Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 18790

AbstractCase ReportDiscussionConclusionReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Case report
Year : 2023 | Month : January | Volume : 17 | Issue : 1 | Page : YD01 - YD03 Full Version

Osteopathic Manual Therapy along with Cranial Electric Stimulation in Primary Dysmenorrhoea


Published: January 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/60491.17246
Sunita Sharma, Kamran Ali, Harneet Narula

1. PhD Scholar, Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Ambala, Haryana, India. 2. Assistant Professor, Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Ambala, Haryana, India. 3. Professor, Department of Radiology, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Ambala, Haryana, India.

Correspondence Address :
Dr. Kamran Ali,
Assistant Professor, Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Mullana, Ambala-133207, Haryana, India.
E-mail: k.alisportsphysio@gmail.com

Abstract

Primary dysmenorrhoea is described as lower abdominal discomfort that occurs soon before or during menstruation but pathology is called secondary dysmenorrhoea. Gynaecological dysfunctions are routinely treated using osteopathy and other physiotherapy treatments. The case report determines pre and postuterocervical angle, pain, physical activity level and psychological state after osteopathy manual therapy and conservative management on primary dysmenorrhoea. A 22-year-old female was diagnosed with primary dysmenorrhoea and was referred to the physiotherapy Outpatient Department (OPD) for conservative management. Physiotherapy assessment included Visual Analog Scale (VAS) for pain, International Physical Activity Questionnaires (IPAQ) for physical activity and Depression, Anxiety and Stress Scale-21 items (DASS-21) for psychological assessment at baseline. She received Cranial Electric Stimulation (CES), osteopathic manual therapy, deep breathing exercise, core strengthening exercise, lower limb stretching exercises and music therapy for relaxation. She received intervention for seven days a month for four consecutive months during menstruation cycles. After four months, her pain and psychological status improved significantly, uterocervical angle increased and there was an increase in physical activity. Thus, CES with osteopathic manual therapy along with conventional therapy helps reduce pain, increase physical functions, improve psychological status and even has a positive effect on uterocervical angle.

Keywords

Anxiety, Menstrual cycle, Physical therapy, Psychological, Uterus manipulation

Case Report

A 22-year-old female had cramps, lower stomach discomfort, lower back pain, and very painful menstruation during her menstrual cycles. The college-going girl staying in a hostel did not get any relief with medicine and was admitted to the hospital several times due to the severity of pain. Finally, she had a visit in Obstetrics and Gynaecology Department and was advised for ultrasonography, which revealed that her anterior uterocervical angle was smaller than normal (Table/Fig 1). She was finally diagnosed with primary dysmenorrhoea. Then she was referred to physiotherapy OPD for conservative management. In the Physiotherapy OPD, her overall assessment was done. Patient Body Mass Index (BMI) was 27.6 kg/m2. Her health and pain related quality of life was measured using the VAS, DASS-21 (1) and IPAQ (2). Baseline scores were pain of 9.1 cm (on 10 cm) VAS i.e. extreme pain; severe stress (14), extremely severe anxiety (10) and moderate depression (8) on DASS-21 questionnaire; decreased physical activity 300 Metabolic Equivalents (MET) (low) on IPAQ score; and decrease in uterocervical angle of 107.7°.

In this case, primary dysmenorrhoea was treated with osteopathic therapy (uterus manipulation), CES with hamstring and quadriceps stretching, quadratus lumborum stretching, core strengthening exercise, deep breathing, and music therapy. Patient position for CES was supine lying, with the therapist standing at the end of the couch (Table/Fig 2). Easy-to-use clip electrodes that were attached to the ear lobes, occipital region, mastoid processes, or temples were used to provide the current for 20 minutes at current densities of 1 mA, 5 A/cm2, and auto-adjustable (1-5 ms) pulse duration (3).

She was then treated by osteopathy (uterus manipulation) treatment for 10 minutes. Barral’s recommendations for testing and therapy in visceral osteopathy were followed. The patient was supine on her back with her legs bent. In order to examine the area posterior to the uterus fundus, the therapist places one hand immediately above the symphysis on the side opposite to the rectus abdominis attachment point (4).

The uterus was translated when both hands were placed on its sides. Ovaries and the uterine broad ligament were stretched-out by the therapist in the supine posture. The therapist envisioned the extension of the ovary while placing one hand on an anterior superior iliac spine symphysis line that was slightly medial to the margin of the psoas. To get this ligament to relay, the therapist slowly slipped her palm backward into the deep. During the expiration phase and the inspiration phase, the posterior-superior and anterior-inferior regions of the tubo-ovarian motility was assessed (Table/Fig 3). The treatment consists of following unimpaired movement at the endpoint for a few cycles and then following impaired movement to a different endpoint. Along with the visceral manipulation, self-static stretching of the quadriceps, hamstrings, and quadratus lumborum was carried out three times with a 15-second hold (3). One set of 10 repetitions of the cat and camel exercise and a plank exercise with a 30-second hold was used to strengthen the core (5).

The patient underwent a deep breathing exercise while seated, inhaling slowly and deeply through their nose for five seconds while keeping their shoulders relaxed, holding their breath for four seconds, then passively expelling for 10 minutes (6). Additionally, the treatment included music therapy, in which the patient spent 30 minutes in a comfortable supine posture while wearing headphones and listening to the classically relaxing Yaman raag in the early evening (7). This protocol was followed for six days for four consecutive menstrual cycles. The last follow-up at four months were 2.2 for VAS, (8) for stress, (4) for anxiety and (4) for depression in DASS-21 scale and 1500 MET in IPAQ. Baseline measurement and postmeasurement was performed before and after treatment; diagnostic ultrasound measurements with physiotherapy treatment indicate substantial change in uterocervical angle from 107.7° to 138.6° (Table/Fig 4).

Discussion

As very few studies have compared the effect of osteopathic manual therapy on primary dysmenorrhoea and no study has been done on CES in primary dysmenorrhoea, this study provides the new advancement that combines the effect of osteopathic manual therapy and craniosacral stimulation in treating primary dysmenorrhoea. After the treatment, patient showed positive impact on pain, psychology and physical activities. Pain reduced to 2.2 from 9.1 on VAS along with this, stress mild (8), anxiety normal (4) and depression normal (4) also showed improvement from severe to normal scores on DASS-21. The results also indicate that the treatment has a positive impact on physical activity on IPAQ score i.e., 1500 MET.

The majority of primary dysmenorrhoea cases occur during adolescence, 6 to 24 months following menarche, and have a definite, cyclical pattern (8). They are often severe on the first day of menstruation and can last upto 72 hours. A 70-90% of affected girls are under 24-year-old and 2-29% of them report having significant pain. Women view primary dysmenorrhoea as embarrassing and taboo, and many also see the pain as a natural side-effect of menstruation. Increased uterine prostaglandin F2 and prostaglandin E2 levels during endometrial sloughing are the pathophysiology of primary dysmenorrhoea.

Similar research was done by Chadwick K and Morgan A to determine how different pain-reduction techniques affected women with primary dysmenorrhoea (9). Soft tissue, Muscular Energy Techniques (MET), and High Velocity Low Amplitude (HVLA) techniques were among the techniques used. Not everyone received the same techniques or combinations of approaches. Then, visceral methods that directly affected the bladder, uterus, ovaries, diaphragm, and big intestine were used. In order to reduce muscle hypertonia and promote organ movement, stretching, articulation, and positional release techniques were used to and around these organs. The methods employed were comparable to those in Barral methodology. The impact of visceral manipulation in primary dysmenorrhoea was emphasised in this study.

Another study was carried out to see the effect of osteopathic manipulative treatment on primary dysmenorrhoea (10). The osteopathy manual therapy protocol included myofascial release, craniosacral manipulation, High Velocity Low Amplitude (HVLA) techniques, balanced ligamentous tension, muscle energy, strain-counter strain and soft tissue techniques. Patients in osteopathy manual therapy group had significant improvement in every outcome, including the average menstrual pain, physical and mental component on SF-12 scale than compared to light touch group. A similar case report was conducted to see effect of osteopathic manipulative treatment on psychosocial management of dysmenorrhoea (11). The study came to the conclusion that somatic dysfunction and psychological aspects should be taken into account while treating dysmenorrhoea, and doctors who administer osteopathy manual therapy for the condition should look for and treat any relevant sacral and pelvic somatic dysfunction.

A recently studied ultrasonographic parameter is the uterocervical angle, which is located between the cervical canal and the uterine frontal wall. It has been claimed in the literature that uterocervical angle and ultrasonographically determined cervical length can both reveal the cervix’s clinical function (12). According to a recent study by Dziadosz M et al., a big uterocervical angle makes it easier and more direct for uterine contents to be moved to the cervix (13). Zebitay AG et al., discovered a significant correlation between primary dysmenorrhoea in virgin adolescent girls, uterine cervical volume and cervical length (14).

The resistance from the uterine cavity is increased by a narrower uterocervical angle (Table/Fig 1). As a result, measuring the uterocervical angle is critical since it is associated with the severity of primary dysmenorrhoea (12). CES is a non invasive electrotherapy treatment that has been demonstrated to considerably reduce anxiety, sadness, and sleeplessness. CES reduces delta activity, which aids in tiredness reduction while increasing alpha activity. This further increases relaxation and lowers beta activity, resulting reduction in negative mental processes (4).

Uterus manipulation management improves the mechanical, circulatory and neurological responses. It improves venous and lymphatic circulation and helps the body decongest. It is also important in the reduction of hypertonicity and spasms. Women with primary dysmenorrhoea may benefit from a three-cycle course of five osteopathic treatments, according to previous research (6).

Spinal segments connected to the uterus may have become more sensitive, leading to an increase in afferent impulses and visceral hyperalgesia. Serotonin and norepinephrine receptors in the spinal cord may have been affected by the manipulation of the muscular, visceral, and joint tissues, which share sensory and motor pathways. This may have decreased the nociceptive convergence between the D10-L2 and S2-S4 spinal segments. Since, the lumbopelvic joints, ligaments, and muscles affected by primary dysmenorrhoea have chronic inflammation that contributes to both peripheral and central sensitisation, it is reasonable to suppose that manipulating these tissues may result in some functional changes in the central nervous system. According to certain studies, descending inhibitory mechanisms may be employed to reduce inflammation-induced hyperalgesia (10). Furthermore studies are required to come in this conclusion.

Deep breathing exercises lower pain severity while also increasing blood oxygenation and lung ventilation (6). Music therapy is useful in the treatment of depression, anxiety, mood swings and labour pain. Premenstrual Syndrome (PMS) symptoms can be alleviated by listening to classical music (7). The robust musculature of the core is built to withstand regular stresses as well as the stress of the menstrual cycle on the body.

Conclusion

The successful outcome of the index patient reveals significantly substantial improvements in pain, psychological state and increase physical activity along with an increase in the uterocervical angle after the application of osteopathy manual therapy, cranial electrical stimulation and conservative physiotherapy treatment. Hence, it can be concluded that osteopathic manipulation is efficacious in pain alleviation in primary dysmenorrhoea.

References

1.
Le MTH, Tran TD, Holton S, Nguyen HT, Wolfe R, Fisher J. Reliability, convergent validity and factor structure of the DASS-21 in a sample of Vietnamese adolescents. PLoS One. 2017;12(7):e0180557. Doi: 10.1371/journal.pone.0180557. [crossref] [PubMed]
2.
Tomioka K, Iwamoto J, Saeki K, Okamoto N. Reliability and validity of the International Physical Activity Questionnaire (IPAQ) in elderly adults: The Fujiwara-kyo Study. J Epidemiol. 2011;21(6):459-65. Doi: 10.2188/jea.je20110003. [crossref] [PubMed]
3.
Morriss R, Price L. Differential effects of cranial electrotherapy stimulation on changes in anxiety and depression symptoms over time in patients with generalized anxiety disorder. J Affect Disord. 2020;277:785-88. [crossref] [PubMed]
4.
Schwerla F, Wirthwein P, Rütz M, Resch KL. Osteopathic treatment in patients with primary dysmenorrhoea: A randomised controlled trial. Int J of Osteopathic Med. 2014;17(4):222-31. [crossref]
5.
Hend SH, Hala ME, Azza H. Stretching or core strengthening exercises for managing primary dysmenorrhea. J Womens Heal Care. 2016;05(01):01-06. [crossref]
6.
Baljon KJ, Romli MH, Ismail AH, Khuan L, Chew BH. Effectiveness of breathing exercises, foot reflexology and back massage (BRM) on labour pain, anxiety, duration, satisfaction, stress hormones and newborn outcomes among primigravidae during the first stage of labour in Saudi Arabia: A study protocol for a randomised controlled trial. BMJ Open. 2020;10(6):e033844; 01-13. [crossref] [PubMed]
7.
Siragusa MA, Brizard B, Dujardin PA, Réméniéras JP, Patat F, Gissot V, et al. When classical music relaxes the brain: An experimental study using ultrasound brain tissue pulsatility imaging. Int J Psychophysiol Off J Int Organ Psychophysiol. 2020;150:29-36. [crossref] [PubMed]
8.
Itani R, Soubra L, Karout S, Rahme D, Karout L, Khojah HMJ. Primary dysmenorrhea: Pathophysiology, diagnosis, and treatment updates. Korean J Fam Med. 2022;43(2):101-08. [crossref] [PubMed]
9.
Chadwick K, Morgan A. The efficacy of osteopathic treatment for primary dysmenorrhea in young women. American Academy of Osteopathy. 1996;6(3):15-17.
10.
Zecchillo D, Acquati A, Aquino A, Pisa V, Uberti S, Ratti S. Osteopathic manipulative treatment of primary dysmenorrhea and related factors: A randomized controlled trial. Int J Med Res Health Sci. 2017;6(11):165-74.
11.
Matsushita S, Wong B, Kanumalla R, Goldstein L. Osteopathic manipulative treatment and psychosocial management of dysmenorrhea. J Am Osteopath Assoc. 2020;120(7):479-82. Doi: 10.7556/jaoa.2020.076. PMID: 32598462. [crossref] [PubMed]
12.
Sahin ME, Sahin E, Madendag Y, Madendag IC, Tayyar AT, Özdemir F, et al. The effect of anterior uterocervical angle on primary dysmenorrhea and disease severity. Pain Res Manag. 2018;2018:9819402. Doi: 10.1155/2018/9819402. [crossref] [PubMed]
13.
Dziadosz M, Bennett TA, Dolin C, West Honart A, Pham A, Lee SS, et al. Uterocervical angle: A novel ultrasound screening tool to predict spontaneous preterm birth. Am J Obstetrics and Gynecology. 2016;215(3):376. [crossref] [PubMed]
14.
Zebitay AG, Verit FF, Sakar MN, Keskin S, Cetin O, Ulusoy AI. Importance of cervical length in dysmenorrhoea aetiology. J Obstetrics and Gynaecology. 2016;36(4):540-43. [crossref] [PubMed]

DOI and Others

DOI: 10.7860/JCDR/2023/60491.17246

Date of Submission: Sep 28, 2022
Date of Peer Review: Nov 10, 2022
Date of Acceptance: Dec 03, 2022
Date of Publishing: Jan 01, 2023

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Sep 30, 2022
• Manual Googling: Nov 08, 2022
• iThenticate Software: Nov 29, 2022 (10%)

Etymology: Author Origin

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com