, we obtained genomics information, clinical signs &amp; symptoms, treatment, diagnosis, transmission, methods of prevention, and risk factors for SARS, MERS and COVID-19. A comparison between viruses was made. Result: Tracing back of the origin of these corona virus epidemics puts China at the epicentre for two of the three outbreaks. Although SARS showed high fatality, COVID-19 has rapidly spread among symptomatic &amp; asymptomatic cases. Inadequate risk assessment, possible data fudging and under reporting of virus considering urgency of situation within China has been a key reason for the spread of the new virus outside mainland to distant countries. None of the virus epidemics have resulted in development of a permanent cure with sporadic outbreaks remains distinct possibility. Conclusion: We conclude that with all available high-end technology and an experience of two prior epidemic of similar viral origin, we still look ill prepared to face challenges posed by epidemics especially the ongoing virus pandemic. Countries should work together in sharing and dispersing of information to limit spread and finally terminate the infection using technologies to best. [Natl J Integr Res Med, 2020; 11(3):77-87]</p> Rahul Saxena, Yogesh Saxena, Vartika Saxena Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 A Case Of Double Outlet Right Ventricle With Extremely Rare Anatomical Features <p>Double outlet right ventricle (DORV) is a rare cardiac malformation especially in adulthood. We report a 27-year-old man with DORV along extremely rare anatomical features. The diagnosis of DORV in this case was made with echocardiography, also the surgical treatment for the case have been discussed. [Patel M Natl J Integr Res Med, 2020; 11(3):88-90]</p> Dr. Monila Patel, Dr. Jyoti Vora, Dr. Sneha Shah, Dr. Sanjay Chaudhary, Dr. Rafe M. Khan, Dr. Shreyans D. Singhvi, Preksha T. Singh Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 Unilateral Giant Spermatocele Mimicking Accessory Testis: A Case Report <p>Spermatoceles are usually asymptomatic and are caused due to an acquired or congenital partial obstruction of spermatic ducts. However, an occasional spermatocele may become large enough to bother the patient and surgical intervention should then be considered. We present a case of an unilateral spermatocele mimicking accessory testis in an adult. [Gupta S Natl J Integr Res Med, 2020; 11(3):91-93]</p> Shweta Gupta, Brajesh Gupta, Ghanshyam Hatwar, Prasad Bansod, Ayush Diyewar Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000 Granular Cell Tumor- Anonymity In Rarity <p>Although an uncommon entity, granular cell tumours have been described in the skin, breast and tongue. The distal oesophagus is the commonest site of involvement by this tumour in the gastrointestinal tract. We report a case of an elderly female presenting with dysphagia who was found to have an esophageal lesion which on histopathology revealed a typical granular cell tumour. [S S Natl J Integr Res Med, 2020; 11(3):94-95]</p> Dr. Shefali S, Dr. Samriti G, Dr. Rattan N Copyright (c) Wed, 01 Jul 2020 00:00:00 +0000