Sreeraj S R - Academia.edu (original) (raw)

Papers by Sreeraj S R

Research Journal of Pharmacy and Technology, 2023

Although non-invasive transdermal application of various pharmaco-therapeutic drugs via phonophor... more Although non-invasive transdermal application of various pharmaco-therapeutic drugs via phonophoresis (PH) is
widely used in physical therapy, the influence of the type of medium in which the drug is prepared and mode of
ultrasound on drug absorption is hardly explored. Hence, the same formed the aim of this study. In this study,
serum concentration of diclofenac sodium (DS) was quantified and compared between gel and cream medium,
using continuous mode (CTUS) and pulsed (PTUS) mode of Therapeutic Ultrasound (TUS) respectively. Study
was conducted on eight healthy adult rabbits with 1% DS in gel and cream as topical application (TA) and PH
using TUS of 1 MHz with 1 W/cm2 in CTUS and 20% PTUS respectively for 8 minutes during each session.
Blood samples were analysed for drug concentration in serum by High performance liquid chromatography
(HPLC) assay. Comparison of DS concentration in plasma showed a significant difference with cream than gel
medium in both CTUS (p=<.001) and PTUS (p=.005) mode. For the modes of TUS, PTUS showed significance
against TA in both gel (p= <.001) and cream (p=.001) and with CTUS better with TA in cream (p = 0.003)
medium. The transdermal drug absorption was significantly higher in the cream than gel medium, having similar
results between continuous and pulsed TUS. PH also confirmed significantly higher drug absorption than TA in
both media and modes of TUS.

MGM J Med Sci, 2020

This is an open access journal, and articles are distributed under the terms of the Creative Comm... more This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. For reprints contact: reprints@medknow.com How to cite this article: Chheda P, Rajan Sreeraj S. Prevalence of musculoskeletal symptoms and quality of life in housekeeping workers of a tertiary care hospital in Navi Mumbai, India: A descriptive study. MGM J Med Sci 2020;7:133-40. Abstract Context: Prevalence of musculoskeletal disorders (MSDs) in India is 90%, leading to loss of working hours, poor quality of life (QoL), and reduction in productivity of the life of the employers. Housekeeping profession, considered a major workforce industry, requires manual labor demanding awkward postures and repetitive movements, leading to MSDs and impacting QoL. Objectives: The objective of this study was to find the prevalence of the symptoms of MSDs and QoL in the housekeeping workers of the hospital. Settings and Design: A descriptive study was carried out among housekeeping workers of MGM Hospital, Kamothe, Navi Mumbai, Maharashtra, India. Materials and Methods: With Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) and WHO-QOL-BREF scale, 82 housekeeping workers were contacted, and an interview-based session was held. Statistical Analysis: Descriptive analysis and graphical representation were carried out using MS Excel. Results: Of the participants, 68.29% were females with a mean age of 42.28 ± 7.4 years, and 31.70% were males with a mean age of 42.04 ± 8.3 years. The prevalence of the symptoms of MSDs was higher in knees followed by lower back and lower leg. Females (80.36%) were affected more than males (61.54%). WHOQOL-BREF for QoL showed a moderate impact without much gender difference. Conclusion: The study concluded that there is a high prevalence of the symptoms of MSDs in housekeeping staff, more likely in the lower back, knee, and lower leg, and WHO QOL-BREF shows comparable mean scores among males and females. Keywords: Global burden of disease, housekeeping workers, musculoskeletal disorders, quality of life Key messages: Studies addressing the influence of MSDs and QoL on the housekeeping workforce of hospitals are scarce and data addressing the same helps to spread more awareness on areas needing attention and prevention programs needed for this population.

International Journal of Physiotherapy and Research, 2017

Background: Studies has demonstrated the development of Kinesiophobia in Low Back Pain (LBP) and ... more Background: Studies has demonstrated the development of Kinesiophobia in Low Back Pain (LBP) and identified as one of the risk factor for chronicity in LBP. In addition to deconditioning effect, Kinesiophobia also install functional disability and does that affect quality of life? Literatures had exposed the association of Kinesiophobia in chronic and acute low back pain separately but paucity in estimating their quality of life thus this study aims to explore the impact of Kinesiophobia on the quality of life in LBP. Materials and Methods: One hundred and twenty study participants were recruited by convenient sampling method between 18-60 years of age. Data were collected by using Tampa scale of Kinesiophobia, Numerical Pain Rating Scale, SF-36 Health Status Questionnaire and Modified Oswestry Disability Questionnaire for LBP. Secured scores were analysed in SPSS software to identify the association between Kinesiophobia and other functional scales. Results: Mean age of the study participant was 39.79±11.22 years. Prevalence rate of high degree of Kinesiophobia was found as to be 58.33% (n=70). As the intensity of pain increases in LBP, the development of Kinesiophobia also increased and its association exhibited as weak positive linear correlation (r=0.256, p=0.032). Development of Kinesiophobia has demonstrated increased functional disability where correlation between Kinesiophobia and Oswestry disability shows moderate positive correlation (r = 0.495, p=0.000) simultaneously correlation between Kinesiophobia and SF-36 shows moderate negative correlation (r =-0.420, p=0.000) indicating decreased Quality of Life. Conclusions: It has been found that there is a direct relationship between the pain and the development of Kinesiophobia in LBP which in turn increase in the development of functional disability thus marking decreased QOL.

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016

Background: Polycystic ovarian syndrome (PCOS) adversely affect women at varying stages of their ... more Background: Polycystic ovarian syndrome (PCOS) adversely affect women at varying stages of their life and imperative to emphasis on prevention strategies since incidence of PCOS is on the rise. Study aims to explore perception on PCOS, awareness on life style modification, emotional attributes, concern regarding PCOS and utilization of physiotherapy services.
Methods: The study was conducted in Mumbai and Navi Mumbai, India. Self-made validated questionnaire was administered. Descriptive analysis was done. Perception on PCOS, lifestyle modification, emotional attribution and biggest concern were calculated as absolute frequencies and were reported as overall percentages. Chi square test was applied on the demographic factor‘s influence on level of awareness.
Results: 21% of the respondents are very well aware about PCOS. 51% reported as doctor was their main source of information about PCOS. 81% expressed that PCOS is manageable one. 62% aware that exercise helps in the management of PCOS. Out of this, 39% are doing exercise on a regular basis. However all the study participants reported, they have not had any consultation from physiotherapist for their structured exercise program.32% attributed to anxiety after the diagnosis of PCOS. 64% of the respondents aware that changing in diet or eating habits can
influence in PCOS. However 95% of the subjects concurred to follow life style modification.
Conclusions: Efforts need to intensify in creating awareness on the general public about PCOS. Absolute majority of the study participant uncoerced to follow lifestyle modification however emphasis needs to address on multidisciplinary approach in managing PCOS.
Keywords: Polycystic ovarian syndrome, Awareness, Lifestyle modification, India

International Journal of Health Sciences & Research, 2015

The transdermal route of drug delivery has attracted medical and pharmacological researchers due ... more The transdermal route of drug delivery has attracted medical and pharmacological researchers due to its advantages over other methods of drug delivery. However, the stratum corneum acts as a barrier that limits the penetration of substances through the skin. Application of ultrasound to the skin believed to increase its permeability and enables the delivery of various substances into and through the skin. The use of ultrasound for the delivery of drugs to, or through, the skin is commonly known as phonophoresis or sonophoresis. Despite a wide usage of phonophoresis in physical therapy, doubts persist as to the relevance, efficacy and conditions underlying the efficacy of phonophoresis treatment. Although phonophoresis utilize ultrasound to increase the skin penetration of permeants, the mechanisms associated with this physical enhancer are not well understood in physiotherapeutic point of view. Specifically, mechanisms responsible for skin permeability enhancement and the location of these effects. In this review, we will discuss the mechanisms associated with penetration enhancement by phonophoresis and the effects of various ultrasound parameters like Frequency, Mode, Time and Intensity and the methods of phonophoresis application to skin. Background on the relevant physics associated with ultrasound transmitted through aqueous media along with implications of these phenomena on Sonophoresis will also be discussed.

Background: Lower limb fractures contribute to the functional impairments and death in people. De... more Background: Lower limb fractures contribute to the functional impairments and death in people. Decreased Quadriceps muscle strength is a common clinical observation in patients with lower limb injury or because of immobilisation. Interferential Therapy (IFT) and Russian Current (RC) are two medium frequency alternating currents with frequencies of 4kHz and 2.5kHz respectively. The purpose of this study is to find the short term and long-term effects of IFT and RC on Quadriceps muscle strength in patients recovering from post-operative cases of lower limb fractures. Methodology: 38 participants between age group 16-70 years were selected according to inclusion and exclusion criteria and divided into 3 groups, Group A(n=14) received Interferential Therapy and Conventional Exercises(CE); Group B(n=13) received Russian Current and CE and Group C(n=11) received only CE for 14 days. Patients were given electrical treatment for 6 days and were assessed pre-intervention, 6 th day after intervention and the 14 th day after intervention. The outcome measures were Numerical Pain Rating Scale (NPRS), Range of Motion and Isometric muscle strength. Result: For within group analysis the Friedman Test and for between group analysis the Kruskal Wallis Test was used. The intra group comparison was statistically significant with p=< 0.05 while the between group comparison was not statistically significant with p=>0.05. Conclusion: RC and IFT were not superior to conventional treatment alone.

Introduction: Hip fracture is a major public health problem because of its prevalence, economic c... more Introduction: Hip fracture is a major public health problem
because of its prevalence, economic costs, and health consequences. Intertrochanteric hip fractures account for approximatelyhalf of the hip fractures in the elderly; out of this morethan 50% fractures are unstable. Displacement and stabilityof an intertrochanteric fracture are an important determinant of treatment.
Aims and objectives: To ind out the level of recovery in different
types of intertrochanteric hip fractures and to assess the
functional capacity of patients who had an intertrochanteric hip
fractures of different types.
Materials and methods: Fourteen subjects who underwent
hip surgery for stable or unstable intertrochanteric fracture with internal ixation since 6 months to 1 year in the age group of 40 to 60 years were analyzed using the Harris hip score (HHS) to assess the level of recovery of the patient.
Results: Fourteen subjects with intertrochanteric fracture
were recruited for the study. The pain component of HHS
depicts that stable type of an intertrochanteric fracture displays
a better mean pain score of 40.00 (SD = 0.00) compared to
unstable t ype with a mean score of 3 6.29 (SD = 6.05) and
the score for activity limitation concludes that there is less
activity limitation in stable type compared to the unstable type
of an intertrochanteric fracture with a mean score of 34.86
(SD = 6.69) and 23.86 (SD = 14.06) respectively. Deformity infers
that stable type of intertrochanteric fracture shows less deformity at a score of 0.000 as compared to unstable type at 0.571 (SD = 1.51) and score for range of motion (ROM) is limited in stable type with a score of 3.86 (SD = 0.72) compared to 4.13
(SD = 0.55) scored by unstable type of intertrochanteric fracture
group. The results for HHS shows stable type of intertrochanteric fracture displays a better HHS at 78.71 (SD = 6.18) compared to 64.85 (SD = 16.33) scored by unstable type group. A statistical comparison of HHS using MannWhitney
U Statistic shows that there is no signiicant difference at 0.05 levels between stable and unstable type of intertrochanteric fracture groups.
Conclusion: This study concludes that a descriptive statistics
of HHS mean scores falling in favor of stable type of
intertrochanteric fracture, but a statistical comparison using
MannWhitney U Statistic shows that there is no signiicant
difference at 0.05 levels between stable and unstable type of
intertrochanteric fracture groups.
Keywords: Intertrochanteric, Recovery, Stable, Unstable.

Background: Evaluation of the results of Total Hip Replacement (THR) traditionally has focused on... more Background: Evaluation of the results of Total Hip Replacement (THR) traditionally has focused on
mortality rates, surgical and technical aspects, survival rates, and assessment by the treating surgeon.
Patients today have high expectations in the ability to return to a higher level of physical functioning as an
important goal of surgery. There is a lack of data on long term functional outcome after THR surgery in
India, so the aim of the study is to evaluate effect on functional status and quality of life, long term
functional outcome predictors and long term quality of life predictors after THR and to correlate SF 36
and Harris Hip rating scale.
Methodology: A questionnaire based survey was conducted among sample size of 35 THR patients
underwent surgery six months to one year before. Two scales were used as outcome measures SF 36 and
Harris Hip Rating Scale
Results: Statistical analysis showed role physical as least improved component of SF 36 and social
functioning as maximally improved component of SF 36. Harris hip rating scale and SF 36 showed
moderate positive correlation of 0.66 within which mental components of SF 36 and Harris hip rating
score showed a mild positive correlation of 0.39 and physical components of SF 36 and Harris hip rating
score showed moderate positive correlation of 0.55
Discussion & Conclusion: This finding supports the idea that Quality of life does not improve in
consistence with functional improvement, mental components show improvement compared to physical
components

The purpose of this case report was to describe the use of ultrasound therapy for synovial chondr... more The purpose of this case report was to describe the use of ultrasound therapy for synovial chondromatosis
of knee joint. A 45 year old house wife with history of synovial chondromatosis of left knee with severe pain on
activities and multiple loose bodies posteromedial to the joint space received ultrasound therapy and isometric strengthening exercises
for two weeks. The patient reported a reduction in pain and a comparative radiographic reading reported minimal resolution in
radio dense opacity size of calcified loose bodies. The results suggested the effectiveness of ultrasound therapy on pain relief resulting
in improved functionality and sclerolytic effect on breaking calcifications.

Introduction: When providing patient care, health care providers must interact with providers fro... more Introduction: When providing patient care, health care providers must interact with providers
from other professions to share information, execute quality and safety checks and help
patients understand and comply with treatment plans. Currently, no formalized pathways exist
in India for each profession to learn about the other. The findings from small number of
studies show that collaboration through practice may improve health care and patient
outcomes. Aims & Objectives: To explore the experience of undergraduate physiotherapy
students and interns about interprofessional relationship in various hospitals and their
awareness about interprofessional collaborative practices. Methodology: 100 Final year
physiotherapy students and interns from medical college hospitals around Navi Mumbai
were invited to complete a self made questionnaire which required to be answered in ‘yes/no’
choices. Results: 81% of physiotherapy students interact with medical professionals
compared to 19% of students and 86% of them claim that this interaction is helpful to them.
The 73% response about polite behavior of other professionals towards physiotherapy
students. Only 18% of students reported that they are allowed to attend rounds with other
medical professionals. 80% of students felt that other medical professionals are not supportive
towards them. 56% students said that complications of patients are not well informed to them
and 60% said that they are not regularly informed about patient recovery. 61% said they were
not given with the task of giving pre operative physiotherapy on regular basis but 68% said
ICU reference is given early for physiotherapy. There is 78% of response to prescription for
home exercise program and discharge summery and 69% of participants agreed that patients
referred to the physiotherapy department at the time of follow up by. Only 37% of
physiotherapy interns and students are aware of interprofessional education against 63% and
they favor regular inter professional meeting with a 67%. Conclusion: The analysis of
overall physiotherapy student’s experience in their interprofessional teamwork giving a
mixed response. Majority of them are not aware about interprofessional education and
interprofessional collaborative practice as an emerging trend all over. However physiotherapy
interns and students of this study favor regular inter professional meeting.

Background: The Quality of Life (QoL) of individuals with amputation in developed countries have ... more Background: The Quality of Life (QoL) of individuals with amputation in developed countries
have been investigated and reported in literature, but there is a paucity of information on the QoL
of people living with amputation in developing countries like India. This study therefore
designed to investigate the QoL of subjects with transtibial amputation among Indian population
Methods: Thirty subjects aged between 25-60 years (46.43±12.49) were selected for the study.
The objectives of the study were to find out psychological adjustments, activity restriction,
satisfaction with the prosthesis and stump pain and phantom limb pain in transtibial amputees by
using TAPES-R questionnaire.
Results: The results for Psychological scale shows that adjustment to limitation is most affected
with a score of 11.3 followed by social adjustment 14.53 and general adjustment 14.67. Activity
restriction results shows that running for bus is affected with a score of 1.8 followed by vigorous
activity and sports 1.7 are majorly affected. Satisfaction with prosthesis results shows that the
only affected component is weight of the prosthesis giving a score of 2.1. Experience of stump
pain, phantom limb pain shows that 43.33% and 10% respectively complained of stump
pain.The overall result shows that the activity restriction 76.78% is majorly affected , followed
by psychological adjustments 67.60% and Satisfaction with the prosthesis is least affected
93.87%
Conclusion: The amputee individuals are coping psychologically with the event but are
restricting themselves from more demanding activities. Stump pain and weight of the prosthesis
are preventing the subjects from achieving better independent quality of life.

Background & objectives: This study was conducted to determine whether slump stretching is benefi... more Background & objectives: This study was conducted to determine whether slump stretching is
beneficial compared to low grade lumbar spine mobilization and exercises for the subgroup of low
back pain patients hypothesized to benefit from these forms of treatment.
Methods: 45 patients between the age group of 25 - 40 years were selected and divided into 3
groups as Group A, B and C each consist of 15 subjects. Group A given with Maitland Grade 1 - 2
lumbar spine mobilization (Central Posterior Anterior) and standard exercises, Group B given
with slump stretching and standard exercises and Group C given with only standard exercises for
a period of three weeks. Patients were evaluated with Numeric pain rating scale (NPRS) and
Roland Morris disability questionnaire (RMDQ) prior to and 3 weeks after the treatment and
scores were analyzed.
Results: One Way ANOVA for NRS Score and Kruskal-Wallis one-way ANOVA for RMDQ
Score among Group A, B and C shows that (F = 22.235, DF = 2, 42, P-value < 0.001 and
Minimum Significant Difference (MSD) of 11.225 respectively), the mean score of at least one
group i.e. Group B is significantly different from the other groups.
Interpretation & conclusion: This study concluded that Slump stretching and exercise is
beneficial for improving short term disability, decreasing pain, and centralization of symptoms
compared to treatment with Grade 1 to 2 Maitland Mobilization and exercises. These data provide
preliminary evidence supporting the notion that patients with LBP can benefit from slump
stretching exercises.

Objective-To test the hypotheses that patients with knee OA will have an altered proprioception i... more Objective-To test the hypotheses that patients with knee OA will have an altered proprioception in ankle. Methods-This study compared the ankle proprioception levels of a group of 35 clinically and radiographically diagnosed cases of unilateral knee OA by the orthopaedic department of MGM Medical College, Navi Mumbai to a control group of 35 normal subjects. The data was analyzed by an unpaired 't' test. Results-Since tcal > ttab and P value is < 0.01 we reject H0 and accept Ha i.e. there is significant difference in ankle proprioception in OA knee cases compared to normal's. Conclusion-There is significant difference in ankle proprioception in OA knee cases compared to normals. These results confirm the strong association between reduced proprioception in ankle in cases of osteoarthritis of knees.

Research Journal of Pharmacy and Technology, 2023

MGM J Med Sci, 2020

International Journal of Physiotherapy and Research, 2017

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016

International Journal of Health Sciences & Research, 2015