bluuebunny/crossref_metadata_2025 huggingface dataset:
Perinatal outcome in pregnancies complicated with oligohydramnios at term
Authors: Bhaskar Suneetha Kambham , Parvathaneni Silpa
Published: January 2022

Background: AFI of less than or equal to five cm is considered oligohydramnios. Various approaches, such as NST, acoustic stimulation, and foetal Doppler velocimetry, are useful in assessing foetal well-being and identifying pregnancies at risk of postnatal complications. The goal of this study was to learn about the negative perinatal outcomes in pregnant women who had oligohydramnios at term and to assess the efficacy of AFI in predicting foetal distress and caesarean delivery.Methods: A retrospective and comparative study of singleton pregnancies outcomes in 60 women diagnosed with oligohydramnios by USG after 37 weeks of pregnancy, compared to 60 women who did not have oligohydramnios and were matched for other factors. Some criteria for inclusion and exclusion were utilised. The data was analysed using statistical criteria such as mean, standard deviation, and chi square test sensitivity, specificity, PPV, and NPV.Results: The occurrence of non-reactive and re-active NST patterns differed significantly between the two groups. In comparison to women with AFI >5 cm, women with AFI 5cm have a higher rate of labour induction. LBW (2.5 kg) was more common in women with oligohydramnios, and LSCS rates were higher in oligohydramnios-complicated pregnancies.Conclusions: After 37 weeks of pregnancy, an AFI of less than 5 cm is a sign of poor perinatal outcome. AFI can be used in conjunction with other foetal monitoring techniques. AFI is a useful screening test for predicting foetal distress during labour that necessitates a caesarean section.
Presentation and intervention in missing Copper T Thread in reference to timing of insertion
Authors: Jafra Pooja R. , Sehgal Alka , Pandher Dilpreet K. , Jafra Bikramjit S.
Published: January 2022

Background: To analyse the impact of time of insertion of Copper T to presentation and intervention for management of missing Cu-T thread.Methods: After approval of the study by research and institutional Ethics Committee, present study was carried out partly prospectively on patients presenting with missing Cu T thread. Retrospective data was also collected from minor OT or admission records for those admitted for removal of IUCD and duly completed telephonically. Proportion of women with missing Cu T thread were calculated in percentages. Correlation between different groups couldn’t be calculated because of major difference in number of subjects in groups. Data was analysed with regard to relation to timing of insertion, presentation, complications, number and kind of interventions for its removal.Results: Among 57 women, 30 had post LSCS CuT insertion, 6 had post NVD, 20 had interval CuT insertion, 1 had post abortal insertion. Misplaced CuT was detected in 8 women on USG, 4 (50%) had post LSCS, 3 (37.5%) post NVD and 1 (12.5%) had interval CuT insertion. OPD removal could be attempted successfully in 30 women; 11 (36.67%) post LSCS, 2 (33.33%) post NVD, 16 (80%) interval and 1 (100%) post abortion insertion. OT removal was needed in 23 women; 17 (56.67%) post LSCS, 2 (33.33%) post NVD, 4 (20%) interval CuT insertion. Spontaneous expulsion diagnosed in 4, 2 post LSCS and 2 post NVD CuT insertion.Conclusions: There is definite impact of timing of Cu T insertion on incidence of misplacement and expulsion and more data and studies are needed for developing a common information performa to develop SOPs for follow up of such patients.
A study of adequacy of informed consent before caesarean section in a tertiary care hospital
Authors: Bhushan Nishu , Manhas Aakriti
Published: January 2022

Background: Informed consent is an ethical and legal requirement and is practiced before all the surgical procedures. Caesarean section is the commonest obstetric surgery so, this study was aimed to assess the adequacy of informed consent in patients who underwent caesarean section at SMGS Hospital, GMC, Jammu.Methods: A cross-sectional study was done. A total of 230 patients were included in the study. A pre-tested and pre-validated questionnaire was used for the study. The data were expressed as percentage of proportion.Results: 230 patients participated in the study. About 96.95% patients knew the name of the procedure. 91.73% patients were informed about the indication of the surgery. 95.21% of the patients were aware about the benefits of surgery and about 93.41% of the patients were knowing risks of surgery. About 83.04% patients were informed about the procedure of the surgery. About 94.78% and 94.34% of the patients were aware about the need for the blood transfusion and future pregnancy options. Only about 4.35% of the patients were informed about the requirement and type of anaesthesia. 22.18% of the patients knew about the choice for alternate procedure and merely 2.18% of the patients were informed about the right to refuse the procedure.Conclusions: It was found that majority of the patients were well informed about the procedure and the related consequences. Still we can improve some elements of the consent process which can be done by proper awareness and training of health care professionals.
Comparison of efficacy of visual inspection with 4% acetic acid, visual inspection with Lugol's iodine, Pap smear and colposcopy in screening cervical precancerous lesions
Authors: Bhattacharya Apurba K. , Sarma Hem K. , Das Antara
Published: January 2022

Background: Cervical malignancy is the fourth most common cancer in women worldwide. Screening of high-grade cervical intraepithelial neoplasia aids in early detection and their effective treatment which constitutes the most effective and widely used strategy to prevent cervical carcinoma throughout the world. Objectives of the study were to: screen women with visual inspection with 4% acetic acid (VIA), visual inspection with Lugol's iodine (VILI), Pap smear and colposcopy who have abnormal symptoms for unhealthy cervix; and to evaluate the sensitivity and specificity of VIA, VILI, Pap smear and colposcopy.Methods: This was a hospital based cross sectional study conducted at Jorhat Medical College, Assam at the department of obstetrics and gynaecology from June 2020 to May 2021, carried out on 60 women. This study was done on 60 women who fulfilled the inclusion and exclusion criteria, were first subjected to Pap smear followed by VIA, VILI, colposcopy and biopsy for confirmation of lesion, if needed. Data was obtained and statistically analyzed.Results: VIA showed sensitivity 96.15%, specificity 62.50% and diagnostic accuracy 88.23%. VILI showed sensitivity 89.65%, specificity 40% and diagnostic accuracy 82.35%. Colposcopy showed sensitivity 96.66%, specificity 25% and diagnostic accuracy 88.23%. Pap smear showed sensitivity of 86.66%, specificity 75% and diagnostic accuracy of 85.29%.Conclusions: Our study shows that VIA, VILI, Pap smear and colposcopy has comparable sensitivity. Pap smear shows better specificity. Therefore, use of combination of these tests gives better sensitivity and specificity for early detection of cervical carcinoma.
Neonatal effects of maternal magnesium sulphate in preeclampsia: a case control study
Authors: Sengottaian Karunaa Joe , Rangappa Sheela Shivamonga
Published: January 2022

Background: Preeclampsia is a significant public health problem in developed and developing countries. It is a multi-organ system disorder, hence making it demanding to find out severity markers.4 Awareness, recognition and knowledge of risk factors of preeclampsia will assist in predicting and lessen the recurrence of preeclampsia. In severe cases of preeclampsia and in eclampsia, magnesium sulfate is an effective anticonvulsant.Aims and objectives were: to document the clinical parameters of patients with or more than 28-week gestation having preeclampsia or eclampsia receiving magnesium sulphate and patients with or more than 28-week gestation having preeclampsia but not receiving magnesium sulphate; and to compare and study the obstetric and neonatal outcomes between the groups.Methods: A case control study was performed among patients who delivered at RLJH hospital during study period (July 2020-July 2021), subjects who were administered magnesium sulphate due to maternal conditions were taken as cases and the subjects who did not receive magnesium sulphate were taken as controls. Obstetrical and neonatal outcomes were compared between both the groups. Data was entered in Microsoft excel sheet. Unpaired t test was performed. P value less than 0.0001 was considered significant.Results: Magnesium sulphate did not have significant effects on the neonatal and obstetrical outcome.Conclusions: The association between magnesium sulphate administration and neonatal outcomes were studied and it concludes that the administration of magnesium sulphate for the mother didn’t have significant effects on the neonatal and obstetrical outcome.
Ectopic pregnancy and unsupervised abortion pills: the hidden truth
Authors: Singh Neha , Pathania Kushla , Negi Kalpna , Rathod Sanjay
Published: January 2022

Background: Aim of the study was the indiscriminate use of self-consumption of abortion pills and its association with complication like ectopic pregnancy reporting to a tertiary care center.Methods: The study was a prospective observational study conducted in the department of obstetrics and gynecology, Kamla Nehru State hospital for mother and child, Indira Gandhi medical college Shimla w.e.f. 1st July 2018 to 30th June 2019. A total of 27 women reported to the hospital who were diagnosed of having ectopic pregnancy after intake of abortion pills.Results: A total of 27 cases presented to the hospital who were diagnosed to have ectopic pregnancy. Maximum 18 (67%) cases were in 21-30 years of age group. Married women constituted 21 (77%) cases. The 14 (52%) belonged to rural area while 13 (48%) belonged to urban area. The chemist was found to be source of procurement in 19 (70%) cases, private practitioner in 6 (22%) cases and only two consumed pills after consultation with registered doctor.Conclusions: This study shows urgent need for legislation and restriction of drugs used for medical termination of pregnancy. Drugs should be made available via health care facilities under supervision to reduce maternal mortality and morbidity due to indiscriminate use of these pills.
Foeto-maternal outcome in oligohydramnios
Authors: Karia Jil , Ninama Pallavi , Pateliya Pinal , Karnavat Ronak
Published: January 2022

Background: Oligohydramnios is defined as an amniotic fluid index (AFI) of ≤5 cm. AFI is calculated by adding the depth in centimetres of the largest vertical pocket in each of four equal uterine quadrants in ultrasonography. We aimed to evaluate the predictive value of amniotic fluid index (AFI) (≤5 cm) for mode of delivery, associated complications, perinatal outcome, birth weight, meconium staining and APGAR scores.Methods: This was a prospective study of 100 antenatal women who presented at our antenatal OPD at GMERS Medical College and Civil Hospital, Sola, Ahmedabad, Gujarat with gestational age between 34 and 41 weeks over a 1-year duration from 2020 to 2021. The women’s history was taken, clinical examination done, and AFI was measured, and results were tabulated.Results: Prevalence was most among the 20-30 age group. Most patients delivered vaginally. Anaemia and gestational hypertension were the most common associated complications. There was no neonatal death in this study. No significant correlation was found between oligohydramnios and low birth weight babies.Conclusions: Oligohydramnios has a significant correlation with caesarean section for foetal distress and low birth weight babies.
Caesarean delivery on maternal request: need to redefine in view of intrapartum cases
Authors: Atnurkar Kishore Bhanudasrao , Mahale Arun Ramkrishnarao
Published: January 2022

Background: The objective of the study was to analyse the data of caesarean section on maternal request (CDMR) both before labour and intrapartum, in low-income society from a town in India.Methods: It was a retrospective observational study of 9331 caesarean section (CS) cases carried out in different small private maternity hospitals over a period of 20 years. We used the data for auditing the CS cases done on maternal request.Results: Out of 9331 CS cases documented, 216 CS were done on maternal request. The incidence of CDMR was 2.31%. About one third cases were intra-partum. The rising trend of CDMR was observed both before labour and intra-partum.Conclusions: There was a need to redefine CDMR in the view of rise in the incidence of women requesting for CS not only before labour but during lab or also. CDMR is no more confined to highly educated, rich and women from urban area. Less educated, low income group women residing in rural area are also becoming aware that CS can be done on maternal request.
Comparative study of intravenous iron sucrose versus intravenous ferric carboxymaltose in the management of iron deficiency anaemia in pregnancy
Authors: Khatun Ferdousi , Biswas Chandralekha
Published: January 2022

Background: Iron deficiency anaemia is the most common anaemia with significant effect over health status. It is a major hematological, nutritional deficiency but manageable health problem among the pregnant women. Anaemia during pregnancy is associated with increased morbidity and mortality of pregnant women and their developing foetuses. In pregnant women, oral iron is often used for prophylaxis and is recommended as first-line treatment for iron deficiency anaemia in pregnancy. Intravenous (i.v.) iron preparations provide greater and more rapid repletion of iron stores than oral iron.Methods: This is a prospective, single center, comparative interventional randomized hospital based study carried among antenatal mother admitted in antenatal ward in the department Obstetrics and Gynaecology, Medical college and hospital, Kolkata from 1st January 2019 to 30th June 2020 (one and half year duration), comprised of 180 pregnant women divided two groups. Group- A (90) received ferric carboxymaltose (FCM), group- B (90) received iron sucrose. All pregnant women between 16 to 34 weeks of gestation with iron deficiency anaemia with hemoglobin values between 7-10 gm%, were counselled and included. Medical eligibility criteria were used for client selection.Results: In FCM group 3 week post treatment hemoglobin level was 9.87±0.77 and in iron sucrose group it was 9.39±0.72 (p=0.001). 6 week post treatment hemoglobin level in FCM group was 11.51±0.76 and in iron sucrose group it was 10.78±0.61 (p=0.001). Mean change in hemoglobin in FCM group after 3 week post treatment was 1.51±0.63   and after 6 week it was 3.15±0.79. In iron sucrose group at 3 week it was 1.16±0.43 and at 6 week it was 2.55±0.52. The mean change in hemoglobin level was higher among patients of FCM compared to Iron sucrose group.Conclusions: Ferric carboxymaltose was safer and more efficient in treatment of iron deficiency anaemia in pregnant women as compared to iron sucrose with lesser adverse effect and better patient compliance.
Study of changes in biochemical parameters of preeclampsia patients, a prospective five year study
Authors: Saha Aditi , Gupta Anirban Das
Published: January 2022

Background: Preeclampsia is associated with changes in biochemical parameters like hepatic dysfunction, increase in blood glucose, thrombocytopenia, urea, creatinine, uric acid, alteration in lipid profile, hypoalbuminemia, electrolyte and C-reactive protein. Based on variability in literature regarding biochemical parameters present study has been designed to evaluate the changes in biochemical parameters in preeclampsia patients in tertiary care hospital.Methods: Pregnant women with pre eclampsia attending OPD of obstetrics department were enrolled for this study based on following inclusion and exclusion criteria. Similarly normotensive pregnant women were enrolled as control per same inclusion and exclusion criteria.Results: Total platelet count was significantly lower in preeclampsia patients then control (2.02±0.7 lakh/µl versus 3.29±.58 lakh/µl). Blood urea was significantly higher in preeclampsia patients than control (29.22±4.56 mg/dl versus 18.32±6.23 mg/dl), (p=0.0001) serum uric acid was significantly higher in preeclampsia patients than control (9.22±1.11 mg/dl versus 5.89±.89 mg/dl). HOMA IR was significantly higher in preeclampsia patients then control (4.52±1.68 versus 2.23±1.98).Conclusions: From present study we can conclude preeclampsia patients were frequent in nulliparous. Preeclampsia is associated with thrombocytopenia. Except increase in AST other hepatic parameters were in normal range and comparable to control. FPG, FPI and HOMA IR were elevated in our finding and it indicates a state of insulin resistance. Preeclampsia patients were also having dyslipidemia. Serum uric acid creatinine and blood urea was significantly higher in preeclampsia patients.
Retrospective study of post-operative care in pandemic in tertiary care centre
Authors: Roshini E. , Indu N. R. , Banu A. Shameera , Hiremath P. B. , Hiremath Reshma
Published: January 2022

Background: COVID-19 pandemic has unfortunately changed the surgical interventions and the post-operative management worldwide. Most of the medical institutes in India had formulated their own protocols from the beginning of the pandemic in March 2020 to stop all elective surgical procedures as soon as possible. However emergencies and all types of obstetric as cases were not stopped as it was unavoidable conditions.Methods: This retrospective observational study was done in the department of obstetrics and gynaecology, at Sri Venkateshwaraa Medical College, Ariyur, Puducherry, during the period April 2020-December 2020. Data was collected from the case sheets and operative notes and retrospective analysis was done.Results: On analysing we have realised that LSCS rate was higher and induction for trial of labour was kept minimal. We had 3 infective morbidity in the form of wound infection and 1 patient was returned to the operation theatre for reexploration. Arranging the blood during the pandemic was also a tedious task.Conclusions: In the present era of pandemic, where the patient load is high, we can rely on post graduate students to look after the post-operative patients through effective communication with the available consultants.
Seroprevalence of chlamydia trachomatis infection in Kashmiri women of reproductive age with mucopurulent cervicitis, infertility and ectopic pregnancy - a hospital based study
Authors: Hassan Qurat U. , Mufti Asma H. , Mufti Samiya
Published: January 2022

Background: Chlamydia trachomatis is one of the most prevalent sexually transmitted infection worldwide. Objective was to find the seroprevalence of the Chlamydia trachomatis infection in women who suffer from infertility, mucopurulent cervicitis and ectopic pregnancy and to investigate the possible role of the chlamydial serology as a screening test by detection of the anti-Chlamydia IgG antibodies using enzyme-linked immunosorbent assay (ELISA).Methods: 160 women who attended the gynecology outpatient department (OPD) at a tertiary care hospital were screened for presence of chlamydia trachomatis IgG antibodies. Patients were categorized based on clinical diagnosis in: group I comprising of 120 patients [40 patients in each sub group - mucopurulent cervicitis (MPC); infertility; and ectopic pregnancy]; and group II comprising fertile women with no clinical signs and symptoms of mucopurulent cervicitis and no history of ectopic pregnancy and infertility. Patients were screened for IgG antibodies to Chlamydia trachomatis.Results: In our study 32.5% women with mucopurulent cervicitis were positive for computed tomography immunoglobulin G (CT IgG). In the infertile group, 22.5% of women were positive for chlamydia IgG antibodies. 30% of ectopic pregnancies were positive for chlamydia trachomatis IgG. Out of 40 patients who were taken as controls, 7.5% screened positive for Chlamydia IgG antibodies. Seroprevalence of Chlamydia trachomatis was 23.12% in our study.Conclusions: Our study has shown that significant proportion of our population harbor Chlamydia trachomatis this infection. So it becomes imperative that health and screening programs be employed to prevent spread of this infection and its long term sequelae in women of childbearing age.
Bipolar vessel sealer versus conventional suturing in non-descent vaginal hysterectomy: comparative study
Authors: Sahu Mahija , Goru Harika
Published: January 2022

Background: The aim and objective of the study is to compare bipolar vessel sealer method with conventional suturing technique in non-descent vaginal hysterectomy.Methods: A prospective observational study was done in the department of obstetrics and gynaecology, S. C. B. Medical College and Hospital, a tertiary care centre, Cuttack, Odisha, in a period from, April 2019 to October 2020. A total of 100 patients fit under inclusion criteria were posted for non-descent vaginal hysterectomy after taking an informed consent. They were divided into (group A) conventional suturing group and (group B) bipolar vessel sealer group, using a randomised computer method. The statistical analysis of data obtained was done using statistical package for the social sciences (SPSS) version 18 software.Results: In the present study the mean procedure time taken in minutes for NDVH using bipolar vessel sealer (BVS) was significantly shorter than suture group (57.54±12.851 versus 29.26±8.808; p<0.001), the mean intraoperative blood loss in ml was also significantly lesser in BVS group (5.96±1.24 versus 3.50±0.73; p<0.001). The mean post-operative pain scores using visual analogue scale (VAS) (0-10) also showed statistically significant reduction in BVS group when observed on immediate post-operative day (POD) (3.50±0.73 versus 5.96±1.24; p<0.001). There was statistical reduction of pain even on POD1, POD2, and POD3 also. The length of hospital stay in days was also significantly shorter in BVS group when compared to suture group (2.10±0.58 versus 5.00±0.404; p<0.001).Conclusions: The bipolar vessel sealer proved superior to conventional suturing in regards to time taken for operating procedure, intraoperative blood loss, post-operative pain (VAS 0-10) and length of hospital stay. The mean post-operative haemoglobin and packed cell volume (PCV) values both were higher in vessel sealer group compared to suturing group although statistical significance was not attained.
The impact of Hashimoto’s disease on female fertility: a systematic review
Authors: Sarantaki Antigoni , Tsiorou Kyriaki , Gourounti Kleanthi
Published: January 2022

Hashimoto’s disease (HT) is the most common autoimmune disease, affecting 5–15% of women of reproductive age. Recent studies have shown that Hashimoto’s thyroiditis can be a risk factor for infertility in women. The aim of the present study is to explore the impact of Hashimoto’s disease on female fertility. This systematic review followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Databases searched included Medline, PubMed, EMBASE and Google Scholar. Search terms included Hashimoto’s disease, Hashimoto’s thyroiditis, thyroid autoimmunity, autoimmune thyroiditis, women, females, infertility and every possible combination of them. The exclusion criteria of this systematic review involved articles written in a language other than English, other disorders that also affect the female fertility, women with infertile partners, with abnormal karyotype or/and with abnormal body mass index (BMI). The search strategy identified 150 unique items. After the initial screening process, 50 studies underwent full text review and 5 studies were finally included in the systematic review, since they met all the inclusion criteria. Four of the included studies found that Hashimoto’s thyroiditis can have a negative effect on female fertility and especially in patients of advanced age. Women with autoimmune thyroiditis might be at risk of ovarian insufficiency because of the decline in ovarian reserve. Consequently, patients with positive anti-thyroid peroxidase (TPO) antibody findings, who wish to start a family, should be aware of their lower reproductive life span. Further randomized controlled trials can clarify the impact of Hashimoto’s disease on female fertility.
Heterotopic pregnancy: a case series
Authors: Mounir Moukit , Rahmoune Mohammed , Allilou Ismail , Elmoubakkir Bouchra , Laghzaoui Omar
Published: January 2022

Heterotopic pregnancy once considered a rare phenomenon is now thought to be more common as the overall incidence of ectopic pregnancy continues to increase. We report a series of six cases of heterotopic pregnancies seen in our department over a period of seven years. Two of these occurred after assisted reproductive techniques; while the other cases were spontaneous heterotopic pregnancies. The clinical presentation of these cases was varied with late diagnosis occurring in two cases. Preservation of the intrauterine pregnancy was obtained in four cases. Unfortunately, the other cases were aborted spontaneously on the postoperative period. Only with an early diagnosis and adequate management the intrauterine pregnancies will reach viability, with a great chance of a favorable obstetric outcome.
Infundebulectomy in management of uterine artery or uterine wall injury during complicated and difficult caesarean section: case series study
Authors: Mitwally Abo B. A.
Published: January 2022

It is case series trying to save uterus in situation where one site of it is severely injured or in severe uncontrollable bleeding in one of the uterine arteries either during control of massive hemorrhage associated with friable tissues with severe adhesion, some cases of placenta accrete spectrum, some cases of uterine rupture and in caesarean section myomectomy.
COVID 19 in pregnancy: our experience amidst second wave of COVID-19 at a teaching institute
Authors: Jamal Shehla , Masroor Kainat , Tyagi Akansha , Agarwal Rajini
Published: January 2022

To analyse the obstetrical outcome during second wave of coronavirus disease 2019 (COVID-19) at Level 2 facility. This is a hospital based analytical study conducted at Raj Shree medical and research institute Bareilly. During second wave a total 87 patients presenting to obstetric emergency department, over a period of one month (April 2021 to May 2021). A total of 26 patients were admitted in the hospital. 20 patients were COVID-19 positive and 6 patients were symptomatic with RT-PCR negative report. Out of 20 patients 19 were antenatal case and 1 case was postnatal. There were 2 mortalities among all positive patients. In all COVID-19 positive patients’ majority of the patients were in 26 to 30 years of age (46%). A High proportion presented in third trimester, at the gestation period between 37 to 40 weeks (54%). Around 23% patients had severe symptoms and there were 4 ICU admissions. 65% patients required supplemental oxygen at a rate of >12 l/min. There were a total 2 mortalities; both were in severe category with rapid deterioration. The significant laboratory derangement observed was coagulation profile deranged in 40% cases. COVID-19 second wave was deleterious for obstetric population in an unprecedented manner. A high morbidity and mortality were seen in this duration. Data and evidence which is continuously evolving needs to be shared for global references and knowledge sharing amongst peers.
Isolated fallopian tubal torsion with underdiagnosed entity: a case report
Authors: Park Seon Hee , Yun Jisun , Chung Eun
Published: January 2022

Isolated fallopian tubal torsion refers to twisting only the tube without involving the ipsilateral ovary. This is a rare type of adenexal torsion and is a gynecological emergency. Since this disease mostly occurs in women of childbearing age, accurate diagnosis and appropriate treatment are more important issues. It is known that ovarian cyst torsion occurs well in sizes greater than 5 cm, but the epidemiology of isolated fallopian tubal torsion is unknown. Even clinically, in patients complaining of abdominal discomfort, a small andexal cyst is difficult to consider as a cause of pain. We presented an isolated fallopian tubal torsion case that can be twisted despite its small size.
Angiomyofibroblastoma: a very rare tumour of vulva
Authors: Verma Urvashi , Nigam Asha , . Chandrakanta , Chowang Romila , Bharti Sadhana
Published: January 2022

Angiomyofibroblastoma is a rare benign mesenchymal tumor of vulva. Patient had history of gradually increased mass over 6 years of duration. It was painless, fibro-cystic mass of 6.8×4.6×2.5 cm hanging over right side labia majora without any menstrual or coitus difficulty. Cosmetic and risk of malignancy were the main issues. After complete examination and investigations simple excision done. Histological examination revealed mass composed of numerous capillaries and some ectatic blood vessels embedded within the hyalinised matrix. No lipomatous component was found within the tumour. Nuclear atypism and pleomorphism were absent and mitotic figures were not detected. All these were suggestive of benign mesenchymal tumor, angiomyofibroblastoma.
A case report of rare presentation of granulosa cell tumor with torsion and capsule rupture
Authors: Basavaraj Nikhitha , Sasikala R. , Varghese Jessy
Published: January 2022

We report a rare case of granulosa cell tumor (GCT) which has undergone torsion and capsule rupture presenting as acute abdomen. The incidence of ovarian torsion among women of reproductive age is 9.9 per 100,000 where dermoid cyst is more common to undergo torsion.
Hysteroscopy: endometrial vascular dystrophy: misnomer
Authors: Eiran Ekta
Published: January 2022

Endometrial vascular dystrophy is a name given to the typical appearance of endometrium on hysteroscopy where in dilated, tortuous, black, worm like capillaries are seen on the endometrial surface. This is a case of a 17-year-old girl who presented with menorrhagia. Pelvic Scan showed endometrial polyp. On hysteroscopy the typical picture of endometrial vascular dystrophy was seen. Though it has been thought to be due to thrombosed capillaries, not much literature is available on this topic. More study is required to understand the cause behind this phenomenon.
Pregnant patients diagnosed with COVID-19 simulate a clinical picture of preeclampsia
Authors: Ayvar Sara L. , Aquino-Ruelas Lizeth , Perez-Díaz Miriam C. , Zepeda-Torres José M. , Ancona-de la Rosa Fanny Elizabeth , Martinez-Guerrero Eva Emilia
Published: January 2022

The current pandemic caused by the coronavirus 2019 (COVID-19) has been a relevant event; we have seen how it spreads rapidly and has an increased risk of becoming severe if the patient has any comorbidity. It is essential to consider that although COVID-19 is a respiratory disease, it can have systemic effects that can trigger various complications. This study is focused on how a COVID-19 infection can present symptoms similar to preeclampsia.
The impacts of internet and transportation access on patients’ health conditions: a cross-sectional study
Authors: Hu Qinglin , Li Xiaobing , Bell Gregg , Yerby Lea G.
Published: January 2022

Background: Use of internet and transportation to access to healthcare resources are 2 essential and effective ways to promote health outcomes and ameliorate health disparities. Despite general widespread availability of internet and transportation, disparities still exist among specific groups and regions. Little is known about the spatial patterns of extents of 2 access determinants on healthcare resources, nor for their compound effects on patient’s health outcomes.Methods: The study uses 2018 health information national trends survey (HINTS) data, geographic information techniques and multiple ordered logistic regression model were applied.Results: The results show that States in West and Midwest tend to have higher proportions on both perspectives, where states in South and Mideast had a relatively low percentage on the healthcare access determinants. Those states had similar socio-economic patterns with underserved population and low development progress in public healthcare system. Another finding is urban people had outstripped its rural neighbors on both internet (79% vs 57%) and transport (74% vs 62%) access to healthcare resources. Furthermore, our study suggests that, when considering compound effects of internet access for healthcare information and transport access to healthcare service, people who had greater barriers tend to have decreased likelihood (-21.30%) towards their health conditions, compare to those with sufficient accesses.Conclusions: Additional work and policy are needed to ensure that internet and public transportation resources and services are prioritized for underserved populations and areas.
Health-seeking behavior and associated factors during the first episode of childhood diarrhea and pneumonia in a coastal area of Bangladesh
Authors: Saha Sanjoy , Haque M. Aminul , Chowdhury M. Abdul Baker
Published: January 2022

Background: Pneumonia and diarrhea are the leading causes of under-five (U5) child mortality in Bangladesh. Seeking appropriate care in timely manner may prevent U5 child mortality due to pneumonia and diarrhea, and thus, it is important to understand perception and barriers of health-seeking behavior of parents during childhood pneumonia and diarrhea in order to develop healthcare policies, and design programs to improve health care utilization practices in disadvantaged areas. The study aimed to explore the factors affecting health-seeking behavior during the first episode of childhood diarrhea and pneumonia.Methods: In a cross-sectional study, survey interviews with 392 mothers, and two focus group discussions (FGD) with fathers (n = 16) were conducted in two villages of Teknaf Upazila in a coastal district in Bangladesh.Results: Logistic regression analysis indicated that during childhood diarrhea, mother’s age, household monthly income, monthly health expenditure and mother’s knowledge regarding danger signs, and during childhood pneumonia, mothers’ education level, monthly household income, monthly expenditure for treatment, household size, and knowledge regarding danger signs were the predictors of mothers’ health-seeking behavior. Results from FGDs indicate that financial problems, low education, distance to health facilities, poor transport facilities hinder the ability to seek timely care during childhood diarrhea and pneumonia.Conclusions: Policies and programs should be in place to address barriers of health-seeking behaviors to reduce child mortality due to diarrhea and pneumonia in coastal areas.
Attitude and factors affecting compliance to diabetes mellitus management among clinic attendees at Jericho Specialist Hospital, Ibadan
Authors: Olonisakin Bolatito T. , Oluwamotemi Christiana A. , Majolagbe Nihinlola T. , Ojoez Philip A.
Published: January 2022

Background: The need to understand factors influencing non-compliance with the treatment of Diabetes Mellitus (DM) will go a long way in addressing the issue in Nigeria. However, this study was aimed at assessing the attitude of diabetic patients and factors affecting their level of compliance to the management of DM among clinic attendees at Jericho Specialist Hospital, Ibadan, Nigeria.Methods: This study employed a descriptive cross-sectional study using a two-stage sampling technique. A pre-tested semi-structured questionnaire was used to obtain information on two hundred and twenty respondents. The attitude was scored on a 5-point scale where <3 and >3 were categorized as negative and positive attitudes respectively. Data were analyzed with SPSS version 21 using descriptive statistics.Results: Mean age of respondents was 49.7±10.3 years and 27.8% were male. Some (32.1%) of the respondents had a negative attitude towards the management of DM. Many 66.5%) disagreed to not bother about the outcome of their disease because they know they will get over it, 100.0% disagreed that the impact of diabetes on their lifestyle is negligible, and 65.6% agreed that they did not like people to know about their status. Amidst all the factors influencing compliance to the management of diabetes among patients with DM, drugs ranked highest with 98.1% followed by frustration due to long treatment and being tempted by inappropriate foods and drinks accounting for 83.5% and 81.1% respectively.Conclusions: There was generally a good attitude on diabetes management. However, there is a need for special programs to encourage compliance by the government.
Use of psychoactive substances among teens and young people in schools in Benin: from experimentation to dependence
Authors: Kougblenou A. Odile , Sossa Charles , Adounkpe Ferdinand M. , Bio Sya A. Assad , Agbanlinsou C. Arnaud , Akpi Eric Ayédjo , Meliho Pierre Codjo , Kpatchavi Codjo Adolphe , Houinato Dismand , Laleye Anatole
Published: January 2022

Background: The use of psychoactive substances among adolescents and young people in schools in Benin is growing despite its consequences on their health. This article analysed this practice, identified the types of use and their determinants along the consumption trajectory.Methods: It was mixed, transversal study and involved 617 students from high schools and colleges in Cotonou and Parakou in 2020. Sampling was in two-degree clusters. 65 students were drawn by reasoned choice and snowball for qualitative interviews. Data processing was done with SPSS software and content analysis.Results: The results show that there was a diversity of substances available, accessible and used by targets in the last three months prior to the survey. Three types of use were identified: experimental use, determined by curiosity (48.14%), the quest for generational identity (25.45%) and sociability (34.20%); misuse, influenced by the quest for physical and sexual performance (17.83%), intellectual performance (28.85%) and peer pressure (22.04%) and dependent use, determined by the precocity of experimentation (69.04%), family type (33.60%) and the relaxation of societal values.Conclusions: Adolescents living in abusive and dependent uses are particularly vulnerable in terms of health and social. This requires a preventive approach based on education in societal values, the fight against the availability of these substances and the early management of cases of dependence.
Awareness, perceptions, and attitude towards COVID-19 vaccine among 18-44 years old adults in India: a cross-sectional study
Authors: Pushkar Kumar , Kapoor Suraj , Teli Prabhakar , Sahu Rajesh , Bobdey Saurabh , Kaushik S. K.
Published: January 2022

Background: The coronavirus disease 2019 (COVID-19) vaccines currently represent an effective and the only effective weapon to effectively combat the Pandemic. Thus, it is especially important to judge the awareness and perception of general population about the study. With this aim, the study was conducted at a vaccination centre among registered adults aged 18-44 years getting the first dose of vaccination to assess knowledge, perceptions about COVID 19 vaccine.Methods: A descriptive cross-sectional study was conducted from 15 June 21 to 25 June 21 among 612 adults aged 18-44 years adults registered for the first dose of vaccination (COVISHIELD Vaccine) at the vaccination centre of tertiary care hospital in Western Maharashtra.Results: A total of 612 study participants aged 18-44 participated. On assessing awareness, perceptions, attitudes towards the COVID-19 vaccine, most of them liked to prefer COVISHIELD (83.7%) over COVAXIN (12.3%). More than one-third liked to have a second dose at 4–6-week interval, with a similar number favouring 6–8-week interval. On assessing the KAP score mean KAP score (±SD) was 18±4.5 out of 35.Conclusions: This study highlights that overall awareness and perceptions of the study population was good. However, there was inadequate knowledge about certain key aspects of COVID-19 vaccination like contra-indications, duration after which protection starts after inoculation. The findings suggest immediate health education programs, risk communication, should be done effectively to curb, vaccine hesitancy and misinformation.
Second wave of COVID-19: more hype than reality
Authors: Rajiva Rajiva , Mahalingam Muruganantham , Basavaraj Thumbavelu , Pardal Maninder Pal Singh , Saxena Aaditya , Chary Sridhar , Mahar Sandeep Singh
Published: January 2022

Background: The second wave of COVID-19 hit India with the nation reporting over 4 lakh cases daily since second week of April 2021. Keeping in view the lack of adequate data in this regard; and the public health importance of the second wave of the Covid-19 pandemic, the researchers proceeded to carry out the study.  The aim of the study was  to  study  the clinicoepidemiolgical profile of hospitalised COVID19 cases in an urban area.Methods: The workers carried out a cross sectional descriptive study. Period of the study was April 2021 to September 2021. Detailed epidemiological, clinical, laboratory and radiological data was obtained in respect of 149 cases of Covid-19.Results: Mean age of the cases was 39.79 years. One hundred and twelve (75.17%) cases were males, while thirty- seven (24.83%) were females. One hundred and twenty-nine (86.57%) gave history of fever. Eight (6.04%) cases were totally asymptomatic. Clinical condition of six (4.02%) cases necessitated them to be placed on ventilator for various periods of time. Eight (5.36%) cases were administered oxygen for various periods of time. All the cases recovered after varying periods of time; and there were no fatalities. Diabetes mellitus was the commonest comorbidity; and it was seen in twenty (13.42%) of cases.Conclusions: Our study has indicated that symptomatology of the disease may vary over time. The researchers believe that the most important conclusion of our work is that the world must remain alert to the characteristics of the virus and the disease.
Scaling up DAKSH intrapartum application: impact, challenges, and learning
Authors: Singh Priyanka , Narwal Ansu
Published: January 2022

Background: DAKSH is an intrapartum monitoring application. It is easy to use, saves time and requires no interpretation skills. In spite of all these advantages, using a digital partograph alone will lead to less benefits to healthcare workers. So an application was developed which includes workflows for registering the patients during the intrapartum period by entering their investigation details, updating delivery/referral status and postpartum data until hospital discharge. The partograph is a major component of DAKSH. The main aim of this pilot was to simplify the use of partograph for better labour monitoring, which will help them in making early decisions for taking action for referral or intervention.Methods: This was a cross-sectional study. Permission to conduct a pilot for one block for 1 year was given by the Karnataka government (2017-18). After the results from the pilot district model were tested out in one district of Karnataka (2019). The pilot phase includes the following components: pre-implementation phase, implementation phase, monitoring and evaluation, regular monitoring through the dashboard and monthly evaluation visit to each health centre. The pre-implementation process was the same for both the block and district levels.Results: The few learnings learnt during the scaling up includes: the dual burden of work is considered as the main cause of not filling the partograph by staff nurses in DAKSH. Behavioural change was seen during the continuous visits while providing them with secondary training and motivation to use the application. The new kiosk provided with an inbuilt printer increased the printing of case sheets and partographs.Conclusions: This study concluded that the DAKSH application was developed for labour monitoring in healthcare facilities. The application was developed after proper need validation and feedback from OBGYNs. Further modifications and changes were made in the application from various valid user feedbacks and issues faced during the pilot which improved the user experience and sustainability.
Effect of providing awareness regarding the text neck syndrome in young adults
Authors: Kulkarni Manjiri A. , Lakhwani Namrata , Prajapati Nisha , Prajapati Dhruvisha , Modi Bhumi , Muni Pooja
Published: January 2022

Background: Electronic gadgets are indispensable part of our life which has reached every doorstep across the globe. With advancing age the use of mobile phones have drastically increased and people spend long hours on their gadgets which has led to several musculoskeletal problems. Constant head down posture and improper alignment of head and neck attained during usage leads to permanent damage in cervical spine such as flattening of spinal curve, early onset of arthritis, spine degeneration, disc compression and herniation. The term text neck can be described as repetitive stress injury and pain sustained from excessive use of handheld devices. Lack of awareness and negligence amongst the young population text neck syndrome can result in inflammation of neck ligaments, muscle and nerves leading to permanent changes. This study aims to find out the effects of providing awareness regarding text neck syndrome and it preventive measures while using hand held device.Methods: 218 young healthy adults were pre given a pre-test regarding the awareness of text neck syndrome, later they were given an information brochure. Following this, the participants were given a post-test to check the effect of providing information regarding Text neck syndrome.Results: Results of the study revealed that there was significant improvement in post test score as compared to pre-test using paired t test (p value >0.05).Conclusions: There was lack of awareness regarding the syndrome and its preventive measures, after appropriate providing information, awareness were established in the young adult population.
Impact of notification and counselling of reactive blood donors at a super-speciality hospital
Authors: Syal Neha , Kukar Neetu
Published: January 2022

Background: Donor notification is emphasized as an efficient method of curtailing TTIs recently. But its limitations like low notification rate and lack of follow up of treatment of notified donors are still unaddressed. The aim of the study was to analyze the response rate of notified reactive donors, to elicit hidden risks factors and to see impact of donor notification on reactive donors.Methods: This retrospective study was conducted in the blood bank of a 350 bedded multispecialty hospital in north India. Data was collected from reactive blood donor counselling register over a period of one year. After six months a telephonic interview was conducted of all the reactive donors who responded to notification calls and came for counselling to inquire if they went for further testing and treatment after they were notified.Results: There were 1345 whole blood donations over a period of 14 months of which 29 (2.15%) were reactive donors. Notification rate was 48.27%. During counselling 4 donors revealed high risk history which they had denied during pre-donation counselling. After telephonic conversation with these notified donors, we analyzed that 7 (50%) donors were taking treatment while 3 donors informed that they got themselves tested from a private lab and were reported negative. Two donors informed that they had not gone for any testing anywhere while we could not trace 2 donors due to change of contact numbers.Conclusions: Curtailing TTI’s through donor notification by blood banks alone is an unattainable mission. A centralized computer data system connecting all blood banks and interlinking of government agencies and blood banks like the recently started NVHCP is need of the hour.