bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of single dose cefuroxime and multiple dose ceftriazone in elective caesarean section
Authors: Raval Ravi , Shrivastava Sweta
Published: April 2022

Background: Caesarean section is a major life saving surgical procedure for mother and baby. The objective of this study to evaluate the efficacy of single dose of 1.5 gm of cefuroxime as prophylactic antibiotic compared to multiple doses of ceftriaxone in elective caesarean section in reducing postoperative morbidity.Methods: This is an observational study conducted at tertiary care teaching hospital. A total of 434 cases were included from January 2017 to September 2018. One group of patients were given single dose cefuroxime 1.5 gm intravenously 30 minutes before the surgery as prophylactic antibiotic. Other group include those patients who have been operated for elective caesarean section before this existing antibiotic policy, where multiple doses of ceftriaxone 1 gm intravenously 12 hourly for 7 days were given as per policy of that time. A data collection forms were designed to record information about every patient including comprehensive history, examination, investigations, intra-operative events and post-operative follow-up course.Results: In cefuroxime group 3.7% and in ceftriaxone group 4.6% had wound discharge. Both the groups had 2.8% of wound dehiscence. In cefuroxime group, 0.9%had other infections like upper respiratory tract infections/urinary tract infections (URTI/UTI), whereas in ceftriaxone group 2.3% patients had other infections. In cefuroxime group 4.1% patients and in ceftriaxone group 6% patients had extended hospital stay.Conclusions: This study supports that single dose of cefuroxime can replace multiple doses of other antibiotics as prophylaxis for post caesarean section infection with reducing infectious morbidity in a cost-effective manner.
Role of hypogastric artery ligation in obstetrics and gynaecology: a 20-year study at tertiary care center, Ahmedabad, western India
Authors: Prajapati Anjali R. , Shah Sapana R. , Vyas Rupa C. , Parikh Prince M. , Patel Ishani , Dodiya Hetal N.
Published: April 2022

Background: Hypogastric artery ligation (HAL) was first introduced by the end of the 19th century to control intractable haemorrhage from the uterus of women with advanced cervical cancer. Bilateral HAL is a lifesaving procedure in massive pelvic haemorrhage.Methods: This is a retrospective study of 58 cases in which HAL was performed in the obstetrics and gynecology department at tertiary care center from January 2000 to December 2020. History, operative procedure findings, immediate and late postoperative complications, morbidity and mortality data were collected and reviewed from records.Results: In this study, total of 58 women who underwent HAL s; 53 bilateral and 5 unilateral. Fifty-three women required HAL for obstetric indications, in 5 cases it was required for gynaecological indications. 20 cases (34.5%) underwent bilateral HAL for atonic PPH, 16 cases (27.6%) during obstetric hysterectomy for morbidly adherent placenta, 5 (8.6%) for colporrhexis, 2 (3.4%) for broad ligament hematoma, 1 (1.7%) for colporrhexis and left sided broad ligament hematoma, 2 cases (3.4%) for secondary PPH and 7 cases (12.1%) for the ruptured uterus. In gynecological cases 4 cases (80%) underwent after vaginal hysterectomy to control pelvic haemorrhage and 1 case (20%) underwent HAL after myomectomy.Conclusions: HAL is an important surgical procedure and should be performed to reduce blood loss when conservation of the uterus is desired. It is also useful in controlling haemorrhage after major gynaecological surgeries and secondary hemorrhage following hysterectomy.
Gynecological correlation of thyroid disorders in women
Authors: R. Pooja , Patil Varsha Narendra
Published: April 2022

Background: Thyroid dysfunctions are a common cause of abnormal uterine bleeding (AUB). They affect menstrual function and reproductive health. The common presenting complaints are weight gain, menstrual irregularities, PCOS, infertility, fatigue, constipation and body aches.In this study we recommended that any woman presenting with undiagnosed fatigue, weight gain, infertility and menstrual disorders should be subjected to Thyroid profile screening. Thus, there is a need to explore this aspect in the earlier stages so as to prevent long term consequences with reproduction and quality of life.Methods: Current study is a retrospective study. The present study was conducted in the department of obstetrics and gynecology, Cama and Albess hospital, Mumbai, Maharashtra, India, from a period of January 2021 to December 2021, 300 women of reproductive age group between menarche to menopause. Quantitative determination of Serum T3, T4 and TSH by CLIA estimated in autoanalyser.Results: The most common age group studied was between 32-40 years. Hyperthyroidism was more common in multipara and hypothyroidism was more common in P2L2. The most common type of menstrual disturbance was menorrhagia. (40.33%) Menorrhagia has been seen to have significant association with thyroid dysfunction. Prevalence of obesity in the study population is 4% and overweight is 23.66%. About 11.33 % of overweight women and 2% of obese women are hypothyroid. 2% of hyperthyroid women are underweight (BMI<18). About 6.33% of women with hypothyroidism had PCOS, most commonly associated with menstrual complaints such as amenorrhoea and oligomenorrhoea. 14% of women with hypothyroidism had clinical findings of anaemia and/or thyromegaly on clinical examination. 14% of women had severe anaemia in the study group, out of which 6.7% of hypothyroid women had severe anaemia. 3.66% women presented with infertility.Conclusions: Biochemical evaluation of thyroid function tests should be compulsory in all patients with menstrual irregularities, PCOS, infertility, fatigue, body aches, anaemia, thyromegaly, weight gain, constipation to detect thyroid dysfunction.
An evaluation of etiology of recurrent pregnancy loss: prospective observational study
Authors: Bavache Aparna B. , Gawali Urmila G. , Aher Gautam S.
Published: April 2022

Background: Recurrent pregnancy loss (RPL) is a global issue, affecting 1-2% of fertile women. RPL can be explained as two or more pregnancy losses which are documented either by ultrasonography or histopathological examination. This study aimed to evaluate etiology of RPLs.Methods: This prospective observational study was carried out in 40 women with history of RPL attending outpatient department (OPD) and inpatient department (IPD) of the department of obstetrics and gynaecology at the tertiary care centre of Dr. Vitthalrao Vikhe Patil Foundation’s (DVVPF’s) Medical College, Ahmednagar. The study was carried out from April 2020 to May 2021 in 40 women with history of RPL.Results: RPL most commonly occurs due to unexplained causes, followed by endocrinal causes. It was found most commonly in 21-30 years age group.Conclusions:
Maternal near miss events, an obstetrician's nightmare
Authors: S. Kalyani , S. S. Prashanthi
Published: April 2022

Background: Near-miss obstetric cases are those who have survived childbirth after a life-threatening complication of pregnancy. The aim of this study is to assess the prevalence of maternal near miss events, fetomaternal outcome and alongside analyze the importance of high dependency unit care for near miss patients in reducing maternal morbidity and mortality.Methods: This hospital based cross-sectional study was conducted in the obstetrics and gynaecology department of Southern railway hospital during June 2019 July 2021. In this study, pregnant or postnatal women with life threatening complications are admitted to the HDU using SAMM composite score and maternal & perinatal outcome are documented. Data entry was done in Microsoft Excel and data were analyzed using Epi Info software (7.1.0.6). Results: Many indicators of maternal near miss are calculated. The incidence of near-miss events was 11.5/1,000 live births. The ratio of near-miss to maternal mortality was 7:1. Hypertensive disorders complicating pregnancy and Obstetric haemorrhage were the most common direct and cardiac diseases complicating pregnancies were the most common indirect causes of admission into HDU care.Conclusions: Evaluation of maternal near miss events provides a good sense about our deficiencies in referral system, treatment protocols and any delay in admission to intervention time. Good maternal outcome after HDU care in MNM patients and also cost-effective benefits.
Assessing the knowledge on periconceptional use of folic acid among women visiting a tertiary care hospital in South India
Authors: R. Hethyshi , Begum Noor Shazia
Published: April 2022

Background: Periconceptional folic acid supplementation is an essential element for the prevention of neural tube defects. Neural tubes defects are congenital malformations affecting the brain and spinal cord associated with substantial mortality, morbidity, disability, and psychological impact. Mere awareness about its use and benefits can prevent a major proportion of these complications. Hence the present study is designed to assess the knowledge of use of periconceptional folic acid among women.Methods: This was a descriptive cross-sectional study conducted at Kempegowda institute of medical sciences, Bengaluru. 250 women attending the outpatient department, consenting to participate in the study were assessed about their knowledge on periconceptional use of folic acid by a self-designed questionnaire and the responses were analysed.Results: Out of 250 women, 194 (77.6%) were aware of folic acid. Among the 194 women 151 (77.83%) had learnt about it only after the diagnosis of pregnancy. The major source of information were health care providers in 182 (93.8%) women. The knowledge that it prevented neural tube defects was known to 79 out of 194 women. However only 18 (9.27%) women took folic acid periconceptionally.Conclusions: Among the study population the level of knowledge on periconceptional use of folic acid was low. The major source of information about the use of folic acid was from health care workers during early pregnancy. Periodic health education, awareness programs, periconceptional counselling at individual level can help in optimizing the intake and preventing the burden of neural tube defects.
A comparative study of high dose vs low dose oxytocin in the augmentation of labour
Authors: Rudra Samar , Rama Amulya , Subramanian Supraja
Published: April 2022

Background: Augmentation of labour is a practice that aims to increase the duration, frequency, and intensity of uterine contractions in order to decrease the duration of labour and reduce adverse events of maternal and fetal outcomes associated with prolonged labour. Although oxytocin is the most commonly used drug for the augmentation of labour, there is no universally accepted dosage regimen as various studies have used different regimens of oxytocin as low dose and high dose, leading to clinical heterogeneity. Hence this study was taken up to study the advantages, disadvantages and complications of a widely accepted regime for this study.Methods: 100 patients in active labour, with inadequate uterine contractions were selected. The patients were randomly selected, allotting alternate cases for high dose and low dose oxytocin. The patients were monitored through the course of labour and compared in terms of augmentation-delivery interval, mode of delivery, maternal and fetal outcome. The findings were tabulated and statistically analyzed.Results: Majority of the patients delivered vaginally in both groups (78% of high dose and 90% of low dose group). The mean augmentation-delivery interval was 7.20 and 7.45 hours for high dose and low dose group respectively. 12% patients in high dose group experienced maternal complications, while none were encountered in low doe group. 12% neonates from high dose group and 14% from low dose group required admission to the NICU.Conclusions: It was concluded with moderate certainty that high dose regimen of oxytocin resulted in reduction in the duration of labour, but cesarean rate, maternal and fetal complications were more. It was concluded that neither regimen has got an absolute advantage or disadvantage over the other.
Depot-medroxy progesterone acetate as contraceptive: study at tertiary care centre
Authors: Gupta Neena , Diwedi Divya , Sharma Neha , Jahan Uruj
Published: April 2022

Background: The aim was to study the acceptability, efficacy and side effects of Depot-medroxy progesterone acetate (DMPA) as contraceptive in postpartum, interval and postabortal period.Methods: The present study was a prospective longitudinal study conducted in the department of obstetrics and gynaecology, GSVM medical college, Kanpur. Total 300 patients were counselled out of which 141 enrolled in the study during a period of January 2019 to September 2020. All reproductive age group (18-45) women who were willing to use DMPA for contraception in postpartum period, postabortal period or in interval period and also ready for follow up were included in the study. At the time of 1st dose DMPA card issued to patient where her particulars, weight, blood pressure, menstrual complaints were recorded. Date of next visit was also mentioned.Results: Despite of benefits and proper counselling, less number of patients (47%) opted for DMPA as contraception. Acceptance (55%) and continuation rate for further doses (36.3% for 4th dose) was maximum in the postpartum period among the three groups taken in our study (postpartum, interval and postabortal). Menstrual changes were the most common reasons for discontinuation (39.7%) in all three groups. Other minor side effects may include change in weight and mood swings.Conclusions: When patients were counselled immediately after delivery, many of them gave positive note, but actual time of application is after 6 weeks postpartum where less number of patients turned up for DMPA. There is a need to create awareness regarding the harmless side effects.
Impact of obesity on semen quality in men of infertile couples: a cross-sectional study in a tertiary care centre
Authors: Rajamanickam Saranya , Nichanahalli Kubera S. , Chaturvedula Latha
Published: April 2022

Background: Obesity is an emerging problem worldwide. The aim of the study was to determine the association of Body mass index and central obesity with semen parameters in men of infertile couples.Methods: This was a descriptive study conducted in a population that included 219 men of infertile couples who attended the infertility clinic. A detailed history was taken from the participants and measurements of height, weight, waist circumference and hip circumference were done by standard methods. General, systemic and urogenital tract examinations were done. The participants were advised to collect semen specimens and semen was analyzed and various semen parameters were noted based on WHO criteria 2010.Results: Among the overweight and obese men, 12.7% and 20.5% were oligozoospermic respectively. Asthenozoospermia was seen in 21.2% and 25% of overweight and obese men. Among men with waist circumference ≥102 cm, 14.3% had oligozoospermia and 35.7% of men had asthenozoospermia. Around 12.2% of men with a Waist-hip ratio >0.9 had oligozoospermia and 19.8% of them had asthenozoospermia.Conclusions: A significant negative association was seen between WHR and sperm concentration, total sperm count, total progressive motility and total motility were seen to be removed. There was no significant association between WC, BMI and sperm concentration, total sperm count, total progressive motility, and total motility.
Study of maternal and perinatal outcome in post-dated pregnancy
Authors: Patel Tejal L. , Rathod Dhrutiben Amarsinhbhai
Published: April 2022

Background: It has been reported that in a pregnancy which has crossed the expected date of delivery, there is an increased risk of oligohydramnios, meconium stained amniotic fluid, macrosomia, fetal postmaturity syndrome, and cesarean delivery, all of which endanger the baby as well as the mother. The present study focus to investigate maternal and perinatal outcome in postdated pregnancies.Methods: The prospective observational study included primigravida and multigravida beyond 40 weeks of gestation admitted from September 2019 to September 2020 in obstetrics and gynaecology department B. J. medical college, civil hospital, Ahmedabad.Results: Out of 100 patients, majority were primigravida 62%, meconium stained liquor with fetal distress was the most common indication for LSCS 23.5 %, fetal distress was the most common fetal complications, rate of NICU admission was 33.33% between 41 weeks 1 day to 42 weeks, rate of induced labour was 71.43% between 41 weeks 1 day to 42 weeks. 88% patients were between 40 weeks 1 day to 41 weeks.Conclusions: Prolonged pregnancy was associated with remarkable risk of perinatal complications like fetal distress, meconium aspiration syndrome, IUGR, obstetric complications like oligohydramnios, perineal tear, atonic PPH and shoulder dystocia. The adverse outcome can be reduced by making accurate gestational age and diagnosis of postterm gestation as well as identifiable and management of risk factors. Considering the maternal and neonatal morbidity associated with prolonged pregnancy, pregnancy should not be permitted to go postterm.
Correlation of ultrasound, hysteroscopic and endometrial histopathology findings in patients with post-menopausal bleeding
Authors: Mahapatra Shalini , Chavan Niranjan N. , Mirza Hera , Rajput Hitenrasing
Published: April 2022

Background: To study endometrial changes by hysteroscopy and ultrasonography in women presenting with postmenopausal bleeding and correlate it with histopathological endometrial findings.Methods: This was prospective observational study carried out in the Department of Obstetrics and Gynaecology at Lokmanya Tilak Municipal Medical College and General Hospital. The materials for the present study included patients diagnosed with postmenopausal bleeding visited to a Municipal Tertiary care centre and teaching institute in between January 2019 to June 2020. Total 51 eligible patients were evaluated.Results: In this study, on TVS examination, maximum patients 45.10% were having endometrial thickness in between 6-12mm. On hysteroscopy, 35.29% of the patients were having atrophic endometrium which was the most common finding followed by Endometrial Hyperplasia in 29.41% patients. The most common histopathological finding was atrophic endometrium in 41.18% patients followed by endometrial hyperplasia in 23.53% patients. In TVS, lowest sensitivity and lowest specificity was in case of Atrophic Endometrium and highest sensitivity and highest specificity was in case of fibroid. In Hysteroscopy, lowest sensitivity was in case of carcinoma and lowest specificity was in case of Endometrial Hyperplasia and highest sensitivity was in case of fibroid and highest specificity was in case of fibroid and carcinoma.Conclusions: Hence from this study, hysteroscopy is found to be an easy, safe, alternative and effective means to investigate postmenopausal women with a thickened endometrium found on TVS. Hysteroscopy guided biopsy in postmenopausal women with uterine bleeding decreases the risk of false negative histopathological report which is more commonly found in blind dilatation and curettage. This is also a useful method of visualizing the uterine cavity pathologies.
Observational study to determine the proportion of types of congenital heart diseases in high-risk pregnancies with detailed prenatal echocardiography
Authors: . Balakrishna , Gehlot Ramanand , Chaturvedy Kirti , Rajpurohit Dalpat Singh , Chandel Manvika , Kumawat Nauratmal , Rathod Viram Singh , Pareek Deepak , Patel Rughnath , Sheoran Pradeesh , Mishra Divyangi
Published: April 2022

Background: Specific factors that increases a mother’s risk of carrying a fetus with CHD, with the use of extended views in fetal echocardiography in addition to basic standard views there is increased detection of CHDs. Purpose of study current study was to investigate the role of fetal echocardiography in prenatal diagnosis of the congenital heart diseases in high-risk pregnancies between 18-36 weeks of gestational age and to determine the proportion of occurrences of different types of CHDs in and high-risk group.Methods: Observational study with consecutive sampling 880 subjects. Study done in department of radiodiagnosis, SNMC, Jodhpur, RajasthanResults: With use of basic standard views, extended views and 3D views total 27 cases were detected out of all 880 subjects, which is significant statistically. Many CHDs which can be missed by the standard views, can be more efficiently detected with use of extended views in the fetal echocardiography.Conclusions: Most common type of CHD was found to be VSD and hypoplastic left heart syndrome.
Role of labour admission test in predicting pregnancy outcome in low-risk cases
Authors: Syeda Bushra B. , Kulakarni Sunanda R. , Chinna Althaf H.
Published: April 2022

Background: The present study was carried out to determine the role of labour admission test (LAT) in detecting fetal hypoxia in labour and to correlate the findings of the test with perinatal outcome in low-risk cases.Methods: In this study 150 low risk pregnant term women were subjected to LAT and classified according to NICE 2017 guidelines. Pregnancy outcome in terms of need for operative delivery and neonatal status at birth were noted. Data was analysed statistically by Chi-square test.Results: The LAT was normal in 78.67%, suspicious in 17.33% and pathological in 4%. Operative delivery for fetal distress was observed in 18.75% of normal group, in 50% of suspicious group and in 100% of pathological group. The incidence of meconium-stained liquor was significantly high in pathological (50%) and suspicious group (19.23%). The incidence of low 5-minute Apgar score was significantly high in pathological LAT group (33.33%) as compared to suspicious (7.69%) and normal LAT groups (2.54%). Admission to neonatal intensive care unit (NICU) was significantly high in pathological test group (50%). LAT in this study showed 48.15% sensitivity, 96.75% specificity and 76.47% positive predictive value as a screening tool for predicting fetal distress in low-risk patients suggesting that a normal LAT in early labour is an indicator of good pregnancy outcome.Conclusions: LAT is an effective, non-invasive screening method with good specificity to detect fetal distress in low-risk woman and helps to plan management accordingly to improve pregnancy outcome.
Study of maternal and foetal outcome in COVID-19 anaemic patients during COVID pandemic in a tertiary centre
Authors: Chavan Niranjan , Ammara Umme , Kapote Deepali , Deshmukh Prasad , Sakhalkar Ashwini
Published: April 2022

Background: The haemoglobin concentration is one of the most critical indicators of the blood's oxygen-carrying ability. Due to the hypermetabolic condition produced by infection, anaemia in COVID-19 positive pregnant women might result in tissue hypoxia due to increased peripheral tissue oxygen demands. Complications such as multi-organ failure and acute respiratory distress syndrome can worsen the prognosis. Since hemoglobin is necessary for tissue oxygenation, anaemia may have a substantial impact on the prognosis of COVID-19 pneumonia, where tissue hypoxia develops as a result of disease pathogenesis. Aim of the current study was to study the effect of COVID-19 on pregnant women with anaemia in pregnancy, including symptoms and foetomaternal outcome in patients admitted to a tertiary care facility.Methods: Observational study done on pregnant females in labour and post-delivery patients who were diagnosed with COVID-19 infection using the SARS COV-2 nasopharyngeal reverse transcriptase polymerase chain reaction (RT-PCR) from 1st April 2020 to 30th June 2021. The required demographic, clinical details and haemoglobin levels were obtained, and selected participants were followed up until they were discharged.Results: In our study, out of 58 women, who had anaemia in pregnancy with COVID-19 infection delivering 59 neonates (1set of twins), 55.5% were in the age group of 25-35 years, 77% reached full term pregnancy and 67% were multigravida. 51.7 % patients were transferred from periphery hospitals. Delivery was by caesarean section in 61% and 39% delivered vaginally. 38.8% neonates delivered had birthweight of <2.5 kg out of which 20% had intrauterine growth restriction and 22.4 % were preterm. 3.4% stillbirth were reported. No maternal deaths were reported.Conclusions: From our study, maternal and neonatal outcome were unaffected by anaemia in COVID-19 pregnant women. Severely anaemic patients with comorbidities should be transferred to centres with appropriate neonatal intensive care facilities for delivery.
Puerperal uterine inversion: a new case report
Authors: Mbodji Aissatou , Wade Mouhamadou , Gueye Mamour , Ndiaye Mame Diarra , Sene Mouhamet , Sylla Mohamadou Nassir , Sow Pahté , Gueye Aminata T. , Mbaye Magatte
Published: April 2022

Puerperal uterine inversion is a rare and severe affection which the uterine fundus collapses into the endometrial cavity. The diagnosis is essentially made on clinical examination, which also allows to determinate the gravity. The management must be done early, which can be surgical or non-surgical. Through a case study we will review the literature.
Microperforate hymen and labial fusion: an unusual case
Authors: Sreenivas Anju , Kate Nina V. , Subhashini M. , Diana Valsa , Sujatha P.
Published: April 2022

Genital tract abnormalities are uncommon, occurring in approximately 7% of female population. Among these cases, hymenal abnormalities are the most frequent, with imperforate hymen occurring in 1 in 2000 girls. Imperforate and microperforate hymen is a congenital disorder of hymenal configuration which does not permit normal menstrual flow. We report a case of 26 year old primigravida at 28 weeks gestation with threatened preterm labor and was incidentally found to have fused labia minor and microperforate hymen. Scope examination through the hymen revealed a normal looking vagina and cervix. Urethral meatus was not made out. She was taken up for elective caesarean section at 37 weeks of gestation with hymenectomy. Intraoperatively, urethral orifice was identified after incising the fused labia minora. A uterine angle fibroid was found, myomectomy done. No uterine anomalies were noted.
Severe primary hypothyroidism leading to life threatening heavy menstrual bleeding: a case report
Authors: Naik Smrity , Jaiswal Jyoti , Singh Dhruw Shweta , Tiwari Rashmi , Padmavati G.
Published: April 2022

Thyroid disorders are one of the leading causes of abnormal uterine bleeding in women of all age groups and in India its prevalence in women is about 26%. Sequelae of thyroid disorders may vary from infrequent menstrual cycle, light menstrual bleeding to even a very severe life threatening heavy menstrual bleeding leading to anemia &shock. It occurs due to anovulation, endometrial hyperplasia and coagulation defects. Thyroid screening is important while investigating all cases of AUB. A 18 year old girl was brought to Dr. Bhim Rao Ambedkar Memorial Hospital Raipur with very severe anemia (Hb: 1.1gm/dl) and grade IV hemorrhagic shock (BP 50/30mm of Hg) but surprisingly pulse rate was normal (80bpm). Her peripheries were cold and clammy. SpO2 -80% on room air, she had facial puffiness and grade III pitting edema over her hands and feet. Her TSH was very high >100 µIU/ml with decreased (T4 - 0.678µg/dl, T3 - 0.359 µg/ml) suggestive of severe primary Hypothyroidism. USG was suggestive of bulky uterus with 14 mm endometrial thickness. Her shock was managed and tablet norethisterone, tranexamic acid, levothyroxine and iron supplements started. Severe hypothyroidism can cause life threatening uterine bleeding. This case is of peculiar interest because of profound hypothyroidism associated with hemorrhagic shock. Early recognition and proper management is important to prevent hazardous complications.
Treatment dilemma in an adolescent girl with idiopathic intracranial hypertension presenting with abnormal uterine bleeding and severe anemia
Authors: Agrawal Prabha , Agrawal Rahul , Mehta Deepti , Kamjula Pragna
Published: April 2022

Abnormal uterine bleeding (AUB), specifically heavy menstrual bleeding (HMB) is a frequent complaint for adolescents. Idiopathic intracranial hypertension (IIH) is a syndrome of raised intracranial pressure, in the absence of any evidence of an intracranial space occupying lesion. Female sex, obesity and polycystic ovarian disease are known risk factors associated with IIH. This case report depicts the unusual case of an 18-year-old girl with IIH who presented with HMB for 28 days with severe anemia with Hb of 5.5 gm%. Urgent ophthalmic and neurological review was taken in view of IIH. Prompt treatment of AUB was done with blood transfusion, hemostatics, and orally administered iron supplements. Despite medical treatment for AUB, patient continued to bleed and hence after multidisciplinary discussion and informed consent she was started on low dose progesterone. Symptoms improved rapidly and she was discharged in a stable condition with tapering doses of medication and regular follow- up advice. Treatment of AUB in adolescents with IIH is a dilemma for physicians. To date, there is no direct evidence suggesting either implantable or oral contraceptives as a cause for IIH but few studies have closely linked oestrogen containing oral contraceptive pills and some levonorgestrel implants in IIH and hence these should be avoided.
A case report: uterine fibroids treated by polyvinyl alcohol particles
Authors: Tonpe Sudhanshu , Warbhe Himandri Harish
Published: April 2022

Uterine fibroids, the most common type of tumor among women of reproductive age, are associated with heavy menstrual bleeding, sub-fertility, abdominal discomfort, and a reduced quality of life. For women who wish to preserve their uterus and who have not had a response to medical treatment, uterine artery embolization and myomectomy are therapeutic options. A 35-year-old asthmatic female came to our hospital with dysfunctional uterine bleeding (DUB) from the past 6 months complicated by severe anemia requiring multiple blood transfusions. Ultrasound of the pelvis shows a bulky uterus with an intramural fundal fibroid indenting the endometrial cavity with fluid collection within. Considering the age and reduced Hemoglobin and the co-morbidity of asthma, endovascular PVA (Polyvinyl alcohol particle) particle embolization of both uterine arteries was performed. Post procedure, there was there were no acute symptoms. Six months after the intervention, the patient’s pelvic USG shows significant reduction in the size of the fundal fibroid with total absence of menstrual bleeding. Therefore, endovascular uterine artery embolization with PVA particles is safe and effective method to treat DUB.
Abnormal uterine bleeding in a woman with caesarean scar defect (isthmocele): a case report
Authors: S. Abhishek , Shreevijay B. , M. Sona , Kulkarni Shashank
Published: April 2022

The caesarean scar defect generally is described as a triangular or circular sonographically anechoic area in the myometrium of the anterior lower uterine segment or cervix at the site of a previous caesarean section. Caesarean section is one of the most commonly performed surgeries and the trend is increasing in the recent years. One long-term complication of caesarean delivery which is not often discussed is the presence of a defect within the uterine scar that is directly associated with a type of abnormal uterine bleeding (AUB) referred to as postmenstrual bleeding. In addition to AUB, presented as pelvic pain, dyspareunia, dysmenorrhea, unexplained infertility. Caesarean scar defect is one such cause of AUB which is overlooked as the history of caesarean section will be many years ago. One such case of woman presenting with abnormal uterine bleeding and pain in abdomen with caesarean defect who was managed in our tertiary care centre reported here.
Caesarean delivery on maternal request: need to redefine in view of intrapartum cases
Authors: Mahale Anannya A.
Published: April 2022

Caesarean delivery on maternal request: need to redefine in view of intrapartum cases. The reasons are two-1) Recently I finished analysing indications for caesarean delivery at my institution for the period 01/04/2018 to 30/03/2019 (pre-COVID-19) as a part of my dissertation. 2) I also read articles from these and other authors related to Robson ten group classification system.
Developing safe porter protective syringe cap to prevent percutaneous injuries; a semi-experimental study
Authors: Akidağı Zeynep , Kızıloğlu Kadircan , Şener Hatice , Şenol Vesile
Published: April 2022

Background: Although healthcare professionals know how to avoid needle sticks, current safe syringes are not capable of preventing percutaneous injuries 100%. Therefore, infections caused by needle sticks could not be completely prevented.Methods: First of all, a Likert type questionnaire were applied as a qualitative method in the study. Based on these survey data, 4 different types of safety syringe caps were developed and tested in a quasi-experimental method.Results: The research was carried out with 344 health vocational school students. As a result of the research, the average level of knowledge of the students about percutaneous injuries was in female students (n=223, 64.8%) compared to male students (n=121, 35.2%) (females, mean: 78.8±10, males, mean: 76.5±10) (p=0.256) in the second grades compared to the first graders. It was found to be higher (1st class: 77.3, 2nd class: 81.0) (p=0.049). The mean level of knowledge showed a significant difference according to educational level (p=0.049), but did not show a significant difference according to programs (p=0.371) and gender (p=0.256). Among the safe injector caps of different diameters developed against percutaneous injuries, the largest diameter injector cap was defined as the most successful, safe syringe cap that prevents percutaneous injuries (p<0.001).Conclusions: It was observed that education or experience was not significantly effective in preventing percutaneous injuries caused by needle sticks, and that percutaneous injuries and thus infections could be prevented by increasing syringe cap diameters.
The effect of characteristics and cool pack on reducing intensity of infustion pain in children in hospital
Authors: Akhriansyah Mareta , Surahmat Raden
Published: April 2022

Background: Intravenous therapy is a type of therapy that is mostly given to pediatric patients who are treated with infusion. Giving this therapy will cause discomfort to the child by inserting a needle into the child's blood vessel which can cause pain. So that syringes are generally feared/hated by children when hospitalized. Untreated pain can have a detrimental impact on children, including anxiety, difficulty sleeping, helplessness and hopelessness. So it is necessary to have complementary therapy with cool packs (cold compresses) is one of the nursing actions that can reduce pain by providing a local anaesthetic effect on the area to be inserted infusion. This study aims to study the effect of cool packs (cold compresses) on pain during infusion in children. Methods: This study uses a Quasy experiment design with a two group Posttest design approach. This study was conducted on children before infusion by giving cold compresses in the infusion area with an intervention group of 15 respondents and a control group of 15 respondents. Pain measurement using the face, legs, activity, cry and consolability (FLACC) scala observation sheet. Data analysis in this study used univariate and bivariate statistical tests using independent t-test. Results: The results showed that the average pain scale for the intervention group with the cool pack was 3.93 with a standard deviation of 1.033, while in the control group the pain intensity was 7.40 with a standard deviation of 1.242. So we get the effect of Cool Pack on the intervention group and control group with a P value of 0.000. Conclusions: There is an effect of cool packs (cold compresses) on pain during infusion in children.
Patient satisfaction with anti-retroviral services at General Hospital, Ogoja, Cross River State, Nigeria: a cross-sectional study
Authors: Ajobgor Benedict , Oladigbolu Remi A. , Ojong Ejoh , Anyanwu Prince , Henry Diojo E. , Aneke George C. , Adung Emmanuel , Nwafejeokwu Afamefune H.
Published: April 2022

Background: Patients have explicit desires for services when visiting hospitals and inadequate inquiries of their needs may result in dissatisfaction. This study aimed to assess the level of satisfaction and its correlates amongst clients receiving ART care and treatment at the General Hospital, Ogoja, Cross River State, Nigeria.Methods: A cross sectional study was conducted among PLHIV age ≥18 years from June 2020 to August 2020 at RISE supported ART clinic of GH Ogoja and satisfaction level was assessed using the PSQ18 instrument. Data was collected using a structured interviewer administered questionnaire and was analyzed for descriptive and inferential statistics using IBM SPSS version 23.Results: Out of the 365 participants enrolled into the study, 60.5% were females. The mean score of PSQ-18 domain was 40.8±2.52 with the highest scores reported in accessibility/convenience (9.4±0.76) and technical quality (9.4±0.74) domains while the lowest was in time spent with doctors/case managers (3.0±0.0). The correlates of patient satisfaction were respondents involved in businesses, earning above the minimum wage, on TLD and no reported missed doses of ART and the only determinant was being on TLD.Conclusions: Access, convenience and technical quality were perceived satisfied by patients receiving care. However, they were dissatisfied with the time spent with them and being on TLD was a determinant of patient satisfaction. Client-centric interventions should include health caregivers spending quality time with their patients and all clients weighing 20kg and above are on DTG-based regimen for their care and treatment.
Knowledge and practices of mothers towards oral health of their 3-5 years children: a rural and urban comparative study
Authors: Srinivasan Pavithra
Published: April 2022

Background: Mothers are responsible for developing novel behaviors in children. The negligibility given to the primary dentition by the mothers in developing good oral hygiene practices was due to the lack of knowledge on its importance. The study aimed to compare the difference in knowledge and practices among rural and urban mothers towards the oral health of their children in the Kanchipuram and Chennai districts of Tamil Nadu.Methods: A community-based comparative cross-sectional study was carried out among 140 rural and 140 urban mothers of children between three to five years of age. The analysis of the study was carried out based on a 45-item questionnaire. The results used for comparison were based on descriptive statistics, chi-square test, independent t-test, one-way analysis of variance, and column proportion test (z test) using the statistical package for social science version 16.0. The significance level of all the tests was set at (p≤0.05).Results: The 37.1% of the rural and 79.3% of the urban mothers were found to have high knowledge. While only 6.4% of the rural and 22.1% of the urban mothers were found to have high practice. Also, there was a significant difference in knowledge (p=0.000) and practice (p=0.008) among different educational groups of rural and urban mothers as well.Conclusions: The majority of urban mothers have adequate knowledge regarding the oral hygiene of their children when compared with rural mothers. But the practices of both groups were drastically very low concerning their knowledge. The educational status of the mother had proved their advantage in their knowledge and practice.
Clinico-epidemiological profile and cost incurred in the management of dengue among the patients admitted in tertiary care hospital of Mysuru, Karnataka
Authors: R. Yashaswini G. , Kulkarni Praveen , Murthy M. R. Narayana
Published: April 2022

Background: Dengue is the most extensively spread mosquito-borne disease; endemic in more than 100 countries. The overall seroprevalence of dengue infection in India was 48.7% (95% CI 43.5-54.0).  One of the major factors that determine the outcome dengue syndrome is the cost incurred in its management. As there are paucity of studies related to cost involved in the management of dengue in southern India, this study was undertaken in a tertiary care hospital. Methods: A cross-sectional study was conducted among 100 patients in JSS hospital, Mysuru Karnataka. Convenience sampling was used to select the patients during the visit and a pre-tested semi-structured questionnaire was used to collect socio-demographic details along with symptoms and cost incurred in dengue treatment. Data analysis is done by arithmetic mean, median, standard deviation, inter quartile range and percentages in SPSS and excel.Results: In this study 98 (98%) of the respondents had fever, 61 (61%) of respondents had muscle pain, 52 (52%) of the respondents had joint pain, 45 (45%) had head ache, 28 (28%) had bleeding, 51 (51%) had abdominal pain, 43 (43%) had chills, 29 (29%) had vomiting, 19 (19%) had pain behind eyes, 15 (15%) swollen glands, 19 (19%) had rashes. Overall direct cost for the management of dengue was Rs. 62505.5/- (46785.50-76958.75) and overall indirect cost was Rs. 17500/- (2250-25500).Conclusions: This study provides that the overall direct cost for the management of dengue treatment was Rs. 62505.5/- (46785.50-76958.75) and overall indirect cost was Rs. 17500/- (2250-25500) respectively.
Assessment on cold chain management system in selected blocks of Purulia district, West Bengal, India
Authors: Haldar Mandira , Majumdar Kunal Kanti , Ghosh Pramit
Published: April 2022

Background: The study was done to assess the status of cold chain point, vaccine storage practice and practice of health workers about immunization activities at cold chain points. The aim was to evaluate the cold chain system in relation to infrastructure, manpower and maintenance of equipment in selected blocks of Purulia district.Methods:It was a cross sectional descriptive study, done at randomly selected sites where vaccines were stored and outreach sessions where immunization services were provided. Five cold chain points were included in the study. Fully structured standardized checklists and questionnaire had been used to collect the data.Results: Only 40% cold chain point (CCP) reported breakdown of cold chain equipment (CCE) in last one year. Ice lined refrigerator (ILR) and deep freezer (DF) were properly placed in 75% of the CCP. All the CCP have displayed contingency plans and latest standard job aids. Vaccines and ice packs were correctly placed. ILR and DF were connected to functional voltage stabilizer. A functional thermometer was placed inside every ILR and DF and twice daily recording of temperature was found in all the CCPs. Record of vaccine wastage was found only in 40% CCPs. CCPs have adequate space for conditioning. No frozen vaccine and vaccine vial beyond expiry date were found in any of the CCPs. All CC handlers had satisfactory knowledge about cold chain management.Conclusions:This study was an effort to assess the status of cold chain points in Purulia district, West Bengal. Overall result was satisfactory, could have been maintained and further improve in future by good supportive supervision practice as a key measure in improvement of cold chain system.
Dynamics of anti-SARS-CoV-2 IgG antibodies over four months period during pandemic in health care workers
Authors: Jain Amita , Verma Anuragani , Shukla Suruchi , Verma Anil K.
Published: April 2022

Background: Person infected with Severe acute respiratory syndrome- coronavirus-2 (SARS-CoV-2) may develop virus specific IgG antibodies but antibody titers might decline over time, if antibody titer decline over time, chances of HCWs getting re-infected are higher.Methods: Here we assessed status of Anti SARS-CoV-2 antibodies in HCWs over a four months period by detection of anti-SARS-CoV-2-IgG antibodies using a semi-quantitative enzyme-linked immunosorbent assay (ELISA).Results: The present follow up study shows that during four months period sero-positivity in HCWs increased from 32% to 42%. Of 100 enrolled HCWs, 37 were RT-PCR positive at least once, of which only 31 were seropositive and six were seronegative. Of 63 RT-PCR negative individuals, one was seropositive. while two HCWs turned sero negative from sero positive and in five HCWs antibody titer increased.Conclusions: Although HCWs are at a greater exposure risk, the sero-prevalence in them at places where adequate preventive measures are taken, is comparable to that of general population.
Mediation effect of psychological factors on betrayal trauma and physical health symptoms among young adults
Authors: Teli Bilal A. , Bano Samina , Paul Mohd A.
Published: April 2022

Background: Betrayal trauma theory postulates abuse perpetrated by a caregiver or someone close to the victim results in worse mental health and physical health problems than abuse perpetrated by a non caregiver. Hence the present study was designed to study the mediation effect of psychological factors on high betrayal trauma and physical health symptoms among young adults.Methods: young adults with history of trauma based on purposive were taken from Delhi. Out of 200 young adults, 100 were high betrayal traumas and 100 were low betrayal traumas with age group ranged from 20-30 years. In order to identify high betrayal trauma and low betrayal trauma the brief betrayal trauma survey, followed by Toronto alexithymia scale, trauma symptom checklist-40, Pennebaker inventory of limbic languidness and socio-demographic data sheet.Results: The present study studied the mediation analyses and found that sexual abuse and sexual problem were mediates the association between high betrayal trauma and physical health problem.Conclusions: The mediation effect by sexual abuse trauma and sexual problem was reported on high betrayal trauma and physical health symptoms It highlights to inform the health professionals about the diverse range of symptoms associated with betrayal trauma and highlights the urgency of immediate intervention of betrayal trauma and helps the health professionals in awareness of connection among betrayal trauma, psychological difficulties, and physical health complaints and make appropriate assessments and referrals.