Generalized anxiety disorder (GAD) is one of the most common anxiety disorders characterized by persistent worrying, anxiety symptoms, and tension. It is most frequent anxiety disorder in primary care and associated with a significant economic burden owing to decreased work productivity and increased use of health-care services. GAD is a highly disabling illness, often complicated by multiple comorbidities, most commonly depression and other anxiety disorders. Being an alarming disease, it requires effective management. Ayurveda, with its holistic approach, can be helpful in such situation. In this direction, to assess the actual efficacy of different Ayurveda treatment modalities; few works have been carried out at Institute for Postgraduate Teaching and Research in Ayurveda (IPGT and RA), Gujarat Ayurved University, Jamnagar. In the current attempt, it has been planned to review all such works done on GAD. Totally, six studies on GAD were done during 2001–2017 that were compiled and screened. Various ayurvedic treatment modalities such as Nasya Karma, Shirodhara, Medhya Rasayana, yogic practice are found to be significantly effective in GAD.

Background: In the present study, attempt has been made to study the determinants of total fertility rate (TFR), by developing the model for TFR so to use TFR determinants for Family Welfare Planning and Programme implementation. Methodology: Principal component analysis was carried out to study the correlates of TFR of Indian states. Further, regression analysis was carried out to estimate TFR, using relevant determinants by studying its correlates and principal components. Results: Two principal components were: (i) “Social Status of Women” explaining 58% of variation comprised “infant mortality rate” with correlation coefficient (−0.95), “Percentage of Literacy of Female” (0.94), “Life Expectancy at Birth” (0.93), “Age at Marriage of Women” (−0.90), and (ii) “Fertility Index” with 20% of variation explained, comprised “Employment Status of Female” (0.762) and “Desire of no more child after Two Living Children” (−0.759). The regression model for TFR with the coefficient of determination (0.466), using desire of no more child after Two Living Children was arrived, with utility to enhance health education and communication to achieve ideal family formation behavior. All Indian states were classified by the regression model (TFR = 3.58–0.019* “Desire of no more child after Two Living Children”) within 68% confidence interval except two states Mizoram and Meghalaya. Conclusions: 'Desire of no more children after two living Children's' has come out the main stay of family formation behavior. Hence, making realize the value of small family size with health education will stabilize the population.

Introduction: Integrated child development service (ICDS) program was launched on October 02, 1975 and is the world's largest and unique program for early childhood care and development. It is working in urban and rural areas through Anganwadi centers. The beneficiaries that come under ICDS are 0–6 year's children, pregnant and lactating women, and adolescent girls. There are six core services provided by ICDS through Anganwadis. It is very essential to assess the knowledge of Anganwadi workers (AWWs) about different components of ICDS. Objective: The objective of the study was to assess the knowledge status of AWW regarding different ICDS components and to compare the knowledge of AWW working in rural and urban areas. Materials and Methods: A cross-sectional study was conducted from February to December 2016 among AWWs of urban and rural health centers under KLE University, Jawaharlal Nehru Medical College. Data collection was done with the help of prestructured questionnaire through interview method. Results: Out of 218 AWW, 33.9% were from urban areas and 66.1% were from rural areas. Maximum number (47.2%) of AWWs were found to be in the age group of 39–47 years. Majority of the AWW (52.3%) had working experience of 16–23 years. Our study found that 68.3% of AWW had moderate knowledge score about components of ICDS, 18.3% had low, and 13.3% had high knowledge score. Knowledge related to supplementary nutrition was found to be good in urban AWWs and knowledge of growth monitoring was found to be good in rural AWWs. Conclusion: Maximum number of AWWs had average knowledge score regarding ICDS components. It is important to organize frequent refreshers training course to enable them to give best of services.

Background: Androgenetic alopecia (AGA) and benign prostatic hyperplasia (BPH) are both androgen-dependent disorders in which the enzyme 5-alpha reductase plays a key role in conversion of testosterone to dihydrotestosterone. The purpose of this study is to analyze the association between AGA and BPH. Materials and Methods: Male patients between the age group of 25–45 years attending dermatology outpatient department at a tertiary care hospital with AGA during the period January 2015–December 2015 were included in the study. Ethical clearance was obtained from the Institutional Ethics Committee of Human Subjects Research. A short questionnaire recording their particulars and a detailed dermatological evaluation of the patient was done. All patients in the study were graded using Modified Hamilton-Norwood Classification, underwent transabdominal ultrasonogram and serum prostate-specific antigen (PSA) level estimation. Data were analyzed by ANOVA and Spearman's rank correlation. Results: Sixty-four patients were enrolled in the study. Nearly 39.1% of patients had Grade III AGA, 32.8% had Grade IV AGA, 25% had Grade V AGA, and 3.1% had Grade VI AGA. The minimum PSA level was 0.1 ng/ml and maximum was 4.8 ng/ml. The minimum prostate volume was 8.08 ml and maximum was 32.2 ml. Conclusion: Even though an increase in the prostate volume in AGA patients was noted, this study showed no association between AGA, prostate volume, and serum PSA levels.

Introduction: Menstruation is a phenomenon unique to females. In India, limited access to products of sanitary hygiene and lack of safe sanitary facilities could increase the likelihood of resorting to unhygienic practices to manage menstruation. Materials and Methods: A cross-sectional study was conducted from April 2013 to April 2014 by interviewing 452 adolescent school girls using a semi-structured, pretested questionnaire. There were 6 schools and 1 PUC college in the study area. Data were analyzed using Epi Info 3.5.3. Objectives: The objectives of this study were (1) to study the knowledge and attitude toward menstruation among adolescent school girls, (2) to study the practices of menstrual hygiene among adolescent school girls, (3) to enumerate the common menstrual morbidities among girls, and (4) to elicit their health-seeking behavior regarding menstrual health. Results: The mean age and standard deviation of girls included in the study were 13.05 years and 0.09472. Only 37.39% girls knew that infection would occur if they do not clean their vagina regularly during menstruation. Only 34.1% girls had the right perception about menstruation as a normal physiological process. Majority of girls used sanitary pads during menstruation. 35.32% of girls said that they were scared when they first attained menarche. Only 11.08% girls said that they had no restrictions during menstruation. Conclusion: The school girls had less than satisfactory knowledge, but good practices regarding menstrual health among those who had attained menarche. Religion, mother's education, and socioeconomic status were factors determining knowledge, attitude, and practices of menstrual health among adolescent school girls.

Introduction: Administration of local anesthetic into the wound before incision has been found to reduce postoperative pain following laparoscopic surgery. Levobupivacaine and ropivacaine which are less cardiotoxic and neurotoxic than bupivacaine are being used for local infiltration. Objective: To compare the efficacy of preincisional port site infiltration of 0.5% levobupivacaine versus 0.5% ropivacaine for postoperative pain relief in patients undergoing laparoscopic appendicectomy. Methodology: By computer-generated randomization table, sixty adult patients undergoing elective laparoscopic appendicectomy under general anesthesia were divided into two groups. Group 1 patients received 14 mL of 0.5% levobupivacaine preincisional port site infiltration and Group 2 patients received 14 mL of 0.5% ropivacaine preincisional port site infiltration, 6 mL at the umbilical port, and 4 mL at each working port. In the postoperative period, anesthesia resident blinded to the drug used assessed for postoperative pain at 0, 1, 2, 3, 4, 5, 6, 10, 14, 18, and 24 h using visual analog scale (VAS) pain scale. If VAS >3 rescue analgesia in the form of injection tramadol 2 mg/kg intravenous (IV) was given. Time of first rescue analgesia as well as total opioid consumption at the end of 24 h was noted. Results: The mean VAS scores were comparable in both the groups at different time intervals postoperatively (P > 0.05). The total amount of rescue analgesic consumed over 24 h in the form of injection. Tramadol IV was 126 ± 14.76 in Group 1 and 122 ± 12.77 in Group 2 and was comparable (P = 0.641). Conclusion: Preincisional port site infiltration with both 0.5% levobupivacaine and 0.5% ropivacaine is equally effective in providing pain relief.

Background: The destruction of periodontal tissue caused by periodontitis affects the sensory function of the periodontal ligament, reduces the mechanical support of teeth, and ultimately results in reduced masticatory performance in natural dentitions. Research on those who have lost a large number of teeth and the effect of periodontal status on masticatory ability remains unknown. Objective: The aim of the study was to assess the correlation between the effect of periodontal status and occlusal support on masticatory performance among various age groups. Materials and Methods: A total of 240 patients included in the study were divided into three groups according to the severity of periodontal disease and occlusal support as healthy controls– A1 (Group 1), moderate periodontitis– B1 (Group 2), and severe periodontitis– C1 (Group 3) based on Community Periodontal Index (WHO 1987) and Eichner's Index (Eichner 1990). They were further categorized into age groups of 20–30, 30–40, 40–50, and 50–60 years, and equal male to female ratio was maintained among all groups. The masticatory performance was assessed by making patients chew a test gummy jelly freely 30 times and expectorate it into a clean cup. To eliminate the remaining glucose sticking to the surface, it was subjected to running water for 5 min and spun in a magnetic stirrer (10 min, 400 rpm) till it completely dissolved. A small amount of the supernatant was collected, and glucose estimation was done using a glucometer. The glucometer values were subjected to statistical analysis. Results: There was a statistically significant decrease in the masticatory performance when Group 3 was compared to Group 2 and Group 1. In addition, there was a decrease in the masticatory performance among females compared to males and a progressive decline in the masticatory performance with advancing age. Conclusion: All groups showed a statistically significant decrease in the masticatory performance with increase in the severity of periodontal disease and decrease in occlusal support. In addition, there was a decrease in the masticatory performance with an increase in age and males showed a superior masticatory performance than females.

Context: Phytochemical investigations of hydroalcoholic extracts of Vitex trifolia Linn and Solanum nigrum Linn suggest the presence of flavonoids, terpenoids, and steroids and have been traditionally claimed to be useful in the treatment of inflammation, fever, edema, and tuberculosis. Aim: In the present study, hydroalcoholic extract of the plants was evaluated for its free radical scavenging capacity against hydroxyl, hydrogen peroxide, and nitric oxide radicals, and it's in vitro anti-inflammatory potential. Materials and Methods: Hydroalcoholic extracts of V. trifolia L. and S. nigrum L. were studied at different concentrations for their scavenging ability against free radicals and their ability to protect against hypotonic solution-induced hemolysis on red blood cells and inhibition of protein denaturation. For evaluation, different in vitro assays were used. Results: Results show that the plant extract possesses free radical scavenging capacity, membrane stabilizing capacity, and protein denaturation inhibition capacity which could be correlated to the traditional claim of the plant being used in the treatment of inflammation. Conclusion: The study supports the traditional claim and the prior in vivo studies carried out. It also helps in understanding the possible mode of action for aforesaid activity.

Background and Purpose: Poststroke shoulder pain is one of the most prevalent impairments (34%–86%) and it hinders the performance of daily activities and also interferes with stroke rehabilitation. The purpose of this study was to examine the effect of scapular proprioceptive neuromuscular facilitation (PNF) on shoulder pain, range of motion (ROM), and upper extremity (UE) function in hemiplegic patients. Methods: Thirty hemiplegic patients were recruited and randomly allocated to Group A (n = 15) and Group B (n = 15). Experimental group received conventional treatment plus scapular PNF-hold relax technique while control group received only conventional treatment comprised passive shoulder ROM and stretching exercises and transcutaneous electrical nerve stimulation for 12 sessions (4 sessions/week). The outcome measures used were visual analog scale, shoulder ROM, lateral scapular slide test, and Fugl-Meyer motor assessment. Results: Statistical analysis showed significant change in shoulder pain and UE function in both the groups with no significant differences between the groups; significant improvement in shoulder ROM in both the groups (except internal rotation in controls) and between-group comparison favored the intervention; scapular position improved significantly in experimental group for position A while all postintervention scapular positions in both the groups showed concordance with position of scapula on unaffected side. Conclusion: Scapular PNF has positive impact on poststroke shoulder pain and ROM, helps in strengthening of proximal muscles of UE, thereby correcting scapular alignment and improving the UE function in stroke patients.

Objective: The aim of this study is to identify the risk factors associated with late preterm births (LPBs). Methodology: This case-control study was conducted in the Department of Obstetrics and Gynecology, teaching hospital attached to KLE University's Jawaharlal Nehru Medical College, Belagavi during May 2015–April 2016. A total of 918 women were enrolled into the study, 459 in each group. Women who delivered between 34 and 36 weeks 6 days were considered cases and controls were women who delivered from 37 weeks onward immediately after a case occurred. Gestational age was confirmed with ultrasonography before 20 weeks. Data were collected from the history of the patient and the medical records. Results: Incidence of LPB was found to be 8% among total births. It was found that 55.1% were spontaneous births. The most common risk factor for LPB was hypertensive disorders of pregnancy (gestational hypertension [HTN]–4.8%, chronic HTN–5%, preeclampsia–36%, eclampsia–4.8%) followed by preterm premature rupture of membranes (32.7%), history of prior preterm births (19.2%), gestational diabetes (17.9%), multifetal gestation (16.6%), placenta previa (13.5%), and abruption placenta (9.8%). On analyzing neonatal outcome, sepsis was found in 25%, hyperbilirubinemia in 21.9%, respiratory distress syndrome in 19%, transient tachypnea of newborn in 9%, and patent ductus arteriosus in 2.9% of the neonates. Conclusion: The indication for the induction or need for termination should be reevaluated in the late preterm gestation. To prevent LPB, identification of the risk factors is necessary and timing of delivery in each risk factor should be reassessed in advance before intended intervention. As LPB constitute the majority of preterm births, it is important to limit late preterm deliveries to clear maternal or fetal indication for delivery.

Introduction: Tobacco is a serious threat to health and ranks second as a cause of death globally, and it also ranks fourth in its input to years of life lost. The worldwide tobacco related mortality rate reached up to 4 million per year in 1998 and is expected to become 10 million per year in 2030. This is more than the total deaths from tuberculosis, malaria, maternal, and major childhood conditions combined. Objective: The aim is to assess the level of knowledge regarding hazards of tobacco use among police personnel in Belagavi city. Methodology: This study design was a cross-sectional study conducted in Belagavi city. Data collected from Civil Police Department of all 22 police stations, involving 120 police officers from different ranks from different police stations, the pilot study was done in one police station with 10% of total sample size. The duration of the study was August 2015 to February 2017. The study data were collected through pretested structured questionnaire from February 2016 to January 2017. Before collecting the data, the written informed consent was obtained from the police personnel. Based on the objective, the data were analyzed using descriptive statistics. Results: The 16.7% of police personnel had the average knowledge and 80.8% were had good knowledge about hazards of tobacco use. Conclusion: The majority police personnel had average and good knowledge about hazards of tobacco use.

Background: Sonographic measurement of the median nerve has been proposed as a useful alternative to the electrodiagnostic test in the diagnosis of the carpal tunnel syndrome because of its ability to reveal morphological changes. Objective: The objective of this study was to investigate the influence of occupation, gender, and hand dominance on the median nerve cross-sectional area (MNCSA). Methodology: One hundred and eighty apparently healthy volunteers were recruited for the study. Hand dominance was ascertained in all volunteers. The device used was Voluson P8 ultrasound system with a 12-MHz transducer, using custom preset for musculoskeletal ultrasound. The Anteroposterior (D₁) and transverse (D₂) diameters of the median nerve were taken bilaterally at the level of the pisiform bone at the anterior surface of the wrist joint. Using these values, the MNCSA was calculated using the ellipse Formula. Results: The volunteers were divided into repetitive and nonrepetitive groups. The MNCSA was significantly higher (P < 0.05) in the repetitive work group than in nonrepetitive work groups. Similarly, a significant difference in mean MNCSA was noted between male and female volunteers in both groups. Again, a significant difference in mean MNCSA was observed in dominant and nondominant hands in the repetitive work group (P < 0.05). However, there was no significant difference in mean MNCSA in the nonrepetitive work groups (P < 0.05). Interpretation and Conclusion: A statistically significant difference in MNCSA was detected between repetitive and nonrepetitive work groups, male and female gender as well as in dominant and nondominant hands. Occupation, hand dominance, and gender, therefore, affect the cross-sectional area of the median nerve.

Background: Infertility is a problem of global proportions, the majority being the residents of developing countries. The contribution of female factor is assuming a tremendous proportion. Laparoscopy remains an indispensable tool in the evaluation of the fertility potential of these female partners. Aims: This study was aimed at determining the various causes of female factor infertility among female partners of infertile couple in a tertiary health facility. Methods: A cross-sectional observational study of ninety seven (97) eligible infertile women who underwent diagnostic laparoscopy between 1st January 2012 and 31st December 2015 were enrolled for the study. The data were analyzed using SPSS/PC version 16.0 and p value was preset at <0.05. Results: The patients aged 21-50 years with a mean age of 33.2 ± 6.6 years. Majority (79.4%) were nulliparous. Fifty (51.5%) had primary infertility. Their duration of infertility ranged from 1to 33years (5.7 ± 5.5 years). Most (63.9%) belong to middle social class and their spouse age ranges between 28-60 years (39.0 ± 7.5). More than a quarter had clomiphene resistant Polycystic Ovarian Syndrome, 19 (19.6%) tubal blockage, 13 (13.4%) uterine fibroid and 10 (10.3%) each had endometriosis, peritubal and ovarian adhesions, ovarian cyst and normal findings respectively. There was significant association between patients' age, intra-operative findings and tubal patency evaluation on laparoscopy (P < 0.05). Conclusion: Laparoscopic procedures are less invasive, more convenient and more precise for diagnosis of infertility in women. The common causes responsible for infertility were polycystic ovarian syndrome, tubal occlusion, uterine fibroid, endometriosis, peri-tubovarian adhesions and ovarian cyst.

Background: Oxiconazole nitrate is a new topical broad spectrum antifungal agent used to treat superficial fungal infections. It has a low aqueous solubility due to which different techniques are employed to enhance its bioavailability. Emulgel has emerged as one of the most interesting topical drug delivery system for hydrophobic drugs like Oxiconazole as it has dual release control systems i.e. emulsion and gel. Objective: In the present work an attempt was made to prepare Emulgel of Oxiconazole nitrate for enhancing its topical delivery. Materials and Methods: Emulgel formulations were characterized by various parameters like pH, viscosity, spreadability, extrudability, in vitro drug release. Skin irritation test on wistar rats and in vitro antifungal test on Candida albicans were performed. Results: Optimized formulation F5 showed 92.06% release at the end of 12 hrs. It showed no skin irritation and observed with maximum zone of inhibition when compared with marketed cream of Oxiconazole nitrate. Conclusion: The optimized emulgel formulation F5 showed better antifungal activity in comparison to the marketed formulation.

Introduction: Diabetes is one of the most common noncommunicable diseases in the world. There is an epidemic of diabetes in developing and nondeveloping countries. Treatment patterns play a very important role in the control of blood glucose levels of the patient. Methodology: A total of 520 type 2 diabetes mellitus patients in the area of Urban Health Centre, Ashok Nagar, were interviewed with the help of a predesigned and pretested questionnaire. Data were collected by house-to-house visit. Results: Out of the 520 participants, 264 were male and 256 were female. Oral hypoglycemic agents were the most common modality of treatment used followed by a combination of oral hypoglycemic agents and insulin. About 82 participants were not on any treatment and 18 participants were on insulin exclusively. Conclusion: Oral hypoglycemic agents are the most commonly preferred drugs. Insulin therapy has some conservation among patients. Imparting health education and the importance of adherence to treatment is of utmost importance in diabetes patients.

Background: The right atrioventricular orifice is guarded by a complex called as tricuspid valve complex. The complex consists of atrioventricular orifice, annulus, leaflets, chordae tendineae, and papillary muscles. The right atrioventricular orifice passes the blood to the right ventricle in one-way direction, and this orifice is guarded by valve called as tricuspid valve. Tricuspid valve prevents the back flow of blood into the right atrium. Materials and Methods: This study was done on thirty human cadavers, which included 15 male and 15 female cadavers belonging to age group ranging from 50 to 70 years. Diameter of tricuspid valve was recorded using cardiac sizer and circumference of tricuspid valve was calculated by formula c = πd. Results: The average diameter of tricuspid valve in males was 26.06 ± 2.49 mm and in females was 24.33 ± 1.75 mm. The average circumference of tricuspid valve in males was 80.8 ± 7.72 mm and in females was 75.4 ± 5.45 mm. Conclusion: Clinically, during the replacement surgery of the tricuspid valve, surgeons are in need of actual circumference and diameter of tricuspid valve. Hence, the main objectives of this study are to measure the diameter and circumference of the tricuspid valve which will be helpful for cardiac surgeons, invasive cardiologists, and for preparation of synthetic (prosthetics) valve.

Background: Stability of the ankle joint during functional activities depends on the presence of intact neural input from proprioceptors in the joint capsules, ligaments, muscles, tendons, and skin. Roller skaters are prone for more ankle injuries due to the nature of the sport. Repetitive falls and sprains lead to deficits that account for decreased performance and increased risk of falls. Purpose: The purpose of this study is to determine the effect of strength and proprioceptive training on functional ankle stability among young skaters. Design: This was a single arm pre- and post-experimental study. Settings: The study was conducted at two skating academies of Belagavi, Karnataka, India. Materials and Methods: Forty-five skaters in the age group of 10–18 years were recruited in the study. Intervention: The strength and proprioception training protocol was given for 3 sessions per week for 6 weeks with each session lasting for 45 min. Measurements: The participants were assessed for three-time points that are week 1, week 3, and week 6. The functional ankle stability was measured using Cumberland Ankle Instability Tool (CAIT), strength of the dorsiflexors, plantar flexors, invertors, and evertors were checked using Push-Pull Dynamometer, and balance was assessed using Star Excursion Balance Test (SEBT). Results: The mean age of participants was 12.91 ± 2.26 years with more male participants than females. There was a significant finding in CAIT at all three-time points with maximum changes at the end of week 6. Both sides showed significant changes with more pronounced readings on the left side. There was statistically significant increase in the strength of all four groups of muscles, but the dorsiflexors strength remained more than the other muscle groups with more percentage change on the left side. The subjects significantly improved on SEBT scores in all the components which were statistically significant. Five components of SEBT showed more percentage of change on the left as compared to the right side. Conclusion: The study concluded that the strength and proprioceptive training protocol has shown statistically significant improvement in the functional stability scores, strength, and balance.

Background: The significant problem in the ocular drug delivery is the attainment of optimal drug concentration at the site of action. Development of therapeutic agents that require repeated long-term administration is a driver for the sustained release drug delivery systems, to result in less frequent dosing, and less invasive techniques. Therefore, to overcome the anatomical barriers and ocular bioavailability constrains, a novel drug delivery system in situ gels have been developed. Materials and Methods: The in situ gelling system comprises gellan gum, an anionic polymer responsible for the ionic gelation. Methylcellulose a nonionic polymer contributes for the viscosity and gels at the body temperature. The formulation was characterized for clarity, appearance, pH, gelation time, drug content estimation, rheological evaluation, effect of sterilization on the viscosity, in vitro diffusion study, isotonicity testing, and ocular irritation testing. Results and Discussion: The developed formulations exhibited sustained release of drug over 8 h thereby increasing residence time of the drug. Sterilization caused no effect on viscosity of the formulation. Optimized formulation was selected on the bases of ability to form instant gel and with increased viscosity of gel with a slow and prolonged in vitro drug release pattern. The optimized formulation was found to be nonirritating with no ocular damage or abnormal clinical signs to the cornea, iris, and conjunctiva. Conclusion: Hence, the developed ophthalmic in situ gel by virtue of its prolonged corneal residence time and sustained drug release could be considered a viable alternative to the conventional eye drops in achieving enhanced bioavailability.

Background: As the environment plays an important role in the development, the regional variation of the femur bone is influenced by geographical area, sex, stature, and heredity. In the present study, measurements on the adult human dry femora have been carried out. The knowledge of variations in the parameters of dry femora will help the orthopedicians and also assist prosthetists to design a suitable prosthesis for restoration of normal neck-shaft angle (NSA) and will also help forensic anthropologists to determine the sex. Objectives: The objectives of this present study is to determine the various parameters including femoral length, anterior neck length, and NSA of femur among Indian population and to compare them with the data available in the literature. Materials and Methods: This study was done on 100 adult dry human femora of unknown age and sex (50 right side and 50 left side), collected from the Department of Anatomy and students of J. N. Medical College, Belagavi, Karnataka, India. Results: In the present study, the length of femur ranged from 336 to 485 mm with the mean of 413.15 mm. Length of right femur ranged from 346 to 472 mm with the mean of 409.4 mm and that of left femur ranged from 336 to 485 mm with the mean of 416.9 mm. The anterior neck length of femur ranged from 20 to 40 mm with the mean of 28.8 mm. The anterior neck length of right femur ranged from 20 to 38 mm with a mean of 28.8 mm and that of left femur ranged from 21 to 40 mm with the mean of 28.8 mm. The NSA ranged from 115° to 140° with the mean of 127.21°. In the right femur, it ranged from 115° to 137° with the mean of 126.78°, and in the left femur, it ranged from 119° to 140° with the mean of 127.64°. Conclusions: There was no comparative difference between the values of right and left sides for all parameters. The values observed for all three parameters were greater in the Western world than in the present study, and it was concluded that Western people were taller and heavier than the average Indians, thus showing the regional variation. Clinically, this study plays an important role for orthopedicians and prosthetists to build suitable prostheses for Indians.

Introduction: Cervical spondylosis is one of the most common degenerative, neurological conditions of the cervical spine by which a major part of population is affected. In today's mobile era, for higher achievements and ambitions, man is moving faster to Mars life and is more prone to degenerative disorders. Apart from age, other risk factors for cervical spondylosis include occupations that may cause more stress on neck, certain neck injuries, incorrect posture while sitting or walking, smoking, sedentary lifestyle and genetic factors. Modern therapies such as analgesics, muscle relaxants, steroids, physiotherapies, and even operative procedures are not fulfilling the patients' goal of healthy life. Materials and Methods: In Ayurveda, Degenerative disorders come under the broad umbrella of Vata Vyadhi and Nasya (Nasal Medication) is specifically indicated in Urdhvajatrugata Vikaras. Keeping this view and the increasing incidence of the disease in modern society, a study was conducted on five clinically diagnosed cases of cervical spondylosis, selected from Outpatient / Inpatient departments of Panchakarma Department. The patients were treated with Anu taila Nasya for first 3 days followed by Avartita Kshirabala Taila Nasya for the next 4 days. Results: Satisfactory relief was seen in symptoms with improved quality of life after treatment and follow up. Conclusion: Nasya Karma can be considered as an effective management of cervical spondylosis

Although some pathologies like demyelination have predilection for middle cerebellar peduncles (MCPs), infarction of bilateral MCP simultaneously is an exceedingly rare presentation of stroke. Patient was a 70-year-old smoker and hypertensive male presented with acute onset vertigo, imbalance while walking and slurred speech for 2 days and examination revealed horizontal nystagmus bilaterally, scanning speech with cerebellar signs and Modified Rankin Score (MRS) of 3. Magnetic resonance imaging brain showed symmetrical areas of diffusion restriction in both MCP, and there was occlusion of bilateral vertebral arteries (partial occlusion of right and complete occlusion of left) and basilar artery in computed tomography angiography. Oral antiplatelet with antihypertensive medication was started along with gait training and speech therapy. Patient had gradual and significant recovery and his MRS improved to 2 after 3 months' follow-up. Hypoperfusion along with atherothrombotic occlusion of vessels can be probable explanation to the bilateral infarction in MCPs which forms important watershed zone in posterior circulation of the brain.

Aluminum phosphide (AlP) is a commonly used pesticide (insecticide) in developing countries like India. It is also one of the most common and deadly causes of suicidal poisoning in rural areas, with a lethal dose of 150–500 mg (unexposed tablet) in adults. Death is due to the rapid release of phosphine gas which causes cellular and mitochondrial toxicity leading to cardiovascular collapse and multiorgan failure. Here, we describe a case of AlP poisoning in a young male who developed severe myocarditis and metabolic acidosis after consumption of 3 g of AlP. In spite of a poor predicted outcome, the patient survived due to prompt and aggressive resuscitative measures.

Systemic lupus erythematosus (SLE) is an autoimmune disease with various systemic manifestations. Neurological manifestations include cognitive decline, headache, seizure, stroke, and aseptic meningitis. Cerebral venous sinus thrombosis (CVST) is a very rare manifestation of SLE and occasionally can be the presenting feature of SLE. However, thrombosis of a deep venous system as a presenting feature of SLE is scarcely reported. We report a case of a 42-year-old female who presented with a deep cerebral vein thrombosis and was subsequently diagnosed SLE. The clinician should be aware regarding this uncommon presentation of SLE as CVST. A high index of suspicion is required for early diagnosis as early treatment may prevent a fatal outcome.