Non-specific chronic low back pain is common and complex and has a large impact on individuals and society. Inculcating physical exercise to promote healthy lifestyle has played an important role in the prevention and management of chronic health conditions. The purpose of this article is to review the published literature on lifestyle factors mainly physical exercise to combat non-specific chronic low back pain. PubMed database was reviewed from January 2000 to November 2018 and searched for ‘exercise and non-specific chronic low back pain’, ‘lifestyle and nonspecific chronic low back pain’ and individual exercise interventions and non-specific chronic low back pain. Articles which fulfilled the criteria were included in the final review. The available evidences from existing systematic reviews and articles suggested that physical exercise does improve pain severity and physical function in chronic non-specific low back pain. Regarding the type of exercises, strengthening or resistance exercises seem to be effective but no specific type of exercise is superior to others. Incorporating physical exercise such as strengthening exercises as part of the lifestyle change could combat non-specific chronic low back pain.

Background and Objectives: Patients undergoing cardiac catheterization and coronary angiography often experience high levels of anxiety and physiological disturbances. Music therapy and music interventions have been found to be effective in bringing down the anxiety and reducing the physiological disturbances for these patients. However, the efficacy of combination of music and yoga therapies for preprocedural anxiety and physiological disturbances needs to be studied. We aimed in this study to compare the effect of music therapy with the combination of music and yoga therapies to impact the psycho-physiological responses like anxiety, blood pressure, pulse rate and respiratory rate of patients who were posted for coronary angiography Material and Methods: A total of 45 patients who were posted for coronary angiography were included in the study and randomly divided into three groups. Music therapy group(n=16) received music listening intervention in the form listening to pre-recorded, patient-preferred, relaxing raga improvisational music for 15 minutes 1) on the previous day of angiography and 2) 15 minutes before being taken to the catheterization lab on the day of the angiography. The combination of music and the yoga group received both music therapy and yoga therapy in the form of pranava pranayama together for 15 minutes. The control group received only the standard medical treatment. The state of anxiety was measured by a five point single item Likert scale and the physiological measures such as systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR) and respiratory rate (RR) were also recorded for the study Results: Both music therapy alone and the combination of music and yoga therapies resulted in within the group significant reduction in anxiety and respiratory rate and music therapy group recorded additionally significant reduction in SBP, DBP and PR scores during the period of intervention. Conclusion: Our findings indicate that music therapy alone can bring down the anxiety levels and reduce the physiological disturbances of patients posted for angiography. Also, combination of music and yoga therapies can bring down the anxiety levels and improve the deep breathing pattern for these patients posted for angiography. More studies are needed to confirm these findings.

Background and Objectives: Lifestyle modification practice which includes weight reduction, salt restriction, physical activity, smoking cessation and consuming healthy food is the foundation of prevention and control of chronic diseases. This non pharmacological approach can be an initial treatment of some non-communicable diseases (NCDs) before the start of a medication or in conjunction to a medication. This study was conducted to establish the knowledge and practice regarding lifestyle modification among a rural community. Material and Methods: This cross-sectional study was conducted by using structured questionnaires among 60 respondents in village ‘Kampung Baru’ in Sungai Petani town at Kedah state in Malaysia from September 1 to October 30, 2017.Simple random sampling was used to select study subjects. Their knowledge and practice regarding lifestyles modification were assessed. Data were analyzed through Statistical Package for Social Sciences (SPSS). Results: The study revealed that the mean ± SD age of respondents was 43.4 ± 19.17 years. Among the respondents 79.9% had good basic knowledge regarding lifestyle modification practices. 96.6% received formal education. Respondents with monthly income of more than 1000 Ringgit (58.3%) were more likely to practice good lifestyle modification practice as compared to those with monthly income of less than 1000 Ringgit. Majority of respondents 38(63.3%) are being involved in physical activity for 30 min per day. The study shows the lower prevalence of overweight (30.2%) and obesity (15.1%) amongst the participants. 83.3% practiced recommended low salt diet, 65% participants are non-smokers and 90% practiced abstinence from alcohol drinking. 56.7% of the respondents were not suffering from any type of illness. Conclusion: In this study majority of the respondents has the positive attitude towards the recommended lifestyle modification practices, while 43.3% respondents are less likely to practice good lifestyle modification. This can be made more effective by sharing the knowledge and attitude, so that a sustainable environment can be created throughout the community.

Background and objective: National Family Health Survey (NFHS) is one of the reliable source to estimate some indicators at State and National level. The first NFHS survey was conducted in 1992-93 and the fourth survey in 2015-16. This analysis is aimed to find the trend of selected maternal and child health indicators over these survey periods to help the programme planners and implementers to plan or modify the strategy towards achieving the goals. Material and methods: The results of four NFHS conducted during 1992-93, 1998- 99, 2005-06 and 2015-16 were taken for analysis to assess the trend over these periods. The trend analysis comprised of antenatal care received, institutional births, fully immunized, stunted and underweight children below five years, infant mortality rate (IMR), under 5 mortality rate (U5MR) and total fertility rate (TFR). Linear regression analysis was applied to assess the trend for the selected variables. Results: The amount of variance explained in linear trend for ante-natal visit, institutional deliveries, fully immunized children, stunted children, underweight children, IMR, U5MR and TFR were 0.85, 0.84, 0.85, 0.92, 0.99, 0.99, 0.99 and 0.96 respectively. Hence, the estimates were concluded as reliable for the future rounds though the interval among the survey was not uniform. The projected antenatal visit was 55%, institutional delivery was 87%, fully immunized will be 66%, stunted 25%, underweight 29%, IMR 30, U5MR 30.25 and TFR will be 1.85. Conclusion: The trends show that the achievement of all the above indicators was not satisfactory.

The list of required competencies for the Indian Medical Graduate (IMG) along with suggested teaching/learning methods and topics for integration have been notified by Medical Council of India. Also, the desired level of proficiency for various competencies has been defined with emphasis on the need to certify some of them. The corresponding Graduate Medical Education Regulations with details of curricular time assignment for various disciplines, scheduling and details of the evaluation process are still to be released and is expected shortly. With implementation fixed for the academic year 2019-20, it is necessary for all faculty to be apprised of the details of the changes being sought to be brought about. This paper will focus on details of the new curriculum, its merits compared to the previous version and some areas of concern which may require attention and rectification later on. One possible strategy for preparing and implementing the curriculum by August, 2019 will be suggested.

Acute undifferentiated leukemias (AUL) is the diagnosis of exclusion and is very rare, the morphology of leukemic cells is not specific. Here we report a rare case of AUL with myelofibrosis with an unusual morphology. A 40 year female presented with anaemia and hepatosple enomegaly with pancytopenia and leucoerythroblastic blood picture on peripheral blood smear underwent bone marrow studies. Bone marrow biopsy showed infiltration of blasts with scant cytoplasm, round to irregular nucleus, dispersed chromatin with grade 3 fibrosis by Reticulin stain and negative Masson trichrome stain. Immunohistochemistry (IHC) on bone marrow biopsy showed CD 34 positivity and negative for Tdt, MPO, CD3, CD20, CD61 markers. Thus diagnosed as Acute undifferentiated leukemia with myelofibrosis. AUL is the diagnosis of exclusion and before categorizing leukemia as undifferentiated, it is necessary to perform immunophenotyping with a comprehensive panel of monoclonal antibodies.

Primary cardiac tumors are rare and myxomas of heart alone account for 80% of benign tumors. Extensive sampling of specimen is important not only to study diverse histologic feature of myxoma cells but also to rule out primary malignant tumor with myxomatous differentiation. Resected margin was free from tumor in the present case, thus reducing the chances of recurrence.

Teratoma of the fallopian tube (solid or cystic) is extremely uncommon. In addition, the incidence of a mature cystic teratoma of fallopian tube containing haemorrhagic fluid in association with uterine adenomyoma is extreme low. In the current case report, we present a case of mature cystic teratoma of the fallopian tube containing haemorrhagic fluid with uterine adenomyoma in a 46 year old female who attended menopause one year back. The patient underwent total abdominal hysterectomy and bilateral salpingooophorectomy. Histopathology confirmed the diagnosis of fallopian tube teratoma.