bluuebunny/crossref_metadata_2025 huggingface dataset:
Obstetric emergencies in a humanitarian context at the Somine Dolo hospital in Mopti, Mali
Authors: Seydou Fane , Amadou Bocoum , Soumana Traore O. , Ibrahima Kante
Published: April 2022

Background: Conflicts are a barrier to physical and financial access to health centers. Our objective was to evaluate obstetric emergencies in a humanitarian context at the Sominé DOLO hospital in Mopti.Methods: This was a descriptive and prospective longitudinal study from January to September, 2020 in the obstetrical gynecology department of the Sominé DOLO hospital in Mopti. Our objective was to evaluate obstetric emergencies in the humanitarian context.Results: The frequency of patients evacuated was 30.61%. The average age of the patients was 27 years with extremes of 15 and 49 years. Hemorrhage during pregnancy was the main cause of reference with 23.83%. The ambulance was the most used means of transport with 51%. Delay in evacuation was observed in 31.33 cases. About 73.03% of our patients had given birth by caesarean section. We recorded 64 maternal deaths, a rate of 10.67%. Fetal mortality in our study was 23.28%. Attacks by armed groups had a negative impact on the referral/evacuation system.Conclusions: The health system had experienced severe challenges due to insecurity. Armed conflicts were the cause of evacuation delays. Haemorrhage during pregnancy was the main reference cause. Maternal and perinatal mortality was high.
Genetic analysis of the M2/ANXA5 haplotype in Syrian healthy population
Authors: Dib Wael , Soukkarieh Chadi , Alhalabi Marwan
Published: April 2022

Background: Annexin A5 (ANXA5) is an abundantly and ubiquitously expressed protein showing the highest levels of concentration in kidney, liver and placenta. ANXA5 plays a central role in the machinery of membrane repair by enabling of a protective 2D bandage at membrane damaged site, has properties anti-inflammatory, pro-fibrinolytic and anti-thrombotic. Four polymorphisms have been identified in the ANXA5 promoter, which were transmitted as a joint haplotype (M2). M2 haplotype decrease the ANXA5 gene promoter activity and mRNA expression which causes several troubles.Methods: The aim of this cross-sectional study is to determine the frequency of M2/ANXA5 haplotype in healthy Syrian individuals and compare the genotype and allele distribution with other populations. In this study 94 (female, 71 and male, 23) unrelated healthy Syrian nationals were involved. 94 DNA samples have been collected in order to determine the spread the genotype M2 haplotype using allele specific polymerase chain reaction (AS-PCR).Results: Our results indicate that the distribution of the alleles and genotypes of M2 haplotype vary considerably in different populations. In the Syrian population the distribution of M2 and wide type (WT) were M2/M2 9.6%, M2/WT 44.7%, WT/WT 45.7%. The M2 haplotype was found in 45 of women (allele frequency 31%) and in 15 of men (allele frequency 32%). The distribution of the ANXA5 genotypes in Syrian study group conformed to Hardy-Weinberg equilibrium (p=0.92).Conclusions: No significant differences were found at frequency distribution of different genotypes and M2 allele between women and men within this Syrian cohort. In comparison with the results of other studies, the results of this study demonstrate that the frequency and distribution of the M2 haplotype in Syrian population are different from most other populations worldwide.
Study of risk factors associated with ectopic pregnancy: an observational study
Authors: Uthpala V. , Gracelyn J. Leila
Published: April 2022

Background: Any pregnancy in which the fertilised ovum implants outside the intrauterine cavity is an ectopic pregnancy. Since none of the extrauterine areas can support placental attachment or a developing embryo, it invariably risks rupture and haemorrhage. It is thus considered a life-threatening emergency. Lower abdominal pain with vaginal bleeding in women of reproductive age raises the suspicion of an ectopic pregnancy. However, this is not always the case; some may present vague symptoms, oblivious to the underlying pathology. Hence this study aimed to document the potential risk factors for ectopic pregnancy.Methods: This prospective study was carried out at a tertiary care hospital and included 60 women diagnosed with ectopic pregnancy. Detailed history, menstrual and obstetric history, clinical examination, urine pregnancy test, and ultrasonography were obtained for each patient. Their clinical profile was noted, including their name, age, marital status, socioeconomic status, parity, and last childbirth. A list of potential risk factors was compiled. The general, systemic, abdominal and vaginal examination was done. Data were collected and evaluated.Results: 60 cases of ectopic pregnancies were diagnosed during the study period. The highest number of patients were noted in the 20-24 years age group (n=21) and the least in the 35–39 years age group (n=1). Pain in the abdomen was the most commonly noted symptom at 88.3%, followed by bleeding per vaginum (76.7%), vomiting (73.3%), fainting (58.3%), shock (30.0%), and abdominal distention (21.7%). While 18.3% of cohorts did not present with any risk factor, pelvic inflammatory disease (n=13) was the most commonly noted risk factor.Conclusions: Ectopic pregnancy is a life-threatening medical emergency which requires a keen eye for detail. A comprehensive narrative of clinical history, signs and symptoms aided by appropriate diagnostic tools will help side-step fatalities.
Fetal outcome in maternal near miss, retro-prospective study at tertiary centre
Authors: Lewis Preeti F. , Gundaiah Bindu , Bavdekar Nitin B.
Published: April 2022

Background: Women are not dying because of diseases we cannot treat. They are dying because societies are yet to decide that their lives are worth saving. The statement completely comprises the unawareness of the importance of maternal health existing in society. As a result of which, there is still a lag in maternal health progression. As a part and parcel, fetal health is compromised giving rise to poor fetal outcomes. Studying fetal outcomes in such near-miss cases establishes a relationship between them.Methods: A retro-prospective observational study, conducted in the Department of Obstetrics and Gynaecology. Study involves all women who are very ill pregnant or recently delivered women who nearly died but survived a complication during pregnancy, childbirth, or within 42 days of termination of pregnancy and their fetal outcome during study period of 18 months.Results: In a study of 3604 deliveries, MNM cases were 107 births. The MNM IR was 30/1000 live births, and the most common determinant leading to near-miss is hypertensive disorders followed by hemorrhage. Total perinatal mortality was 439 with a PNMR of 125/1000 births. Among the 107 near-miss cases perinatal mortality was seen in 29 pregnancies contributing to 6.6% of the total PNMR.Conclusions: Fetal outcome improves with improvement in maternal health, as the maternal morbid condition is directly proportional to fetal outcome. This requires identifying and filling up gaps in the maternal health system to improve women’s health, further reducing fetal morbid conditions and consumption of neonatal resources.
Incidence of cervical stump metastasis after subtotal hysterectomy done to cases proved later by histopathology to be endometrial cancer in Al Shatby university maternity hospital patients
Authors: El Sokkary Hossam , Abd El Zaher Eman
Published: April 2022

Background: Subtotal hysterectomy is associated with lesser complication, lesser time consuming than total one, but total hysterectomy has advantage of radicality of its management in cases of accidentally undiagnosed endometrial cancer proved later on by histopathology, that why hysterectomy should be total even in apparently benign causes that indicate it. The aim of this study was to access incidence of cervical stump invasion by malignancy in endometrial cancer cases and its relation to pathological types after subtotal hysterectomy done to cases proved later by histopathology to be endometrial cancer.Methods: Following approval by our institutional ethics committee a prospective and retrospective observational descriptive study was done on 100 patients recruited from gyne-oncological outpatient clinic of Shatby university hospital of Alexandria from August 2018 to June 2021 with past history of subtotal hysterectomy. All these cases were proved later after histopathological examination of the uterine body to have type 1 or type 2 endometrial cancer. Stumpectomy was done to all patients after a written informed consent were taken from them before the study. Histopathological examinations of the cervical stumps were done and incidence of stump invasion with cancer in relation to its type was analyzed.Results: Histopathological examination of the stump of all cases revealed that only 13 cases showed microscopic stump invasion. 7 cases with stump invasion were type 1 endometrial cancer, 4 cases were grade 1 and 3 cases were grade 2 in relation to 6 cases of stump invasion were type 2 endometrial cancer with papillary serous adenocarcinoma. Regarding relation between stump invasion and pathological types of endometrial cancer there was a significant statistical difference between them as type 2 are associated by higher number of stump invasion (p=0.0001).Conclusions: The present study concluded that cases subjected to subtotal hysterectomy with undiagnosed endometrial cancer are associated with considerable incidence of cervical stump invasion and type 2 endometrial cancer have higher incidence of cervical stump invasion in relation to type 1 endometrial cancer.
A study to determine association of ovarian morphology with endometrial morphology and postmenopausal bleeding conducted in a tertiary care hospital
Authors: Chaturvedi Madhu , Wadgaonkar Khushboo
Published: April 2022

Background: Postmenopausal ovaries are chiefly composed of stroma and continue to have potential for hormonal synthesis. Ovarian stromal hyperplasia and endometrial hyperplasia/cancer are often identified concurrently, suggesting that ovarian morphology may represent a marker of cancer risk among older women.Methods: An observational analytical cross-sectional study was conducted. Morphology of endometrium and ovary was studied in the specimens of total abdominal hysterectomy with unilateral/bilateral salpingo-oopherectomy in females with postmenopausal bleeding.Results: Forty two specimens of total abdominal hysterectomy with bilateral hysterectomy were studied. Age of patients ranged from 45 to 80 years. Majority of patients were in the age group 45-55 years. Average duration of menopause was 6.2 years ranging from 1.5years to 30 years. Most common endometrial pathology noted was proliferative endometrium (20, 47.6%) followed by primary endometrial malignancy and endometrial polyp (14.3%). Majority of the ovaries were unremarkable (35.8%). Most common change noted was stromal hyperplasia (31.4%).Conclusions: The study did not find statistically significant association between stromal hyperplasia/large ovary and high risk endometrial pathology.
Perioperative concerns and outcomes in obstetric patients undergoing lower segment caesarean section in the wake of the COVID-19 pandemic: a retrospective analysis
Authors: Wani Reena J. , Doshi Kruti , Ansari Sumayya , Bhatt Mahin C.
Published: April 2022

Background: In the current COVID-19 pandemic, pregnant women are considered high risk due to adverse maternal and foetal complications that are known to occur with antepartum viral infections. In addition to immunological changes in pregnancy that alter the response to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, the disruption of routine antenatal services as a result of the pandemic has also adversely affected expectant mothers.Methods: We conducted this retrospective observational study as a comprehensive comparative analysis of the method of delivery in COVID positive women, the choice of anaesthesia and maternal and foetal outcomes in women undergoing lower segment caesarean sections with COVID infection as well as the COVID negative patients during the first wave of the pandemic.Results: The rate of caesarean section was comparable between the two groups. The rates of general and regional anaesthesia did not change with COVID positive status. However, we found that meconium-stained liquor with foetal distress as an indication for lower segment caesarean section (LSCS) was markedly higher in COVID positive patients. There was also a significantly higher requirement for ICU admission and ventilator support in the positive patients as a result of COVID-related complications. No significant difference was observed in the maternal and neonatal mortality rate between the two groups.Conclusions: In our experience, COVID-19 positive status did not impact the rate of LSCS, but significantly increased the need for intensive care.
Comparative study of fundus changes in hypertensive and normotensive pregnant females in third trimester at tertiary care centre
Authors: Kadam Dhruvika , Imti Jongpongyangla N. , Rastogi Radha , Sharma Anuj , Meena Kanupriya
Published: April 2022

Background: According to ACOG, hypertension in pregnancy can be defined as systolic blood pressure of 140mmhg or higher, diastolic blood pressure of 90mmhg or higher confirmed on atleast two occasions 4-6 hours apart but within a maximum of a week period. The retinal vascular changes have been said to correlate with the severity of hypertension. Many studies have considered the progression of retinal vascular changes as a sign of increasing severity of PIH and have correlated them with fetal mortality. The aim of the study was to comparison of fundus changes among hypertensive and normotensive pregnant female in third trimester.Methods: 50 hypertensive and 50 normotensive pregnant women were included in the study. All patients fulfilling inclusion and exclusion criteria diagnosed with pre-eclampsia, eclampsia, chronic hypertension were studied for ocular fundus changes and retinal changes were graded according to Keith Wagener classification.Results: Nearly 3/4th of patients in this study group were primigravida. 64% of patients were in the gestational age less than 36weeks. A significant number of PIH changes were noted in the age group 21-25 however significant number of fundal changes were noted in age group 26-30. 58.33% of study group showed fundal changes of grade III.Conclusions: The vascular changes in the retina correlate with the severity of the systemic and vascular involvement. Fundoscopy should be offered to all hypertensive pregnant females so that if positive findings are noted, active intervention can be done correlating with other radiological and biochemical findings.
A prospective study on reproductive health problems and menstrual hygiene practices among women in rural population
Authors: Biju Vidya , Peddolla Sushma Reddy , Inuganti Bhavana , Gollapudi Surendra
Published: April 2022

Background: Menstruation is defined as periodic discharge of blood from uterus occurring more (or) less at regular monthly intervals throughout the active reproductive life of a female. Hygiene-related practices of women during menstruation are considered important because it can increase vulnerability to reproductive tract infections (RTIs).Methods: A prospective, observational study was done for a period of 6 months to assess the reproductive health problems and menstrual hygiene practices among women in rural population. It was conducted by first considering RTI cases among female in-patients of obstetrics and gynaecology department at MNR hospital, Sangareddy, Telangana, on the basis of which the study was extended to certain villages of Andole Mandal, where RTIs were found to be more prevalent. The data was collected using pre designed and semi-structured questionnaire.Results: Out of 106 cases taken in the hospital, cervicitis was most prevalent 40 (37.7%). A maximum of 36 (34%) cases were from Andole Mandal, so the community-based study was done here. Among the 710 subjects considered, 206 (29%) were found to use sanitary napkins and 85 (12%) of them used disposable cloth. Majority 392 (55.2%) of the women disposed their menstrual absorbent by burning and many were presented with RTI symptoms such as lower abdominal pain, vaginal discharge.Conclusions: In the health status of women among the reproductive age group, RTIs are known to pose a serious and continuing threat, which has become a silent epidemic that devastates women’s life which is closely related with poor menstrual hygiene. Hence, there is an urgent need to provide accurate and adequate information about hygienic practices to be followed during menstruation, so as to enable them to lead a healthy reproductive life.
Reaching the one billion mark: accomplishing the success story of COVID vaccination through public interrogation
Authors: Sarkar Avir , Roy Kallol Kumar , Zangmo Rinchen , Jayraj Aarthi K. , Kaushik Durga , Rai Rakhi
Published: April 2022

Background: The COVID vaccination drive in India has recently crossed the one billion mark which is certainly a tremendous feat. Although women were initially hesitant, public propaganda and behaviour change communications encouraged them to come forward. The aim of the study was to assess the vaccination status of female population of the country through interrogation in obstetrics and gynaecology out patient departments (OBG OPD).Methods: Through this cross-sectional study, all women visiting OBG OPD were asked about type and number of vaccine doses received, dates of administration of first and second doses and whether they had any significant side effects following immunization.Results: A total of 1456 women were recruited in the study. Mean age of participants was 33.24±4.65 years. 36.26% participants were pregnant. 89.97% women had received at least one dose of vaccine and 48.76% participants were fully vaccinated. Majority received Covishield vaccine. Majority of the participants received first shot during the months of July, August and September. No women suffered from any adverse effect following immunization. Most women got motivated for vaccination from television (76.91%) and alert messages in mobile phones (61.59%). The results of our study reflects the success story of vaccination campaign as almost 90% of the participants had received at least one dose of vaccine.Conclusions: The proactive participation and untiring efforts of the frontline workers has been instrumental in achieving this remarkable landmark. India's successful vaccination campaign is a lesson to the world at large.
Surgical outcome in germ cell tumor of ovary
Authors: R. Pooja , Patil Varsha Narendra
Published: April 2022

Background: Ovarian cancer accounts for 225,000 new cases and 140,000 deaths every year. Ovarian germ cell tumors account for 15-20% of all ovarian malignancies and incidence of malignant ovarian germ cell tumors is 2-6%. These tumors typically occur in adolescent girls and young women. Appropriate fertility conserving surgical treatment for patients where fertility needs to be preserved and resection of all visible disease can be successfully performed. For patients with advanced-stage disease, debulking surgery is done.Methods: Current study is a retrospective study. The present study was conducted in the department of obstetrics and gynecology, Cama and Albess hospital, Mumbai, Maharashtra, India, from a period of May 2019 to December 2021. This study was conducted with 30 patients to evaluate the outcome in operated cases of germ cell tumors of ovary.Results: Majority of the patients (30%) were in the age group of 31-40 years, 17 (56.7%) patients were unmarried while 13 (43.3%) patients were married. The most common symptom was abdominal mass and pain (86.7%). The most common histologic type was dysgerminoma (46.7%). Out of total 19 patients with FIGO stage I, 13 patients (68.4%) underwent Fertility sparing surgery (FSS) and 6 patients (31.6%) underwent non fertility sparing surgery (non-FSS).Conclusions: Surgery has an important role in the management of germ cell tumors. Initial careful surgical staging is of great importance for appropriate subsequent therapy. Fertility sparing surgery is feasible in most cases. Malignant ovarian germ cell tumors have excellent prognosis for stage I and for advanced stages.
Neonatal outcome in deliveries complicated by meconium-stained amniotic fluid
Authors: Shah Parul T. , Kothari Kinjal A. , Patel Rina V. , Panchal Payal P.
Published: April 2022

Background: Meconium staining amniotic fluid is associated with lots of adverse outcome and has long been considered to be a bad predictor of fetal outcome. This prospective observational study was undertaken to find out immediate fetal outcome in meconium-stained liquor.Methods: The design of the study was prospective. This study was conducted from July 2021 to December 2021.The study included women with meconium-stained amniotic fluid in labor with gestational age >37 completed weeks.Results: Total 100 cases were enrolled. Majority of the patients (74%) were in the age group of 21-30 years with the mean age being 24.6±2.4 years. Fetal distress occurred in 30% of babies, more in association with thick meconium (15%). Caesarean deliveries were 70%. Apgar scores between 0-3 was seen in 17% babies and 1% at fifth minute, between 4-6 in 21% babies and between 7-10 in 62% babies at first minute of birth. Admission in neonatal ward was 32% with perinatal mortality of 6%.Conclusions: Meconium-stained amniotic fluid was associated with higher rate of caesarean delivery, increased need for neonatal resuscitation, increased rate of birth asphyxia with hypoxic ischemic encephalopathy, meconium aspiration syndrome, hospital admission and mortality. It is more commonly associated with pregnancy induced hypertension (PIH), post-datism, oligohydramnios and gestational diabetes mellitus.
Study of fetomaternal outcome in eclampsia
Authors: Budhewar Amita , Ubale Sunita , Anand Mamta , Naykodi Priti , Senapati Jaynarayan
Published: April 2022

Background: Eclampsia is preventable and treatable cause of maternal mortality and morbidity with poor fetomaternal outcomes in developing countries. Poor knowledge, lack of education, malnutrition and lack of antenatal care major causative factors for increase in eclampsia in developing countries.Methods: This was a retrospective single center observational study including 106 pregnant women with eclampsia in antenatal, intranatal and postnatal period over period of one year in our institute.Results: 106 women included in this study. In present study mean age of the study population was 25.41 years. 1 maternal death reported during study period. Antepartum eclampsia was commonest type 78%. Most of the patients were referred. In this study LSCS most common mode of deliveries. Perinatal mortality rate was 152/1000 live birth.Conclusions: Eclampsia is important cause of maternal and Fetal mortality and morbidity. Prevention of eclampsia is not possible, whereas early diagnosis can be done through clinical signs and symptoms, so as to prevent complications leading to mortality and morbidity related to eclampsia. Improvement in antenatal care services quality, increasing patient awareness about warning symptoms, investigations timely delivery, intensive monitoring in intrapartum and postpartum period have potential to improve fetomaternal outcomes.
Cardiac disease and pregnancy: a case series of 19 patients
Authors: El Ghani El Hassan , Meziyane Jihane , Aouragh Soukaina , Taheri Hafsa , Saadi Hanane , Mimouni Ahmed
Published: April 2022

In industrialized countries, cardiac disease is a major cause of maternal mortality. The cardiac pathology is further made worse by the significant decrease in the heart function. Our work is a case series of 19 patients who have been admitted to the gynaecology-obstetrics department for the occurrence of pregnancy in the context of cardiac pathology. We report our results, along with a discussion and a review of literature. Cardiac disease is a major cause of maternal mortality in industrialized countries. Management of cardiac diseased pregnant women should be multidisciplinary.
Sigmoid volvulus in pregnancy: a rare case
Authors: Barkase Akanksha A. , Salunke Chetana U. , Gawandi Prabhakar S. , Sathe Vijaysinha P.
Published: April 2022

Sigmoid volvulus in pregnancy is an extremely uncommon condition, with only 84 cases to have been reported in the English literature. Sigmoid volvulus is the most common cause of bowel obstruction complicating pregnancy, accounting for up to 44 per cent of cases. Overall bowel obstruction in pregnancy varies from 1 in 1500 to 1 in 66,431 deliveries. Intestinal obstruction in pregnancy can be caused by many factors including congenital or postoperative adhesions, volvulus, intussusceptions, hernia and appendicitis, history of intestinal tuberculosis. Patient presented with acute onset abdominal distension associated with multiple episodes of vomiting. When history and clinical examination was suggestive of acute abdomen, diagnosis was confirmed with imaging modalities like abdominal ultrasound, CT (Computerized tomography) scan. Sigmoid volvulus is a surgical emergency and is to be treated promptly. Here we presented a case report on sigmoid volvulus in third trimester pregnancy which was managed by emergency exploration.
Assessment of knowledge, attitude and practice towards management of postpartum hemorrhage among third year nursing students at University of Namibia, main campus
Authors: Shinyongo Victoria , Nashandi Hilde L. , Amakali-Nauiseb Taimi
Published: April 2022

Background: Postpartum hemorrhage (PPH) is commonly defined as blood loss of 500ml or more within 24 hours after birth. PPH is the leading cause of maternal mortality in the low-income countries and the primary cause of nearly one quarter of all maternal death globally. Namibia recorded the highest direct cause of maternal deaths for the period of April 2010 to March 2012 which was linked to bleeding after delivery. The purpose of the study was to assess the knowledge, attitude and practice towards management of PPH among third year nursing students at University of Namibia and to assess the maternal nursing care students rendered to woman with PPH.Methods: The researcher used descriptive research design and quantitative approach to collect the data. The researcher obtained primary data directly from 49 third-year nursing students of the University of Namibia (UNAM). Students filled in the Google form/online survey provided to them and all the responses were recorded on the researcher’s Google account.Results: From the study, 83.7% of the participants were females, while 14.3% were males and 2% prefer not to respond.  The results indicate that majority of the participants are competent and have sufficient knowledge and positive attitude toward management of PPH.Conclusions: It is critical that student nurses at UNAM, Main campus are trained well with the necessary PPH knowledge to save maternal lives.
Risk factors associated with the prevalence of Helicobacter pylori among community members in Kibwezi West Sub-County, Makueni County
Authors: Muma Benedict M. , Osero Justus O. , Kanini Caroline M.
Published: April 2022

Background: Helicobacter pylori are gram-negative pathogens that live in the digestive tract and are linked to intestinal ulcers, stomach open wounds, prolonged inflammation, stomach malignancy, and a variety of extra-gastric problems. Close to half of the world's populace is afflicted. The principal focus of the investigation sought to establish the extent of Helicobacter pylori infection in Kibwezi West Sub-County and socioeconomic parameters that drive it.Methods: Purposeful selection, cluster selection, and simple random sampling strategies were utilized in the study's analytic cross-sectional architecture. Participants ranged from 18 to 70 years old, and their stool samples (344) were analyzed using the concept of immunochromatography in vitro to determine the antigens of Helicobacter pylori in stool. At p≤0.05, Chi2 tests were conducted between independent and dependent variables.Results: A number of 344 residents of Kibwezi West Sub-County were surveyed, with a response rate of 100% (344). The majority of those sampled were aged below 58 years (90.1%, n=310), married (81%, n=280), female (75%, n=259), and practicing Christians (84%, n=288). The H. pylori test results indicated 32% (n=109) tested positive, with 68% (n=225) returning negative results. The statistical significance of education level (p=0.024), source of drinking water (p=0.001), and diabetic status (p=0.010) was confirmed.Conclusions: The extent of H. pylori is lower than reported throughout Kenyan studies, including the Kenya health information system. Infection with H. pylori was strongly linked to education, drinking water source, and diabetes. This study proposes a number of intervention strategies.
Impact of health education on knowledge, attitude and practices about menstrual hygiene among adolescent girls of a college in Vijayapura
Authors: Janvekar Sadafara S. , Doddihal Chandrika R. , Pattankar Tanuja P.
Published: April 2022

Background: Menstrual hygiene is an issue that is inadequately recognized. Lack of privacy and sanitation for the adolescent girls make them susceptible for physical and psychological problems especially during the days of menstruation. Education about menstrual hygiene is a vital aspect for the wellbeing of the adolescent girls.Methods: Pre and post-test was done regarding the knowledge, attitude and practice of the Adolescent girls towards the menstrual hygiene.Results: Total of 68 adolescent girls studying in Pre university were enrolled in the study which was conducted for the period of 5months from March to July 2019. Mean age of the participants was 16.5years. 89.7% were residents of Urban area. In our study, we found that they were not properly maintaining the menstrual hygiene. Only 88% of girls knew that menstruation is a physiologic process, 37% knew that menarche is caused by hormones. 85% of them used the pads during the menstruation but 15% disposed it unhygienically.Conclusions: Embracing high quality menstrual hygiene will play an important role in prevention of reproductive Tract Infection, pelvic inflammatory diseases and Cancer of cervix among the women population. Therefore, endorsing positive approach towards management of menstruation and related problems among the adolescents is the need of the hour.
Perceived domains that could improve helmet wearing behaviour in two-wheeler riders: a cross sectional study among internet users residing in Tamil Nadu
Authors: T. Rangapriya A. , V. Ambayiram A. , R. Muruganandham
Published: April 2022

Background: Road traffic accidents are major cause of morbidity and mortality. Correct helmet use can reduce fatal injuries of head and neck and death. The purpose of the study is to assess the knowledge, attitude and practice towards helmet wearing and to assess the barriers and facilitators of helmet wearing practice among internet users.Methods: An observational cross-sectional study was carried out among Internet users who rode motorcycle between August 1, 2020 to October 1, 2020. A pretested semi-structured online questionnaire was used to collect data for the study. The collected data was entered into Microsoft Excel Version 2019 and was analysed using SPSS version 26.Results:  29.9% had poor knowledge regarding helmets followed by 64.5% with moderate knowledge. 5.6% had good knowledge. With regard to attitude, only 5.5% had poor attitude while 66.4% and 27.9% had moderate and good attitude, respectively. Domains perceived by the participants influencing the helmet wearing behaviour included comfort (52.2%), legislative measures (38.5%), awareness (34.4%), design and quality of helmet (27.4%), cosmetic disadvantage (17.1%) and infrastructure (16.7%).Conclusions: Improving the knowledge and attitude among the participants would aid in promoting helmet wearing behaviour. Improving the comfortability while wearing helmet, more strict enforcement of laws for helmet wearing along with increasing the severity of them and increasing awareness through various means were the three most listed domains that could improve helmet wearing among two-wheeler riders.
Post COVID health effects on patients discharged from tertiary COVID care hospital of Southern Rajasthan, India: a cross-sectional study
Authors: Das Subhashree , Singh Lakhan , Nadeem Sharique , Dubey Deepak Kumar
Published: April 2022

Background: The World Health Organization declared the 2019-20 Coronavirus outbreak a public health emergency of international concern on 30th January 2020 and a pandemic on 11th March 2020. It has been creating havoc and a sense of serious insecurity and panic like situation. After recovery patient remain at risk of lung disease, heart disease, and mental health disorders. There have been long term sequelae of adverse effects. This study is being conducted as of now there is limited evidence of post-COVID sequelae as well as the initial psychological impact of COVID-19 is known and further research is required in this topic. Methods: Cross-sectional study was conducted on patients of a teaching hospital in south Rajasthan. Along with socio-demographic proforma, impact of event scale-revised (IES-R Scale) was used to collect the sociodemographic details and psychological impact on patients after they recovered from the disease. Chi-square test was used to find out statistical significance.Results: A total of 153 patients were taken for analysis. Fever followed by breathing difficulty was found to be most common post COVID physical symptoms. IES-R scale had significant associations with age group, co-morbid condition, smoking and alcohol intake.Conclusions: During the initial phase of pandemic, India presented with a high prevalence of post COVID health effects along with a psychiatric sequela. Considering this as an alarming impact, it is suggested to routinely monitor the patients even after discharge from the hospitals.
A study on knowledge of contraceptive usage and its determinants among married women in urban slum of Nalgonda district
Authors: Gunda Sandhya , Tirupathi Sushmitha , Ratna Balaraju , Sarma M. M. V. Prasada
Published: April 2022

Background: India was the first country in the world to launch National Family Welfare Programme in 1951.Modern contraceptive use remains an important public health intervention to reduce maternal mortality, avert unintended pregnancies, and to control population explosion especially in developing countries. To determine the extent of knowledge, awareness and practices of contraceptive use among married womenMethods: A descriptive cross-sectional study was done for a period of three months duration conducted among married women in reproductive age group of 15-49 years in urban slums of field practice area. Results: Among eligible couple, those who want to avoid pregnancy, though they have knowledge and awareness (93.5%), Out of them only 21% of participants were using temporary methods. Most of them (37.4%) were opting for tubectomy. The source of information is mostly from health personnel (46.8%), followed by friends and family members 42%. Partner (38.7%) and “in-laws” (14.8%) consent, fear of side effects (29.6%), illiterates (31.6%) and low socio-economic status (47%) playing major role as barriers of acceptance of birth control methods.Conclusions: The prevalence of contraceptive usage in our study was found to be 58.7%. In present study 41.2% women use no contraceptives which clearly indicate that awareness about contraceptives is not sufficient for its actual use in this community and extended efforts will be needed.
Effects of a mindfulness based intervention on mental well-being and quality of life in Indian adults: an early attempt for integration into community clinical practice
Authors: Pal Anirban , Mukhopadhyay Purnava , Dawar Pal Nidhi
Published: April 2022

Background: In India, the burden of mental ill-health is ever increasing. There is an urgent requirement for the implementation of interventions to prevent psychosocial problems from getting manifested as psychiatric diseases. The researchers see potential in mindfulness, an evidence-based group therapy popular in Western countries. This study shares a ground-level experience with an eight-week face-to-face mindfulness-based intervention. The aim was to see the effects of mindfulness on anxiety, depression, and quality of life in Indian adults.Methods: Participants were randomized into two groups (n=74): group M participated in the mindfulness program while group C attended placebo sessions. The Hospital anxiety and depression score (HADS) for anxiety and depression and WHO quality of life (WHO QOL 100) were measured pre-program and post-program. Statistical analysis used was the paired and unpaired t-Test and one-way ANOVA for the outcome variables.Results: The HADS-A (anxiety) and HADS-D (depression) improved with p=0.0001 and p=0.0003 with the practice of mindfulness. In the mindfulness group, domains 1, 2, and 4 of WHO quality of life also improved post-session with p<0.0001 when compared to the control group.Conclusions: Mindfulness improved the anxiety, depression, and quality of life of Indian adults. Mindfulness holds initial promise for integration into community clinical practice. This study being an early attempt, further studies will be needed before widespread implementation in the country.
Assessment of the knowledge, attitude and practice regarding management of biomedical waste among medical personnel working at SMS Hospital, Jaipur, Rajasthan
Authors: Meena Shyamlal , Verma Mahesh Chand , Bhardwaj Shiwangi , Bairwa Pushpendra , Garg Vedant
Published: April 2022

Background: Bio-medical waste is defined as any waste that is generated during the diagnosis, intervention, treatment, immunisation and research activities. Hospital waste refers to all waste generated in hospitals whether biological or non-biological. As per World Health Organization (WHO) fact sheet, total of waste generated by health care activities 20% are hazardous among them 18%–64% of waste from health care facilities have unsatisfactory management as per protocol because of improper segregation and gaps in knowledge and practice. To assess the level of knowledge, attitude and practices regarding management of bio-medical waste among medical personnel.Methods: A hospital based descriptive study was done over the period of one year (April 2019 to March 2020). On the basis of the eligibility criteria total 500 medical and paramedical personal were finally got enrolled. Pre-designed, pre-tested, structured questionnaires were used.Results: The majorities of participants were male (68%) and the distribution of participants was as followed; doctors (36.6%), nursing staff (37%), lab technicians (4%), 4th class workers (7.6%), and sweeper (15.80%). 63.40% participants score >36 (good score) and only 20.80% score <18 (poor score) on knowledge of BMW management. 45% of participants were known about the risk factors of waste handling. In respect to attitude towards BMW Management, 78% of participants score >36 (good score) and in respect to practice behaviour regarding BMW Management, 79% score >22 (good score).Conclusions: Our study revealed gaps in certain components of knowledge awareness and practice in between various cadre, so we need to reinforce the reorientation training programs at regular intervals to keep them up-to-date and motivated for BMW management.
Socio-demographic determinants of open defecation in rural parts of Bhopal city
Authors: Namdev Garima , Gupta Sachin , Narkhede Vinod , Tiwari Pradeep K.
Published: April 2022

Background: Open defecation (OD) is still prevalent in many parts of India in spite of launching Swachh Bharat Mission (SBM) by central government. So, this programme is extended to achieve the target of open defecation free (ODF) India. To determine the prevalence of open defection and associated socio-demographic factors.Methods: A total 1000 study participants were included for study in the rural field practice area of medical college which was carried out for the duration of one year. A pre-designed, pre-tested questionnaire was chosen as a tool for data collection. Binary logistic regression analysis was applied to show the association between OD and socio-demographic factors using statistical package for the social sciences (SPSS) 23 version.Results: The prevalence of OD was 27.7% and factors such as age, education, occupation, socio economic status (SES), marital status and type of family were found significantly associated with it.Conclusions: OD is more commonly prevalent (27.7%) in rural area in present study. This practice is associated with various socio demographic factors and age, education, occupation, SES, marital status and type of family were found significant predictors for OD.
Assessment of nutrition and its effect on scholastic performance of school going children in rural field practice area of Jhalawar Medical College, Jhalawar, Rajasthan
Authors: Das Subhashree , Dubey Deepak Kumar , Kukreja Srishti , Singh Lakhan
Published: April 2022

Background: Health is a universal human need. School going children constitute one-fifth of the total population and are the future of the nation. The health supervision of school going children is necessary and can help identify the magnitude of morbidity and malnourishment in a community. Malnutrition is associated with significant morbidity, mortality and economic costs in developing countries. In most part of our country, the children in rural areas are nutritionally deprived and are prone to illnesses. A child who is undernourished owing to socioeconomic or other reasons is prone to get diseases and often misses classes and therefore may not perform well in the examinations. Objectives of current study were to assess the nutrition of children attending a government school in rural field practice area of Jhalawar Medical College and to study the association of nutritional status with scholastic performance.Methods: A cross-sectional study was done among children studying in the Government School of Mandawar, Rajasthan. Demographic and socio-economic variables were obtained. Their nutritional status was calculated in terms of weight for height and weight for age and were assessed clinically for presence of any diseases. Attendance and grades were obtained from class teacher to assess the scholastic performance.Results: Out of 122 students studied, based on the anthropometric measurements, dietary intake and physical examination, nutrition status was found good among 77 (63%) students and poor in 45 (37%) students. Students with good nutritional status are more likely to have good scholastic performance.Conclusions: Nutrition impacts the attendance and grades of the students.
Health technology assessment: a tool for evidence-based decisions for quality health care in India
Authors: Chawla Suraj , Gupta Vikas , Kocher Manisha
Published: April 2022

Health technology assessment is widely used methodology internationally for optimization of healthcare resource allocation. It is a multidisciplinary process that gathers policy relevant evidence about the clinical effectiveness, cost effectiveness, ethical and social issues related to the use of a health intervention in a systematic, comprehensive, transparent and robust manner to help policy makers in decision making while formulating policies for incorporating or excluding health interventions from the health system. In order to achieve the ultimate goal of universal health coverage, Government of India has set up health technology assessment in India under the department of health research, ministry of health and family welfare. The health technology assessment framework in India must utilize its entire capacity to guide government and policy makers in explicit priority setting that ensures that available health budgets are spent after weighing all options, and coming to a fair and just conclusion.
Psychological effects of COVID-19 pandemic on Indian population: a review
Authors: Patwekar Mohsina , Patwekar Faheem , Riyaz Muzafar , Tabassum Shahana , Tarkash Shoheb , Rather Gulzar Ahmed
Published: April 2022

The coronavirus disease 2019 (COVID-19) pandemic has changed the lives of millions of people and led to a major health crisis across the globe. According to various surveys and observations, people who were suffering from pre-existing mental issues, neurological defects, psychological disorders, were the more prone to COVID-19 infection. Based on this scenario, people from upper classes to lower classes, from infants to senior citizens, big business persons to small entrepreneurs, government agents to private-sector employees; all kinds of people faced various challenges, which weakened their strength of living. These situations snatched the power of normal living life and negativity suppressed globally. Break down of the education system, devastating socio-economic conditions, helpless healthcare system for uncertainty etc. were reasons for extreme level imbalanced psychological issues. Inside the crematorium, the fume of the burning fire of dead loved ones made people distressed in a daily manner. Some people gave up and wanted to end their lives, while most did suicidal attempts. Some people found themselves as jobless. Suddenly, People discovered themselves, fighting with hunger pain. It was the toughest war; struggling for existence, taking up arms against the unseen. The present study explored the psychological impacts of COVID-19 pandemic. The target of this study is to assess the effects of lockdown on the Indian citizen with an objective to appraise the manifestation of anxiety, mental trauma and depressive issues.
Disposal of medical waste: a legal perspective in Zimbabwe
Authors: Nyakatswau Stuart T. , Bangure Donewell , Pierre Gashema , Nyika Howard
Published: April 2022

The constitution of Zimbabwe provides that everyone has the right to an environment that is not harmful to their health and well-being. However, the illegal dumping and inappropriate disposal of hazardous waste poses a danger to the health of scavengers who are directly exposed to it and to the environment when pollutants migrate into water sources, spread into air and ultimately causing widespread of infection and toxicity.2 The safe disposal of hazardous waste is governed by legislation and regulations which in turn gives effect to the constitution.
Estudio de caso sector de arándanos en Argentina: informe final
Authors: Aggio Carlos , Milesi Darío , Lengyel Miguel
Published: April 2022

Este trabajo analiza el desempeño productivo y exportador del negocio de arándanos en Argentina desde sus inicios, en los años noventa, hasta 2019. El arranque lento de unas pocas firmas pioneras estuvo seguido de una fase de expansión sustentada en un contexto macroeconómico favorable, en aprendizajes tecnológicos y productivos y en la sostenida demanda de los mercados del hemisferio norte (EEUU y Europa) por fruta fresca de contraestación. Desde el 2008, de la mano de la crisis internacional, el sector viene experimentando una importante crisis competitiva que se vio profundizada por la irrupción disruptiva de Perú que rápidamente se posicionó como primer productor y exportador mundial de arándanos. El trabajo, enfatiza en las iniciativas publico privadas sectoriales y en las estrategias empresariales que en una primera etapa permitieron explicar su despegue y más recientemente se encuentran orientadas a superar la crisis competitiva actual.