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PICTORIAL ESSAY
Dental radiographic signs
Swati Phore, Rahul Singh Panchal, Pallavi Baghla, Nuzhat Nabi
July-December 2015, 8(2):85-90
DOI:10.4103/2349-5006.174234  
Many lesions that occur in the jaw present with a similar radiographical appearance and it is often difficult to differentiate among them. Despite the development of various cross-sectional imaging modalities, the radiograph still remains the first, and the most important investigations. Some diseases have typical radiographical signs and findings that are particular to a specific disease. The aim of this review is to describe collective esoteric knowledge, about various radiographic signs associated with the orofacial region.
  36,901 1,938 -
CASE REPORTS
Ayurvedic management of vicharchika with special reference to eczema: A case report
Mahesh P Savalagimath, Jyoti Rani, Santosh F Patil
January-April 2018, 11(1):92-96
DOI:10.4103/kleuhsj.kleuhsj_81_17  
Vicharchika (Eczema) is a type of kshudrakustha often encountered by Ayurvedic Dermatologists characterized with symptoms, namely, kandu (itching), srava (discharge), Pidaka (vesicles), and Shyava varna (discoloration). Vicharchika is often correlated to eczema based on the clinical presentations. No satisfactory treatment is available in contemporary medical practice except antihistamines and topical steroids. Main line of treatment for vicharchika in Ayurveda is Shodhana and shaman oushadhis. A patient approached to outpatient department with chief complaints of discharge, edema, and erythematous skin lesions with intense itching at the ankles and dorsum of both foot, dorsal aspect of the hands, and on cheeks was treated with Virechana and few Agada preparations. A remarkable improvement in the condition was observed in a span of 2 months.
  31,789 718 -
EXPERT REVIEW
Algorithm of ancient Ayurveda method of semen analysis and integrative approach toward male infertility
Sreenivasa Prasad Buduru, Giridhar Vedantam
January-April 2016, 9(1):5-13
DOI:10.4103/2349-5006.183681  
Ayurveda scientifically described as andrology (Vajikarana) incorporates semen morphology in normal and pathological conditions, as 8-fold pathological condition and therapy are based on them. Morphological and physicochemical evaluation methods of semen are useful in better diagnosis of clinical manifestation of underlying etiopathology. Based on the standard publications on andrology, an attempt is made to integrate the clinical and laboratory diagnostics of semen physiology and pathology, which help in understanding the abnormalities in conventional Ayurveda as well as modern medicine to plan appropriate pharmacotherapy. Integrative approach would open up new arena in andrology and widen the scope of therapeutic benefits to more infertile males.
  30,711 990 1
CASE REPORTS
Clinical profile of nasal polyp in a pediatric patient: An Ayurvedic approach
Aziz Ahmed Arbar, Sweta Verma
Sep-Dec 2016, 9(3):335-338
DOI:10.4103/2349-5006.196338  
Nasal polyp is a chronic inflammatory disease affecting the nasal cavity and the paranasal sinuses. It is a relatively common disease occurring in 1%–4% of the general population, but it is also seen in the pediatric population. Children present with nasal polyps are also known to have other underlying systemic diseases, mainly cystic fibrosis and bronchial asthma. Nasal polyp is common in the pediatric population especially in teenage, and is found usually bilateral. It is also commonly associated with bronchial asthma and many other systemic diseases. Beginning in preschool age, up to 50% of patients experience obstructing nasal polyp. In contemporary science, nasal polyp is not curable but can be clinically stabilized. When conservative measures are exhausted, surgical intervention combining endoscopic sinus surgery and supportive conservative treatment is performed. In the present paper, we aimed to present a treated patient of nasal polyp by the ayurvedic modalities such as Snehana, Swedana, Nasya, Gandusha, and Dhoompana with a positive change in the clinical picture.
  23,529 399 -
An unusual case of Bell's palsy (Ardita vata) managed through Ayurveda
Swarnima Mishra, Abhay Kumar Prajapati, Vithal G Huddar
September-December 2019, 12(3):251-256
DOI:10.4103/kleuhsj.kleuhsj_40_19  
Ardita vata presenting with palsy of one side of the face is akin to Bell's palsy or acute idiopathic lower motor neuron facial palsy. This is characterized by sudden-onset paralysis or weakness of the muscles to one side of the face controlled by the facial nerve. Bell's palsy is an idiopathic, presumed immune-mediated phenomenon, possibly with an infection as the inciting event. In contemporary science, administration of steroids is the treatment of choice for complete facial palsy. A 17-year-old boy diagnosed with Ardita vata due to chronic ear infection was treated with Karpasasthyadi taila Nasya and oral Ayurvedic medicines along with two sittings of the Panchakarma procedure. The total duration of the treatment was 4 months; however, significant results observed after 1 month of treatment shown almost complete recovery without any concurrent medications. The patient suffers from the same complaint 5 years ago in the right side of his face, and for that, he took 2 years of allopathic treatment and got complete relief. This case is evidence to demonstrate the effectiveness of Ayurveda treatment in case of Ardita vata (Bell's palsy) and as a proposition for further research on a greater number of patients.
  19,068 393 -
REVIEW ARTICLE
An overview on sildenafil and female infertility
Jyoti M Benni, Paragouda A Patil
May-August 2016, 9(2):131-136
DOI:10.4103/2349-5006.191247  
Endometrial thickness (EM) is one of the strongest predictors of implantation rate and ongoing pregnancy success rate. The endometrial growth is dependent on the uterine blood flow and angiogenesis. Recently, some reports discussed the possible beneficial effects of sildenafil citrate on EM. Sildenafil citrate leads to smooth muscle relaxation and vasodilation. Because of these biological properties, it is a potential candidate for female infertility, especially in the management of thin endometrium, which leads to low implantation and pregnancy rates. An updated electronic search was performed through PUBMED, MEDLINE, and COCHRANE and focused on peer-reviewed, randomized controlled trials, and observational cohort or case-control studies for the role of sildenafil in thin endometrium. Systematic search through all the clinical studies showed favorable results. They documented the beneficial role of sildenafil citrate in the treatment of thin endometrium in failed in vitro fertilization-embryo transfer cycles, assisted intrauterine insemination cycles, or resistant endometrium, where it increased the uterine receptivity.
  17,994 960 4
REVIEW ARTICLES
Medicinal plants and related developments in India: A peep into 5-year plans of India
Janmejaya Samal
January-April 2016, 9(1):14-19
DOI:10.4103/2349-5006.183698  
Medicinal herbs/plants or the herbal drugs refer to the use of plant and plant-based products for the management of common ailments. World Health Organization has defined herbal medicines as finished labeled medicinal product that contains an active ingredient, aerial, or underground parts of the plant or other plant material or combinations. In India, more than 70% of the population uses herbal medicine for their health-related problems. Many of the institutions adopt “reverse pharmacology” approach to study the clinical efficacy of medicinal plants and their pragmatic utility in healthcare. Moreover, the herbal therapeutics constitutes a major share of all the officially recognized Indian systems of medicine such as Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH). However, there is evidence of spurious drugs, irrational use, and adverse drug reactions of herbal drugs which should certainly be monitored with governmental patronization. Furthermore to be accepted as a viable alternative to modern medicine vigorous method of scientific and clinical validation must be applied to prove the safety and effectiveness of these herbal products. However, the clinical trial of herbal drugs is difficult owing to some of the obvious reasons. Around 20,000 medicinal plants have been identified for their medicinal properties; however, only 7000–7500 medicinal plants are being used by traditional practitioners. Similarly, the export of AYUSH-related items has increased from 2011 to –2012 and 2012 to –2013 and decreased in 2013–2014; however, import has been consistently increased during these years. Given this background, a brief review was carried out to assess the medicinal herbs and their development in India primarily through 5-year plan documents of India.
  17,152 976 7
CASE REPORTS
Isolated fetal ascites: A case report with review of literature
Santosh B Kurbet, Niranjana S Mahantshetti, Prashanth Gouda Patil, Mahantesh V Patil, Dinesh Singh
January-June 2014, 7(1):55-57
DOI:10.4103/2349-5006.135048  
Fetal ascites is commonly seen with hydrops fetalis. Historically, fetal ascites has been associated with significant mortality and morbidity. Primary isolated fetal ascites occurs independently as an isolated disease due to numerous congenital abnormalities. Extensive antenatal and postnatal evaluation for the detection of the cause is done in these cases, if found and appropriately treated have shown good results. In conclusion, even a rare case of fetal ascites can be managed successfully.
  16,569 1,054 4
ORIGINAL ARTICLES
Correlation of serum ferritin levels, in female patients with chronic diffuse hair loss: A cross sectional study
Sridevi Ramachandra Raichur, AM Pandit, Anil Malleshappa
May-August 2017, 10(2):190-195
DOI:10.4103/kleuhsj.ijhs_312_16  
Context: Iron is involved in critical physiological processes within the hair follicle, suggesting that iron deficiency (ID) could disrupt hair synthesis. The relationship between body iron status and hair loss has been investigated in a number of studies, however, with relatively discrepant findings. Aim: The aim of this study is to evaluate whether chronic telogen effluvium (CTE) and female pattern hair loss (FPHL) in patients were associated with decreased tissue iron stores, as measured by serum ferritin levels. Setting and Design: This was a cross-sectional study, conducted in a teaching hospital. Materials and Methods: Forty female patients aged between 15 and 45 years, having chronic diffuse hair loss, were recruited. Statistical Analysis Used: Statistical analysis used in this study was Mean ± standard deviation, Pearson's correlation coefficient, and one-sample t-test. Results: The mean serum ferritin levels in all participants, CTE, and FPHL were 18.6 μg/L, 16 μg/L, and 36.64 μg/L, respectively. Almost 57.5% of participants had serum ferritin levels <12 μg/L indicating ID, and 15% of participants had serum ferritin levels ranging 13–20 μg/L indicating iron depletion. Twenty-five percent of participants had serum ferritin levels ranging from 21 to 70 μg/L, indicating that serum ferritin levels were lower than required for normal hair cycle. Since there is a wide range of serum ferritin level (6–160 μg/L), a cutoff level of 41 μg/L was used to observe ID. There was a significant difference between the mean serum ferritin levels of participants as compared to the cutoff level of serum ferritin. Mean serum ferritin levels of all participants and in participants with CTE were low. Many participants had serum ferritin levels less than the normal lower range. The participants showed ID, at cutoff level of serum ferritin (41 μg/L), which was significant. Conclusion: Participants of this study had low serum ferritin levels at different definitions of ID, and the participants showed ID, which was significant. Hence, chronic diffuse hair loss was associated with decreased iron stores.
  16,118 525 3
A study of knowledge, attitude, and practices of menstrual health among adolescent school girls in urban field practice area of medical college, Tumkur
Purva Shoor
September-December 2017, 10(3):249-255
DOI:10.4103/kleuhsj.ijhs_375_16  
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.
  14,135 1,305 5
CASE REPORTS
Unusual occurrence of stony hard material in posterior anal fistula (bhagandara)
Pradeep S Shindhe, Sunny Mathew, N Dongargoan Tajahmed, S Killedar Ramesh, YM Santosh, Amruta A Wali
January-June 2015, 8(1):68-71
DOI:10.4103/2349-5006.158248  
The occurrence of stony material in the anal fistulous tract is a very rare clinical presentation; till today there are only three evident citation in pubmed indexed journals. Anal fistula (bhagandhara) is a chronic inflammatory tubular structure connecting the anorectal canal with peri-anal skin. A 66-year-old male patient presented with complaints of persistent pain in the perianal region and soiling of the undergarments with stool and constipation since 2 years. The case was diagnosed as posterior low anal fistula by per rectal digital, proctoscopic, and by fistulogram. It can be correlated to agantuja/unmargi bhagandhara. In the present case, "stasis" and "infection" might the reasons for the formation of stony hard material. Patient was successfully treated by the excision of whole tract with the unusual stone under local anesthesia. The presence of stony hard material in the fistulous tract is a very rare presentation and was successfully managed.
  14,280 313 -
ORIGINAL ARTICLES
Knowledge and perception regarding childhood pneumonia among mothers of under-five children in rural areas of Udupi Taluk, Karnataka: A cross-sectional study
Susan Mary Pradhan, Arathi P Rao, Sanjay M Pattanshetty, AR Nilima
January-April 2016, 9(1):35-39
DOI:10.4103/2349-5006.183690  
Background: A large number of children die due to pneumonia making it the single largest infectious cause of death more than AIDS, measles, and malaria combined. In India, acute respiratory infection is a major public health problem, especially for the age group of 0–5 years which contributes to 15–30% of deaths falling under this age group and most of these deaths are preventable. Objective: To assess the level of knowledge and perception regarding childhood pneumonia among mothers of under-five children. Materials and Methods: A cross-sectional study was conducted among 460 mothers of under-five children. Interviewer-administered structured questionnaire was used for data collection and the sampling technique used was three-stage cluster sampling. The questionnaire was divided into three sections as socio-demographic profile, level of knowledge, and level of perception. Results: The study found that mothers were predominantly secondary school graduates (32.6%) out of which, 93.7% were homemakers, 41.3% mothers had fair knowledge, and 41.5% had fair perception about pneumonia. Age and education level of mothers had a significant association with the knowledge as well as with perception. There was a significant association between level of knowledge and perception of childhood pneumonia among these mothers. Conclusion: Overall, mothers had fair knowledge and fair perception of childhood pneumonia. The lack of knowledge about simple signs and symptoms and factors related to pneumonia needs to be addressed.
  13,288 1,137 1
Effect of Panchatikta Ksheera basti with Kati basti in Katishoola w. s. r lumbar disc degeneration – A clinical study
Neelam Kaalia, Santosh Kumar Bhatted, SH Acharya
January-April 2021, 14(1):108-112
DOI:10.4103/kleuhsj.kleuhsj_264_20  
Context: Low back pain is the most common clinical presentation in musculoskeletal disorder due to spinal pathology. Factors such as improper sitting postures, jerky movements in travel, sports activities, aging, and bad sleeping posture are the important factors to produce spinal disorders. Lower back pain has been associated with degeneration of the intervertebral disc. Aims: This clinical study was carried out to judge the effectiveness of Panchatikta Ksheera Basti (medicated herbal therapeutic enema) with Kati Basti in lumbar disc degeneration-induced Katishoola. Settings and Design: This was an open-labeled, single-arm, interventional clinical study. Subjects and Methods: Fifteen diagnosed cases of low backache with lumbar disc degeneration were registered from the outpatient and inpatient departments of All India Institute of Ayurveda, New Delhi, India, and Panchatikta Ksheera Basti as yoga basti followed by Kati Basti for 8 days was administered. Statistical Analysis Used: The data were statistically analyzed using paired t-test. Results: Significant (P < 0.05) result was found in all the assessment parameters, namely, pain, stiffness, and fasciculation. Conclusions: Panchatikta Ksheera Basti with Kati Basti is an effective treatment method for safe and effective management of Katishoola w. s. r lumbar disc degenerative disease.
  13,633 299 -
REVIEW ARTICLES
Fundamental tenets of epidemiology in Ayurveda and their contemporary relevance
Janmejaya Samal
January-April 2016, 9(1):20-26
DOI:10.4103/2349-5006.183694  
Background: Ayurveda, the science of life, is the most ancient medical doctrine of human civilization. Some of the basic principles described in Ayurveda are still the same as today's medical science. Ayurveda does not have a specific text as epidemiology, but the principles described in piecemeal can be compiled, analyzed, and interpreted in the light of modern theories of epidemiology. Objective: An initial systematic literature review by the help of internet-based search engines revealed very negligible work in the field of Ayurveda and epidemiology. Hence, an attempt was made to analyze various principles of Ayurveda relevant to epidemiology and interpret their contemporary significance. Methodology: The work is mainly based on theoretical research using standard textbooks of epidemiology and classical treatises of Ayurveda. Discussion: A good number of principles are found in the classical texts of Ayurveda, which can be compared with the concepts of epidemiology. In the process of theoretical analysis, the following concepts were found relevant, such as the concept of causation of disease/Etiology of disease, causes of epidemic, classification of disease, modes of communicable disease transmission, and natural history of disease. In this study, attempt has been made to understand these concepts in the light of epidemiology with their most approximate delineation. However, being a classical medical doctrine, it has its own appeal that cannot exactly be compared with the concepts of epidemiology. Conclusion: It is interesting to note that the tenets described centuries back are very much relevant at this present era, and their importance cannot be neglected.
  12,933 994 4
An empirical understanding on the concept of Sattvavajaya Chikitsa (Ayurveda Psychotherapy) and a mini-review of its research update
Govardhan Belaguli, HP Savitha
January-April 2019, 12(1):15-20
DOI:10.4103/kleuhsj.kleuhsj_175_18  
Sattvavajaya Chikitsa (SC) (Ayurveda Psychotherapy) is one among the brainchild concepts of Acharya Charaka (father of Indian medicine). In Ayurveda, SC is considered to be having the psychospiritual approach with a nonpharmacological treatment modality which solely deals on the mind and its related attributes. SC has 5 methodology, 2 principles, 3 dimensions, 3 psychotherapeutic domains, and 5 techniques. This psychotherapy helps in controlling Manas (mind) away from Ahita Artha (distractible, unwholesome objects/thoughts/perceptions). Withdrawal of the bothered mind from unwholesome objects is the prime focus of SC. Mainly focusing on the intelligence, consciousness, memory, and spiritual aspects of the affected individuals, SC aims at stimulating consciousness, altering, and discriminating the maladaptive thoughts/actions. Thus, it helps in managing psychiatric, psychological, and psychosomatic ailments. The present review article throws light on the detailed descriptions of basic doctrines of SC concept and also offers a brief note on its contemporary relevance, recent insights, and applied clinical facets. The paper reports the researches, reviews, and studies on SC encompassing nonpharmacological nootropic efficacy.
  12,721 839 2
REVIEW ARTICLE
Epithelial-mesenchymal transition - A fundamental mechanism in cancer progression: An overview
Punnya V Angadi, Alka D Kale
July-December 2015, 8(2):77-84
DOI:10.4103/2349-5006.174233  
The epithelial-mesenchymal transition (EMT) has a significant role in embryogenesis. EMT is also implicated as a fundamental step development of invasive phenotypes associated with progression of cancer. EMT confers the cancer cells with migratory and invasive properties that allow them to come into the stroma, which creates a conducive environment for cancer progression and metastasis. Moreover, acquisition of EMT is linked with resistance to chemotherapy that could lead to recurrences and enhance the morbidity and mortality related to cancers. Consequently, EMT has been associated with carcinogenesis, invasion, metastasis, recurrence, and chemoresistance. Research into EMT and its role in cancer pathogenesis has advanced in a rapid pace, but since its participation shows considerable variation among different cancer types and the exact mechanism operative in different cancers remains ambiguous; EMT continues to be a significant issue for research. In this review, we present an overview of EMT, its role in cancer progression and the clinical implication of its identification.
  11,443 1,992 1
ORIGINAL ARTICLES
Formulation and evalution of new polyherbal toothpaste for oral care
S Abhay, Basavaraj M Dinnimath
January-June 2015, 8(1):24-27
DOI:10.4103/2349-5006.158217  
Aim and Objective: The main objective of this research was to formulate medicated polyherbal toothpaste with better antimicrobial activity from natural sources for dental infections. Materials and Method: The hydroalcoholic extracts of apple peel, lemon peel, orange peel, banana peel was carried out and the formulated toothpaste from the above extracts were subjected for antimicrobial activity study against Gram-positive bacteria (Staphylococcus aureus, Enterococcus faecalis, Streptococcus mutans) and Gram-negative bacteria (Porphyromonas gingivalis). Results: Antibacterial activity of the toothpaste was determined by the 2-fold serial dilution method. All the extract has showed good antimicrobial against P. gingivalis, with apple extract showing the best result (7.8 mg/ml). Conclusion: Thus, our study shows the potent antibacterial activity of the formulated polyherbal toothpaste compared with the marketed formulation against dental caries.
  10,308 1,096 -
Epidemiology of diabetic foot complications in a podiatry clinic of a tertiary hospital in South India
V Jyothylekshmy, Arun S Menon, Suja Abraham
January-June 2015, 8(1):48-51
DOI:10.4103/2349-5006.158231  
Introduction: The prevalence of diabetes is increasing worldwide resulting in foot complications, which leads to poor quality of life and increased cost of living. Aim: The main aim of this study was to find out the foot complications in diabetic patients and to analyze the underlying etiology. Methodology: A retrospective study was carried out in the podiatry Department of Amrita Institute of Medical Sciences, Kerala among 277 diabetic patients with recent and recurrent foot complications. Results: Systemic hypertension (76.89%) has been found to be one of the major risk factor coexisting in the study population. 49.45% patients had preexisting peripheral neuropathy and non-healing ulcers were seen in 41.51%. Other complications include charcot arthropathy (10.46%), gangrene (9.38%), cellulitis (7.94%), fungal infections (6.89%), callus (3.61%), osteomyelitis (3.97%), and necrotizing fasciitis (2.52%). Culture report on foot ulcer patients revealed that Gram-positive Staphylococcus species (18.8%) and the Gram-negative Pseudomonas species (18.2%) were the predominant organisms. Other organisms isolated were Klebsiella species, Escherichia coli, Acenetobacter, Proteus, Enterococcus species, and streptococci. Fluoroquinolones were the most commonly prescribed antibiotics (33.5%), followed by penicillin (8.3%), clindamycin (6.1%), carbapenems (5.05%), cephalosporins (2.8%), cotrimoxazole (2.5%), and chloramphenicol (0.7%). Conclusion: The study highlights the importance of foot care, relevance of early detection of diabetes and subsequent monitoring of diabetic complications.
  10,250 1,101 8
REVIEW ARTICLES
Are extravasation injuries “Negligence”?
Neeraj Nagpal, Nimisha Nagpal
Sep-Dec 2016, 9(3):247-250
DOI:10.4103/2349-5006.196335  
Recent High Court and Supreme Court judgments have awarded large compensations for complications arising out of intravenous treatment. Extravasation of fluids and drugs is the most common complication of any medical procedure worldwide. Extravasation injury leading to gangrene occurs rarely and is due to factors related to patient characteristics, underlying disease, and the type of drug which is being injected. Human error rarely may be contributory to development of the extravasations and injury resultant thereof, but to label all of these complications as negligence by the application of “res ipsa loquitur” has serious consequences. High compensation risk for a complication which is faced universally by all doctors has the potential to raise the cost of this simple procedure.
  10,142 997 -
ORIGINAL ARTICLES
Effect of scapular proprioceptive neuromuscular facilitation on shoulder pain, range of motion, and upper extremity function in hemiplegic patients: A randomized controlled trial
Deepak Joshi, Jeba Chitra
September-December 2017, 10(3):276-282
DOI:10.4103/kleuhsj.kleuhsj_44_17  
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.
  9,458 1,143 1
Effect of uphill, level, and downhill walking on cardiovascular parameters among young adults
Samir Adhikari, Parwati P Patil
May-August 2018, 11(2):121-124
DOI:10.4103/kleuhsj.kleuhsj_79_17  
BACKGROUND: Uphill walking and downhill walking are the different forms of walking which causes cardiovascular changes in the body. By changing the gradient of the treadmill, we can change the severity of exercise by keeping the speed constant. AIM: This study aims to evaluate the cardiovascular changes during uphill, level, and downhill walking in young adults. STUDY DESIGN: This was an experimental study MATERIALS AND METHODS: Twenty participants (15 males and 5 females) having normal body mass index were made to walk on the treadmill at different gradients of −15%, 0%, and +15% at a preferential speed for a constant duration of 15 min. The heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and rate pressure product (RPP) were recorded before and after walking. STATISTICAL ANALYSIS: Statistical analysis was done by ANOVA test using SPPSS, version 20 (IBM, Bangaluru, Karnataka ,India), where P < 0.05 was taken as statistically significant. RESULTS: There was a significant increase in HR (105.8 ± 20.06), SBP (133.3 ± 13.54), and RPP (14146 ± 3025) during uphill walking as compared to downhill and level walking. There were no significant changes in cardiovascular parameters when level walking and downhill walking were compared. DBP did not show any significant changes at any gradient of walking. CONCLUSION: Cardiovascular response increases during uphill walking, but level walking and downhill walking show no difference in cardiovascular response. These findings can be used to prescribe the exercises for young adults.
  10,246 268 1
Substantiating accuracy of Goodsall's rule in fistula-in-ano (Bhagandar) with anatomical consideration
Pradeep Shahajirao Shindhe, Ramesh Shivappa Killedar
May-August 2018, 11(2):151-154
DOI:10.4103/kleuhsj.kleuhsj_271_17  
BACKGROUND: The exact identification of the internal opening in the surgical treatment of anorectal fistulae is of basic importance for effective management, and the same concept was existed long back which was described by Acharya Sushruta in the context of Bhagandar (Arvachina and Parachina).In the current practice, the rule of Goodsall enables identification of the internal opening whether anterior or posterior with relation to its external opening. OBJECTIVES: The objective of this study is to substantiate the accuracy of Goodsall's rule and to establish rationality of the rule with anatomical consideration MATERIALS AND METHODS: A total of 53 operated (kshara sutra ligation) cases of fistula-in-ano during 2014–2015 were retrospectively assessed for locations of the primary (Arvachina) and secondary (Parachina) openings from the case sheets. The normal distribution test was used for the data analysis. RESULTS: Totally 46 anal fistula patients followed the Goodsall's rule while 7 patients were not as per rule, and all of them were falling in anterior external opening group. CONCLUSION: Posterior external opening fistulas were as per Goodsall's rule and anterior opening >3.25 cm or far had a straight or radial fistulous tract, which are against the Goodsall's rule.
  10,029 338 1
CASE REPORTS
Clinical profile of a case of axonal sensory neuropathy: An Ayurvedic management
Vittal G Huddar, Neha Sharma, Riteshkumar Lahoti
January-April 2016, 9(1):108-110
DOI:10.4103/2349-5006.183679  
A 19-year-old female diagnosed as asymmetrical axonal sensory neuropathy by nerve conduction study, with the complaints of severe burning, sweating, and pricking type of pain in both the feet more in right foot, for 5 months attended the Kayachikitsa (General medicine) OPD. Based on clinical presentation, it was diagnosed as burning feet syndrome, a condition that causes severe burning and aching of the feet, hyperesthesia, and vasomotor changes of the feet that lead to excessive sweating. This condition occurs more frequently in women and usually manifests itself when a person is between 20 and 40-year-old. The pathophysiology of burning feet syndrome is not very clear and treatment varies depending on the etiology. According to Ayurveda, this condition is akin to padadaha. Padadaha is explained in vata vyadhi adhyaya (neurological diseases) where there is an association of pitta and Rakta. In the present paper, we are presenting a case successfully treated with two courses of mrudu virechana (purgation therapy) each of 9 days duration at the interval of 30 days. Then follow-up after 30 days. During follow-up, the patient was on oral medicine. Total duration of the treatment including follow-up was 90 days. After the treatment, the symptoms of burning and pricking pain were completely reduced.
  9,896 265 -
ORIGINAL ARTICLES
Clinical evaluation of Nasya Karma in cervical spondylosis: Case series
Sangeeta R Tanwar, Anup B Thakar, Rajkala Ramteke
September-December 2017, 10(3):335-339
DOI:10.4103/kleuhsj.kleuhsj_111_17  
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
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Knowledge of pregnant women about congenital anomalies: A cross-sectional study in north of Iran
Pourmohsen Masoumeh, Khoshravesh Vahid, Alavi Majd Hamid, Khaleghinezhad Khosheh, Khayat Samira
January-June 2015, 8(1):41-47
DOI:10.4103/2349-5006.158230  
Background: Proper knowledge about risk factors and prevention of congenital malformations in pregnant women can lead to primary prevention of disease. The aim of this study was to explore pregnant women's knowledge about congenital anomalies, risk factors, and prevention in relation to their sociodemographic profile. Materials and Methods: A cross-sectional study of the expecting mother's population was conducted over 3 months. Data collection was done through a questionnaire completed in face to face interviews using simple nonrandom sampling method in 150 pregnant women who visited the prenatal clinics in Rasht. The questionnaire contained 6 questions about specific knowledge and 12 questions for risk factors and prevention of congenital anomalies. Statistical analysis was performed using descriptive statistics, Pearson correlation, as well as multivariate regression analysis was performed using SPSS 21 software. Results: The overall knowledge of pregnant women about congenital anomalies showed a significant relationship with age (P = 0.001) and the level of education (P = 0.000). However, there was not a significant relationship between overall knowledge and parity (P = 0.183) and the number of antenatal visits (P = 0.097). The participant who had High School and University education had the highest score in overall knowledge about the disorder. The age group 41-50 years had the lowest overall knowledge about the disorder. Conclusions: There is a need for public programs to increase awareness about congenital anomalies in pregnant women and people. Use of genetic counseling for families at risk for congenital anomalies is proposed.
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