iosr-JDMS   Volume-18 ~ Issue-12 ~ December-2019

Abstract: Background: Blood safety is a major issue all over the world in transfusion medicine. For this, donor selection is necessary in addition to the screenings of blood bags for infectious diseases. Deferrals lead to loss of precious blood/components available for transfusion. For preventing this, we should be having knowledge of blood donor deferral pattern and the causes of deferral. Materials and Methods:A prospectivestudy was carried out in a tertiary care hospital over a period of 20 months from January 2018 to August 2019. Data were collected from the donor deferral registry with respect to age and gender. The causes of deferral were categorized as temporary and permanent. Results: A total of 23091 registered donors were screened and 2818 (12.2%) were deferred. Overall, men (82.2%; 2315/2818) were deferred more than women (17.8%; 503/2818). However, women had higher deferral rate (20.6%; 503/2440) compared to....

Key Words: Blood safety, donor deferral, donor selection, permanent deferral, temporary deferral

[1]. Zou S, Musavi F, Notari EP, Fujii KE, Dodd RY; ARCNET Study Group.Prevalence of selected viral infections among temporarily deferred donors who returned to donate blood: American Red Cross blood donor study. Transfusion. 2005;45:1593–1600.
[2]. Rehman S, Arif SH, Mehdi G, Mirza S, Saeed N, et al. (2012) The Evaluation of Blood Donor Deferral Causes: A Tertiary Care Centre-based Study.J Blood Disorders Transf 3:131.
[3]. Shah A, Joshi P, Aghera GB, KJ Shah.A study on analysis of blood donation deferral during blood donation camp at tertiary-care teaching hospital in south Gujarat region. Int J Med Sci Public Health 2016;5:894-897
[4]. Krishna MC, Sharada MS, Harish SG, Raman MH.An analysis of Pre-donation deferral of blood donors in a tertiary care teaching hospital Blood bank unit,Tumakur,Karnataka,India.International Journal of Healthcare Sciences 2015;2(2):258-262.
[5]. Taneja K, Bhardwaj K, Arora S, AgarwalA.Analysis of the reasons for deferral of prospective blood donors in a Tertiary Care Hospital in North India. J ApplHematol 2015;6:154-6..

Abstract: Diabetes mellitus refers to a group of disorders presenting with hyperglycemia, having several distinct causes, resulting from complexinteractions of genetic and environmental factors. Hyperglycemia results from decreased insulin secretion decreased glucose utilization or increased glucose production. Peripheral artery disease is common in type II diabetics both men and women, though most are not detected in spite of severe blood flowlimitation.Ankle brachial index (ABI) was measured using sphygmomanometer and hand held doppler in both the cases (diabetic) and control (non diabetic) and compared. Prevalence of low ABI was significantly higher in diabetics compared to non diabetics (16% v/s 4%) . The aim of the study was to establish the high prevalence of undetected, asymptomatic peripheral arterial disease in type 2 diabetes in patients attending Coimbatore Medical College and Hospital.

[1]. Frowkes FG.The measurement of atherosclerotic peripheral arterial disease in epidemiological surveys.Int J Epidemiol 17:248-254 1988
[2]. Dachun Xu, Jeu Li, Liling Zou, Ya wei Zu, Dayi Hu, Pagoto SL, Yunsheng Ma].Sensitivity and Specificity of ABI to diagnose peripheral arterial disease: a structural review. Vasc Med 2010 oct; 15(5):361-9
[3]. cheng sw,Ting AC, Lau H,Wong J): Survival in patients with chronic lower extremity ischemia:A risk factor ananlysis.Ann vasc surgery 14:158-165,2000
[4]. Pyorala K,laakso M, Unsitupa M: Diabetes and atherosclerosis:an epidemiological view. Diabetic Metab Rev 3:463-524,1987. Donahue RP,Orchard TJ: Diabetes mellitus and macrovascular complications: an epidemiological perspective.Diabetes care 15:1141-1155,1992
[5]. Chapter 30: Type 2 Diabetes Mellitus; John B. Buse, Kenneth S.Plonsky, and Charles F. Burant. Williams Textbook of Endocrinology; 11thEdition. Editors: Henry M. Kronenberg, Sholomo Melmed, Kenneth S.Plonsky, P. Reed Larsen. Saunders Elsevier 2008

Abstract: Congenital talipes equinovarus (CTEV) is a commonmusculoskeletal condition in newborns, affecting one-to-two perthousand babies. The Ponseti method is a treatment regime forthe management of CTEV which describes a detailed method ofmanipulation, casting and bracing. This popular method was first published in 1963, it only started to become popular in the 1990s.1 Since then, the common material used for Ponseti cast is Plaster of Paris. This paper demonstrates a modern modification to the aged Ponseti method, with the incorporation of 3D technology and 3D printing method.

[1]. David C, Simon B and Nicola M (2007), "Subjective and objective outcome in congenital clubfoot; a comparative study of 204 children", BMC Musculoskeletal Disorders, vol. 8:53
[2]. Chotel F, Parot R, Durand JM et al. Initial management of congenital varusequinus clubfoot by Ponseti's method. Rev ChirOrthopReparatriceAppar Mot. 2002; 88(7): 710-7.
[3]. Herzenberg JE, Radler C, Bor N. Ponseti versus traditional methods of casting for idiopathic clubfoot. J PediatrOrthop. 2002; 22(4): 517-21
[4]. Frick SL: The Ponseti method of treatment for congenital Clubfoot; Importance of maximal forefoot supination in initial casting. Orthopedics, Jan. 28 (1), 63-65, 2005
[5]. Ponseti IV; Congenital clubfoot fundamentals of treatment.1st ed. NewYork: Oxford University Press Inc. 1996; 1(2): 448-54.
[6]. Terry Canale S, James H. Beaty, William Campbell's; Operative Orthopedics, 12th edition, 2013; 1: 994-1012

Abstract: Background: Allergic Rhinitis is one of the commonest atopic diseases with greater morbidity and significant social and economic burden. The Allergic rhinitis and its impact on asthma (ARIA) group proposed a new classification based on the duration and severity of symptoms. Objective: To determine the diagnostic and treatment outcome of allergic rhinitispatients. Methods: This was a Prospective clinical study included 100 patients with a clinical diagnosis of allergic rhinitis in the Dept. of Otolaryngology-Head and Neck Surgery,Combined Military Hospital and Central Medical Board, Dhaka Cantonment, Bangladesh during from 1st September 2018 to 31th August 2019. Patients with clinical diagnosis of allergic rhinitis presented with two or more nasal symptoms of excessive sneezing, watery nasal discharge, nasal congestion and itching of nose and eyes in all age group and sex were taken in study. According to severity, the patients were divided into the mild groups and the moderate-severe groups. The patients were given questionnaires on allergic rhinitis related symptoms. The total day time nasal symptom score was calculated by adding the individual scores for the four characteristics symptoms of allergic rhinitis. Data

Key Words: Allergic rhinitis, ARIA, Treatment outcome.

[1] Scadding G, Durham S. Allergic rhinitis. In: Gleeson M, editors. Scott-Brown's Otorhinolaryngology, Head and Neck Surgery 7th
ed. (London UK: Edward Arnold; 2008)1386-1407.
[2] Pawankar R, Mori S, Ozu C, Kimura S. Overview on the pathomechanisms of allergic rhinitis. Asia Pac Allergy. 2011;1(3):157-67.
[3] Nathan RA. The burden of allergic rhinitis. Allergy Asthma Proc. 2007; 28(1):3-9.
[4] Dykewicz MS, Fineman S. Executive summary of joint task force practice parameters on diagnosis and management of rhinitis. Ann Allergy Asthma Immunol. 1998; 81(5):463-8.
[5] Bousquet J, Khaltaev N, Cruz A, Denburg J, Fokkens WJ, Togias A, et al. Allergic Rhinitis and its Impact on Asthma (ARIA). Allergy. 2008:63 Suppl 86:8-160.

Abstract: Cardiovascular disease is a major cause of morbidity and mortality among patients with Chronic kidney disease.Majority of patients die from cardiovascular system complications. Dyslipidemia is a major risk factor for coronary heart disease.Many epidemiological studies have shown that CKD is associated with dyslipidemia. Our aim was to study Lipid profile in 100 patients of chronic kidney disease who were admitted in the Medicine Department of Regional Institute of Medical Sciences Hospital, Imphalfrom January 2016 to December 2016.Lipid examination showed 7% patients having high cholesterol (>240mg/dl) and hypertriglyceridemia was seen in 23% patients. Maximum number of patients (39.1%) with diabetic nephropathy had hypertriglyceridemia. LDL cholesterol was found to high in 10 % of patients and 55% patients had low HDL cholesterol level.

[1]. National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification and Stratification. Am J Kidney Dis 39:S1-S266, 2002 (suppl 1)
[2]. Mani MK. Prevention of CRF at the community level. Medicine update 2002; 12: 768-74.
[3]. Ma KW, Greene EL, Raij L. Cardiovascular risk factors in chronic renal failure and haemodialysis population. Am J Kidney Dis 1992; 6:505-13.
[4]. Eggers PW. Mortality rates amongs dialysis patients in Medicare's end stage renal disease program. Am J Kidney Dis 1990; 15: 414-21.
[5]. Gerald A, Cohen JJ, Harrington JT, Zusman CJ. Lipid abnormalities in renal disease. Kidney Int 1991; 39:169-83.

Abstract: INTRODUCTION Medical errors are one of the most important quality problems in health care today. A medical error is a preventable adverse effect of care whether or not it is evident or harmful to the patient. Reporting errors is fundamental to error prevention1. Reporting both errors and near misses has been key to improve safety. It sets up a process so that errors and near misses can be communicated to key stakeholders. Once data are compiled, health care agencies can then evaluate causes and revise and create processes to reduce the risk of errors. A crosssectional descriptive study was done by adopting a 27 itemed questionnaire regarding the opinion of resident doctors working in tertiary care teaching hospital about improving patient safety by reporting medical errors.Data was analyzed using Microsoft Excel 2007 version statistical software. Period of the study was from May 2019 to July 2019.

Keywords: Patient safety, Medical error, error reporting, quality patient care

[1]. Wolf ZR, Hughes RG. Error Reporting and Disclosure. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 35. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2652/ [2]. Sirio CA, Keyser DJ, Norman H, et al. Shared Learning and the Drive to Improve Patient Safety: Lessons Learned from the Pittsburgh Regional Healthcare Initiative. In: Henriksen K, Battles JB, Marks ES, et al., editors. Advances in Patient Safety: From Research to Implementation (Volume 3: Implementation Issues). Rockville (MD): Agency for Healthcare Research and Quality (US); 2005 Feb. Available from: https://www.ncbi.nlm.nih.gov/books/NBK20528/
[3]. Institute of Medicine (US) Committee on Quality of Health Care in America; Kohn LT, Corrigan JM, Donaldson MS, editors. To Err is Human: Building a Safer Health System. Washington (DC): National Academies Press (US); 2000. 5, Error Reporting Systems. Available from: https://www.ncbi.nlm.nih.gov/books/NBK225170/
[4]. Walsh K, Burns C, Antony J (2010) Electronic adverse incident reporting in hospitals. Leadership in Health Services 23: 1751-1879.
[5]. Paterick ZR, Pateric JD (2009) The challenges to transparency in reporting medical errors. J Patient Saf 5: 205-209.

Abstract: Introduction-Habitual dislocation of patella (HDP) is a condition where the patella spontaneously dislocates on flexion and relocates on extension of the knee. It is a rare condition and is more common in paediatric age-group than in adults. Many surgical procedures using proximal realignment and distal realignment have been reported in children with satisfactory results. However, HDP in adults with late presentation is rare and treatment plan is yet to be established.Materials and method- A case study of a 28yrs female presenting with HDP for 3 yrs with h/o fall and patellar dislocation 12yrs prior. She was managed with a combination of procedures-Proximal realignment, distal realignment, medial placation, lateral release. Result- Patient had extensor lag of 15 degrees initially but improved with vigorous quadriceps exercise. At 1yr follow up, her kujala knee score is 89 with ROM of 0-90degrees and with no evidence of patellar maltracking or instability. Conclusion- Successful result requires a combination of procedures depending on clinical and intraoperative findings on an individual basis......

Keywords: Habitual dislocation of patella, Proximal realignment, distal realignment, medial placation ,lateral release.

[1]. Deie M, Ochi M, Sumen Y, Yasumoto M, Kobayashi K, Kimura H. Reconstruction of the medial patellofemoral ligament for the treatment of habitual or recurrent dislocation of the patella in children. J Bone Joint Surg Br. 2003;85:6. [PubMed]
[2]. Gao GSX, Lee EH, Bose K. Surgical management of congenital and habitual dislocation of the patella. J Pediatr Orthop. 1990;10:255–60. [PubMed]
[3]. Marcacci M, Zaffagnini S, Lo Presti M, Vascellari A, Iacono F, Russo A. Treatment of chronic patellar dislocation with a modified Elmslie-Trillat procedure. Arch Orthop Trauma Surg. 2004;124:250–7.[PubMed]
[4]. Raghuveerreddy K, Somasekharreddy N. trochleoplasty and medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Indian J Orthop. 2012;46:242–5. [PMC free article][PubMed]
[5]. Shen HC, Chao KH, Huang GS, Pan RY, Lee CH. Combined proximal and distal realignment procedures to treat the habitual dislocation of the patella in adults. Am J Sports Med. 2007;35:2101–8. [PubMed]

Abstract: Tobacco is considered to be one of the most important etiological factor for development of Oral cancer. It was Christopher Columbus who first discovered tobacco and there after it was widely used in Europe. Later Spanish and Portuguese sailors carried this tobacco to other parts of world. Initially tobacco is known as a plant with medicinal values and was used in various forms like tobacco ointments, pastes, mouth rinses etc., to treat various maladies [1]Subsequently ,it was discovered that tobaccos possess various harmful substances. Numerous chemical compounds are identified in both smoked as well as non-smoking form of tobacco. They act not only as irritants and toxins, but are also......

Key Words: Ulcero proliferative growth; keratosis, Dyskeratosis, Leucoplakia, Erythroplakia , oral cancer

[1]. Charlton A. Medicinal uses of tobacco in history. J R Soc Med. 2004;97:292–6. [PMC free article]
[2]. Chaly PE. Tobacco control in India. Indian J Dent Res. 2007;18:2–5.
[3]. Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol2009;45:309–316.
[4]. Maia HC de M, Pinto NAS, Pereira J dos S, de Medeiros AMC, da Silveira ÉJD, Miguel MC da C. Potentially malignant oral lesions: clinicopathological correlations. Einstein. 2016;14(1):35-40. Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC487291
[5]. Saraswathi TR, Ranganathan K, Shanmugam S, Sowmya R, Narasimhan PD, Gunaseelan R. Prevalence of oral lesions in relation to habits: Cross-sectional study in South India. Indian J Dent Res. 2006;17:121–5.

Abstract: Purpose: The aim of this study was the clinical and radiographic evaluation of maxillary implants after rehabilitation of edentulous maxilla complicated with combination syndrome with All On Four® Implant supported fixed prosthesis Materials and methods: Twelve patients with total edentulous maxillary ridgesand partially edentulous mandibular ridges (class I Kennedy classification) received maxillary fixed prosthesis supported on four implants placed according to All On Four® concept and mandibular distal extension RPD. Clinical evaluation of maxillary implants was made at in term of plaque index, gingival index, pocket depth and implant stability at time of prosthesis insertion (T0), 6 months (T1) and 12 months later (T2) while radiographic.....

[1]. Kelly E. Changes caused by a mandibular removable partial denture opposing a maxillary complete denture. J Prosthet Dent. 1972;27:140-50.
[2]. Cabianca M. Combination syndrome: treatment with dental implants. Implant Dent. 2003;12:300-5.
[3]. Cune MS, de Putter C, Hoogstraten J. Treatment outcome with implant-retained overdentures: Part II--Patient satisfaction and predictability of subjective treatment outcome. J Prosthet Dent. 1994;72:152-8.
[4]. Krekmanov L, Kahn M, Rangert B, Lindstrom H. Tilting of posterior mandibular and maxillary implants for improved prosthesis support. Int J Oral Maxillofac Implants. 2000;15:405-14.
[5]. Ahuja S, Cagna DR. Defining available restorative space for implant overdentures. J Prosthet Dent. 2010;104:133-6.

Abstract: Objective: To determine the frequency of metabolic complications in infants of diabetic mothers. Methods: This study was conducted in NICU, RIMS RANCHI over a period of one year. Infants born to diabetic mothers (n = 80) were enrolled in this study and kept in NICU for first 24 hours of life. Serial blood glucose monitoring was done using glucose strips. Serum calcium and serum magnesium level were done at 6hrs.and 24 hrs. of life. Results: Out of 80, infant of diabetic mothers, 42 (52.5%) were males and 38 (47.5%) were females. Birth weight was between 2.5 kg to 3.99 kg in majority of infants (73.8%). The most frequent metabolic complication was hypoglycaemia that occurred in 32 (40%)neonates,hypocalcaemia was seen in 10 (12.5%) neonates and hypomagnesaemia in 4 (5%) neonates. Conclusion: Metabolic complications are commonly occurring complications in infants of diabetic mothers (IDM). Their monitoring and early treatment is very important so that overall outcome is improved and any future complication could be avoided..

Keywords: IDM, hypoglycaemia, hypocalcaemia, hypomagnesaemia.

[1]. Roglic G. Diabetes in women: the global perspective. Int J Gynaecol Obstet. 2009;104Suppl 1:S11–S13. [PubMed] [Google Scholar]
[2]. Wang Z, Kanguru L, Hussein J, Fitzmaurice A, Ritchie K. Incidence of adverse outcomes associated with gestational diabetes mellitus in low- and middle-income countries. Int J Gynaecol Obstet. 2013;121:14–19. [PubMed] [Google Scholar]
[3]. Mitanchez D, Burguet A, Simeoni U. Infants born to mothers with gestational diabetes mellitus: mild neonatal effects, a long-term threat to global health. J Pediatr. 2014;164:445–450. [PubMed] [Google Scholar]
[4]. Simeoni U, Barker DJ. Offspring of diabetic pregnancy: long-term outcomes. SeminFetal Neonatal Med. 2009;14:119–124. [PubMed] [Google Scholar]
[5]. Pedersen J. Weight and length at birth of infants of diabetic mothers. ActaEndocrinol (Copenh) 1954;16:330–342. [PubMed] [Google Scholar].

Abstract: Background -Pterygium is a degenerative condition of subconjuctival tissue which proliferate as vascularised granular tissue to invade the cornea destroying the superficial layer of stroma and bowmans membrane and whole covered by granulation tissue.the prevalence of pterygium in india vary widely from 0.75% to 10.42%there are numorous studies showing demographic profile and prevalence of pterygium. Aim -The study was performed to provide information about the changing demographic profile and prevalence of pterygium in southern odisha.it helps us to create awareness about pterygium among the general population. Material and methods-A retrospective study was conducted in department of ophthalmology from sept.2017 to feb. 2018 for a period of 6months.all the patients having pterygium without any ocular morbidity were included in the studythe demographic rate laterality and site of pterygium recorded.....

[1]. Parson's disease of the eye,21st edition;chapter 14;p-
[2]. MM singh;GV murthy,k venkatram.Astudy of ocular morbidity among elderly population in rural central india,IJO1997,45[1],61-65
[3]. H.Hanemi et al/journal of current ophthalmology xx[2016]1-5
[4]. T Vijaypriya et al,IJCEO,April-june 2018,4[2]245-248
[5]. Lup,chenx,kangy et al.clin experiment ophthalmology2007 828-33

Abstract: Objective: To evaluate the maternal and neonatal 25 hydroxyvitamin D (25(OH)D) level and effect of 25 hydroxyvitamin D level on development of neonatal sepsis. Method: This prospective study was performed in NICU, RIMS RANCHI, between January 2017 – December 2017. 51 term neonates with sepsis group and 56 term neonates with control group were included in this study. Blood samples for whole blood count, CRP, Calcium, Phosphorus, Alkaline phosphatase, cultures, 25 hydroxyvitamin D were obtained from all neonates. Results: Mean vitamin D level for neonates and......

Keywords: Vitamin D, Sepsis, Neonate

[1]. Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M. Vitamin D deficiency in children and its management:Review of current knowledge and recommendations. Pediatrics. 2008;122:398–417. [PubMed] [Google Scholar]
[2]. Mulligan ML, Felton SK, Riek AE, Bernal-Mizrachi C. Implications of vitamin D deficiency in pregnancy and lactation. Am J Obstet Gynecol. 2010;202:429, e1–9. [PMC free article] [PubMed] [Google Scholar]
[3]. Wang TT, Nestel FP, Bourdeau V, Nagai Y, Wang Q, Liao J, et al. Cutting Edge:1,25-Dihydroxyvitamin D3 Is a Direct Inducer of Antimicrobial Peptide Gene Expression. J Immunol. 2004;173(5):2909–2912. [PubMed] [Google Scholar]
[4]. 4Sankar JM, Agarwal R, Deorari AK, Paul VK. Sepsis in the newborn. Indian J Pediatr 2008; 75: 261–266.
[5]. Ng PC, Lam HS. Diagnostic markers for neonatal sepsis. CurrOpinPediatr 2006; 18: 125–131. 3 Lawn JE, Cousens S, Zupan J. For the Lancet Neonatal Survival Steering Team. Neonatal survival 4 million neonatal deaths: When? Where? Why? Lancet 2005; 365: 891–900. 4 Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet 2010; 375: 1969–1987. 5 Stoll BJ, Hansen NI, Sánchez PJ, Faix RG, Poindexter BB, Van Meurs KP et al..

Abstract: Learning and memory are some of the most intensively studied topic in neuroscience. Dementia is a syndrome of gradual onset and continuous decline of higher cognitive functioning. It is a common disorder in older persons. The common causes accounting for dementia are Alzheimer's disease (AD), vascular dementia, and other neurodegenerative diseases. Alzheimer's disease is progressive neurodegenerative disorder associated with loss of cholinergic neurons in distinct brain areas. Dementia and dyslipidemia may be co-morbid condition because both conditions predominantly affect elderly people. Drugs, currently available for dementia have several potential side effects. Further, with many drugs patients develop tolerance. Anti-dyslipidemic drug is one of the most commonly prescribed drugs today. Amongst anti-dislipidaemic drugs, statins have been found to have neuroprotective effects. The aim of the present study was to assess the cognitive effect of atorvastatin and to compare.....

[1]. Richard Gross, Psychology: The Science of Mind and Behaviour 6E, Hachette UK, ISBN 9781444164367.
[2]. A. Sosa, E. Albanese, C. Blossom et al., ―Prevalence, distribution, and impact of mild cognitive impairment in Latin America, China, and India: a 10/66 population-based study, PLoS Medicine. 2012. vol. 9, no. 2, pp. 1–11.
[3]. C. P. Ferri, M. Prince, C. Brayne et al., ―Global prevalence of dementia: a Delphi consensus study, The Lancet, 2005. vol. 366, no. 9503, pp. 2112–2117.
[4]. R. N. Kalaria, G. E. Maestre, R. Arizaga et al., ―Alzheimer"s disease and vascular dementia in developing countries: prevalence, management, and risk factors, The Lancet Neurology. 2008. vol. 7, no. 9, pp. 812–826.
[5]. Alzheimer's Disease International. Policy Brief for G8 Heads of Government. The Global Impact of Dementia 2013-2050. London: Alzheimer's Disease International; 2013.

Abstract: The aim of this study was to evaluate the adjunctive effects of the diode laser in open flap debridement as compared with the conventional surgical techniques. Chronic periodontitis patients on low dose aspirin were randomized into test (diode laser application after flap surgery) and control( flap surgery without laser ). The results showed less blood volume lost and better clinical improvements in the test sites. Henceforth the study has proved that lasers can form an integral part of periodontal therapy in patients on low dose aspirin(<150mg) without altering their drug regime.

[1]. Hennekens CH, Dyken ML, Fuster V. Aspirin as a therapeutic agent in cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation 1997;96(8):2751-3.
[2]. Dalen JE. Aspirin to prevent heart attack and stroke: what‟s the right dose? Am J Med 2006;119(3):198-202.
[3]. Owens CD, Belkin M. Thrombosis and coagulation: operative management of the anticoagulated patient. Surg Clin North Am 2005;85(6):1179-89, x.
[4]. Brennan MT, Shariff G, Kent ML, Fox PC, Lockhart PB. Relationship between bleeding time test and postextraction bleeding in a healthy control population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94(4):439-43.
[5]. Ardekian L, Gaspar R, Peled M, Brener B, Laufer D. Does low-dose aspirin therapy complicate oral surgical procedures? J Am Dent Assoc 2000;131(3):331-5.

Abstract: Background & Objectives: Cold Spinal Sprayis specially made equipment that directs multiple small but powerful streams of water to spinal portion on the patient. It is clinically used as a treatment modality in Naturopathy however its effects on Autonomic and Respiratory variables (ARV) has not been reported. The present study was aimed at evaluating the effect of Cold Spinal Sprayon ARV in healthy volunteers in causing sympathetic/parasympathetic activation immediately post treatment. Methods: A Pre-post study was conducted consisting of 60 healthy students from the SDM College of Naturopathy and Yogic Sciences, Ujire. Group 1(n=30) were assessed for Heart Rate, Heart rate Variability, Pulse Plethysmography (PPG) and Respiration before and immediately after the intervention using the Polygraph [BIOPAC MP36]. Each subject underwent the Cold Spinal Sprayfor 10 minutes during the treatment. Group 2 (n=30) were assessed for.....

[1]. Rajiv Rastogi. Current Approaches of Research in Naturopathy: How Far is its Evidence Base? J HomeopatAyurv Med. 2010; 1:107.
[2]. Sarris J, Wardle J Eds. Clinical Naturopathy: An Evidence Based Guide to Practice. Sydney: Elsevier, 2010.
[3]. AANP "Definition of Naturopathic Medicine" House of Delegates Paper-Amended 2011
[4]. Fleming SA, Gutknecht NC. Naturopathy and the Primary Care Practice. Prim Care. 2010; 37:119–36.
[5]. Kellogg J.H. Rational Hydrotherapy-Part III; Michigan: Battle Creek, 1903.2nd Edition, Reprinted by National Institute of Naturopathy, Pune, March 2005