Four Different Bleaching Agents-an in vitro Study
SUMMARY AND CONCLUSION
After 12 weeks of meditation practice there was significant reduction in heart rate, diastolic blood pressure, respiratory rate and anxiety status. Stress is a hypermetabolic physiological state associated with increased heart rate, blood pressure, respiratory rate, oxygen consumption and blood flow. Meditation which is a wakeful hypometabolic state associated with greater alertness and causes significant reduction in heart rate, respiratory rate, oxygen consumption, anxiety and plasma cortisol. Most of our observations are attributable either entirely or largely to induction of a hypometabolic state / relaxation response by meditation. Most of the studies on effect of meditation have been coupled invariably with practice of a set of asanas and kriyas. Old and physically weak people may not be able to perform these asanas. There is paucity of study of effects of meditation alone. Hence this study was undertaken to find out effect of meditation in only sukhasana posture, on some parameters related to stress in healthy young medical students.
Though Practice of various asanas were not included, only sukhasana which is the posture required for performing meditation was included, OM meditation along with OM chanting was taught and practiced. Hence only meditation without asanas and kriyas is also effective in reduction of stress. This can be a boon to the hypertensive, diabetic patients who have already crossed middle age and may not be able to carry out various asanas. Meditation brings better hormony between mind and body, which is essential to face stressful situations. Meditation modulates stress response and modifies one’s attitude towards stress.
Regular practice of meditation is highly beneficial in reduction of stress and to keep good health.
REFERENCES
1. Harris research International survey, Associates for research into science of enjoyment (ARISE).
Stress relaxation and pleasure amongst office workers. Nov 1994.
2. Malathi A, Damodaran A. Stress due to exams in medical students- Role of yoga. Ind J Physiol Pharmacol. 1999; 43(2): 218-224.
3. William E Prentice. Fitness of college and life. 5th edition; 1994: 333-354.
4. Ding John-E Young Eugene Taylor. Meditation as a voluntary hypometabolic state of biological
estivation. News Physiol Sci, Jun 98; 13: 149-153.
5. Benson H, The relaxation response. NewYork;
William Morrow and Co. 1975.
6. Farrell DJ. The reduction in metabolic rate and heart rate of man during Meditation, Lawrence E, Mount (Ed), E A A P, Publication # 26, Butterworth and Co. (Publishers) Ltd Australia.
1980; 279-282.
7. Dillbeck MC, Orme–Johnson D W. Physiological differences between transcendental meditation and rest. American Psychologists, 1987;42:
879-881
8. Gaylord C, Orme–Johnson D and Travis F. The effects of the transcendental meditation technique and progressive muscle relaxation on EEG coherence, stress reactivity and mental health in black adults. International J Neuroscience. May 1989; 46(1): 77-86.
9. Farrow JT and Hebert JR. Breath suspension during the transcendental meditation, technique.
Psychosomatic Medicine 1992; 44(2): 133-153.
10. Stehle R. Ventilation, Heart rate, Respiratory Partial Pressures of Athletes Practicing the Transcendental Meditation technique cologne, W.
Germany 1975.
11. Khanam,A A., Sachdeva, U,. Guleria R, and Deepak KK. Study of pulmonary and autonomic functions of asthma patients after yoga training.
Indian J of Physiol Pharmacol; Oct. 1996; 24.
12. Wallace RK. Physiological Effects of Transcendental Meditation. Science 1970;
167:1751-4
13. Delmont MM. Physiological responses during meditation and rest. Biofeedback Self Regulation.
Jun 1984; 9(2): 181-200
14. Zeier H. Arousal reduction with biofeedback supported respiratory meditation. Biofeedback Self Regulation. Dec 1984; 9(4): 497-508.
15. Sudsuang R, Chentanez V and Veluvan K. Effect Buddhist Meditation on Serum Cortisol and Total Protein Levels, Blood Pressure, Pulse Rate, Lung Volume and reaction time. Physiology Behavior, Sep 1991; 50 (3): 543-8
16. Schneider RH, et al. A randomized controlled trial of stress reduction for hypertension in older African Americans. Hypertension, Nov 1995;
26(5): 820-7.
17. Cooper M and Aygn M. Effect of meditation on serum cholesterol and blood pressure. J of the Israel Medical Association, 1978; 95: 1-2.
18. Alexander CN et al. Transcendental meditation, mindfullness and longevity- an experimental study with the elderly. J of Personality and Social Psychology, 1989; 57(6): 950-964.
19. Corey P W. Airway conductance and oxygen consumption changes associated with practice of transcendental meditation technique. University
33 R N Raichur 137-142.pmd 141 8/27/2012, 6:39 PM
of Colorado Medical centre, Denver Colorado, USA, 1973.
20. Wallace RK, Benson H and Wilson A. A wakeful hypometabolic physiologic state. Am J Physiol.
1971; 221: 795-9.
21. Farrow TJ. Physiological changes associated with transcendental consciousness- the state of least excitation of consciousness. Psychophysiology laboratory, 1975; MERU: Switzerland.
22. Spielberger C D, Gorsuch R L, Jacobs G A, Luschene R E, and Vagg P R. Manual for State Trait Anxiety Inventory. 1983, Palo Alto CA, Consulting Psychologist Press.
23. Malathi A, damodaran A. Stress due to Exams in Medical Students – Role of Yoga Ind J Physiol Pharmacol. 1999: 43(2): 218-224.
Ramesh B H1, Shashikala P2, Doddikoppad M M3, Mallikarjuna Swamy C M4, Chandrasekhar H R5
1Associate Professor, Department of Pathology, Mysore Medical College and Research Institute. Mysore
2Professor and Head, Department of Pathology. S. S. Institute of Medical Sciences and Research Centre Davangere
3Professor, Department of Pathology J.J.M.M.C. Davangere, 4Assistant Professor, Department of Pathology.
S. S. Institute of Medical Sciences and Research Centre, Karnataka
5Professor, Department of Pathology J.J.M.M.C. Davangere, Karnataka
ABSTRACT
Background: Fibroid is the commonest tumor of the reproductive tract and frequently encountered problem in gynecological practice.
Aim and Objectives: To observe the frequency of uterine leiomyoma in relation to age, parity and clinical manifestations.
Material & Methods: Over a period of two years, 1827 hysterectomy specimen sent for histopathology was studied. Uteri with fibroids were included for the study. Clinical data including age, parity, menstrual pattern, presenting symptoms, surgical treatment history of these patients with fibroid was collected and analyzed.
Results: Hysterectomy specimens constituted 65.48% of the total gynecological specimen during the period of two years. Leiomyoma was diagnosed in 314 patients out of 1827 hysterectomies (17.18
%.) Greater frequency (83.45%) was found in late reproductive and perimenopausal years ie 4th and 5th decade with a mean age of 40.9 years. Most of the patients were parous (98.09%) with more than one child. Menorrhagia (46.17%) was the commonest symptom followed by dysmenorrhoea (22.09%).
In 72.03% of cases uterus was between 6-12 weeks size.
Conclusion: Leiomyoma is the most common benign tumor of uterus occurring during reproductive age group. Incidence of leiomyoma is increasing in parous women. Patients with abnormal uterine bleeding have to be investigated to find out the exact etiology so that anemia due to prolonged blood loss is prevented and early therapeutic intervention prevents huge growth of the mass, thus preventing secondary complications.
Key words: Leiomyoma; Hysterectomy; age; Parity; Menorrhagia
Correspondence Address:
Dr Ramesh B H
No 17, 3rd Cross, KN extension Yeshwantpur
Bangalore-22
INTRODUCTION
Uterine leiomyoma (also referred to as myoma, fibromyoma, or fibroid), is the most common benign neoplasm of the female reproductive tract. It represents the clonal expansion of a cell within the myometrium of the uterus. These benign tumors occur in up to 30%
of symptomatic reproductive aged women, with the true prevalence estimated to be as high as 70%.The incidence peaks in the fourth decade and declines after menopause. Uterine leiomyoma is one of the leading
indications for hysterectomy. The clinical symptoms and severity usually depend upon the size, position and number of fibroids present. They are asymptomatic in more than 50% of the cases.
Dysmenorrhea, abdominal pain, Abdominal mass, pressure symptoms, infertility and repeated miscarriages may be The presenting symptoms.1, 2 3
Their growth is considered to be dependent upon estrogens excess, as leiomyomas Contain more estrogen receptors than normal myometrium4 and they usually Regress after menopause. Other benign tumors of the organ are so rare that they Need only minimal discussion.
Though uterine leiomyomas are common, it is difficult to obtain much information regarding clinical and pathological aspects of it in Indian literature. This
34 Ramesh BH st 143-146.pmd 143 8/27/2012, 6:39 PM
prompted the present study. The exact incidence is difficult to assess as most of the patients do not come to the hospital unless and until there is presence of progressive symptoms of some duration.
Most of the leiomyomas are believed to be asymptomatic when small and progress slowly.
Unfortunately their symptomatology continues to be variable5.
Much attention has been focused on the association of leiomyomas with a state of hyperestrinism and as the factor responsible for their growth. Here we present an analysis of leiomyomas in relation to age, parity and clinical manifestations from a large series of hysterectomies.
MATERIAL AND METHODS
This is a descriptive study on patients with leiomyomas, diagnosed in hysterectomy specimen.
Over a period of two years, 1827 hysterectomy specimen sent for histopathology were studied in detail both macroscopically and microscopically for the presence of leiomyomas. Uteri harboring leiomyomas were segregated and particulars of those patients regarding age, parity, clinical symptoms were collected from the case records and analyzed.
RESULTS
Gynecological surgical specimen constituted 26.41% (2790) of the total surgical specimen (10,562) received for microscopic diagnosis to the department of pathology during the study period. Of the 2790 gynecological specimen, hysterectomy specimen was 1827 (65.48%). Leiomyoma was diagnosed in 314 specimen (17.15 %.) which included three myomectomies.
Age (Figure 1): Age of these patients ranged from 21 to 70 years with most of the patients in 4th (49.37%) and 5th decade (34.08%). Only two patients were in 7th decade. The mean age was 40.9 yrs.
Parity (Figure 2): Of the 314 patients with leiomyomas, 308 patients (98.09%) were parous with more than one child and only 6 were nulliparous (1.91%). Seventeen patients had a single child (uniparous).
Fig. 1:
Fig. 2:
Symptomatology (Table 1): Menorrhagia (46.17%) was the commonest symptom followed by dymenorrhoea (22.29%), pain abdomen (12.74%) and mass per abdomen (14.01%).
Table 1. clinical Symptoms
Symptoms No. of Cases %
Menorrhagia 145 46.17
Dysmenorrhoea 70 22.09
Pain abdomen 40 12.74
Mass per abdomen 44 14.01
Prolapse 28 8.91
White discharge per vagina 24 7.64
Mass per vagina 5 1.59
Backache 7 2.22
Bladder disturbances 4 1.27
Metrorrhagia 20 6.36
Polymenorrhagia 10 3.18
Sterility 6 1.91
Fever 5 1.59
Amenorrhea 1 0.05
Total 314 100
Clinical assessment of uterine size: In 72.03% of cases, uterus was between 6-12 weeks size, as assessed clinically followed by uterine size of 12-20 weeks (8.04%) and with more than 20 wks in 8.04%. Atrophic uterus was found in only 2 (0.64 %) cases.