Janaki Medical College Journal of Medical Science

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https://imsear.searo.who.int/handle/123456789/149790

Executive Editor: Assoc. Prof. Kshitiz Upadhyay-Dhungel

ISSN: 2091-2358 (Online) 2091-2242 (Print)

Frequency: 2 issues a year

Language: English

Official journal of the Janaki Medical College.

Online Peer-reviewed journal

Web site: https://www.nepjol.info/index.php/JMCJMS/index/

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Now showing 1 - 20 of 110

Sacral Hiatus Study in Dry Human Sacra
(Janaki Medical College, 2014-11) Mishra, M; Singh, AK; Satyavathi, P; Sah, N
Background and objectives: The sacral hiatus is the site for caudal epidural anaesthesia during perineal surgery and also for a painless delivery. It is also used for three dimensional colour visualization of lumbosacral epidural space in orthopaedic practice for diagnosis and treatment. Work on the morphometrical study of the sacral hiatus is limited, especially in south indian population. So this study is carried to examine, measure and record the morphometry of sacral hiatus in order to study the anatomical variations which will be useful for caudal epidural anaesthesia. Material and Methods: The study was conducted in the Department of Anatomy, Prathima Institute of Medical Science, Naganur, Andhra Pradesh. 93 dry sacra with complete sacral hiatus were taken for the study. The shape of the sacral hiatus was noted by naked eye. Level of the apex and base of the sacral hiatus was noted with respect to the sacral vertebra. The length of sacral hiatus was measured from apex to the midpoint of base, the anteroposterior depth of sacral hiatus at the apex was measured with the help of vernier calipers. The transverse width of sacral hiatus at the base was measured between the inner aspects of inferior limit of the sacral cornu with the help of divider and then adjusted, and calculated with vernier caliper. Results: In 47 (50.53 %) sacra the shape was Inverted-U and in 25 (26.9 %) sacra Inverted-V. The irregular shaped of sacral hiatus was observed in 11 (11.8 %) cases. A “Dumbbell” shaped sacral hiatus was observed in 5 (5.4%) cases with a nodular bony growth projecting medially from both margins. The dorsal wall of sacral canal was entirely absence in 4 (4.3%) cases. Absence of sacral hiatus, a rare phenomenon, was observed in 1 (1%) specimens only. Conclusion: In the present study, elongated hiatus and narrowing of the sacral canal at apex of sacral hiatus was found in a significant percentage, which should be kept in mind while giving the caudal anaesthesia in Andhra Pradesh region.
Current view on biomedical applications of synthetic metal-polymer nanocomposites
(Janaki Medical College, 2014-11) Kaushik, R; Sharma, NK
Recent advances in the field of nanotechnology led several groups to recognize the promise of recruiting nanocomposities to the ongoing battle against pathogenic gram-positive and gram-negative bacteria and metal-polymer nanocomposites are a typical example. On the basis of recent literature, the nanocomposities are synthesized mainly by two techniques i.e. in-situ and ex-situ technique and these nanocomposities have great biomedical applications in terms of their antibacterial activity. A large battery of newly developed and discovered nanocomposities has been accumulating during the last decade.
Antimicrobial susceptibility test of pathogens isolated from urinary tract infection suspected cases
(Janaki Medical College, 2014-11) Yadav, K; Prakash, S; Serayi, RC; Shilpkar, T; Shrestha, S
Background and objectives: Urinary tract infection (UTI) is associated with multiplication of organisms in urinary tract and is defined by the presence of more than 105 organisms per ml in a midstream sample of urine (MSU). UTI is most commonly acquired bacterial infection in ambulatory and hospitalized populations. E.coli is the most predominant organism to colonise the urethral meatus and perineum before ascending to the bladder. Drug resistance of pathogens is a serious medical problem, because of very fast arise and spread of mutant strains that are insusceptible to medical treatment of UTI. Therefore, this study was carried out to determine the common pathogenic bacteria causing UTI and to determine their antibiotic susceptibility pattern. Material and Methods: Mid stream urine samples of the UTI suspected pateints were collected in the Mid Stream Urine (MSU) samples were collected in the sterile clean dry wide mouthed bottle. Standard protocol was followed to isolate and identify organism which was followed by disc diffusion antibiotic sensitivity tests. Results: A total of 100 samples were collected. Out of 100 samples, 25 samples showed a significant growth E.coli, Citrobacter diversus, Klebsiella pneumoniae, Staphylococcus aureus were isolated. E.coli (84%) was found to be the most prevalent causing UTI. Conclusion: UTI was found more common in female than male and E.coli was found to be main causes of UTI. Ciprofloxacin showed more effective drugs in the treatment of UTI.
Study on Risk factors, presentation and management of stroke in a tertiary care hospital
(Janaki Medical College, 2014-11) Sapkota, S; Chhetri, H; Sharma, RP
Background and Objectives: Many studies in recent years have focused attention on identification of risk factors associated with stroke. However, most of these studies have been conducted in the developed countries. Only few studies have been conducted in Nepal. So the present study has been undertaken with the aim of determining the risk factors and management pattern of stroke and makes the people aware of those factors. Material and Methods: It is a descriptive prospective study conducted with 50 consecutive patients who presented in medicine and emergency department at Universal College of Medical Science, Bhairahawa, Nepal from December 2009 to July 2010. Data were collected using a standard questionnaire and encounter form after receiving a verbal consent from the patient. The collected data were coded, tabulated and analyzed using SPSS version- 16. Results: The present study showed that 56% of stroke patients were male. Hemorrhagic stroke (60%) was more than the ischemic stroke (40%).The age was common non modifiable risk factor. The common–modifiable risk factors were hypertension (86%), alcohol consumption (74%) and smoking (56%). Calcium channel blocker (44.18%) and combination of it with Diuretic (18.60%) and ACE inhibitors (20.93%) were the commonly prescribed drugs for lowering blood pressure. Prescribed drugs therapy and lifestyle modification improved the health condition of patients (80%). The non compliance to the drugs was due to multiple dosages (51.52%), side effects (18.18%) and forgetfulness (18.18%). Conclusion: Finding of this study will be helpful for the practitioners as well as researcher in the future. Practitioners can make people aware on the risk factors and preventive measures of the stroke. Researchers will be helped by knowing the commonest risk factors of stroke and its management pattern.
Gender Determination by Linear Dimension of Permanent Canine: An Odontometric Analysis
(Janaki Medical College, 2014-11) Sharma, B; Balaji, N; Sumathi, MK
Background and objectives: Identification, an aspect of forensic anthropology, is the recognition of an individual based on the physical characteristics unique to the individual. Among the four main attributes i.e. gender, age, stature and ethnic or racial background of an individual’s biological identity, sex determination is usually the first step in the human identification process. Teeth can be used as a means of sex determination as teeth are resistant to post-mortem degradation and survive deliberate, accidental or natural change. This study was carried out with an objective to determine the sexual dimorphism of maxillary and mandibular canine by linear tooth diameter for permanent dentition in Moradabad population. Material and Methods: A total number of 40 subjects (20 Males and 20 Females) were included in this study. After obtaining an informed written consent, alginate impression was taken with help of perforated impression trays and study models were prepared with type IV dental stone. Linear (MD, BL, Crown Height) were taken with digital vernier caliper. Results: It was observed that males’ shows more mean linear crown diameter as compared to females. Also, the mesiodistal and buccolingual measurement shows statistically significant difference for all canines, being higher for males than females. Conclusion: The present study has expressed sexual dimorphism of permanent canine using Student’s test and indicate that linear dimension of maxillary canine can be used for sexual diamorphism with accuracy along with other accepted procedure for sex determination.
A Study on Perception and knowledge regarding HIV/AIDS among school students and significance of educational intervention
(Janaki Medical College, 2014-11) Dhungel, BA; Chaudhary, M; Singh, S
Background and objectives: HIV/AIDS is a burning crisis worldwide. Cure of HIV is not yet possible so prevention is of prime importance in control of HIV. Education plays an important role in bringing awareness. This study is planned to find the existing knowledge and significance of educational intervention. Material and Methods: This study was an experimental design in which same group of subjects (students to class 9 and 10) of selected schools in Imadol, served as control and experimental group. Participants’ perception and knowledge about various aspects of HIV/AIDS were studied by noting their agreement with a set of 65 statements (questionnaire) using a modified Likert-type scale. The data was entered in SPSS. A p value less than 0.05 were taken as statistically significant. Result: In this study, educational intervention has proved statistically significant in public school (p value 0.02). Among different sub groups total median score for knowledge about HIV/AIDS and idea about vulnerable group was also statistically significant ( p value 0.01). Conclusion: Educational intervention does play significant role in strengthening knowledge and perception regarding issues related to HIV/AIDS.
Treatment of class III Malocclusion with maxillary expansion and face-mask therapy: A case report
(Janaki Medical College, 2014-11) Mansuri, M; Singh, VP
The developing class III malocclusion is one of the most challenging problems for the practicing orthodontist to manage clinically. True class III malocclusion is rare in our region as compared to Class II and Class I malocclusion. With adults, orthognathic surgery and dental camouflage is the viable treatment option. A variety of treatment alternatives exists for patients in the developing stages of a Class III malocclusion. In the past much of the therapy has focused on restriction of mandibular growth with chin cups and functional appliances. This is based on the traditional thought that developing Class III malocclusions were the result of prognathic mandible. Recently, however, there has been a growing awareness that the majority of patients with a developing Class III skeletal pattern exhibit a maxillary deficiency with a normal or only slightly prognathic mandible. Therefore, considerable attention has been given to early treatment using maxillary protraction therapy. Using facemask therapy in conjunction with maxillary expansion has been shown in clinical reports to be a successful and predictable treatment option. Treatment should be carried out as early as possible with the aim to prevent it from becoming severe. A case treated with biphasic therapy – orthopaedic appliance followed by fixed orthodontic treatment is presented here.
Promoting medical student research in Nepal
(Janaki Medical College, 2014-11) Shanker, PR
Health seeking behavior during pregnancy and delivery in Morang District of Nepal
(Janaki Medical College, 2014-11) Sah, RB; Subedi, L; Shah, U; Jha, N
Background and objectives: Importance of maternal health has been recognized over the last decade, however information about the perception of illness and health care behavior of obstetric complication is lacking. So, this study was conducted to find out the prevalence of taking care during pregnancy and delivery, and to find out the association between sociodemographic characteristics and taking care during pregnancy and delivery. Material and Methods: The study is a cross-sectional study conducted among the residents of Rangeli VDC of Morang District in Eastern Nepal where 300 households were taken as subjects. Semi-structured questionnaire was used and face to face interview was conducted. Chi-square test was applied to find out the association between sociodemographic characteristics and taking care during pregnancy and delivery. Results: Almost forty percent of pregnant women have taken care during pregnancy and delivery i.e. delivery conducted in Health Care Center (HCC). Only 21.8% of women were applied antiseptics after cutting cord and sixty three percent of women have fed colostrums to their babies. All of the women with Brahmin/ Chhetri have conducted delivery in Health Care Center. The women with SLC and higher education have conducted delivery at HCC more (91.1%) than below SLC (51%) and illiterate (12.5%). The women with service have conducted delivery at HCC more than other occupational groups. Conclusion: The problem of taking care during pregnancy and delivery is common and has become a key public health concern for all. Lack of education and poor occupation of wife and husband led some of the respondents not taking care during pregnancy and delivery.
Chitta, The Mind-stuff as a Cognitive Apparatus: Model of mind and process of cognition as in Yogasutra of Patanjali
(Janaki Medical College, 2014-11) Upadhyay-Dhungel, K; Dahal, BK
Background and Objectives: Medical sciences have developed tremendously but yet it has to understand the brain, mind, consciousness and cognition process. In this article, authors have made an attempt to present a process of cognition with a model of mind explained in yoga sutra of Patanjali. Material and Methods: Understanding the mind with the modern scientific tools is often difficult. Here an attempt has been made to understand mind with the help of various literature in yoga especially in yoga sutra of patanjali, a valid text of yoga. Hermeneutical approach, a method used in qualitative method of inquiry is used for this study. Reading, re-reading the texts and finding the meaning out of the text is the process used. Results: A model of mind has been proposed as finding of the study. This model of mind has a ‘chitta’ (Mind stuff) as a cognitive apparatus and important component for cognition. ‘Chitta’ interacts with the external manifested world (Prakriti). ‘Chitta’ has Mana, Buddhi and Ego as Antakahrana (internal organ) and ‘Indriyas’ (Five Gyanendriyas and Five Karmaindriyas) as external organ. This concept of mind and cognition works for the plane of ‘chitta-vritti’ state where vrittis are the external world. But YSP also talks about next plane of cognition which is beyond the scope of this study. Conclusion: A cognitive model explaining the concept of mind forms a major finding of this research. This finding may initiate future researches in the field of understanding the mental processing and acts as links between ancient wisdom of yoga and modern concept on mind and cognition and how they can complement each other. This model of concept of mind can also be used as concept for psychological counseling and psychological therapy.
Challenges of Medical Education in Nepal
(Janaki Medical College, 2013-03) Shankar, PR
Alpha and Beta amylase activity of Fagopyrum esculentum (Buckwheat): A Medicinal Plant
(Janaki Medical College, 2013-03) Prakash, S; Deshwal, S
Background and Objectives: Fagopyrum esculentum, common buckwheat popularly known as mithe fapar is one of the staple food crops of the mountain region. Traditionally, it is used to treat constipation and bowel upsets. It is also used by diabetic in different parts of Nepal and India. Due to its high nutritive and medicinal value, medical scientist and researchers are interested in developing this as pharmaceutical plant. In this regard department of biochemistry, College of Applied Education and Health Sciences, C.C.S. University, Meerut, India is working to analyse the biochemical composition and benefits of this plant. So, as a part of a multidimensional project of analyzing various components and their impact on health and diseases, here we are reporting the amylase activity during germination of seed in Buckwheat (Fagopyrum esculentum) plant. Methodology: Common buckwheat (Fagopyrum esculentum) seeds were taken and germinated in dark at room temperature from 0 hours to 192 hours. Biochemical analysis for total amylase, alpha and beta amylase activities was measured by the standard method designed by Bernfeld (1955). Results: The seeds of buckwheat showed high level of amylolytic activity during different stages of germination. At 0 hours, negligible amylase activity was found. The first amylase activity was found at 24 hours and increases up to 96 hours. After 96 hours the total amylase activity starts decreasing and becomes almost negligible at 192 hours. Alpha and Beta –Amylase activity is reported separately. Conclusion: The amylases from the buckwheat showed different level of enzymatic activity during seed germination. Alpha amylase contributed a larger account to total amylase activity. The activity starts increasing and becomes maximum at 96 hours and starts decreasing and becomes lowest at 192 hours suggesting that alpha amylase plays a important role in starch metabolism in developing as well as geminating seeds which can be used for the drug discovery and treatment of several diseases like diabetes, polycystic ovary syndrome, constipation, bowel upsets, obesity and others.
Research article Evaluation of Genotype MTBDRplus Assay for identifying Multidrug Resistant Mycobacterium tuberculosis isolates in Nepal
(Janaki Medical College, 2013-03) Dahal, B; Adhikari, N; Shah, Y; Simkhada, RC; Maharjan, B; Shrestha, B
Background and Objectives: Multidrug-resistant (MDR) Mycobacterium tuberculosis strains are serious threats to the control of tuberculosis and comprise an increasing public health problem. Rapid detection of such strains is quite critical in timely management of such issues. The study was performed with an objective to compare Genotype MTBDRplus reverse hybridization probe assay (Hain Lifescince, GmBH, Nehern, Germany) with culture based proportion method for rapidly identifying MDR-TB strains from suspected multi drug resistant cases, referred to GENETUP Kathmandu, Nepal. Methodology: A commercially available new Genotype MTBDRplus assay was evaluated for its ability to detect mutations in Mycobacterial isolates conferring resistance to rifampicin (RMP) and isoniazid (INH). A total of 64 MDR isolates (i.e., at least resistant to RMP and INH), 5 fully susceptible strains and 1 RMP sensitive strains by conventional proportion method were analyzed using Genotype MTBDRplus assay. MTBDRplus assay is designed to detect the mutations in the hot spot region of rpoB gene, katG and regulatory region of inhA gene. Results: The MTBDRplus assay detected 59 of 61 RMP resistant strains (96.72%) with mutations on 81-bp hot spot region of rpoB gene and 60 of 63 INH resistant strains (95.23%) with mutation in codon 315 katG and regulatory region of inhA. The sensitivity and specificity for the detection of RMP resistance were 96.72% and 100% respectively. While, value of the same two variables for INH resistance were 95.23% and 100%, respectively. Conclusions: The new Genotype MTBDRplus assay represents a rapid, reliable, upgraded tool with high sensitivity and specificity for the detection of INH and RMP resistance strains that can readily be included in a routine laboratory work for the early diagnosis and control of MDR-TB.
Prevalence of Staphylococcus aureus in Intensive care Units and Post Operative Ward as a possible source of Nosocomial infection: An experience of tertiary care hospital
(Janaki Medical College, 2013-03) Bhattarai, P; Dhungel, BA; Shah, P; Amatya, J
Background and Objectives: Hospital Acquired Infection (HAI) also called nosocomial infection is a global problem. It also acts as a leading cause of death and increased morbidity among hospitalized patients. Staphylococcus aureus is one of the commonest pathogens causing HAI and is also closely associated with human body. WHO study has shown highest prevalence of HAI in Intensive care unit (ICU), Neonatal care unit (NICU), Post operative ward (POW). Hence it becomes very imperative to check the prevalence of HAI. Therefore this study was carried out to determine the prevalence of S. aureus in hospital environment as a possible source for HAI. Material and Methods: Environmental samples and blood samples of the patients were collected from ICU, NICU, POW using sterile cotton swabs during study period. Standard protocol was followed to isolate and identify S. aurues which was followed by antibiotic sensitivity tests. Results: A total of 216 environmental samples were collected out of which 18.98% (41) samples showed the presence of S. aureus. It was also isolated from the blood samples of patients admitted to ICU (7.5%) and NICU (6.8%). None of the isolates from environmental samples were MRSA(methycillin resistant Staphylococcus aures). Conclusion: S. aureus was found as a prominent environmental flora of hospital setting. Presence of these organisms in sensitive units like ICU, NICU, POW and the isolation of S. aureus from clinical samples indicates a possibility of HAI. It indicates the necessity of continuous surveillance of hospital environmental for quality control.
Magnesium induced vascular relaxation and role of Calcium-dependent K+ Channels
(Janaki Medical College, 2013-03) Upadhyay-Dhungel, K; Kim, CJ; Dhungel, A
Background and objectives: Magnesium is established as a neuro-protective agent and now also known as a vasodilator. It has been known for treating vasospasm following subarachnoid hemorrhage. However, its action mechanism in cerebral vascular relaxation is not clear. Potassium channels play a pivotal role in the relaxation of smooth muscle cells. To investigate their role in magnesium-induced relaxation of basilar smooth muscle cells, we examined the effect of magnesium on potassium channels using the patch clamp technique on cells from rabbit basilar artery. Material and Methods: Fresh smooth muscle cells were isolated from the basilar artery by enzyme treatment. Whole cell current recording was done using patch-clamp technique. Appropriate bath solution was used to have potassium current. The effect of Magnesium was observed and to identify the potassium (K+) channel involved in the magnesium-induced currents, different potassium channel blockers were used. Results: Magnesium increased the step pulse-induced outward K+ currents by more than fortyfive percent over control level (p<0.01). The outward K+ current was decreased significantly by application of tetraethylammonium, a non-specific K+ channel blocker, and by iberiotoxin, a largeconductance Ca2+-activated K+ (BKCa) channel blocker, but was not inhibited by glibenclamide an ATP-sensitive K+ (KATP) channel blocker. Magnesium failed to increase the outward K+ currents in the presence of IBX. Conclusion: These results demonstrate that calcium dependent pottassium (BKCa) channels has role in magnesium induced vascular relaxation in rabbit basilar smooth muscle cells and needs to be worked out for human.
Prevalence of Pulmonary Tuberculosis among the suspected patients visiting tertiary care hospital in Birgunj, Nepal
(Janaki Medical College, 2013-03) Shrestha, S; Shakya, B; Shrestha, P
Background and Objectives: Mycobacterial disease continues to cause high morbidity and mortality and is a major public health problem in Nepal. Bacteriological examination of sputum is the cornerstone in the diagnosis of pulmonary tuberculosis in the developing world. This prospective study was carried out with an objective to evaluate the prevalence of pulmonary tuberculosis among the patients visiting National Medical College Teaching Hospital by Ziehl- Neelsen (Zn) staining microscopy. Material and Methods: The study was cross-sectional study. Three consecutive early morning sputum collected from 626 patients were subjected to Zn staining and observed under oil immersion. Results: Among 626 patients, 85 (13.57%) were found to be Acid fast positive by Zn staining microscopy. Of total suspected patients,16.0% of male and 8.7% of female were infected, common among 41-60 years group (17.2%) followed by 21-40 years (12.6%) and multibacillary cases was 71.8%. Conclusion: The prevalence of pulmonary tuberculosis among National medical college teaching hospital was found to be higher than the Nation pulmonary tuberculosis detection rate, most commonly infecting males.
Effect of Lamotrigine on fetal rat brain morphology
(Janaki Medical College, 2013-03) San, N; Pandit, RK; Dhungel, S
Background and Objectives: Lamotrigine is a “second generation” anti-epileptic drug (AED) approved by the Food and Drug Administration (FDA) and is the first FDA-approved therapy after Lithium for maintenance treatment of bipolar I disorder. It crosses the placenta easily indicating that the maternal treatment leads to a considerable fetal exposure. This study is planned to study the morphological and histological changes induced by Lamotrigine in the fetal rat brain. Material and Methods: The morphological effect of lamotrigine on fetal rat brain was studied after giving four times its recommended therapeutic dose to 12 pregnant rats and placebo to 6 control rats during the period of organogenesis. The rats were sacrificed on the twentieth day of pregnancy. Body weight, body length, brain weight, brain volume, histological examination of the cerebral cortex and ventricular size of all the delivered fetuses were studied. Non-parametric Mann-Whitney test was used to compare the data. Results: There was no significant difference in mean body weight, mean body length, mean brain weight and mean brain volume in control and experimental rat fetuses. However one lamotrigine exposed rat fetus had exencephalic malformation and its histological study of the cerebral cortex revealed ill defined plexiform layer and dilated lateral ventricle. Conclusion: Probability that lamotrigine produces congenital malformation in fetal rats, when used during pregnancy, is low.
Cardiopulmonary fitness test among Nepalese students
(Janaki Medical College, 2013-03) Hada, S; Amatya, S; Gautam, K
Background and Objectives: Maximum Oxygen uptake (VO2 max) is a good predictor of cardiopulmonary and muscle fitness. Maximum oxygen uptake is defined as the highest rate at which oxygen can be taken up and utilize by body during severe exercise. The present study aims to find out the level of VO2 max using Mc Ardle equation and to compare obtained values from Chatterjee’s equation in Nepalese population. Methodology: Maximum oxygen uptake was determined by using the Queen’s college step-stool of 16.25 inches and popular Mc Ardle equation. Stepping was done for a total duration of 3 minutes at the rate of 24 cycles per minute for males and 22 cycles per minute for females. After completion of the exercise, subjects remained standing while the carotid pulse rate was taken as heart rate. Maximum oxygen uptake was calculated using obtained heart rate. Results: Queen’s college step test (QCT) was used as a submaximal exercise and the estimated VO2 max in boys and girls was 48.8± 7.3 ml/kg/min and 37.4± 2.7 ml/kg/min respectively with Mc Ardle equation and the value was higher when compared with Chatterjee’s equations. The value of VO2 max was observed and found to be less in smokers and sedentary individuals. Conclusion: As the values of VO2 max obtained from different equations are different, this research strongly argues the need of developing a prediction equation specifically for the Nepalese population.
Medicine counseling services at Tertiary care Hospital in Nepal
(Janaki Medical College, 2013-03) Bajracharya, O; Shankar, PR; Jha, N; Banstola, A; Shrestha, R; Thapa, H
Background and Objectives: Patient needs specific guidelines from their pharmacist in support of better compliance of their medicine used. Counseling of the patient and patient representative is important for improving the therapeutic out comes. Counseling patients can improve their understanding regarding medication, disease and life style modifications which in turn improves compliance. Material and Methods: Patients and/or patient party were counseled as per the Omnibus Budget Reconciliation Act-1990 guidelines. The data was collected as per OBRA-90 during the period of eighteen month and was analyzed using statistical software SPSS version 17. Results: Three hundred and fifty patients were counseled during the study period. Majority of the counseled patients were females [75.9%]. Mean counseling time taken by the pharmacist was 7.43 minute. Minimum time taken to counsel the patient was 6-10 minutes in 58.41% of the counseled, followed by less than 5 minutes in 19.68% and 11-15 minutes in 8.89%. About 10.47% were counseled for more than 15 minutes by the pharmacist. Greater numbers of the patients referred to the Medicine Counseling Center (MCC) were from Obstetrics and Gynecology departments and most of them were directed by doctors [50.47%]. Conclusion: This study highlights that role of doctor is important to encourage patient to attend counseling services. Counseling is the integral part that not only help patient to understand the use of their medicine but also to improve their therapeutic out comes. The effect of counseling on compliance should be studied in future.
Physiology of nostril breathing exercises and its probable relation with nostril and cerebral dominance: A theoretical research on literature
(Janaki Medical College, 2013-03) Upadhyay-Dhungel, K; Sohal, A
This article discuss about scientific basis of benefits of practicing slow pranayama, especially alternate nostril breathing pranayama. It explains the basis of benefit of alternate nostril breathing exercises and its probable relation with nasal cycle, cerebral dominance and autonomic nervous system. The airflow through one nostril is greater than next at any point of time which later switches to another. This is called nasal cycle. The nasal cycle lasts from 30 minutes to 2-3 hours. The nasal cycle occurs naturally. This nasal cycle is related with the cerebral dominance. When one nostril is dominant, the contra lateral hemisphere is active. The right nostril breathing leads to increased sympathetic activity while left nostril breathing decreases sympathetic activity and increases parasympathetic tone. So it has been speculated that these three phenomenon viz. nasal cycle, cerebral dominance and autonomic activities are correlated. This review also suggests that practicing alternate nostril breathing (Nadisodhan pranayma) regularly keeps the two hemispheres active and balances the sympathetic and parasympathetic activities in the body. Sympathetic or parasympathetic activity alternates automatically in our body which is important for our survival. Due to our hectic and stressful life, this naturally occurring alternate breathing cycle gets disrupted and we suffer from different ailments. These ailments are due to imbalance of autonomic nervous system which can be resolved by practicing alternate nostril breathing, the Nadisodhan pranayama. It’s just like returning back to nature.

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