International Archives of Integrated Medicine

6-14

Authors: Jyoti Srivastava, Anuradha

Introduction: Violence against women is the highest in Australia, Canada, Israel and South Africa and women make up 40 to 70% of homicide victims. Forced marriage is still practiced in the parts of South Asia, East Asia and Africa and among immigrants to the West from these regions. The objectives of the study were to explore and compare the violence in the married women living in urban and rural areas. Material and methods: The study adopted a comparative research approach. The study was conducted on married women of age group between 16-40 years. The population comprised of 60 married women (30 subjects each from urban and rural areas respectively) was drawn by convenient sampling technique. Data was collected through interview, by using socio demographic proforma and structured intimate partner violence questionnaire. Data was analyzed by using descriptive and inferential statistics. Results: The overall prevalence of violence among women was high. There was no significant difference between rural and urban area with respect to psychological and physical violence. The findings showed that majority of violence in urban area women were more than the rural area women. Conclusion: Women are more frequent victims of violence. Violence is a universal phenomenon, so effective actions should be taken to stop intimate partner violence at no time.

22-29

Authors: Tushar M Shah, Keeranmayee Mishra, Pallavi Ninama, Chirag Parikh

Background: Total 0.2% to 4% of all pregnancies are complicated by cardiac diseases. In non western countries, rheumatic heart diseases (RHD) constitute 56-89% of the cases and congenital heart diseases only 9-19%. Aim and objectives: To review all obstetric patients with co-existing cardiac diseases admitted to a tertiary care center over a period of one year and ascertain the causes of admissions and the maternal and perinatal morbidity and mortality. Material and methods: A retrospective, analytical study of all patients with cardiac diseases who delivered over a period of January 2013 to December 2013 was conducted. A tabulated representation of the data was done. The various cardiac diseases were categorized according to their severity, NYHA category, type of pathology, the maternal and perinatal outcome was assessed and maternal mortality and perinatal mortality was recorded. Conclusion: Total 69% cardiac lesions in pregnancy were rheumatic in origin and 15% belonged to high risk category while 13.1% were NYHA type IV. Total 69% deliveries were by vaginal route. Epidural analgesia preferred in LSCS of cardiac patients. Perinatal and maternal complications were observed to increase with increase in NYHA class.

36-43

Authors: Hitesh Khandra, Nilesh Patel, Hiren Parmar, Rajan Patel

Background: Incisional hernia is protrusion of part or whole of abdominal viscus through the weakness in layers of anterior wall in the scar of previous operation. The major predisposing factors being post operative wound infection or hematoma. This incidence increases in the presence of adverse factors (local and systemic) such as wound infection, obesity, hypoproteinemia. In all suture repair techniques the tissues are under tension and this increase the risk of ischemia, suture cut out and repair failure. The studies showed that the complication seen in open incisional hernia repair is seroma, hematoma, wound infection, stitch sinus, and recurrence. To overcome this complications and recurrent rates of open incisional hernia repair the Laparoscopic repair of incisional hernia was introduced in the 1990s, which reports (Olmi study) have showed more improvement in recovery time, hospital stay and complication rate. Objective: The purpose of this study was to compare the difference of incidence of post-operative complications, operative time, length of hospital stay, duration of return to work and recurrence of patients undergoing laparoscopic or open repair of their ventral/incisional hernia a meta-analytic technique for observational studies. Material and methods: The present study was a prospective study which had been carried out, during the period of July 2010 to September 2012 at a tertiary care centre. A total number of 50 cases were studied and were followed up for a period of 6 months. All patients were operated on by the same surgical team, adapting the type of surgical technique depending on the type of hernia. In the selection process of the technique patients were randomly allowed to opt for any of the two modalities after analyzing the biological status of the patient but also the associated his/her comorbidities. Patient selection criteria were as below. Inclusion criteria: Wall defect: >3 cm to <8 cm, Post-surgical and gynecological procedure, BMI < 30 kg/m2, Patient willing for surgery. Exclusion criteria: Complicated hernia, BMI >30 kg/m2, Conversion of laparoscopic repair to open repair. Results: Incidence of incisional hernia was maximum in the age group of 31-50 years (66%) with female preponderance (74%). 25 patients had risk factors like chronic cough (5), hypertension (13), diabetes mellitus (5) and difficulty in micturition (2). 27 had previous emergency surgery while 23 had undergone planned surgery. 60% of patients had undergone gynecological procedures, among which LSCS was the most common operation followed by hysterectomy. 60% of patients had wound complications in previous surgical procedure. Mean operative time for laparoscopic incisional hernia repair was 2 hour 45 minutes and for open hernia it was 2 hour 05 minutes. 46% of patients had duration of return to work (6-10 days) in laparoscopic surgery, 40% of patients had duration of return to work (11-15 days) in open surgery (mean 16), 4% in laparoscopic surgery (mean 10.24 days), 10% of patients had duration of Return to work (16-20 days) in open surgery. Conclusion: An optimal technique for mesh placement has not yet been determined and is still a subject of debate among surgeons. Laparoscopic techniques seem to have many benefits, including decreased length of hospital stay, decreased postoperative pain, and reduce the time to return to work and normal activities, but require long learning curve and are still not very accessible to all surgeons, especially in our country.

50-61

Authors: K. Immaculate jeyasanta, Aswathi E.M., Saritha K., Jamila Patterson

Histamine is a biogenic amine, which is developed in protein rich food as a result of histidine decomposition and this decomposition is caused by growth of certain types of bacteria. The biogenic amine of histamine content is an essential quality parameter in sea food quality and strict upper limits on acceptable levels have been introduced in US and EU markets. The present work addressed histamine content of the local consumers demanded fishes from local fish market, street vendors and from the fish landing centers. The results showed higher histamine development was observed in sea foods from street vendors followed in the fishes in the local fish market. Slow histamine development observed in sea foods from the landing centers. The results revealed that, histamine development in sea foods depends upon the quality of the sea food and fishes exposed longer time to the environment is possible for the development of biogenic amines.

71-75

Authors: Khandra Hitesh P, Vyas Pratik H, Patel Nilesh J, Mathew Jovin G

Despite the advances made in asepsis, antimicrobial drugs, sterilization and operative technique, post-operative wound problems continue to be a major threat. Clean sound healing of laparotomy wound after any intra-abdominal procedure is a cardinal index of good surgical repair. Post-operative wound problems delays recovery and often increases stay and may produce lasting sequel and require extra resources for investigations, management and nursing care, therefore its prevention is relevant to quality patient care. Post-operative wound problems seldom causes death, yet it does prove to be an economic burden on patient and on health system and induce psychological trauma to the surgeon as it robs his hours of dedicated work on operating table and good carrier. Considering wound problems is quite common in developing countries like India the present study was taken up to find out the incidence of post-operative wound problems and factors that influence its occurrence. Present study aimed to discover the sound, ideal method for the abdominal wound closure with regard to the problems associated with laparotomy wound.

83-94

Authors: Amita Jindal, Rupinder Kaur, Mahesh Jindal

Introduction: The incidence of diabetes in urban Punjab is on the rise and the number of diabetics is increasing year by year. Material and methods: This 24 week study was designed to compare vildagliptin versus pioglitazone as an add-on therapy in patients of type 2 diabetes mellitus inadequately controlled with metformin alone in Punjabi population. Sixty patients were randomized in two groups to receive either vildagliptin 100 mg (group 1) or pioglitazone 30 mg (group 2) in addition to metformin 1000 mg. The primary efficacy end point was change in FBG, PPG and HbA1c. Secondary end point included lipid profile, body weight and peripheral edema. Results: There was no significant difference between mean reduction in FBG, PPG and HbA1c in both groups. There was significant decrease in mean body weight in group 1 in contrast to significant increase in group 2. Both the treatment groups reported a significant decrease in TG, TC, LDL and increase in HDL. Conclusion: Vildagliptin displays robust efficacy with the added benefits of a much lower risk of peripheral edema, hypoglycemia and no weight gain, making it a promising alternative to pioglitazone as an add-on therapy to metformin in Punjabi population.

100-102

Authors: A.J. Thanenthiran, K.B. Galketiya, MVG Pinto

Bile leak is a known complication following hepatico-jejunostomy performed for bile duct injury. We presented a case history where a leak was successfully managed with an open abdomen which allowed sepsis to settle and facilitate natural healing.

108-111

Authors: Aesha A. Patel, Tushar M. Shah

HELLP syndrome is a serious complication in pregnancy characterized by hemolysis, elevated liver enzymes and low platelet count. This case demonstrated the importance of rapid and early diagnosis and treatment of HELLP syndrome to reduce maternal and perinatal mortality and morbidity. 26 years old, 2nd gravida with 31 weeks of gestation with severe pre-eclampsia was admitted to Department of Obstetrics and Gynecology at Civil Hospital, Ahmedabad. Patient suddenly developed epigastric pain, blood tinge urine (not frank hematuria) and decrease urine output within 24 hours of admission. Investigations revealed platelet count 44,300, serum bilirubin 12, direct bilirubin 3.44, and indirect bilirubin 8.56, SGPT 193.5 and was diagnosed as a HELLP syndrome class 1. She underwent cesarean section and there was dramatic improvement of her symptoms and all blood investigations (S. bilirubin, Platelet count) were declined to normal limit within 48 hours post operatively. HELLP syndrome, a variant of severe pre-eclampsia, if diagnosed and manage timely ensure favorable maternal and perinatal outcome.

116-120

Authors: Shivangi Patel, Gunvanti Rathod, Purva Shinde, RK Tandan

Adenocarcinoma of urinary bladder is rather rare and so that here we present the case of a 55 years old male patient who presented with hematuria and diagnosed as adenocarcinoma of the urinary bladder. Because of no specific characteristics for symptoms, signs and accessory examinations compared with common urothelial carcinoma, adenocarcinoma of urinary bladder was diagnosed mainly on histopathology and with the help of Immunohistochemistry (IHC). For recurrent tumor after transurethral resection of bladder tissue (TUR-BT), the patient should undergo total cystectomy or radical surgery.

125-130

Authors: Aakriti Jaswal, Jatinder Pal Singh

Viruses are important to the study of molecular and cellular biology as they provide simple systems that can be used to manipulate and investigate the functions of cells. The study and use of viruses have provided valuable information about aspects of cell biology. For example, viruses have been useful in the study of genetics and helped our understanding of the basic mechanisms of molecular genetics, such as DNA replication, transcription, RNA processing, translation, protein transport, and immunology. This Review focused on the neurological complications of the human herpes viruses (HHVs), and discusses optimal virological tests to identify the etiological agent, along with state-of-the-art treatments for these disorders.

137-140

Authors: Manu Batra, Aasim Farooq Shah, Subha Soumya Dany, Prashant Rajput, Jasbir Mehar

In this century, dental colleges will be gauged by their capacity to anticipate the kind of doctors required by evolving health systems. They will need to consider the challenges these systems face as they grapple with critical health concerns in society. The roots of ill health lie in poverty, discrimination, lack of education, misdistribution and misuse of often scarce resources; and in any given country, those who identify health issues, act on health determinants, decide on the use of resources, deliver health services, or train health manpower are usually different groups that may not share the same value system and priorities. Thus, fragmentation is a serious threat to the efficiency and effectiveness of health systems everywhere. Meeting requirements of social accountability is a real challenge for dental colleges as it is for the dental health professions, health service organizations, health insurance schemes, and health policy leaders. So this article tries to evaluate the need for social accountability in the dental education system.