RajivGandhi UniversityofHealth Science,Karnataka

Bangalore

PROFORMA SYNOPSIS FOR REGISTRATION OF SUBJECT FOR DISSERTATION

DISSERTATION PROPOSAL

A STUDY TO EVALUATE THE EFFECTIVENESS OF PLANNED TEACHING

PROGRAMME ON THE MANAGEMENT OF SELECTED MINOR AILMENTS IN
TERMS OF HOME REMEDIES AMONG PRIMIGRAVIDA MOTHERS IN
SELECTED COMMUNITY AREA, BANGALORE

SUBMITTED BY
MISS. SMITHA THOMAS
I YEAR M.SC., NURSING,
BHAGATH COLLEGE OF NURSING,
NO.60, UTTARAHALLI MAIN ROAD,
UTTARAHALLI HOBLI,
BANGALORE – 61
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,
BANGALORE
PROFORMA SYNOPSIS FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1 Name of the Candidate and Address Miss. Smitha Thomas

1year M.Sc., Nursing,
BhagathCollege of Nursing,
No.60, Uttarahalli Main Road,
Uttarahalli Hobli,
Bangalore – 560 061.
2 Name of the Institution BhagathCollege of Nursing,
Bangalore.
3 Course of Study and Subject I year M.Sc., Nursing
Obstetrics and Gynaecological
Nursing
4 Date of Admission to Course 01/10/2011
5 Title of the Topic:
“A Study To Evaluate The Effectiveness Of PlannedTeaching Programme On
The Management Of Selected Minor Ailments In Terms Of Home Remedies
Among Primigravida Mothers In Selected Community Area, Bangalore”
6 Brief Resume of the Intended Work
6.1. Need for the Study Enclosed
6.2. Review of Literature Enclosed
6.3. Objectives of the Study Enclosed
6.4. Operational Definitions Enclosed
6.5. Hypothesis of the Study Enclosed
6.6. Assumptions Enclosed
6.7. Delimitations of the Study Enclosed
6.8. Pilot Study Enclosed
6.9. Variables Enclosed
7 Material and Methods:
7.1. Source of Data: Data will be collected from Primigravida mothersin selected
community area, Bangalore.
7.2. Method of Collection of Data;Structured Knowledge Questionnaire
7.3. Does the study require any investigations or interventions to be conducted on
clients or other human or animals? Yes
7.4. Has ethical clearance been obtained from your institution? Yes, Ethical
committee’s report is enclosed here.

8 List of References Enclosed

 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,
BANGALORE
PROFORMA SYNOPSIS FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1 Name of the Candidate and Address Miss. Smitha Thomas

1year M.Sc., Nursing,
BhagathCollege of Nursing,
No.60,Uttarahalli Main Road,
UttarahalliHobli,
Bangalore – 560 061.

2 Name of the Institution BhagathCollege of Nursing,

Bangalore

3 Course of Study and Subject I year M.Sc., Nursing

Obstetrics and Gynaecological
Nursing

4 Date of Admission to Course 01/10/2011

5 Title of the Topic:

“A Study To Evaluate The Effectiveness Of Planned Teaching Programme On
The Management Of Selected Minor Ailments In Terms Of Home Remedies
Among Primigravida Mothers In Selected Community Area, Bangalore”
6. BRIEF RESUME OF THE INTENDED WORK

INTRODUCTION

Making a decision to have a child--it's momentous. It is to decide forever to

have your heart go walking around outside your body.
- Elizabeth Stone
Pregnancy is that wonderful period in a woman’s life when she spends each
and every day in pleasant anticipation, waiting to hold her bundle of joy in her arms at
the end of the ninth month. Everything feels rosy and she enjoys every bit of
pampering that she gets from her husband, in-laws, and parents. Every woman hopes
for a normal pregnancy and normal delivery so that she can cradle and nurse a healthy
baby.

The physiological transition from being a pregnant women to becoming a

mother means an enormous change for each women both physically and
psychologically. Every system in the body is affected and the experience although
unfortunately not joyous for all, represents a major transition in a women’s life.
During pregnancy women may experience one or more wide varieties of discomforts.
Every pregnancy is different, discomfort felt during one pregnancy may not appear in
another. Most discomforts experienced during pregnancy are due to the result of
abundant hormonal changes.1

Majority of pregnant women will experience the symptoms of morning

sickness,heartburn, common cold, lower backache, lower abdominal pains,
constipation, carpal tunnel syndrome, oedema and various skin changes during the
course oftheir pregnancy.2

Nausea with or without vomiting, is oneof the most common complaints

pregnant women present with. It occurs any timeof the day despite being referred to
asmorning sickness.Morning sickness is usually mild andtransient and resolves
spontaneously bythe end of the first trimester. However,some cases may be severe
and protracted(hyperemesis gravidarum), inducing avariety of debilitating and life-
threateningcomplications.

1
 Heartburn is more common during the last three months of pregnancy and is
caused by a number of things. During pregnancy, all muscles and ligaments relax to
prepare body for childbirth. Unfortunately this also causes the valve between your
stomach and oesophagus to relax. This causes the acid from the stomach to push into
the oesophagus. The growing baby also pushes onto the stomach and worsens the
problem.3

Constipation is a common problem in pregnancy. It occurs due to reduced

bowelmotility, increased water and salt reabsorption from the colon, and due to the
obstructive mechanical effects of the uterus. It tends to get worse as the pregnancy
progresses. Patients may develop severe discomfort and pain if not managed
adequately.4

The mechanical effects of the progressively enlarging gravid uterus cause an

alteration in the posture of the lumber spines, leading to an exaggerated lumber
lordosis. This then leads to lower back pain in many pregnant women.5

Stuffiness and blocked nostrils are often noted as normal physiological

changes induced by the hormonal milieu in pregnancy. About 30% of pregnant
women experience significant rhinitis symptoms. The mucosa of the nasopharynx
becomesoedematous and hyperaemic causing hypersecretion of mucus, leading to
complaintsof chronic colds during pregnancy. Polyposis of the nose and nasal sinuses
may also develop, leading to worsening of symptoms.2

Pregnancy causes a generalised increase in soft tissue mass attributed to

hormonallymediated increase in capillary permeability and sodium and water
retention. The eyelids, face and hands are particularly affected. One of the more
commondiscomforts of pregnancy namely carpal tunnel syndrome, is the result of
thischange.12 In the legs, the hormonally mediated pitting oedema is aggravated by
theobstructive effects of the gravid uterus. These changes also predispose pregnant
patients to varicose vein development.6

2
 Many of these minor ailments gets worse if not treated earlier. The nurse
has a very important role to play in educating patients and managingminor conditions,
therefore preventing many hospital admissions. Treatment mustbe individualized and
serious conditions must be excluded and referred without
delay.3

6.1 NEED FORTHE STUDY

During pregnancy an expectant mother’sbody will undergo hormonal

changes,which often give rise to a range ofrelatively minor, yet troublesome
ailmentssuch as heartburn, nausea, vomiting andconstipation. As the pregnancy
progresses,the increasing maternal weight can alsocause physical stresses on the
body,producing uncomfortable symptoms.7

Often this minor ailments associated withpregnancy can cause discomfort. The
discomfort can be overcome by makingsmall adjustments to your lifestyle, thereby
ensuring that you have a healthy andcomfortable pregnancy.

Nausea and vomiting is a common complaint, especially during the first three
months of pregnancy. It is helpful to keep some dry biscuits handy, as hunger may
worsen the feeling of nausea. Often it helps to eat a dry biscuit before even geting up
in the morning. Drinking enough fluids between meals and eat food that is high in
protein like fish, meat, eggs or cheese is also beneficial.3

Studies have shown that ginger iseffective in relieving symptoms.Fischer-

Rasmussen et alconducted arandomized trial of ginger for thetreatment of morning
sickness. After 4days, there was a significant reductionin both nausea and vomiting
inpatients receiving 125 mg of gingersix hourly.8

Constipation may occur due to the hormone progesterone that slows the
passage of food through digestive tract, but it can also occur due to iron supplements.
To relieve the symptoms. Constipation can be improved by eating lots of fruit,
vegetables and bran cereals and drinking plenty of fluids.9
3
 Gastro-oesophageal reflux disease is common in pregnancy, affecting 30 –
50% of all pregnant patients.Patientsreport worsening of symptoms duringmeals and
at bed time. The etiologicalfactors include a decrease in the loweroesophageal
sphincter pressure due tohormonal changes induced by thepregnancy, delayed bowel
transit timeand possibly the physical spaceoccupying effects of the gravid
uterus.Heartburnmay also represent anexacerbation of a pre-existing
gastrooesophagealreflux disease. However,pregnancy induced heartburn resolvessoon
after delivery.10
A study was conducted on 500 pregnant women by giving a questionnaire to identify
interventions used by women to alleviate their symptoms. All the pregnant women
reported that dietary and lifestyle changes helped to improve the symptoms of nausea
and vomiting during pregnancy.10

During the posting in antenatal clinics and community visits the investigator
observed that many of the antenatal women suffer from one or other minor ailments
during pregnancy and they lack knowledge regarding its management. So the
investigator took interest in the study through which antenatal mothers can be
informed regarding home remedies of minor ailments of pregnancy which will reduce
discomfort during pregnancy.

6.2. REVIEW OF LITERATURE

The review of literature is a broad, comprehensive, in depth, systematic and

critical review of scholarly publication, unpublished scholarly print materials, audio-
visual materials and personal communications. A literature review is a written
summary of the state of existing knowledge on a research problem. The task of
reviewing research literature involves the identification, relation, critical analysis and
written description of existing information on a topic11.

Review of Literature is mainly divided into two headings.

Review related to minor ailments of pregnancy

4
Review related to remedies of minor ailments of pregnancy

Review related to knowledge of minor ailments of pregnancy

Review related to minor ailments of pregnancy

A cross-sectional survey was done to determine what advice and support

midwives give to women experiencing nausea and/or vomiting in pregnancy, with a
particular interest in if and how herbal and alternative therapies are prescribed in a
public, tertiary maternity hospital in Melbourne, Australia among forty-nine midwives
who provide antenatal care. The findings indicated that the advice most commonly
given to women experiencing nausea and/or vomiting was to eat frequent small meals
and snacks (91%). Other common advice was given by half the midwives or less:
avoidance of fatty/spicy foods (53%); eating before rising in the morning, e.g.
consumption of dry biscuits/toast (51%); and keeping hydrated (49%). Most
midwives (39/46, 85%) included some form of vitamin or herbal supplement in their
advice for nausea and vomiting in pregnancy; however, many were unaware of
potential harmful side effects or what would constitute appropriate doses. The study
suggested that that herbal medicines and alternative treatments should be included in
common advice given for nausea and vomiting of pregnancy.12

A study was conducted to investigate the attitudes and behaviours of

consumers and healthcare professionals to discover what motivates and inhibits self-
care of common minor health problems. On-line surveys were conducted with 1317
consumers, 131 GPs, 130 Nurses and 159 Pharmacists from England and Wales. In
addition 401 patients attending pharmacies to collect prescriptions self-completed a
questionnaire. The study findings indicated that many consumers with a new minor
ailment self treat (52%), or do nothing (22%). However behaviour is repetitive, with
62% choosing to visit a GP or nurse if a prescription was issued on the last suffering
occasion. Conversely, past experience with self-care appears to build confidence with
84% choosing this for new episodes.13

5
 A study determined the prevalence of gastrointestinal symptoms among
healthy pregnant women attending antenatal clinic at the University of Maiduguri
Teaching Hospital. Questionnaires were randomly administered to consecutive
antenatal clinic attendees until the sample size was reached. The findings indicated
that out of 307 pregnant women who were interviewed. Heart burns, easy fullness and
nausea were the commonest gastrointestinal symptoms in 45%, 40.2% and 39.9% of
cases respectively. Primigravida had significantly more symptoms than multiparae.
There were also significantly more gastrointestinal symptoms in the first trimester of
pregnancy. The study concluded that gastrointestinal symptoms are common among
healthy pregnant women and even though these represented well-known physiological
changes, they must be carefully assessed to exclude any pathological disorder that
may require intervention.14

The present study was undertaken to estimate the prevalence and time course
of reflux-type symptoms in Singaporean women and to determine if these symptoms
were associated with nausea and vomiting of pregnancy. Consecutive pregnant
women in the first trimester of pregnancy were recruited during attendance at an
antenatal clinic in a Singapore teaching hospital. A total of 35 of 47 women originally
enrolled (response rate 74%) completed the study. Heartburn alone, acid regurgitation
alone and both heartburn and acid regurgitation were reported by 5.7, 17.1 and 17.1%
of the subjects, respectively. Subjects who had these symptoms were more likely to
suffer daily nausea and/or vomiting (78.6%) than those who did not (33.3%, P <
0.05). In the majority of subjects, heartburn and/or acid regurgitation began in the first
trimester (78.6%) and disappeared during the second trimester (71.4%). Nausea alone
and in combination with vomiting similarly came on in the first trimester (100%) and
subsided by the second trimester (85.7%) in the majority of the subjects studied. The
reported prevalence of heartburn and/or acid regurgitation among Western pregnant
women were 48–96% and 62%, respectively.15

6
Review related to home remedies of minor ailments of pregnancy

A review was done to assess the effects of treatment to relieve the symptoms
associated with varicosity in pregnancy and to reduce leg oedema. The Cochrane
Pregnancy and Childbirth Group trials register was searched for randomized trials of
any form of treatment for varicosity or leg oedema in pregnancy. The findings shown
that three trials of three different treatments were included. A total of 115 women
were involved. In one trial, two thirds of women were given rutoside capsules in the
last three months of pregnancy noted an improvement in symptoms compared with
only one third given placebo. They had a decrease in ankle circumference at 36
weeks' gestation after eight weeks of treatment, while women given placebo had a
small increase. In one trial, women with ankle oedema had a small non-significant
reduction in lower leg volume when treated with external pneumatic intermittent
compression for 30 minutes. Fifty minutes immersion in water at 32 degrees Celsius
resulted in greater diuresis and fall in blood pressure than 50 minutes bedrest. The
study concluded that rutosides appear to relieve symptoms of venous insufficiency in
late pregnancy. External pneumatic compression appears to reduce ankle swelling.
Immersion in water for 50 minutes results in diuresis and fall in blood pressure.16

A study was conducted to compare the effectiveness of ginger and vitamin B6

for the treatment of nausea and vomiting in early pregnancy. Pregnant women with
nausea, who first attended the antenatal clinic at or before 17 weeks gestation, were
invited to participate in the study. Over a 3-month period, 70 women were
randomised to receive either ginger 1g/day or vitamin B6 40 mg/day for 4 days. The
findings indicated that the decrease in the visual analogue scores of post-therapy
nausea in the ginger group was significantly greater than that for the vitamin B6 group
(p = 0.024). The number of vomiting episodes decreased in both groups, and there
was no significant difference between the groups. In the ginger group, 29/35 women
reported an improvement in nausea symptoms, compared with 23/34 women in the
vitamin B6 group (p = 0.52). The study concluded that ginger was more effective than
vitamin B6 for relieving the severity of nausea, and is equally effective for decreasing
the number of vomiting episodes in early pregnancy.17

7
 A study was conducted to ascertain patterns of use of herbal medicinal
products by pregnant women in selected health care centers in Area of Enugu State,
Nigeria. Data were collected from 60 respondents. The findings from the study
showed that a greater percentage of the women (58.3%) (n = 35) used herbal drugs in
pregnancy-free periods while 41.7% (n = 25) used them in the current pregnancy.
When asked for their reasons for using the products, a good number of the pregnant
women (n = 27; 45%) asserted it is safer and the majority (n = 33; 55%) said it works
better than orthodox medicine. However, half of the women (n = 30; 50%) considered
herbal products to be harmful to the baby during pregnancy, and yet 25 of the women
(41.7%) were still taking it in their current pregnancy. The study recommended that a
comprehensive coordinated health approach is needed to provide information about
medication in pregnancy and this should be made available and translated into safe
and effective use.18

This study was conducted in and around Cape Town, South Africa, at two
primary obstetric facilities and in the antenatal clinics of two secondary hospitals.
Findings shown that majority of the Xhosa speaking women follow indigenous
healing practices for both themselves and their babies for strengthening the womb
against sorcery, to prevent childhood illnesses, and to treat symptoms of minor
ailments. Self-medication with non-prescribed drugs, herbs and Dutch remedies was
common practice amongst the Afrikaans speaking women for both themselves and
their babies.Herbs and Dutch remedies were mainly used to treat indigenous illness,
while non-prescribed over-the-counter drugs were used to treat minor ailments
associated with pregnancy.19

A study was conducted to assess the effectiveness of Vitamin B6 in reducing

nausea and vomiting .Two randomized trials of vitamin B6 shown a benefit in
reducing nausea and vomiting. Women taking periconceptional multivitamins were
less likely to have severe nausea and vomiting. The combination of vitamin B6 and
doxylamine has been shown to be safe for the fetus and effective in reducing nausea
and vomiting. Ginger was shown, in 2 studies, to reduce nausea and vomiting.
Vitamin B1 (thiamine) deficiency can lead to Wernicke's encephalopathy in women
with severe NVP. Replacement is needed for all women with vomiting of more than 3

8
weeks' duration. The study concluded that prophylaxis with multivitamins and therapy
with B6, with or without doxylamine, are safe and effective therapies for nausea and
vomiting.20

Review related to knowledge of minor ailments of pregnancy

A study on the role of the nursing personnel in relation to the informational

needs of primigravida mothers and information they received at antenatal clinic in
Lady Hardinge Medical College and Hospital , New Delhi. One of her objectives was
to find out the areas in which mothers want information. The study findings shown
that highest percentage of mothers wanted information regarding normal
physiological changes occurring during pregnancy and a good percentage of mothers
wanted information regarding minor ailments.21

A study was conducted, at the Gosford and Wyong Antenatal Clinics of the
Central Coast Area Health Service, by voluntary questionnaires to 46 pregnant
teenagers attending the clinics, to determine the antenatal educational needs of
pregnant teenagers, and if their needs differed from adult pregnant women. Data were
collected from 46/50 pregnant teenagers at 2 prenatal clinics in New South Wales,
Data were gathered from questionnaires with 21 open and fixed questions. It was
found that 69% of the respondents would like to attend peer discussion groups. The
most important topics were hospital procedures (78%), life after the baby's birth
(65%), weight gain (58%), minor disorders of pregnancy (56%), Most of the
respondents wanted the program to begin during the early gestation period and to be
held in conjunction with appointments at the prenatal clinic. The study noted that
pregnant mothers wanted to be informed regarding antenatal education for better
health of their babies and themselves.22

9
6.3. OBJECTIVES OF THE STUDY

1. To assess the knowledge of primigravida mothers regardingmanagement of

selected minor ailments in terms of home remedies

2. To develop and conduct a planned teaching programme for primigravida

mothersregarding management of selected minor ailments in terms of home
remedies.

3. To evaluate the effectiveness of planned teaching programme among

primigravida mothersregarding management of selected minor ailments in
terms of home remedies by posttest.

4. To find out the association between knowledge level and selected

demographic variables of primigravida mothers.

6.4. OPERATIONAL DEFINITIONS

1. Assess:Assess refers to process of determining knowledge regarding

management of selected minor ailments in terms of home remedies among
primigravida mothers.

2. Effectiveness:Effectiveness refers to gain in knowledge score achieved by

Primigravida mothersregarding management of selected minor ailments in
terms of home remedies.

3. Planned teaching programme: It is a systematic information, instruction or

training given to Primigravida mothers regarding management of selected
minor ailments in terms of home remedies.

4. Knowledge:Knowledgerefersto awareness regarding management of selected

minor ailments in terms of home remedies.

10
 5. Minor ailments:Minor ailments refers to temporary systemic disturbances as
may arise during pregnancy. It comprises of nausea and vomiting,
constipation, heartburn, headache, back ache etc.

6. Home remedies: Home remedies refers to home prepared relief measures for
the minor ailments during pregnancy.

7. Primigravida mothers: Primigravida mothers refers to those who are

pregnant for the first time and residing in selected community area, Bangalore.

6.5. HYPOTEHESIS OF THE STUDY

H1:There will be statistically significant difference between pre and posttest

knowledge scores ofprimigravida mothers on management of selected minor ailments
in terms of home remedies.
H2:There will be statistically significant association between knowledge regarding
management of selected minor ailments in terms of home remedies among
primigravida mothersand selected demographic variables.

6.6.ASSUMPTIONS

 Primigravida mothersmay have some knowledge regarding management of

selected minor ailments in terms of home remedies.
 Primigravida mothers’ knowledge regarding management of selected minor
ailments in terms of home remedies can be measured by using a structured
knowledge questionnaire.
 Primigravida mothers’ knowledge regarding management of selected minor
ailments in terms of home remedies can be improved by structured teaching
programme.

6.7. DELIMITATIONS OF THE STUDY

The study is limited only to Primigravida mothersattending antenatal clinic, in
selected community area, Bangalore.
11
6.8. PILOT STUDY
The study will be conducted with 6 samples. The purpose of the pilot study is
to find out the feasibility for conducting the study and design onplan on statistical
analysis.

6.9 VARIABLES
A concept which can take on different quantitative values is called a variable.

 Dependent Variable: Knowledge level of Primigravida mothersregarding

management of selected minor ailments in terms of home remedies.
 Independent Variable:Planned teaching Programme.
 Extraneous Variable: Age, religion, education, type of family, occupation
and source of information.

7. MATERIALS AND METHODS

7.1.1 SOURCES OF DATA

Primigravida mothersattending antenatal clinic, in selected community area,
Bangalore.will be the source of data.

7.1.2RESEARCH DESIGN
The research design adopted for this study is pre experimental in nature. One
group pretest posttest design.

7.1.3 RESEARCH APPROACH

Evaluative research approach

12
7.1.4. SETTING OF THE STUDY
The study will be conducted in selected community area, Bangalore,
amongprimigravida mothers who meet the inclusion criteria.

7.1.5. POPULATION
Primigravida mothers, in selected community area, Bangalore.

7.2. METHOD OF COLLECTION OF DATA (INCLUDING SAMPLING

PROCEDURE)
The data collection procedure will be carried out for a period of one month.
This study will be conducted after obtaining permission from the concerned
authorities.
The investigator will collect data from the Primigravida mothersby using a structured
knowledge questionnaire. The investigator will assess the effectiveness of planned
teaching programme by assessing the pre-test andposttestscores obtained from the
structured knowledge questionnaire.
Data collection instrument consists of following sections:
Section A:Demographic data
Section B:Questions to assess the level of knowledge of Primigravida
mothersregarding management of selected minor ailments in terms of home remedies.

7.2.1 SAMPLING TECHNIQUE

Non-probability convenience sampling will be adopted for selection of samples.

7.2.2. SAMPLE SIZE

Sample consists of 60 Primigravida mothers in selected community area, Bangalore.

13
SAMPLING CRITERIA

7.2.3 INCLUSION CRITERIA

 Primigravida mothersin selected community area, Bangalore.
 Primigravida motherswho are willing to participate in the study.
 Primigravida mothers who are available at the time of study.
 Primigravida mothers who know Kannada or English.

7.2.4.EXCLUSION CRITERIA
 Primigravida motherswho were selected for pilot study.
 Primigravida motherswith unsound mind.

7.2.5. TOOL FOR DATA COLLECTION

A structured knowledge questionnaire is used to collect the data from
thePrimigravida mothersregarding management of selected minor ailments in terms of
home remedies, in selected community area, Bangalore.

7.2.6. DATA ANALYSIS METHOD

The data collected will be organized, tabulated and analyzed by using
descriptive and inferential statistics.

 Descriptive Statistics:Frequency and percentage for analysis of demographic

data and mean, mean percentage and standard deviation will be used for
assessing the level of knowledge.

 Inferential Statistics:Chi-square test will be used to find out the association

between knowledge score and demographic variables of the Primigravida
mothersand paired‘t’ test for the effectiveness of planned teaching programme
regarding management of selected minor ailments in terms of home remedies.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR

INTERVENTIONS TO BE CONDUCTED ON PATIETNS OR OTHER
HUMAN ORANIMALS?
The study requiresinvestigation and interventions.
14
7.4.ETHICAL CLEARANCE
Yes, ethical committee’s clearance has been obtained from the institution. The
purposes and details of the study will be explained to the study subjects and assurance
will be given regarding the confidentiality of the data collected.

15
8. LIST OF REFERENCES: (VANCOUVER STYLE FOLLOWED)

1. Ed. Fraser DM, Cooper MA Myles Textbook fot Midwives; 15th ed ,

2009
Elsevier Philadelphia, p 457
2. Biko J. Minor ailments in pregnancy: A basic approach. Professional Nursing
Today March / April 2007 Vol. 11 No. 2 p 16-19
3. Ronel Van Der Watt. Minor ailments early in pregnancy. UBISI MAIL |
JUNE 2008 p 43 – 45
4. Biko J ,PREGNANCY: A Basic Approach SA Pharmaceutical Journal –
January/February 2007 p 28 – 30
5. Jain S, Eedarapalli P, Jamjute P and Sawdy R. Review: Symphysis pubis
dysfunction. A practical approach to management. The Obstetrician and
Gynaecologist 2006; 8: 153 – 158.
6. Parmley T and O’Brien T. Pigment and soft tissue skin changes during
pregnancy. Clinical Obst and Gynecol 1990. 33; 1: 713 – 717
7. Williams EOptimal treatment of minor ailments in pregnancy requires careful
evaluation of the risks and benefits; Drugs in pregnancy September 2009
Pharmacy In Practice 80 - 84
8. Fischer-Rasmussen W, Kjaer SK, Dahl C et al: Ginger treatment of
hyperemesis gravidarum. European J obstetr and gynecolReprod Biol. 1990;
38:19
9. Dr.Mohith .M, Dr. SudanSD, Minor Ailments During Pregnancy. Medical
Network Monday, 11 October 2010 03:45]
Available at: http://doctor.sd/articles/obs/219-minor-ailments-during-
pregnancy
10. Richter J E. Gastro-esophageal reflux disease in pregnancy. Gastroenterol
clinic North Am. 32: 235-261
11. Polit D.F, Hungler BP. Nursing Research, Principles and Methods.
Philadelphia: JB Lippincott. 2003
12. Banks I. Self Care of Minor Ailments: A Survey of Consumer and Healthcare
Professional Beliefs and Behaviour. SelfCare2010; 1 (1) :1-13
Available at: http://selfcarejournal.com

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13. Wills G, Forster D. Nausea and vomiting in pregnancy: what advice do
midwives give? Midwifery. 2008 Dec;24(4):390-8.
http://www.ncbi.nlm.nih.gov/pubmed/17850938
14. Audu BM, Mustapha SK. Prevalence of gestrointestinal symptoms in
pregnancy; Niger J ClinPract. 2006 Jun;9(1):1-6.
Available at: http://www.ncbi.nlm.nih.gov/pubmed
15. khek YH, Kang JY. Symptomatic gastro-oesophageal reflux in pregnancy: A
prospective study among Singaporean women. Journal of Gastroenterology
and Hepatology; Volume 13 ( 10); P1020–26, October 2008
16. Young GL, Jewell D. Interventions for varicosities and leg oedema in
pregnancy; The Cochrane Library. 18 Oct 2006
Available at: http://onlinelibrary.wiley.com
17. Ensiyeh J, Sakineh MA. Comparing ginger and vitamin B6 for the treatment
of nausea and vomiting in pregnancy: a randomised controlled trial.
Midwifery. 2009 Dec;25(6):649-53
Available at: http://www.ncbi.nlm.nih.gov/pubmed/18272271
18. Achema G, Emmanuel A, Oguche M. Evaluation of the use of herbal drugs by
pregnant women in Nigeria; African Journal of Midwifery and Women's
Health, Vol. 6 (2), 18 Apr 2012, p 78 – 83
Available at: http://www.intermid.co.uk/cgi-bin/go.pl/library
19. Abrahams N, Jewkes R, MvoZ.Indigenous healing practices and self-
medication amongst pregnant women in Cape Town, South Africa. Afr J
Reprod Health. 2002 Aug;6(2):79-86.
20. Niebyl JR, Goodwin TM. Overview of nausea and vomiting of pregnancy with
an emphasis on vitamins and ginger; Am J ObstetGynecol 2002; 186 (5):p253-
5. Available at: http://www.sciencedirect.com/science
21. LyndallMollartPregnantteenagersantenatal education researchAustralian
College of Midwives Incorporated Journal; 8(4); Dec 2005, P 26–28

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9 Signature of the Candidate

10 Remarks of the Guide

11 Name and Designation of

11.1 Guide

11.2 Signature

11.3 Co-Guide

11.4 Signature

11.5 Head of Department

11.6 Signature

12 12.1 Remarks of the Chairmen and

Principle

12.2 Signature

18