Protective Role of Moolabandha While Practicing Bhastrika and Kapalabhati by Women Vulnerable to Bladder Dysfunction: A Preliminary Ultrasound Study.

AIM: Obstetrical trauma and chronic exposure to increased intraabdominal pressure (IIAP) are known to increase vulnerability toward stress urinary incontinence. Bhastrika and Kapalabhati being fast yogic breathing maneuvers (FYBM), their association with IIAP is likely. Therefore, a preliminary descriptive study was conducted using transabominal ultrasound mode, to find whether impact of FYBM reinforced by prevailing risk factors had any adverse effect on the bladder neck status and urethral mobility of female yogic practioners and whether simultaneous application of Moolabandha inhibited such impact. MATERIAL: Mindray DC N3 model of diagnostic ultrasound unit with M probe was used for assessment. METHODS: This study included 15 heterogenous female yoga teachers having average age, years of practice, and body mass index as 42.7 years, 7.33 years, and 24.86 kg/m2, respectively. Retrovesical angle (RVA) and posterior displacement (PD) and inferior displacement (ID) of urthetrhra were assessed while performing Bhastrika and Kapalabhati maneuvers with and without applying Moolabandha. Data obtained were then used for descriptive analysis. RESULTS: Analysis showed a mixed picture, i.e., negative impact as well as preservation of protective strain-levator reflex in certain variables while practicing FYBM. Complicated labor and practice of power yoga appeared to reinforce the impact of FYBM. The values of RVA as well as PD and ID dropped and were statistically significant when FYBM was performed with Moolabandha. Aging factor, uneventful vaginal labor, or obesity could not confirm as prevailing risk factors. CONCLUSION: Moolbandha proved its protective behavior while practicing Bhastrika and Kapalabhati by vulnerable women.

Evidence-based practice in Physiotherapy curricula: A survey of Indian Health Science Universities.

INTRODUCTION: Evidence-based practice (EBP) is the conscientious, explicit and judicious use of the current evidence in clinical decision making. The physiotherapy profession has expressed a commitment to the development and use of evidence. However, very little is known about the extent to which EBP is integrated in physiotherapy curricula in India. The purpose of this study was to describe integration of EBP in Indian physiotherapy programs. METHODS: An observational study was conducted where a review of curricula of all Health Science Universities (HSU) in India, offering an undergraduate (UG) and post-graduate (PG) degree program in physical therapy was conducted using a data abstraction sheet. It gathered data on inclusion of research components of EBP in the curricula, content and hours of teaching EBP, and assessment methods. Data were analyzed descriptively. RESULTS: Curricula of fifteen HSU offering physiotherapy programs were reviewed. Contents relevant to EBP were incorporated from the 2nd yr to final year. Common courses included research methodology (84.61%), research project (69.23%) and clinical management subjects (57.14%). No guidelines were given about adopting EBP in clinical practice. Didactic lectures were the mode of teaching (81.81%). Preferred method for assessing research projects was viva (44.44%). Ccritical appraisal was least included in the entry level education. Contents relevant to all the five steps of EBP were included in PG curricula. CONCLUSIONS: Though physiotherapy programs are introducing EBP teaching at the entry level, it lacks structured systematic approach and is fragmented. There is inadequate emphasis on clinical oriented teaching of EBP and assessment methods. Moreover, there is adequate coverage of EBP content in PG curricula.

Cultural adaptation, reliability, and validity of neck disability index in Indian rural population: a Marathi version study.

STUDY DESIGN: A cross-sectional study to develop a cultural adaptation of the Marathi-neck disability index (NDI) and to investigate its validity and reliability. OBJECTIVE: To conduct a study concerning the cultural adaptation of the NDI and investigate the validity and reliability of its Marathi version in patients with neck pain. SUMMARY OF BACKGROUND DATA: The NDI is a reliable instrument for evaluating self-rated disability due to neck pain, but there is no published Marathi version and also it has not been tested on a rural population yet. Successful linguistic and cultural translation may allow appropriate cross-cultural comparison for clinical and laboratory research analysis, even in the rural parts of the Maharashtra state of India, where English is not the language of communication. METHODS: Eighty-one patients having neck pain for at least 3 months were included in the study. The NDI and visual analogue scale for pain were completed by all subjects. Test-retest reliability was determined by using intraclass correlation coefficient and Pearson correlation analysis. For the determination of construct validity, the relation between the NDI and visual analogue scale was examined by Pearson correlation analysis. RESULTS: Intraclass correlation coefficient score for test-retest reliability was 0.95 and the Cronbach α was 0.97. For construct-related validity the correlation of the NDI-Marathi version was found to be 0.95 (P < 0.0001). These results showed that the construct validity of the Marathi version of the NDI was excellent. CONCLUSION: The results suggest that the Marathi version of the NDI that is validated in this study is an easy to comprehend, reliable, and valid instrument for the measurement for the limitation of activities of daily living and pain caused by neck disorders in the Marathi-speaking population.

Work related stress and its anticipated solutions among post-graduate medical resident doctors: a cross-sectional survey conducted at a tertiary municipal hospital in Mumbai, India.

CONTEXT: It is now known that resident doctors registered for postgraduate studies are prone to work related stress and eventual burnout. Though stress can happen in any profession, reduced performance of resident doctors due to vocational stress could cause an increase in medical errors and thus affect the quality of life of the patients. Resident doctors at a Municipal hospital in India form a unique population as number of stresses they undergo are many and varied. AIMS: To study the prevalence of work-related stress and its anticipated solutions among the resident doctors registered for postgraduate studies in clinical subjects at a tertiary Municipal hospital. SETTINGS AND DESIGN: A stratified sampling cross-sectional survey was conducted at the Inpatient, Outpatient, and Intensive Care Units at a tertiary Municipal hospital in Mumbai, India. MATERIAL AND METHODS: Data collection was done using a validated 20-point questionnaire to assess the factors causing stress and their anticipated solutions. STATISTICAL ANALYSIS: Simple percentage analysis of stress questionnaire. RESULTS: 71 resident doctors completed the survey. The major stressors in this cohort were inadequate hostel/quarter facilities (92.1%), and the need to perform extra duties (80.0%). Also, non-conducive environment for clinical training and studies (81.7%), inadequate study (78.9%) and break (81.2%), threat from deadly infections (74.6%), and overburdening with work (69.0%) were the other major stress causing factors. The perceived stress busters were good music (40.8%) and family and friends (40.8%). Eighty-seven percent of the respondents perceived regular physical exercise to be an effective mode of stress management and 83.8% expressed their need to have a simple therapeutic gymnasium established within the campus with a qualified trainer. CONCLUSIONS: There is a high level of work related stress among the resident doctors registered for postgraduate clinical studies at a tertiary Municipal hospital in Mumbai. One of the perceived stress busters is regular physical exercise that is structured and under supervision.