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Objectives: To evaluate the AIIMS Modified INCLEN tool for the diagnosis of epilepsy. Methods: This cross-sectional study enrolled 250 children aged 1 month to 18 years presenting with complaints of abnormal body movements to either the pediatric or neurology outpatient departments in our institution between October 1, 2018 and June 30, 2020. The All India Institute of Medical Sciences (AIIMS) modified International Clinical Epidemiology Network (INCLEN) diagnostic tool for epilepsy (AIIMS modified INDT-EPI) was administered and a diagnosis was made, which was further verified by a pediatrician or a neurologist. Specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results: The study tool had a sensitivity of 87.6% and specificity of 84.0%. The PPV and NPV of the study tool were 86.8% and 84.9%, respectively. Conclusion: The study tool has good psychometric properties for physician assessment with regard to diagnosis of epilepsy.
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Among all the psychological disorders, depression is the most common mental disorder nowadays. According to WHO, approximately 280 million people have depression worldwide. In Ayurvedic classics Vishada and Avasada are the two mentioned conditions which have close resemblance with depression. Acharaya Charak quote “Vishado Rogavardhanam” i.e., it is the most foremost factor to worsen the condition of any disease. It comes under one of the eight Vataja nanatmaja vikaras which indicate that it cannot occur without the involvement of Vata dosha. In modern science there are enormous drugs for treatment of mental disorders but with so many adverse effects. The prolong consumption of these medications leads the patient more dreadful condition which became fatal at later stage. Acharya charak has quoted the definition of best treatment in Charak Samhita. He explains that the treatment that cures any diseases without causing any morbid condition or side effect said to be the best treatment. In this case study we try to explain the impact of Satvavjyachikitsha along with Samshaman and other Panchkarma procedures as given in the patient. The result came out as an eye opener about the experience made in this case without any side effects.
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Background: Caesarean sections done at full cervical dilatation with impacted fetal head are technically very difficult and are associated with increased incidence of maternal and fetal morbidities. The objective of this study was to compare the maternal and neonatal morbidities between the Patwardhan technique and the Push method for extraction of the fetus in second stage caesarean section. Methods: This is retrospective analysis of all caesarean sections done in the second stage at tertiary care centre at Dehradun, UK, India from 2014 to Dec 2016. Women with single fetus, with anterior vertex, at term with a deeply impacted fetal head into pelvis, in whom decision of caesarean section was already taken, were included in the study. Results: The patients were divided into two groups, Group 1 (study group) consists of all cases in which extraction of fetus was done by Patwardhan technique and group 2 (control) in whom extraction of fetus was done by push method and extracted as vertex. Complications like extension of the incision, injury to surrounding organs , PPH, need for blood transfusion and neonatal outcome in terms of weight , APGAR and NICU stay were compared in both groups Out of these 120 cases,56 belonged to group A .( Patwardhan) and 64 belonged to group B (push method ). Traumatic PPH and blood transfusions were significantly less in Patwardhan as compared to Push method (3%,16%,p=.0049). There were significantly less uterine incision extension seen in Patwardhan group as compared to Push method (5%, 22%, p=.0031).Baby outcome was almost similar in both the groups. While complications are inherent in both the techniques Patwardhan method has been shown to cover considerable advantage in prevention of maternal morbidities. Conclusions: Patwardhan is a useful manoeuvre in intra operative disengagement of fetal head in second stage CS and it should be learnt and practiced as the primary technique.
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Background: Woman with polycystic ovarian syndrome (PCOS) are at increased risk of developing Metabolic syndrome (MS). MS is a clustering of factors known to increase the risk of diabetes mellitus and cardiovascular disease. Aim of this present study was to determine the prevalence and predictors of MS in PCOS women of Uttarakhand. Methods: This prospective observational study was conducted in department of Obtstetrics & Gynecology, SHRU from May 2016 till May 2017. A total of 200 women, diagnosed with PCOS between the ages of 15-40years were involved (by Rotterdam’s criteria). Clinical and biochemical parameters for MS, were defined by National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Statistical analysis were performed with descriptive analytical methods using SPSS software version 16. Results: The prevalence of MS in PCOS was 22 (44 cases). The rate of central obesity, FBS more than 110mg/dl, triglycerides more than 150mg/dl, high density lipoproteins cholesterol levels (HDL-C) less than 50mg/dl and blood pressure ≥130/85mmHg in PCOS women were 30 (60), 3.5 (7), 34 (68), 70 (140) and 11 (22), respectively. PCOS has evolved as a risk factor for endocrinal and metabolic derangements. Conclusions: Special strategies are required to prevent MS and its associated complications in PCOS women.
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Background: Cervical cancer is a significant health issue worldwide. About 493 million new cases of cervical cancer are diagnosed each year. About 274 thousand women die from this disease annually and 83% of these cases are in developing countries. The aim of this study was to determine the frequency of abnormal cervical cytology among women attending Gynaecology OPD and to assess the presence of associated risk factors. Methods: This hospital-based cross-sectional study was conducted using a questionnaire involving women attending Gynaecology OPD of HIMS, Dehradun from January to December 2016. All pap smears cytological examination was conducted using Bethesda system of classification. Results: 248 (11.6%) women had abnormal cytological findings with a mean age of 36.84 years. Duration of marriage was found be significantly longer among those with abnormal Pap smear (18.34 years verses 15.72 years (p<0.05). Conclusions: Early marriage, increasing parity and longer duration of marriage are strongly associated with abnormal Pap smear results.
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Background: Postpartum anemia effects every fourth women in India. Parenteral iron therapy in comparison to oral is much faster in correction of Hb level, and replenishment of iron stores with much better compliance. The two available preparations of parentral iron that is iron sucrose and ferric carboxymaltose were compared in the present study for safety and efficacy. Methods: This prospective observational study was conducted in the department of obstetrics and gynecology (SRHU Dehradun Uttarakhand) for a period of 18 month. 180 women of iron deficiency anemia were divided into two groups. 100 mg of IV iron sucrose was given in multiple dose of 200mg on alternate day over a period of 10 days to one group. 1000 mg of IV ferric carboxymaltose was given a single dose to the 2nd group of 90 women. side effects and reactions were noted. Results: Hb% and serum ferritin were done after 14 day of last injection the mean rise in HB in both groups were 1.71%( Group I) versus 3.20 % (Group II) serum ferritin levels was found significantly higher (p vol < 0.0001) in group II there were no serious adverse reactions in either group. Conclusions: FCM proved its efficacy better than iron sucrose. short stay at hospitals, large dose were given at over with very few adverse reactions were the main advantage.