bluuebunny/crossref_metadata_2025 huggingface dataset:
Pattern and risk factors of non-fistulous urinary incontinence among gynaecological clinic attendees in a Nigeria tertiary health institution
Authors: Njoku Charles O. , Njoku Amarachukwu N. , Emechebe Cajethan I. , Okpe Andrew E. , Iklaki Christopher I.
Published: May 2020

Background: Urinary incontinence is the involuntary loss of urine. It is rarely disclosed by the patients and usually under-reported. Objective of this study was to determine the prevalence, pattern and risk factors of non-fistulous urinary incontinence among women attending gynaecological clinics in Calabar, Nigeria.Methods: This was a cross-sectional study of 658 women attending gynecological clinic from June 2018 to June 2019. English version of International consultation on incontinence questionnaire-urinary incontinence-short form (ICIQ-UI-SF) was used to obtain data. Statistical analysis was done using SPSS version 22.Results: The prevalence of urinary incontinence was 16.1%. Stress incontinence was the commonest of urinary incontinence (73.3%), other types were urge incontinence (17.2%) and mixed incontinence (9.5%). Independent risk factors for urinary incontinence were 40 years and above (AOR = 5.610; p<0.001), parity ≥3 (AOR = 4.454; p<0.001), lower educational level (primary) (AOR = 2.588; p<0.001), vaginal/instrumental deliveries (AOR = 4.358; p<0.001), carrying heavy load (AOR = 3.688; p<0.001) and farming (AOR = 3.510; p<0.001).Conclusions: Non-fistulous urinary incontinence is common among women in our environment. Stress urinary incontinence was the most common type. Advanced age, higher parity, vaginal and instrumental deliveries and farming were independent risk factors for urinary incontinence.
Acute abdomen with adnexal masses in the reproductive age group: diagnosis and management
Authors: Murki Anuradha D. , Kamineni Vasundhara , Velagapudi Sowmya R. , Deshpande Ashok K.
Published: May 2020

Background: Women with adnexal masses can present with acute symptoms such as abdominal pain, nausea and vomiting. As there is insufficient evidence on the frequency, presentation and management of adnexal masses we conducted this study to evaluate the clinical profile, surgical findings and histopathology of adnexal masses in women presenting with acute abdomen and needing surgical intervention.Methods: In this prospective observational study, history, examination, investigations and ultrasound of abdomen and pelvis were evaluated in women presenting with acute abdomen with adnexal mass and needing surgical intervention. Diagnosis was confirmed from the operative findings and histopathology. Etiology and its correlation with clinical symptoms and signs and radiological diagnosis formed the primary objective of the study.Results: Of the 79 patients enrolled in the study, the mean age was 30.82±6.69 years. Younger women were likely to have ectopic pregnancy while older women (>35 years) other tubal pathologies. Pain abdomen (n=70) and nausea (n=53), bleeding per vagina(n=33), menstrual irregularities (n=18), fever (n=10) abdominal distension (n=10) and dysuria (4) were the common symptoms. Etiology of the adnexal mass was ectopic pregnancy (57%), ovarian mass (34%), tubal mass (7.5%), tube and ovary (2.5%) in 46, 25, 6 and 2 patients respectively. 61% (n=48) of the women underwent laparoscopic management. Women with ruptured ectopic pregnancy were more likely to have abdominal distension, pallor, hypotension, cervical motion tenderness and need for blood transfusions.Conclusions: In women from reproductive age group with adnexal mass and needing surgery, ectopic pregnancies and benign ovarian tumours were the common etiologies. Urine pregnancy test and ultrasound are useful tests to differentiate ectopic from ovarian and tubal pathology.
A prospective clinical study of foetomaternal outcome in relation to oligohydramnios in pregnancies beyond 36 weeks of gestation
Authors: Meena B. S. , Gupta Nimisha , Nagar Oby , Trivedi Swati
Published: May 2020

Background: Amniotic fluid is contributed by both mother and foetus. It plays a vital role in foetal growth. The main purpose of this study was to evaluate the foetomaternal outcome in pregnant females with oligohydramnios beyond 36 weeks of gestation.Methods: This study was conducted on 230 pregnant females beyond 36 weeks of gestation with decreased liquor clinically and confirmed sonographically. It was conducted from May 2018 to May 2019. Females with leaking per vaginum, patients who did not give consent and with intrauterine foetal death were excluded. Complete labour record was made. Assessment of maternal outcome was done in terms of mode of delivery and foetal outcome was done in terms of birth weight, Apgar score at one and five-minute, respiratory distress, meconium aspiration, seizures in first 24 hours of life, congenital malformations, neonatal intensive care unit admission and death of baby.Results: A total of 230 pregnant females met the inclusion criteria who were having AFI <5. 121 (53%) females were primigravida and 119 (52%) underwent for caesarean section. Most common indication of LSCS was foetal distress. Apgar score at 1 minute was <7 in 97 (42%) babies and after 5 minutes, it was <7 in 93 (40%) babies. Other neonatal outcome results were IUGR in 59 (26%) babies, meconium aspiration syndrome in 52 (23%) babies, respiratory distress in 92 (40%) babies, congenital malformation in 6 (3%) babies, NICU admission of 93 (40%) babies and neonatal death of 11 (5%) babies.Conclusions: Oligohydramnios increases the chances of maternal morbidity and perinatal morbidity and mortality.
Knowledge of pregnant women on the factors that influence anaemia in pregnancy in a rural farming district of the Western Region of Ghana
Authors: Konlan Kennedy D. , Amoah Roberta M. , Saah Joel A. , Abdulai Juliana A. , Mohammed Iddrisu , Konlan Kennedy Dodam , Doat Abdul Razak
Published: May 2020

Background: The presence of anaemia in pregnancy is one of the serious public health concerns across the globe especially in developing countries like Ghana. This study assessed pregnant women's knowledge on factors influencing aneamia in pregnancy in a low-income district of Ghana.Methods: A quantitative descriptive cross-sectional study. Data was collected using a pretested questionnaire. 112 pregnant women seeking antenatal care were recruited using systematic sampling technique in the Wassa East district of Ghana. Data were cleaned and entered into SPSS version 22 and analysed into descriptive statistics.Results: Majority of participants; 72.3% did not know the causes of anaemia in pregnancy. Pregnant women (27.7%) indicated nutritional deficiency as a common cause of anaemia; 18.7% of them could identify appropriately at least one sign of anaemia in pregnancy with 28% asserting that pregnancy-related anaemia can affect labour, despite 72% indicating that anaemia could cause maternal mortality. The reasons for irregular ANC attendance included; perceived non importance of ANC (18.8%), financial difficulties (17.9%), health facility inaccessibility (18.8%) and time constraints (44.5%). There was a strong association between knowledge level on the cause of anaemia in pregnancy and the educational level of pregnant women (p=0.005 chi square = 50.289).Conclusions: Lack of knowledge on the importance of antenatal care and financial constraints were among the reasons leading to a surge in anaemia amongst pregnant women in the district. Health providers should incorporate services which enable pregnant women to access valuable information on anaemia prevention in pregnancy.
Evaluation of clinical outcome of post placental insertion of Cu T 380 A in women undergoing caesarean delivery
Authors: Singh Dineshwar , Thakur Sita , Sood Ajay
Published: May 2020

Background: The objective of the study was to evaluate clinical outcome of insertion of post placental Cu T 380 A in women undergoing caesarean delivery.Methods: A prospective observational study was carried out in the department of obstetrics and gynecology, Dr RPGMC Kangra at Tanda (Rural Medical College) to evaluate the clinical outcome of post placental Cu T 380 A insertion in women undergoing caesarean section after taking approval of protocol review and institutional ethics committee of the institution. A total of 104 women delivering by caesarean section and wanting post-placental intra-caesarean Cu T 380 A insertion and who were meeting WHO standard medical criteria for PPIUCD insertion and were willing to comply with the study protocol was recruited for the study.Results: The present study showed that there were no major complications and only minor side effects were like pain, fever, discharge and irregular bleeding which were observed in only 5-15% of women during hospital stay and during follow up visit up to 6 months. String became visible in 72.12% of women at the 6 weeks follow up visit. The string visibility increased with time and at 6 months follow up stings became visible in 90.81% of the cases. Continuation rate was 100% at 6 weeks post-partum follow up. After that spontaneous expulsion occurred in 4 cases (3.84%) and another 4 women (3.84%) requested removal for various reasons leading to continuation rate of 92.3% at six months post-partum follow up. There was no case of pregnancy with Cu T in situ with no failure at the end of study at six months post-partum.Conclusions: Intra caesarean insertion of PPIUCD is practical, convenient, safe, effective and acceptable contraceptive method for spacing of the birth in this rural setting.
A prospective study to know the efficacy of short-term use of injectable depot medroxy progesterone acetate for contraception in tertiary care hospital from North West Rajasthan, India
Authors: Kochar Swati , Kumar Arun , Nama Ankur , Suthar Neha
Published: May 2020

Background: Population explosion is a major issue especially in our country with the second largest population in world next only to china starting the use of contraception in postpartum period is an effective method of increasing the gap between two pregnancies and hence reducing the family size. Objective was to study the efficacy of DMPA injection in postpartum period for contraception.Methods: The study was a prospective study conducted on 100 patients during June 2018 to May 2019 in the department of obstetrics and gynaecology, S. P. Medical College Associate A. G. H., Bikaner, Rajasthan, India.Results: In present study mild irregular bleeding was present in 21, 35 and 38 cases at initial visit, at 3 months and at 6 months follow up respectively. Moderate irregular bleeding was present in 8 cases at initial visit, 27 cases at 3 months and 18 cases at 6 months follow up while 37 and 43 cases had severe irregular bleeding at 3 and 6 months follow up respectively. At baseline, 89 and 10 and 1 cases had their blood sugar <100, 100-120 and >120 respectively, at 3 months follow-up, 94, 6 and 0 cases had their blood sugar level <100, 100-120 and >120 respectively while at 6 months follow-up 97, 3 and 1 cases had their blood sugar level <100, 100-200 and >200 respectively.Conclusions: Injection DMPA use in postpartum period is safe, effective and reversible method with no deleterious metabolic effects and do not need special training to administer to it, so it is a good option of contraception for women who are lactating.
A study to assess proportion of the maternal near miss to maternal death in a tertiary care teaching hospital of North East India
Authors: Sarkar Pradip , Baidya Jahar Lal , Rakshit Ashis Kumar
Published: May 2020

Background: The objective of present study was to assess the proportion of maternal near miss and maternal death and the causes involved among patients attending obstetrics and gynaecology department of Agartala Govt. Medical College of North Eastern India.Methods: Potentially life-threatening conditions were diagnosed, and those cases which met WHO 2009 criteria for near miss were selected. Maternal mortality during the same period was also analyzed. Patient characteristics including age, parity, gestational age at admission, booked, mode of delivery, ICU admission, duration of ICU stay, total hospital stay and surgical intervention to save the life of mother were considered. Patients were categorized by final diagnosis with respect to hemorrhage, hypertension, sepsis, dystocia (direct causes) anemia, thrombocytopenia, and other medical disorders were considered as indirect causes contributing to maternal near miss and deaths.Results: The total number of live births during the study period (January 2017 to June, 2018) was 9378 and total maternal deaths were 37 with a maternal mortality ratio of 394.5/1 lakh live births. Total near miss cases were 96 with a maternal near miss ratio of 10.24/1000 live births. Maternal near miss to mortality ratio was 2.6. Of the 96 maternal near miss cases - importantly 20.8% were due to haemorrhage, 19.8% were due to hypertension, 13.5% were due to sepsis, and 11.5% were due to ruptured uterus. In maternal death group (n-37), most important causes were hypertensive (40.5%) followed by septicemia (21.6%), haemorrhage (10.8).Conclusions: Haemorrhage, hypertensive disorders and sepsis were the leading causes of near miss events as well as maternal deaths.
Analysis of epidemiological factors for pelvic floor defects in Indian women
Authors: Parulekar Maitreyee S. , Parulekar Shashank V.
Published: May 2020

Background: Pelvic floor defects is one of the commonest conditions requiring gynecological reference. This study was aimed at evaluation of epidemiology which would help us in having a better understanding regarding the prevalence, risk factors, the natural course and associated complications of the disease in Indian women where the number of women presenting with pelvic floor defects is on a rise but there is a considerable lack of research in literature as compared to the western population.Methods: It was an observational, non-interventional, prospective type of study including 88 patients over a period of 3 years at the department of obstetrics and gynecology at a tertiary hospital in Mumbai, Maharashtra, India.Results: The mean age of the patients was 52.38±11.35 years, 54 (61.36%) of the patients were of postmenopausal age group. The mean duration for which the complaints were present were 48±6.73 months. Seventy-six patients (86.83%) presented with complaints of mass per vagina, 22 patients (25%) had history of prolonged labor and 9 patients (10.2%) had history of instrumental delivery. Eighty-six women (97.72%) had history of all vaginal deliveries and only 4 (4.54%) patients had history of a caesarean section. Forty-four patients (55.69%) of patients had grade 3 utero-vaginal descent, 74 patients (84.09%) presented with cystocele and 79 (89.77%) of the patients presented with rectocele.Conclusions: This paper provides an insight into the factors affecting the prevalence of this disease in Indian women and the unique differences from other populations.
Lomiphene citrate versus letrozole as first line ovulation induction drug in infertile anovulatory polycystic ovarian syndrome women: a prospective randomized controlled trial
Authors: Soni Monica , Gupta Jeevika , Meena Arti
Published: May 2020

Background: The present study was design to compare letrozole (5 mg) and clomiphene citrate (100 mg) as first line ovulation induction drug in infertile anovulatory polycystic ovarian syndrome (PCOS) women.Methods: This prospective randomized clinical trial included 60 cases of PCOS with anovulatory infertility. The first group comprised of 30 patients who received 5 mg letrozole daily and the second group received 100 mg clomiphene citrate daily for 5 days starting on day 2-5 of menses. Both the groups were followed by ultrasound for follicle monitoring, ovulation and endometrial thickness. When dominant follicle reaches a diameter of more than or equal to 18mm and endometrial thickness ≥7.5 mm, human chorionic gonadotrophin (hCG) 5,000 IU was given intramuscularly and timed intercourse was advised. Main outcome measures were occurrence of ovulation, endometrial thickness and pregnancy rates.Results: The mean age, body mass index, and number of cases of primary and secondary infertility in both the groups showed no statistically significant difference. Multi-follicular development during induction was statistically significantly greater in the clomiphene group (1.27±1.11 versus 2.03±1.65; p=0.041). Ovulation occurred in 24 subjects (80%) in letrozole group and 18 subjects (60%) in the clomiphene group, with a statistically significant difference between the two groups (p=0.024). Pregnancy occurred in 16 subjects (53.33%) in letrozole group and 7 subjects (23.33%) in clomiphene group, which shows statistically significant difference between the two groups (p=0.048).Conclusions: Though number of developing follicles was found statistically significant with clomiphene citrate but ovulation rate and pregnancy rate were higher with letrozole group. Therefore, letrozole is a safe and better alternative for ovulation induction in patients of anovulatory PCOS, and it may be considered as a first line treatment for ovulation induction in these patients.
Study of obstetric and perinatal outcome of twin pregnancy
Authors: Mehta Chandni V. , Patel Babulal S. , Shah Akshay C. , Jani Shashwat K. , Shah Dipal C. , Patel Vismay B. , Patel Adwait B.
Published: May 2020

Background: Multifetal pregnancy constitutes a significant portion of high-risk pregnancies. This is due to the increasing obstetric and perinatal morbidity and mortality rates associated with it. Maternal and perinatal outcome of twin pregnancies has been evaluated in this study.Methods: Total 30 patients with twin pregnancy and having gestational age more than 28 weeks were included in this observational study.Results: Incidence of twins in the study was found to be 2%. Twin pregnancies were more common in multiparous women aged between 20 and 30 years. Most common foetal presentation was vertex- vertex presentation. Most common maternal complication was preterm labour seen in 67% women, followed by anaemia seen in 50% women. Most of the women were delivered by caesarean section (63.3%). Most common perinatal complication was birth hypoxia (41.6%). Other perinatal complications were jaundice, septicemia, intrauterine growth restriction. 71% of the neonates had birth weight less than 2.5 kg. Perinatal mortality was found to be 11.6%.Conclusions: Twin pregnancies are high risk pregnancies associated with higher obstetric and perinatal morbidity. Perinatal morbidity was more common for the second coming twin. Regular antenatal visits, planned delivery and better NICU facilities can help combat these complications. A team of skilled obstetricians and pediatricians along with a multidisciplinary approach is essential for the effective management of twin pregnancies.
Aggressive angiomyxoma of the vulva - a rare entity: case report and review of literature
Authors: Gaurav Amrita , Gill Poonam , Khoiwal Kavita , Chowdhuri Sandipan , Kapoor Dhriti , Chaturvedi Jaya
Published: May 2020

Aggressive angiomyxoma (AA) is an extremely rare locally invasive mesenchymal tumor with a high risk of recurrence. Till date, only about 350 cases reported worldwide. Because of the rarity it should be considered as differential diagnosis whenever patient present with vulvovaginal growth. The diagnosis is clinched on histopathology. These are hormone-dependent and have estrogen and progesterone receptors. Hence sometimes GnRH agonists are used for ovarian estrogen secretion suppression but long-term use is not advocated due to side effects. A 45-year-old P4 L4 perimenopausal female presented to the GOPD with a 4×4×3 cms pedunculated painless globular mass on right labia majora. On palpation, the globular mass was firm, non-tender and with a smooth surface. Mass was excised and on gross histopathology, cut sections showed white myxoid areas. On microscopy epidermal lined tissue with stellate and spindle-shaped mesenchymal cells was found, embedded in a loose myxoid stroma with few collagen fibers. The cells were small and bland and lacked nuclear atypia. Small to medium-sized blood vessels were present with the thickened wall. Entrapped nerves and adipocytes were also present. No necrosis or mitosis was identified. All these features were suggestive of an aggressive angiomyxoma. Immunohistochemistry markers ER, PR, CD34, desmin, SMA were all positive. Imaging was done to rule out metastatic lesions and wide local excision was done around the stump with laparoscopic bilateral oophorectomy. Aggressive angiomyxoma is a rare disease. In women with asymptomatic growth in the vulvovaginal region, perineum or pelvis, aggressive angiomyxoma should be considered as a differential diagnosis. Ideal treatment is a wide local excision to prevent local recurrences, which are common and a hypoestrogenic milieu is created by either GnRH Agonists or by bilateral oophorectomy due to their hormone-sensitive nature.
Sex cord stromal tumor of ovary masquerading as polycystic ovarian syndrome
Authors: Jhirwal Manisha , Shekhar Shashank , Sharma Charu , Tak Apoorva
Published: May 2020

Virilization is a portentous sign that suggests the possibility of an ovarian or adrenal neoplasm. Diagnosis may be delayed in some patients due to nonspecific symptoms and overlapping symptoms with that of polycystic ovarian syndrome (PCOS). However, it must be remembered that PCOS usually causes mild to moderate elevation of serum testosterone with hirsutism whereas serum testosterone levels are many times elevated in cases of androgen secreting tumors and virilization is a norm. So high testosterone level with new onset virilization rule out PCOS. Authors are reporting two cases of Sertoli Leydig cell tumor despite their similar histopathology and equivalent levels of serum testosterone had a varied clinical spectrum of virilization.
46XX pure gonadal dysgenesis with dysgerminoma along with leydig cells: a unique presentation
Authors: Tak Apoorva , Singh Pratibha , Yadav Garima , Rao Meenakshi
Published: May 2020

Authors report a unique case of 46XX gonadal dysgenesis, with dysgerminoma in one ovary and other streak ovary with hilar nests of leydig cells. It is exceptionally rare to find dysgerminoma in a dysgenetic gonad with no Y chromosome and so is the presence of leydig cells in the contralateral streak ovary in a patient with 46XX pure gonadal dysgenesis.
Unruptured ovarian ectopic gestation: a rare clinical scenario
Authors: Ghuman Navdeep K. , Mathew Priya S. , Nalwa Aasma
Published: May 2020

Ovarian pregnancy is a rare event, with the incidence ranging from 1 in 2000 to 1 in 60 000 deliveries and accounts for 3% of all ectopic pregnancies. The first case of ovarian pregnancy was published by Saint Monnisey. Authors report a case of a 23-year-old patient with severe lower abdominal pain following five weeks of amenorrhea diagnosed as tubal ectopic pregnancy on ultrasonography. The patient was taken up for emergency laparoscopy and unexpected finding of ovarian pregnancy was established. Early diagnosis and prompt treatment go a long way to prevent serious outcomes and to ensure favourable future reproductive potential.
Depot medroxyprogesterone: the way forward
Authors: Mehta Sumita , Kale Ekta , Rashid Fatima
Published: May 2020

India has a high rate of unintended pregnancies and abortions contribute to 8% of maternal mortality. The addition of injection depot medroxyprogesterone (DMPA) to the basket of contraceptives has allowed women to use a long-term contraceptive which does not require any user action to maintain efficacy and whose effect is easily reversible. Injectable progestins are now estimated to be used by 6% women globally.1
Correlation between atherogenic factors in complicated and uncomplicated type 2 diabetes mellitus
Authors: S. Rajdeepak V. , G. Rekha , C. Jayashree S.
Published: May 2020

Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. The factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization and increased glucose production. The vascular complications of DM are subdivided into microvascular (retinopathy, neuropathy, nephropathy) and macrovascular complications (coronary artery disease, peripheral vascular disease, cerebrovascular disease). There is an observed disparity between various vascular complications of diabetes and the atherogenic factors.Methods: The patients with type 2 diabetes mellitus attending outpatient and inpatient departments in Dr. B. R. Ambedkar Medical College and hospital, from September 2014 to September 2016 were selected for this study. All patients were subjected to detailed history, physical examination and laboratory investigations with respect to complications of diabetes mellitus.Results: In this study, 76% of the patients had poor glycemic control with elevated HbA1c >7%. 38% of patients had normal BMI. 36% of patients were overweight and 26% were obese. 62% of patients were either overweight or obese. Hypercholesterolemia was seen in 26% of patients with poor glycemic control. Hyperhomocysteinemia was present in 38% of patients with microvascular complications and 33% of patients with macrovascular complications.Conclusions: Type 2 diabetes mellitus showed a strong correlation between glycemic status and incidence of diabetes complications. Hypercholesterolemia and hyperhomocysteinemia have added to the increased incidence of complications as additional factors in metabolic derangements as a consequence of poor glycemic control.
Incidence of tuberculosis and opportunistic respiratory infections in cases of human immunodeficiency virus: a one-year study at a tertiary care hospital
Authors: Subrahmanyam Chintha Venkata , Vidavaluru Mahesh
Published: May 2020

Background: Evaluation of respiratory signs and symptoms among HIV patients is a challenging task for a number of reasons. A definitive diagnosis is highly recommended before starting management protocol. Objectives of this study was to primarily evaluate the incidence of pulmonary tuberculosis and opportunistic respiratory infections among the cases of HIV and to estimate the CD4 counts of all the patients and correlate with the respiratory infections among the cases.Methods: The present study was a one-year study conducted at Narayana Medical College and all the cases of HIV presented with signs and symptoms of lower respiratory tract infections were included after obtaining consent. Relevant biochemical, microbiological investigations and CD4 counts of all the cases were done and noted. The data was entered in Microsoft excel spread sheet and analysed for any corrections. Mean, median and SD was calculated for all the continuous variables.Results: A total of 127 cases with 87 males and females 40 females with a ratio of 2.2:1 were included. Mean age of the total cases in the study was 46.12±8.3 years and 29.92% were above 60 years. Hetero sexual exposure was the commonest cause and 59.84% of cases were diagnosed with bacterial pneumonia. Prevalence of tuberculosis among the cases of this study was 22.05%. The mean CD4 cell count with SD among the study was 168.57±142.21.Conclusions: Knowledge of the pattern of pulmonary complications in patients with HIV infection in relation to CD4 count will help clinicians develop faster diagnostic and therapeutic approach to patient management.
Lifestyle modification advice provided by health care professionals in the treatment and management of hypertension in Kenya
Authors: Mbogori Teresia
Published: May 2020

Background: Hypertension is one of the main modifiable risk factors for cardiovascular disease morbidity and mortality. Pharmacological and lifestyle modification approaches are used in the treatment and management of hypertension. The purpose of this study was to identify lifestyle modification advice provided to the general population and to those diagnosed with hypertension by health care providers (HCP) in Kenya.Methods: A secondary data analysis of cross-sectional data collected among 4500 Kenyans participating in the 2015 Kenya stepwise approach to surveillance study was conducted. Questions related to the consumption of salt, sugar, fat, fruits and vegetables as well as physical activity and weight management were evaluated.Results: Among all the participants, only 12.5%, 20.7%, 12.2%, 10.7%, 10.3% and 11.6% were advised to either reduce salt intake, eat 5 or more servings of fruits and vegetables, reduce fat intake, reduce intake of sugary beverages, lose or maintain weight and start or do more physical activity respectively.  Of those diagnosed with HTN, 37% were advised to increase intake fruits and vegetables, 37%, 27% and 25% were advised to reduce, salt, fat and sugary beverages intake respectively, 21% and 22% were advised to start or do more physical activity and maintain a healthy body weight or lose weight respectively.Conclusions: Majority of Kenyans had not received dietary modification advice from HCP despite this being a policy recommendation in Kenya. Policy makers need to work closely with HCP to develop appropriate policy implementation strategies.
Assessment of the health needs of elderly residing in selected villages of district Sirmour
Authors: . Sameeksha , Kaur Jasneet , Kaur Simarjot
Published: May 2020

Background: Ageing is a universal phenomenon experienced by every human being across various cultures. Ageing varies with time scale. Some people appear much older than their chronological age, whereas many old people act and look much younger than actual age. Study objective was to assess the health needs of elderly residing in selected villages of district Sirmour.Methods: Descriptive cross-sectional design was used. 163 elderly were selected by non-probability convenient sampling technique and data was collected by using socio demographic sheet and checklist based on Omaha problem classification scheme through interview, in vivo bio physiologic and observation method.Results: 62.2% of the elderly were in the age group of 60-70 years and half of the elderly were males i.e., 50.9%. 35.6% were private employees where as 18.4% were home makers and 26.4% were farmers. 68.7% of the elderly responded that they had medical history 66.9% of the elderly had more than 5 family members. 45.4% of the elderly responded that their annual income is between 2.5-5 lakh. 124 insufficiencies were found in the environmental domain, 262 needs were identified related to the psychosocial domain, 929 needs were related to physiological domain and 442 needs were due to poor health related behavior.Conclusions: Results of the study revealed that most of the elderly had health needs. So this study concludes that there is need to take actions for the health promotion and prevention of diseases in the elderly.
Demographic profile of pregnant women and effect of anaemia in gestational diabetes mellitus: a cross sectional study from rural Assam
Authors: Chanda Subrata , Singh Amarjeet
Published: May 2020

Background: In Assam, gestational diabetes mellitus (GDM) screening is not routinely done during antenatal check-up in Assam, whereas anemia screening is done. Consequently, state-wide GDM estimate and its association with anemia in rural Assam is not available. Hence, we aim to study the demographic profile of pregnant women and their anaemia in relation to prevalence of gestational diabetes mellitus in rural Assam.Methods: The present study was part of a larger community based cross-sectional study, conducted in Assam to determine the prevalence of GDM. The pregnant women in the gestational age of 24-28 weeks, who were free of any chronic illnesses, screened for Anaemia and, GDM through oral glucose tolerance test (OGTT) as per diabetes in pregnancy study group in India guideline.Results: A total of 1212 pregnant women underwent the OGTT and test for haemoglobin estimation. Mean age of GDM women was (24.40±4.60 years), slightly higher than non-GDM women (23.50±4.04 years, p=0.007). After hemoglobin estimation, 83% of pregnant women found to be anaemic, 77% of these were GDM positive, which is quite significant with p value 0.025. A higher fraction of the pregnant mothers in our study were found suffering from anemia (83%). The independent association of GDM and anemia adjusted for other variables showed an inverse relationship.Conclusions: Though prevalence of anaemia and GDM in low resource setting in rural Assam found to be quite high, but they have inverse relationship. Anaemic pregnant women were found to be GDM protective.
Knowledge, attitude and preventive practices regarding tuberculosis care and control among health care professionals at TB centres: implications for TB control efforts
Authors: Jaiswal K. M. , Vaishnao Lohit S. , Dudhgaonkar Sujata , Raghte Latesh , Kewalramani Mahek S. , Jawade Ashutosh S. , Chugh Kunal C.
Published: May 2020

Background: Tuberculosis (TB) ranks as the leading cause of death from infectious disease. The World Health Organization (WHO) has considered TB a global public health disaster since 1993. Four factors affect non-adherence to treatment-the patient, healthcare systems, pharmaco-therapeutics and the key persons, health care professional (HCP). So, the study was conducted to evaluate knowledge, attitudes and practices regarding TB care and control in HCPs working in TB units.Methods: This was a cross-sectional, observational, questionnaire-based study conducted in all the HCPs working for the TB care and control.Results: The responses to the questions of knowledge were variable indicating incompleteness of information, facts, understanding related to TB in HCPs. HCPs show very strong positive attitude for finding every new case of TB is essential. The HCPs disagree to some statements like traditional or alternative medicine assists in wellbeing of TB patients. Practice competency was low with average score 2.32 out of 6, doctors having higher score of 4.62 followed by nurses, lab-technicians, pharmacist and activist with score of 2.57, 1.66, 1.5, 1.25 respectively.  The activist are the key persons in the national tuberculosis program, exhibited the least score in this study indicates they do not have much orientation about the practice of TB treatment. Specific deficiencies existed for some knowledge statements of HCWs on TB. There was disagreement in attitudes regarding stigma and traditional medicine, and practice competencies were poor. Improvement in aspect of KAP of HCPs on TB will help India achieve the goal of End TB.Conclusions: Specific deficiencies existed for some knowledge statements of TB in paramedical staff as compared to doctor participants. There was disagreement in attitudes regarding stigma and traditional medicine, and practice competencies were poor in activists. Improvement in knowledge, attitude and practices of TB in paramedical staff by conducting CME, Workshop, training sessions will help India to achieve the goal of End TB.
Descriptive profile of patients attending antirabies clinic: a hospital based study of animal bite cases in Patiala
Authors: Chaudhary Neha , Brar Manmohan Singh , Mishra Shradha , Randhawa Avneet
Published: May 2020

Background: The word “Rabies” is derived from Latin word ‘Rabus’, which in turn is derived from the Sanskrit word ‘Rabhas’ which means ‘to do violence’. In India, the dog has always existed as the main reservoir of rabies. Globally Asia contributes to highest Rabies mortality; with the highest incidence reported in India followed by China.Methods: A cross-sectional study was conducted at the antirabies clinic during the period of one year (2016-2017). A self-administered, pretested questionnaire was used to extract information on demographic profile, biting animal, nature of biting dog, vaccination status, WHO category of bite, site of bite. Information of 500 animal bite cases were collected during the study period.Results: Maximum cases were reported among children below 15 years age group i.e. 157 (31.4%). Majority reported cases 342 (68.40%) were males and maximum reported cases 338 (67.60%) were from urban area. Majority 472 (94.4%) were bitten by dogs. Approximately two third (66.74%) of the biting dogs were stray while, among the total 157 (33.26%) pet dogs; approximately only one third 59 (37.58%) were vaccinated.Conclusions: Since young children are more at risk of animal bite. So, educational sessions providing knowledge to protect themselves from bites should be a part of School Health Programme. A cooperative approach involving measures like proper garbage disposal, discouraging community owned dogs, helping dog catching squad and sterilization will help to reduce the dog population.
Knowledge, practices and problem towards menstrual cycle with their socio economic status: a comparative study of tribal and non tribal female
Authors: Dey Jhuma , Mahapatra Biswait
Published: May 2020

Background: Menstruation is a normal biological process and a key sign of reproductive health. Good hygiene practices are essential during menstruation. The current study was conducted to assess the knowledge, awareness and practices related to menstrual hygiene management and find out the relationship between the socio economic status and age at menarche (AAM) among tribal (Oraon) and nontribal female in Paschim Medinipur, West Bengal.Methods: A field based cross-sectional study was conducted among tribal (Oraon) and nontribal female in Paschim Medinipur, West Bengal. A total of 120 samples (60 tribal and 60 nontribal) were interviewed by using pre-tested structured questionnaire. Data were statistically analyzed using SPSS (ver. 16).Results: The present study shows that the tribal female had poor knowledge about menstruation and menstrual hygiene than the nontribal female. Use of sanitary napkins among the nontribal female (66.7%) where as reverse in case of tribal female (use of cloths 66.7%). Study shows with increasing monthly family income and socio economic status, mean AAM decreases. There was statistically significant difference between the two groups (tribal and nontribal) for all socio economic parameter but not AAM distribution.Conclusions: There is an urgent need to create awareness regarding menstrual hygiene among all the females in the society. The role of teachers and media should be enhanced. This will help in reducing the burden of menstrual related health problem and improve the reproductive health.
COVID 19 and rural India: better now than later
Authors: Naik Gitismita , Kumar M. Mohan
Published: May 2020

COVID 19 is devastating lives worldwide and India is no exception. Government of India on 15th April classified districts as hotspots or red zones (123 districts with large outbreaks and 47 with clusters) and non-hotspots or orange zones (207 districts). This leaves more than 300 of the country’s 731 districts which are not yet affected by the pandemic, classified as non-infected districts or green zones. Of India’s 1.21 billion people, about 376 million people live in the districts now classified as green zones and while 68.8% of India’s population lives in rural areas (Census 2011), the share of rural population in the green zones is relatively higher at 84%. This stands true across big states, Kerala being the only exception. It is this proportion of population who has to be protected in the battle against COVID 19 to ultimately emerge victorious and limit any further spread.
Present Situation and Countermeasure of Camellia Oleifera Industry in Guizhou Province
Authors: Long Yang
Published: May 2020

Starting from the current situation of the development of camellia oleifera industry in Guizhou Province, China, this paper systematically summarizes the development advantages, and puts forward the countermeasures for further development. Moreover, it points out that camellia oleifera industry must strengthen the propaganda, put the promotion of science and technology in the first place, deal with a series of problems such as variety resources, planting technology, capital investment, low-yield forest transformation, and processing of camellia oleifera, so as to speed up the processing development of camellia oleifera industry in Guizhou Province.
Tratamiento médico de las cervicitis con un polímero del ácido gamma amino butírico
Authors: Ruíz Martínez Hernando , Jaramillo Uricoeche Roberto
Published: May 2020

Se trata el proceso de reepitelización del cuello uterino, en 40 pacientes afectadas de cervicitis, con un polímero del ácido gamma amino butírico, por aplicación local y pulverización . Previamente se trata la noxa actuante con fármacos específicos en óvulos vaginales. Se excluyen los casos de sospecha oncológica por citología exfoliativa y las inflamaciones específicas (TBC, Lúes y Blenorragia), por exámenes serológicos y bacteriológicos de las secreciones. El tratamiento se realiza localmente mediante aplicación y pulverización del fármaco sobre el cuello uterino, obteniendo los siguientes resultados, clasificados clínicamente a la observación especuloscópica : 31 casos con resultados satisfactorios, 77.5%  8 casos con resultado regular, 20% 1 caso con resultado nulo (2.5%) (Ectopia Circinada). Se deduce de los resultados obtenidos, una metodología práctica en el tratamiento de estos procesos benignos del cuello uterino, útil para el médico general, o en medios alejados de los centros especializados, evitando el desplazamiento de los pacientes de su lugar habitual. Se observan algunas ventajas en pacientes afectadas por esterilidad .
Programa materno infantil y dinámica de población -1
Authors: Daza Parada Luis , Henao Echeverri Oscar , Barragán Espinosa Jairo
Published: May 2020

A partir del año de 1975 cuando se estableció en el país el Sistema Nacional de Salud, implicaba la organización de los servicios en un esquema de regionalización, con referencia de pacientes de niveles inferiores hacia los niveles superiores y un sistema de docencia y supervisión de los niveles superiores hacia los niveles inferiores. Teniendo como base el área rural, e iniciando la prestación de los servicios por las promotoras rurales de salud y como cúspide los hospitales universitarios de la más alta tecnología.
Programa materno infantil y dinámica de población -3. Planificación familiar
Authors: Daza Parada Luis , Henao Echeverry Oscar , Barragán Espinosa Jairo
Published: May 2020

Los programas de Planificación Familiar en Colombia nacen en el año 1965, dada la iniciativa de dos instituciones del sector privado como son Profamilia y Ascofame y unas pocas del sector oficial.
Malformaciones y patología de la glándula mamaria en adolescentes
Authors: Duarte-Contreras Alberto
Published: May 2020

Desde el punto de vista ginecológico se considera la adolescencia como el tiempo que transcurre entre la menarca y el final del tercer año ginecológico o postmenárquico (los 17 años en promedio entre nosotros) Bajo este concepto adelantamos el presente estudio.
Estados hipertensivos del embarazo. I. Hipertensión arterial inducida por el embarazo
Authors: Cobo Edgard
Published: May 2020

La enfermedad hipertensiva que se presenta en mujeres embarazadas puede ser producida por cualquiera de las causas conocidas de hipertensión arterial. Sin embargo, se conoce como toxemia del embarazo a un síndrome de aparición exclusiva durante la gestación humana, generalmente después de la vigésima semana y caracterizado por hipertensión, edema y proteinuria. Esta denominación es inexacta ya que hasta el momento no se ha identificado ninguna toxina responsable del síndrome y por ello algunos prefieren denominarla hipertensión inducida por el embarazo y otros EPH- Gestosis, denominación que representa las iniciales de los signos clínicos: edema, proteinuria e hipertensión. Para evitar confusión preferimos usar en este capítulo la denominación convencional de toxemia del embarazo.
S.O.A ¿Una manifestación clínico-patológica de diferentes estados hiperandrogénicos?
Authors: Gómez T. Gustavo , Herrera C. Enrique , Escobar N. Raúl M. , Romero V. Eduardo
Published: May 2020

En un período de cinco años se han diagnosticado y tratado 194 pacientes con síndrome de ovario androgénito en la clínica de Endocrinología e Infertilidad del Hospital Universitario del Valle. Sus características clínicas, determinaciones hormonales, evaluación y respuesta al tratamiento, son manifestaciones de los diferentes estados el ínicos y patológicos de una entidad que tiene como manifestación persistente un estado hiperandrogénico.
Revisión de temas. Problemática Sexual del Adolescente
Authors: Cardona Arango Fernando
Published: May 2020

A través de la experiencia obtenida en doce colegios de bachillerato, masculinos, femeninos y mixtos y con una muestra de 286 encuestas, se logran clasificar los problemas que inquietan a los adolescentes en el campo de la sexualidad humana, en cinco áreas bien delimitadas que son comentadas, usando en cada grupo como modelo las preguntas mas características. Se hacen algunos comentarios de las modalidades de las preguntas. Se insiste en la necesidad de una mas completa educación sexual.
Clínica de riesgo obstétrico
Authors: Quintero J. Carlos A. , Rodríguez Jaime , Muñoz Ramiro
Published: May 2020

Se hizo una revisión de la Clínica de Riesgo Obstétrico referente a su funcionamiento, recursos humanos y tecnológicos y criterios de riesgo. Se revisaron 1.100 historias clínicas que correspondieron a los primeros 5 años. Se descontaron 30% por dificultades de archivo o error de clasificación del diagnóstico. Se analizaron las características, antecedentes y evolución del embarazo con sus correspondientes diagnósticos, así como los exámenes de laboratorio realizados. Se hace una descripción de la patología materna, fetal y del recién nacido. Se intentó hacer un cruce entre patología obstétrica y el resultado del embarazo y el recién nacido, con el fin de buscar dependencia entre las variables pero posiblemente debido a que la muestra era incompleta no pudo encontrarse. A manera de ejemplo se hizo lo anterior, para pacientes que presentaron toxemia. Finalmente, se hacen los comentarios y las recomendaciones pertinentes al funcionamiento de una Clínica de Riesgo Obstétrico haciendo énfasis en la planificación de la misma desde el punto de vista operacional administrativo, tecnológico y ei uso de información sistematizada que permita evaluar permanentemente con el fin de efectuar acciones en salud.
Estudio comparativo de dos dispositivos intrauterinos, la espiral delta y la espiral de Lippes D colocados a pacientes postparto
Authors: Beltrán Saavedra , Waszak Cynthia
Published: May 2020

Los dispositivos intrauterinos (DIU), como método anticonceptivo de las mujeres que han tenido alumbramientos recientes, se han utilizado en forma limitada debido a las altas tasas de expulsión relacionadas con su colocación en el período de postparto. En un esfuerzo por corregir dicho problema, el Programa Internacional de Investigaciones en Fertilidad (IFRP) ha introducido modificaciones en dos tipos de DIU, a saber, la espiral de Lippes D y el dispositivo T de cobre 220C. La modificación consiste en el agregado de tres suturas de catgut No. 2 que se desechan biológicamente al completarse el proceso de involución. El estudio se diseñó con el objeto de poner a prueba la espiral de Lippes D modificada (espiral Delta) y compararla con el Lippes Loop D estándar. La espiral Delta se insertó en 136 mujeres del Hospital de Juan Noé en Arica, Chile.En cada uno de los casos, la inserción ocurrió dentro de los 10 minutos después de la expulsión de la placenta. El estudio confirmó la expectativa de que la tasa de expulsión de las espirales Delta sería significativamente más baja que la de las espirales sin modificar, pues las tasas fueron de 15,8 en el caso de las usuarias de espirales Delta y 28.3 para las usuarias de espiral de Lippes D (p < 0,05). A los tres meses, las tasas de continuación de uso de los dos grupos fueron de 81,6 y de 68,1, respectivamente.
Aplicación de un modelo de historia clínica perinatal
Authors: Cobo Edgar
Published: May 2020

Se presentan los datos obtenidos mediante la implantación de un modelo de Historia Clínica Perinatal y la realización manual de su análisis, en 8.181 pacientes hospitalizadas en el Departamento de Obstetricia y Ginecología del Hospital Universitario del Valle. Este artículo es solo descriptivo y por ello solo permite algunas pocas conclusiones y recomendaciones, expuestas al final del mismo.