Introduction: Adolescence is a period of maturity, a point of physical, emotional, social and psychological change. Menstruation is described as the exclusive sign of femininity and it is a physical manifestation of complex endocrine axis. Body mass index or BMI have the most control over menstrual irregularity. The increasing trends in the prevalence of childhood obesity, early puberty and menarche, and ethnic racial differences in the effect of body mass index on the reproductive characteristics of young females around the world, warrant continuous evaluation. Hence, we aim to investigate possible variations in the influence of body mass index on the age at menarche as well as duration of menstrual cycle and menses in young girls. Material and Method: Present study was conducted on 300 young female medical students over a period of 18 months. Young and unmarried female medical students in the age group of 17-25 years of age group were included. Married or who were on treatment for menstrual problem or had primary amenorrhoea or undergone pelvic surgery were excluded. Structured questionnaire was used to determine the occurrence of menstrual problem. Body mass index was calculated and the collected data was analysed between the relationship parameter i.e. body mass index and menstrual abnormalities. Result:The mean age of the study population was 21.98 yrs. The mean of BMI in the study population was found to be 21.42kg/m 2 . Irregular menses (including short and long cycles) is highly significantly associated with underweight and overweight BMI as clear with P-value of 0.0001 and 0.0001 respectively. Irregular cycles were seen in 45 cases out of which 9 were having Polymenorrhea i.e. cycle length less than 21 days, 10 were having irregular cycle with no fixed length, and 26 were having oligomenorrhea. Out of 45 cases with irregular cycle 19 were in underweight category, 9 in overweight category, and 2 in obese class 2 and rest 15 in normal BMI category. Conclusion:The present study suggests alteration in body mass index was associated with changes in menstrual pattern. Maintaining the correct weight according to the height is utmost important to avoid so many menstrual irregularities as well as long term metabolic complications.

This study was carried out to assess the effectiveness of lifestyle modification counseling using lifestyle intervention holistic model and its adherence towards glycemic control in type 2 diabetes mellitus patients. This quasi-experimental prospective study was conducted among 224 type 2 diabetes mellitus patients in Delhi Diabetes Research Center, New Delhi. The study participants were allocated to lifestyle modification counseling group (intervention) and usual care (control) group based on receiving or not receiving lifestyle modification counseling using lifestyle intervention holistic model. Effect of counseling on glycemic control was assessed at baseline and follow up of both the groups at 3rd, 6th and 12th months after receiving lifestyle modification counseling. The collected data was analyzed for percentage, mean, median, standard deviation, chi-squared, t-test and Wilcoxon test. In this study, the lifestyle modification counseling proved to be effective and showed significant improvement in fasting blood sugar (175.5±32.3 to 144.7±17.6), postprandial blood sugar (275.5±61. to199.0±48.3), hemoglobin A1c by 9.3±1.5 to 8.4±1.3. Significant improvement was observed in diastolic blood pressure (82.6±7.0 to79.4±6.1) and high-density lipoproteins cholesterol (47.3±10.5 to 58.8±5.6) from 3rd to 12th months follow up with significant p value 0.001 in the intervention group. The study showed good adherence to balanced diet, physical activity, and tobacco and alcohol cessation but less adherence was observed towards meditation for stress management, regular checkups, and medicine adherence. Lifestyle modification counseling is an effective, noninvasive approach towards glycemic control in type 2 diabetes mellitus patients. Lifestyle intervention holistic model used in this counseling may be helpful for type 2 diabetes mellitus patients to improve adherence and self-care behavior towards the management of their diabetes.

Diabetes is a costly, lifestyle disorder which increases the burden of disease and deteriorates the Health-Related Quality of Life (HRQOL) of diabetes patients and this study was conducted to assess the effect of lifestyle intervention on medical treatment cost and HRQOL in type 2 diabetes mellitus (T2DM) patients. This quasi-experimental prospective study was conducted in Delhi Diabetes Research Center, New Delhi and included 224 T2DM patients. Patients were divided into LMC and usual care group on the basis of receiving or not receiving lifestyle modification counseling. The follow-up of both groups was done at 6th and 12th months. Collected data were analyzed through IBM, SPSS software v 21 for mean, median (min-max), SD, t-test and Wilcoxon scores (rank sums) test. The results of this study showed a statistically significant reduction in diabetes medication costs, hospitalization and surgery costs in the LMC group as compared to the usual care group. The significant improvement was also observed in HRQOL domains which includes - physical functioning (62.40±6.738 to 83.67 ± 5.4920), physical health (35.30±22.069 to 64.50±13.62), emotional problem (37.90±28.93 to71.46±16.75), energy (54.31±11.858 to 80.75 ± 15.52), emotional well-being (63.06± 9.828 to 85.79±6.36), social functioning (38.848±20.805 to 65.54±8.39) and general health (54.51±11.679 to 82.398± 11.7) at 12th month follow up in LMC group. The ADS score also showed significant improvement in overall HRQOL of LMC group. This study concludes that lifestyle intervention may improve HRQOL and reduce medical treatment cost of T2DM patients.

Background: First trimester vaginal bleeding (FTVB) plays a role in occurrence of late pregnancy complications in both mother and infant. Late pregnancy outcomes in mothers and infants are the main concerns for the obstetricians. The purpose of this study was to assess the perinatal outcome of pregnancies complicated by first trimester vaginal bleeding.Methods: The present study included total 100 singleton pregnant women with history of FTVB whose pregnancy was confirmed chemically. Patients were closely observed and follow up done 2 weekly upto 36 weeks and weekly after that. Late pregnancy outcomes such as gestational hypertension, pre eclampsia, placental abruption, preterm delivery and pre mature rupture of membranes in the mothers and  low birth weight, intrauterine growth ristriction, apgar score after 1 and 5 minutes,  and  NICU admission in new born were calculated.Results: Incidence of PROM, gestational hypertension and placental abruption is more in women with FTVB. However there infant had higher rate of IUGR and LBW. Apgar score after 1 and 5 minutes were less than 5 and admission to NICU too.Conclusions: FTVB is an important factor to predict both the maternal and fetal outcomes in late pregnancy. It is therefore important to evaluate and consider these pregnancies as high risk group and provide careful antenatal care.

The prevalence of diabetes mellitus has become a global public health issue. Natural herbal treatments for type 2 diabetes mellitus have been widely used in traditional societies but has recently become popular among western societies as well. The aim of this study was to explore the experience of type 2 patients with diabetes mellitus who are currently on natural herbal treatment. A qualitative, phenomenological design has been used. Twelve participants from both males and females, aged between 25 and 75 years, who were on medical treatment, were selected for sampling. In-depth interviews were conducted at the diabetes clinic in a selected hospital in southern Sri Lanka. The athematic analysis was conducted, and 6 themes were derived. The majority of participants (75%) were motivated to use natural herbal treatments other than oral glycemic therapy. Experiences have been identified as the most influential factors in the use of natural herbal treatments. The need for educational interventions on natural herbal treatments and to propose the integration of herbal medicine into current medical systems is recommended.