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   Table of Contents - Current issue
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January-June 2018
Volume 9 | Issue 1
Page Nos. 1-49

Online since Wednesday, January 24, 2018

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ORIGINAL ARTICLES  

Efficacy of integrated neuromuscular inhibition technique in improving cervical function by reducing the trigger points on upper trapezius muscle: A randomized controlled trial Highly accessed article p. 1
Shagun Aggarwal, Garima Bansal
DOI:10.4103/mjmsr.mjmsr_40_17  
Background: The efficacy of ischemic compression, strain/counterstrain, and muscle energy techniques were supported by literatures to relieve myofascial trigger points. However, no high-level research is available regarding the integrated neuromuscular inhibition technique (INIT). Objective: To document the efficacy of INIT in improving cervical function by reducing the trigger points on upper trapezius muscle over the traditional approach. Methods: Thirty adults in the age group of 18–35 years diagnosed with mechanical neck pain with upper trapezius trigger point were selected by the simple random sampling for two group pretest-posttest design. They were allocated randomly into two equal groups, Group A and Group B, respectively. Group A received hydrocollator pack, INIT, neck strengthening exercises, scapular stabilization exercises, shoulder stabilization exercises, postural correction, and ergonomic advice while Group B received the same treatment except INIT. They were treated for six sessions on alternate days for 2 weeks. Visual analog scale, neck disability index, and tenderness grading scale were noted at baseline, 3rd session, and 6th session after the above treatment on both the groups and analyzed. Results: In all the outcome measures, Group A showed significant (P < 0.05) improvement when compared to Group B. Conclusion: There is a sufficient evidence to prove the efficacy of INIT in improving cervical function by reducing the trigger points on upper trapezius muscle
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Prevalence and risk factors associated with underweight among under-five children in a rural area of Puducherry p. 7
Jomon Mathew John, Jomol Sara John
DOI:10.4103/mjmsr.mjmsr_16_17  
Background: Nutrition has been recognized as a basic pillar for social and economic development. One in every three malnourished children in the world lives in India. The objective of this study was to measure the prevalence and to study the selected factors associated with underweight among the under-five children in a rural area of Puducherry. Aims: This study aims to study the prevalence of underweight among children under-five years of age and to study the associated risk factors. Methodology: This was a cross-sectional study conducted over a period of 13 months with a sample size of 500. The anthropometric assessments were taken and plotted on the Indian Academy of Pediatrics growth charts.Results: The prevalence of underweight was found to be 23.8%. The age of the child, gender, socioeconomic status, duration of exclusive breast feeds, birth order, and birth weight were found to have statistical significance in underweight. However, the maternal education did not show any significance in underweight. Conclusion: Nutritional status of under-five years children is one of the important indicators of overall development of community and thus country. Intervention to reduce the burden of underweight should be directed toward the education of the mothers regarding the importance of nutrition by community health workers.
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Clinical profile of pediatric neurotuberculosis patients at a tertiary care center of Western India p. 12
Ranvijay Singh, Nishitha Shetty, Maryam Naveed, Mridula Preetham Talari, Deepak Verma, Varsha Kulkarni
DOI:10.4103/mjmsr.mjmsr_33_17  
Aim: The aim of this study is to determine the clinical profile of neurotuberculosis in the age group of 6 months to 10 years and its association with biochemical analysis of cerebrospinal fluid (CSF) and neuroradiological findings. Methods: Retrospective assessment of the medical records of confirmed cases of neurotuberculosis from January 2010 to June 2014 was carried out. Results: Of the 46 cases studied, mean age at presentation was 3.4 years. Male-to-female ratio was 1.55:1. Fever, vomiting, headache, seizures, and focal neurological deficits were the most common presenting clinical symptoms. Protein–energy malnutrition (PEM) was detected in 39 cases. On systemic examination, the order of involvement of cranial nerves was VII, II, III, IV, VI, and V. Positive Mantoux test was present in only 11 cases. CSF findings showed lymphocytic predominance, raised protein levels with a decreased to normal glucose levels. Neuroimaging by computed tomography scan/magnetic resonance imaging of the brain gave a definite diagnosis in thirty cases of which hydrocephalus, basal exudates, tuberculoma, and infarctions were the most common findings. The primary focus of tuberculosis was found in the lungs on chest roentgenogram in 12 cases. Conclusions: Neurotuberculosis occurs with increased frequency in the age group of 1–5 years. Fever may be of short duration at presentation in contradiction to current medical literature. PEM is a predisposing factor for the development of the disease. A tuberculin sensitivity test may be negative in cases of neurotuberculosis. CSF analysis and neuroimaging are pivotal in the establishment of a diagnosis.
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Study of the serum sodium changes in children between 3 months and 5 years age receiving isotonic maintenance intravenous fluids p. 16
Esther Soundharya Maddukuri, MD Jaidev, Dipthi Nishal Castelino, Habeeb Ullah Khan, Pavan Hegde
DOI:10.4103/mjmsr.mjmsr_53_17  
Background: Isotonic fluid is now the accepted standard of practice as maintenance intravenous fluids. The use of hypotonic fluids has been associated with electrolyte imbalance which could potentially lead to morbidity and mortality. The aim of this prospective study was to assess whether the use of isotonic fluids causes significant changes in the serum sodium concentration and is associated with any related complications in the age group between 3 months and 5 years. Methods: Serum sodium was measured at 0, 12, 24, and 48 h of commencement of isotonic intravenous fluids. Results were analyzed separately for groups between 3–12 months and 13–60 months. Results: All the children in the study group had sodium levels within normal range before the commencement of intravenous fluids. There was no significant change in the mean sodium levels at 12, 24, and 48 h of commencement of intravenous fluids in the age groups between 3–12 months and 13–60 months. There were no complications noted with the use of isotonic intravenous fluids. Conclusion: Use of isotonic intravenous fluids in the age group between 3 months and 5 years is not associated with significant changes in the serum sodium concentrations or adverse events. Hence, isotonic intravenous fluid can be used safely for maintaining hydration in children.
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Efficacy of progressive relaxation technique and yoga in patients with stress-induced asthma: A randomized controlled trial p. 19
S Veena Kirthika, K Padmanabhan, S Sudhakar, CV Senthil Nathan, S Ramachandran
DOI:10.4103/mjmsr.mjmsr_36_17  
Background: Asthma is a chronic inflammatory disorder of the airway. In susceptible individuals, this inflammation causes recurrent episodes of wheezing, breathlessness, and coughing. Various physiotherapy techniques help in the reduction of symptoms associated with asthma which includes deep breathing exercises and relaxation postures. Progressive relaxation technique (PRT) is useful in reducing the respiratory symptoms and stress in asthma. Yoga techniques have shown clinically relevant improvements in their quality of life and effective reduction in the frequency of attacks and degree of stress. Objective: The objective of this study is to compare the effect of PRT and yoga in patients with stress-induced asthma (SIA) so that better treatment program can be adopted in the reduction of symptoms in participants with SIA. Methodology: Thirty participants with asthma were recruited for the study and were divided into two groups. Group A (n = 15) was treated with PRT and Group B (n = 15) was treated with yoga technique for a duration of 3 months. Outcome Measures: Asthma Quality of Life Questionnaire (AQOL) and Depression, Anxiety and Stress Scale (DASS) were used. Results: Group B (yoga group) showed a significant difference, P < 0.05 in the mean values of DASS and AQOL when compared to Group A (P > 0.05). Postyoga intervention, the patients with SIA demonstrated decrease in the symptoms of depression, anxiety, and stress, and increased quality of life. Conclusion: Three-month duration of yoga is more effective than PRT in patients with SIA in reducing asthmatic symptoms and improving quality of life.
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SHORT COMMUNICATIONS Top

A second victim of pregnancy: “Phobic first-time expectant fathers” p. 25
Thilagavathy Ganapathy
DOI:10.4103/mjmsr.mjmsr_62_17  
A positive paradigm shift is required in reproductive child health services, from a women-centric care to a broader family perspective with the focus firmly on men-friendly hospital initiatives to promote healthier concepts of fatherhood within families.
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Development of a module to successfully implement competency-based medical education program in an institute p. 27
Saurabh Rambiharilal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
DOI:10.4103/mjmsr.mjmsr_50_17  
Medical education aims to train students in such a way that they are empowered to meet the health needs of the population. Competency-based medical education (CBME) aims to ensure that the student acquires the desired competencies to meet the needs of people in a community and even addresses the constraints attributed to the conventional medical education. Institutes with an active CBME program in place, but in novice stages, have an immense need to sensitize the faculty or the postgraduate students about the different domains of CBME. Having a module, which is designed in a systematic and structured manner, can prove to be a wonderful tool to carry out the sensitization session. The overall process of preparation of a module goes through the stages of needs assessment, designing of the module, and finally the development of a module. To conclude, the presence of a structured module built on the comprehensive needs assessment can help an institute to successfully implement CBME within their setup.
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CASE REPORT Top

A rare cause of pneumothorax: Diesel aspiration pneumonitis p. 30
Ajay K Verma, Anubhuti Singh, Kislay Kishore, Surya Kant
DOI:10.4103/mjmsr.mjmsr_9_17  
Chemical pneumonitis refers to the aspiration of an inoculum that is inherently toxic to the lungs. Diesel aspiration is an uncommon cause of chemical pneumonitis, and aspiration leading to pneumothorax is an even rarer occurrence, not having been reported in adults so far. We are reporting a case of a young adult male who developed pneumothorax secondary to accidental diesel aspiration.
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LETTERS TO EDITOR Top

Employing one-minute preceptor model in clinical settings p. 34
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
DOI:10.4103/mjmsr.mjmsr_42_17  
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Need to differentiate between descriptive and prospective study in a clinical setup p. 35
Radha Saini
DOI:10.4103/mjmsr.mjmsr_66_17  
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Could this be Milroy's disease? Our experience p. 36
Ibrahim Aliyu
DOI:10.4103/mjmsr.mjmsr_44_17  
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Acral gangrene following diarrheal disease p. 37
Mahmood Dhahir Al-Mendalawi
DOI:10.4103/mjmsr.mjmsr_45_17  
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Ant sting at an unusual site p. 38
Ibrahim Aliyu
DOI:10.4103/mjmsr.mjmsr_17_17  
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Costophrenic angle blunting: Always abnormal? Highly accessed article p. 39
Venkatraman Indiran
DOI:10.4103/mjmsr.mjmsr_35_17  
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Multifocal osteomyelitis involving the clavicular bones p. 40
Ibrahim Aliyu
DOI:10.4103/mjmsr.mjmsr_29_17  
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Use of in-depth interviews in medical education research p. 41
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
DOI:10.4103/mjmsr.mjmsr_56_17  
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An unusual florid polypoidal presentation of gastric neuroendocrine tumor p. 43
Fouzia Siraj, Sharma Shruti
DOI:10.4103/mjmsr.mjmsr_22_17  
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Utilizing a toolkit to respond to the health needs of migrant people in the European region: World Health Organization p. 44
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
DOI:10.4103/mjmsr.mjmsr_51_17  
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Different rules for different quality of articles: A potential predatory nature of journal? p. 46
Shaikat Mondal, Himel Mondal
DOI:10.4103/mjmsr.mjmsr_59_17  
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Addressing the issue of ethics in public health surveillance: World Health Organization p. 47
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
DOI:10.4103/mjmsr.mjmsr_31_17  
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Inconsolable cry: It may be insect bite p. 48
Ibrahim Aliyu
DOI:10.4103/mjmsr.mjmsr_47_17  
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