bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of prophylactic salpingectomy on ovarian function in premenopausal women in tertiary referral center
Authors: Abdel Dayem Tamer M. , Badawy Amira M.
Published: September 2017

Background: Epithelial ovarian cancers (EOCs) are the most common cause of death from gynaecological malignancy. Serous ovarian carcinomas represent (68%) of Epithelial ovarian cancers, they are further divided into low-grade (type I) and high-grade (type II) serous ovarian carcinomas. There has been increasing evidence that fallopian tubes are considered the most important site of origin of pelvic high grade serous carcinoma. Salpingectomy is thought to be effective in reducing ovarian cancer risk in the future and prolonging average life expectancy, however, there are some concerns regarding ovarian function after elective salpingectomy in premenopausal women. The current study was carried out to assess the effect of salpingectomy on ovarian function in premenopausal women.Methods: 60 premenopausal cases were recruited and subjected to open abdominal hysterectomy without oophorectomy (for benign indications). Included cases were below 45 years, with documented active ovarian functions. Cases with genital malignancy, ovarian gross pathology and suspected or known ovarian failure were excluded. Cases were randomly allocated to one of two groups; group-A (where salpingectomy was performed), and group-B (where salpingectomy was not done). For all patients, ovarian functions were assessed prior operation, and at one and three months after operation using serum anti-Mullarian hormone (AMH) as well as early follicular antral follicular count (AFC), serum follicle stimulating hormone (FSH) and serum oestradiol (E2).Results: The mean pre-operative AFC, AMH, FSH, and E2 levels showed no significant changes after operation at one and three months postoperative follow up in both studied groups, denoting preserved ovarian function in both groups.Conclusions: Prophylactic salpingectomy is a safe and simple procedure that has no effect on ovarian reserve or function when performed in premenopausal women.
Analysis of endometrial blood flow with color Doppler energy in predicting outcome in GnRH antagonist down regulated ICSI/IVF cycles: a prospective cohort study setting
Authors: R. Rubina , Y. S. Ling , T. T. Yong , A. T. Keat , H. Rajesh
Published: September 2017

Background: The study was conducted to assess the association between endometrial blood flow pattern assessed with colour Doppler around the day of HCG administration and IVF outcome following GnRH antagonist down regulated cycles.Methods: It was a prospective, cohort study. Total of sixty-eight patients undergoing IVF-ET/ICSI were recruited in the study. All the patients underwent controlled ovarian stimulation with a step-up protocol, and GnRH antagonists were used for down-regulation. Transvaginal ultrasound measurements of all patients were performed on the day of HCG injection. A 6.5 MHz pulsed Doppler system was used for blood flow analysis. Bilateral uterine arteries, pulsatility index and resistance index were calculated along with uterine artery peak systolic velocity on both sides. Endometrial blood flow was analysed by detecting flow in the intra-endometrial or the adjacent sub-endometrial regions.Results: Baseline FSH in pregnant group was lower (6.29) than non-pregnant group (7.36). The overall pregnancy rate was 45.6% (n=31) and the ongoing pregnancy rate was 41.1% (n=28). Total of 57 patients out of 68 patients had both good endometrial and sub-endometrial blood flow. The overall pregnancy rate in this group was 47.3%. Similarly, in patients who had minimal endometrial and sub-endometrial blood flow the pregnancy rate was 37.5%. There was no significant correlation between pregnancy outcomes and the color flow Doppler parameters such as average uterine PI, average uterine RI and right/left uterine peak systolic velocity.Conclusion: Uterine artery PI, RI and PSV has no role in predicting endometrial receptivity and thus pregnancy outcome in IVF-ET cycle, however those patient with good endometrial and sub-endometrial flow have higher pregnancy rate than those with minimal flow rate.
Abruptio placenta: a retrospective study on maternal and perinatal outcome
Authors: Sengodan Subha Sivagami , Dhanapal Mohana
Published: September 2017

Background: Abruptio placenta is separation of a normally situated placenta after 20 weeks of gestation and prior to the birth of the fetus. It is an important cause of antepartum haemorrhage and presents as an acute abdomen in the third trimester of pregnancy. Obstetrical haemorrhage is one of the triad (Haemorrhage hypertension and infection) of causes of maternal deaths in both developed and underdeveloped countries.Methods: This is a retrospective study of Abruptio Placenta cases carried out between January 2015 and December 2015 at Government Mohan Kumaramangalam Medical College Hospital, Salem and about its perinatal and maternal outcome.Results: Incidence of Abruptio placenta is 0.5%. It is most common in the women of age group 26-30yrs. 67% of cases were associated with severe pre-eclampsia. Live births were 69.8% while stillbirths were 30.2%. PPH occurred in 19.6% of cases. DIC accounts for 16.7% of the complication.Conclusions: Abruptio placenta is associated with poor maternal and fetal outcome. Hence early diagnosis and prompt resuscitative measures would prevent both perinatal and maternal mortality and morbidity.
Awareness about cervical cancers among health workers in Shimla district, Himachal Pradesh, India
Authors: Fotedar Vikas , Fotedar Shailee , Thakur Purnima , Sharma Mukesh , Sharma Aman
Published: September 2017

Background: Cervical cancer, although largely preventable, remains the most common cause of cancer mortality among women in low-resource countries. Aim of this study was to assess knowledge and awareness of cervical cancer prevention among health workers in Shimla district, Himachal Pradesh.Methods: A cross sectional study was conducted among multipurpose health care workers (both males and females) in Shimla district, Himachal Pradesh. A self-administered close ended questionnaire was used. The questionnaire, consisted of two parts. The first part comprised of questions relating to demographic data and the second part had questions on knowledge about cervical cancers. The data was analyzed using the statistical analysis program SPSS version 16.0.  Tests used were Chi square, t test and ANOVA. A p-values <0.05 were considered  statistically significant.Results: Out of 122 subjects, there were 45 (36.9%) males and 77 (63.1%) females. The mean knowledge percent of the population was 55.9+16.4. Among the age groups it was highest for the age group of 21-30 years (62.5+23.6) and lowest for the age group of 51-60 years (53.6+16.4). Knowledge about risk factors was correctly reported by 44.3% of population. Who should be screened for cervical cancers was reported correctly by 29.5% and at what interval screening should be done was reported by 14.8%.Conclusions: Half of the population had moderate overall knowledge about cervical cancers, but the knowledge about risk factors and screening eligibility and screening interval was inadequate. So, education programs should be arranged for the health workers in order to prevent cervical cancers.
Relationship of umbilical coiling index and perinatal outcome
Authors: Rahi Shayesta , Akther Gulshan
Published: September 2017

Background: In placental mammals, the umbilical cord is a conduit between the developing embryo or foetus and the placenta. Present work was done to study the association of umbilical coiling index and perinatal outcome.Methods: One hundred umbilical cords were examined. The umbilical coiling index was calculated, by dividing the total number of coils by the total length of the cord in centimetres. The umbilical coiling index <10th percentile and >90th percentile was considered as hypocoiled and hypercoiled, respectively. The outcomes measured in terms of birth weight, Apgar score, meconium staining, Intrauterine growth restriction, gestational age at birth and Neonatal intensive care unit admission.Results: The mean umbilical cord length was 51.2 cms, mean number of coils 10.8 and mean umbilical coiling index 0.2. 80 umbilical cords showed normocoiling, 10 hypercoiling and 10 had hypocoiling. Meconium stained liquor was present in 80%, 37.5% and 20% in hypocoiling, normocoiling and hypercoiling group, respectively, with p valve of <0.05. 40% of babies with hypocoiling cords had Apgar at 1 minute <4 and apgar score at 5 minutes <7. Intrauterine growth restriction and low birth weight babies were significantly higher in hypercoiling group. Neonatal intensive care unit admission was higher (40%) in both hypocoiling and hypercoiling group as compared to normocoiling group (10%).Conclusions: Present study thus shows abnormal coiling index is associated with adverse perinatal outcome.
Hysterolaparoscopy in the evaluation and management of female infertility
Authors: Antaratani Ramalingappa C. , B. Harsha
Published: September 2017

Background: To study the role of hysterolaparoscopy in the evaluation and management of female infertility.Methods: A retrospective study of the 677 case files of all the patients who underwent diagnostic hysterolaparoscopy for infertility between January 2011 to December 2016 at Karnataka Institute of Medical Sciences, Hubli and Sushruta Multispeciality hospital, Hubli. These infertile women were confirmed to have normal ovulatory cycles, hormonal assays and seminogram report. Dye studies as well as inspection for abnormal pelvic and intrauterine pathology and necessary therapeutic interven-tions were done during the procedure. Abnormal pelvic and intrauterine pathology by hysterolaparoscopy were categorized.Results: Out of 677 cases, 74% patients had primary, 26% patients had secondary infertility. As a whole pelvic pathology was confirmed in 59.5% and intrauterine pathology in 22.3% patients by hysteroscopy. The most common laparoscopic abnormality detected was Polycystic ovaries (27.1%), followed by pelvic adhesions (18.7%). Tubal block comprised 8.1% whereas distorted uterus by fibroid in 6.2% and pelvic endometriosis in 8.7%. In hysteroscopy, the incidence of uterine anomaly was 54 (7.9%). Septate uterus is the most common with a mean incidence of approximately 37 (67.8%).Conclusions: Diagnostic hysterolaparoscopy is an effective diagnostic and therapeutic modality for certain significant and correctable abnormalities in pelvis, tubes and uterus which are missed by other imaging modalities.
Gestational diabetes and fetal outcome: a study in a tertiary care centre
Authors: Vanamala V. G.
Published: September 2017

Background: Due to urbanization and sedentary lifestyle, dietary changes, and increased obesity of the people, the incidence of GDM is steadily on the rise. It is associated with severe morbidity to the mother and the child. It is therefore imperative that an early diagnosis needs to be done so that appropriate treatment can be given.Methods: 1654 women who were included in the study were in their 24 – 28 weeks of gestation. A standardized questionnaire was formatted and details regarding the age, weight, body mass index (BMI), parity, previous medical and obstetrics history and familial history of diabetes, tests for glucose levels, complete blood picture, routine urine examination. Oral glucose tolerance test was done for all the patients after fasting overnight.Results: 87 (5.3%) of them were positive for OGTT and were considered to have Gestational Diabetes mellitus. 67.8% of the patients were in the 25-30 age group. 41.4% were pregnant for the first time and 58.6% were multi gravid. The majority of the patients had a BMI between 26-30. Most of the babies had a birth weight of above 3kgs. Out of them, 39 (44.8%) had a birth weight between 3.1-3.5kgs. <2kgs were seen in 7 (8.0%) patients.Conclusions: GDM complicates pregnancy and results in higher frequency of adverse effects in the mother and new born. Thereby, early detection can result in prompt treatment and lowering the morbidity of the fetal outcomes.
A comparative study on efficacy and safety of intravenous iron sucrose and oral iron among anaemic pregnant females
Authors: Zia Khan Naheed , Ahmad Mufazzal , Dwivedi Akhilesh Dutt , Shukla Mukesh
Published: September 2017

Background: Iron deficiency anaemia (IDA) is the most common medical problem in pregnancy. Both parenteral and oral iron therapies are modalities used for management of anaemia in pregnant females. The present study aimed to compare the efficacy of oral and intravenous iron therapy in improving iron deficiency anaemia in pregnancy and restoring iron stores, compare the pregnancy outcome in the two groups and evaluate their safety.Methods: This prospective randomized clinical trial conducted among pregnant women between 14 and 36 weeks with established IDA who were treated with IVIS (Intravenous Iron Sucrose) or OI (ferrous sulphate). All patients were monitored for laboratory response and adverse effects. Independent sample-t test, Chi square test and ANOVA were used for statistical analysis. P <0.05 was considered significant.Results: From first follow up till the end of the study the mean hemoglobin level of IV Group was found to be significantly higher as compared to that of oral Group. The MCV (mean corpuscular volume) values increased to a significant level in the intravenous group as compare to oral. After therapy increase transferrin saturation in the intravenous group were significantly higher at all-time interval than the oral group. The mean neonatal hemoglobin at birth was significantly higher in IV group 16.88±1.96 gm/dl than oral group 16.88±1.96 (p= p<0.0001).Conclusions: Intravenous iron sucrose is comparatively more efficient in improving haemoglobin than oral iron and has better pregnancy outcomes.
Delays in reporting of cancer cervix in rural India: sociodemographic and reproductive correlation
Authors: Deshmukh Varsha L. , Rathod Archana D.
Published: September 2017

Background: Cervical cancer, caused by sexually-acquired infection with human papillomavirus (HPV), continues to be a public health problem worldwide as it claims the lives of more than 270,000 women every year. The majority of cervical cancer deaths (85%) occur in women living in low- and middle-income countries. Assessment of socio-demographic profile and reproductive history gives a better picture of the determinants of cervical carcinoma in low-resource settings.Methods: This hospital-based cross-sectional study was undertaken at a Regional Cancer Institute at Aurangabad, India. Hundred newly diagnosed women with advanced cervical cancer (stage 2B-4B), who were undertaking radiotherapy and/or chemotherapy, were included to assess their socio-demographic, reproductive and clinical profile. The causes for late presentations were also noted.Results: The mean age of women at the time of detection of cervical cancer was 57.35 years (30-82 years). More than 81% of patients were illiterate and belonged to low socioeconomic status. 47% of the study subjects had their first sexual experience before 15 years of age. Nearly 78% women had 5 or more pregnancies, among them, unusual discharge from vagina (39%) followed by bleeding after menopause (28%) and pain in abdomen (13%) were the most common presenting complaints. The average duration of symptoms was (28 days), time interval between the symptoms and biopsy was (3.6 months). Combination of radiotherapy and chemotherapy was the most common modality of treatment. Most common cause of delay in diagnosis was lack of awareness about the symptom of cancer (11%), feeling ashamed (10%), no one paid attention (19%), not diagnosed and referred at periphery and financial causes (23%) were found.Conclusions: Prevention of cervical cancer include delaying the age at initiation of sexual activity to above 18 years, spreading cancer awareness in women and with well-equipped health workers with diagnosis and knowledge of cancer cervix. This can prevent the medical and patient delay in the diagnosis of cancer cervix.
Doppler study of umbilical and fetal middle cerebral artery in severe preeclampsia and intra uterine growth restriction and correlation with perinatal outcome
Authors: Singh Santosh Kumar , Mishra Priti
Published: September 2017

Background: Pre-eclampsia and IUGR are two conditions resulting from defective trophoblastic invasion of spiral arteries and an increase in vascular resistance in uteroplacental circulation. Doppler offers a non-invasive tool for evaluation of fetoplacental blood flow and correlate with fetal compromise giving early warning sign of fetal distress.Methods: The study was conducted in Command Hospital, Lucknow in 100 singleton pregnancies with vertex presentation between 28-40 weeks of gestation with severe preeclampsia and/or IUGR. Doppler analysis of UA and MCA was done. Pregnancies were terminated depending on clinical condition and Doppler results.Results: Abnormal Umbilical artery S/D ratio had strong statistical correlation with poor perinatal outcome. Elevated RI had 100% sensitivity in predicting APGAR<7 at 5 minutes. Elevated PI values was statistically significant in all parameters (except NICU stay>48hrs) in predicting poor perinatal outcome. PI values had highest sensitivity for predicting low APGAR values and highest specificity for predicting NICU admission. AEDF and REDF also correlated with adverse perinatal outcome. MCA S/D ratio had a high sensitivity (96.8%) in determining NICU stay>48h and specificity (70%) in determining NICU admissions. RI had highest sensitivity (71.8%) for NICU stay >48hrs and highest specificity for predicting NICU admissions (76.5%). MCA PI had a sensitivity of 66.6% in determining APGAR<7 at 5min and a specificity of 78.7% in determining NICU admissions. CPR had the highest sensitivity (100%) among all indices.Conclusions: The study showed an adverse fetal outcome in cases of severe preeclampsia and or IUGR which showed abnormal Doppler results and thereby help to determine the optimal time for delivery.
Prospective study of contraceptive knowledge among the patients seeking medical termination of pregnancy in 1st and 2nd trimester in a tertiary health care
Authors: K. M. Sunanda , G. S. Anitha , M. Chaitra
Published: September 2017

Background: A rapid population growth is a burden on the resources of many developing countries. Unregulated fertility, which contributes to such situations compromise the economic development and political stability.Methods: It was a prospective, observational study over a period of 12 months at Vani Vilas hospital, attached to Bangalore Medical College and Research Institute. All patients seeking medical termination of pregnancy in I and II trimester in tertiary health care were evaluated for contraceptive knowledge.Results: Majority of the patients were from 25 – 30 years, educated, and had married life of 5 years, multipara, with no relationship with religion. The major reason for seeking termination of pregnancy was V i.e. failure of contraception. Intrauterine devices are the most popular method of contraception. There were various sources for knowledge.Conclusions: This study concludes that there is considerable level of knowledge and awareness about contraception in the above studied women but actual practice of those methods is low.
A retrospective study to assess and correlate maternal periodontal status with term of pregnancy and weight of newborn
Authors: Jain Mayuri N. , Suragimath Girish , Varma Siddhartha A. , Zope Sameer Anil , S. R. Ashwini
Published: September 2017

Background: Periodontitis is an inflammatory disease affecting the tooth supporting structures; studies have shown that it also affects the systemic health and conditions like pregnancy. With this background the present retrospective study was conducted to assess and correlate periodontal status of pregnant women with their pregnancy outcome.Methods: A total of 150 pregnant women two days postpartum were examined for periodontal status using following parameters: Oral hygiene index- simplified (OHI-S), modified gingival index (MGI), probing pocket depth (PPD) and clinical attachment loss (CAL). The level of education, body mass index (BMI), gestational age and weight of the baby were recorded and correlated with the periodontal status.Results: Out of 150 women, 83 (55.3%) women suffered from gingivitis and 67 (44.7%) had periodontitis. The incidence of preterm low birth weight babies was seen in 65 (43.33%) women. Body mass index, education level and periodontal disease were significantly associated with preterm low birth weight infants.Conclusions: A significant association was found between periodontitis and preterm low birth infants. The promotion of early detection and treatment of periodontal diseases in women before and during pregnancy will be beneficial. This will minimize the cost of post natal care and morbidity in the new born.
Assessment of knowledge, practice and perception of menstruation among adult women in the reproductive age group, in Mangalore, India
Authors: Kotian Shashidhar M. , Chaudhary Vyom K. , Mutya Venkata S. , Sekhon Anurag S. , Sriraman Sheetal , Prasad Prashasti
Published: September 2017

Background: Women often lack knowledge regarding reproductive health including menstruation which can be due to socio-cultural barriers in which they grow up. The present study is aimed at assessing the level of knowledge regarding menstruation and hygienic practices and perceptions during menstruation.Methods: It was a cross sectional study, conducted among 110 adult women to assess their knowledge regarding menstruation, practices followed during menstruation and their perceptionof menstruation. The collected data was analyzed using SPSS version 17. 0. Chi square test was applied. P<0.05 was considered to be significant.Results: Only 52% of the study population has satisfactory knowledge regarding menstruation. Women between 15 to 20 years of age and those from the middle and higher socio-economic groups seem to possess maximum knowledge regarding menstruation. Women of the higher socio-economic group practice better sanitary measures during menstruation with 100% of them using pads, as compared to women of lower socio economic group who showed a trend of using cloth (87.5%). Women of the upper socio-economic class (42.78%) had better perception towards menstruation (p<0.05).Conclusions: It is very important that lower socio-economic group should be educated about the importance of maintaining hygiene during menstruation by proper health education and equip them with skills regarding safe and hygienic practices to prevent the risk for reproductive tract infections.
Randomised trial of mefenamic acid versus tranexamic acid in management of menorrhagia
Authors: J. Madhu , A. S. Shylaja
Published: September 2017

Background: The objective of the study was to compare the efficacy of mefenamic acid, a non-inflammatory drug with tranexamic acid, an antifibrinolytic drug in management of menorrhaghia.Methods: Randomised trial of women attending outpatient department of St. Philomena’s hospital, Bangalore with complaints of menorrhagia. Fifty four patients with complaints of menorrhagia were randomly assigned to receive either mefenamic acid 500 mg tid (group A- 24 patients) or tranexamic acid 1 gm TID (group B- 26 patients) from day one to day five for three consecutive menstrual cycles.Results: Reduction in menstrual blood loss as assessed by pictoral blood loss assessment chart was more in group B (50%) than in Group A (30%) (ANOVA, covariates with F=59.647, p<0.001). Difference in improvement of dysmenorrhoea was not statistically significant (p=0.640). Side effects were less in group B compared to group A (p=0.271). Post treatment Hb% significantly improved in both groups (p=0.015 in group A, p<0.001 in gr B). Acceptability was statistically similar in both groups (p>0.05).Conclusions: Both mefenamic acid and tranexamic acid were effective in management of menorrhagia. Tranexamic acid was significantly superior to mefenamic acid in terms of reduction in menstrual blood loss.
Psycho sexual profile of perimenopausal and post-menopausal women visiting a tertiary care centre
Authors: Sharma Smita , Mani Poonam , Prateek Shashi , Yadav Lalita , Dhingra Jasneet
Published: September 2017

Background: The objective was to study the psychosexual profile of perimenopausal and postmenopausal females visiting a tertiary care centre.Methods: The present study was carried out in the Obstetrics and Gynecological Department of Subharti Medical College and Hospital from July 2013 to June 2015.A questionnaire was made including the questions regarding the various symptoms and problems encountered by both peri and postmenopausal females. A detailed interaction in the form of history and examination was done on a total of 220 patients which included both type of females. They were then given a questionnaire which they filled it by themselves or with assistance from our side. The females in both the groups were then analysed on the presence or absence of a particular symptom and whether the difference was statistically significant or not and the data was analysed using Chi square test.Results: The study showed varied symptoms in both the type of females be it Perimenopausal or post-menopausal. The vasomotor and the psychological symptoms were more common in the perimenopausal females whereas the physical and sexual symptoms were more common in post-menopausal females. Variations from this pattern were also found. The mean age of menopause was found to be 48.3 years with only 1.81% females above 70 years.Conclusions: The perimenopausal and postmenopausal females do undergo many physiological as well as psychological changes that surely affects their social, personal as well as sexual life. Thus they require a lot of care and support and adequate evaluation so that they can be treated well.
Perinatal outcome in relation to maternal glycaemic control in gestational diabetes mellitus
Authors: K. Kanmani , Subramanian Sudha
Published: September 2017

Background: Early diagnosis and treatment of gestational diabetes with adequate antenatal care are essential to reduce the adverse neonatal outcomes.Methods: All selected women were subjected to a detailed history taking comprising of age, parity, prepregnant body weight, medication history, family history, medical history, detailed obstetric history. Then they were subjected to clinical examination and routine laboratory investigations. Antenatal women were diagnosed with GDM, when 75gm GCT ≥140mg/dl based on DIPSI criteria. Fasting and postprandial blood sugars (2hours) were done and if FBS and PPBS were normal, the patient was labelled as GDM on meal plan. If fasting > 96 mg/dl and 2-hr postprandial blood sugar >121 mg/dl, Inj.insulin was started. Patients were managed according to the FBS and PPBS values throughout antenatal period and the perinatal outcomes were studied.Results: Among 150 patients, multiparous women constitute 65.3% and primi 34.7%. 60% of the patients were in age group of 26 to 30 years.59.3% of patients were in BMI of range 25 to 30.Family history of diabetes was present in 24.7% of the patients. Previous history of GDM was present in 27.3% of cases.98% of GDM were detected in 2nd trimester. The percentage of cases presented with macrosomia was 8.7%, RDS 3.3%, hypoglycaemia 6%, hyperbilirubinemia 3.3%, IUD 0.7%, perinatal injury 1.3%, NICU admission requiring ≥3 days of admission was 12%.Conclusions: There is association of elevated FBS and PPBS values with occurrence of adverse perinatal outcome.
Massive subchorionic haemorrhage: a rare case report associated with secondary PPH due to uterine artery pseudoaneurysm
Authors: Arumaikannu J. , Rani S. Usha , Thasleem T. S. Aarifa
Published: September 2017

Massive subchorionic hemorrhage is a rare but serious condition in pregnancy in which a large amount of blood, mainly maternal collects between the uterine wall and the chorionic membrane and may leak through the cervical canal. Although many associations have been reported, an underlying etiology has not been elucidated. Association of massive subchorionic hemorrhage with thrombophilias have been reported in few articles. We are reporting a case of massive subchorionic hemorrhage presented at 13 weeks of gestation associated with secondary post-partum hemorrhage due to uterine artery pseudoaneurysm.
Propranolol versus topiramate in prophylaxis of migraines among children and adolescents: a randomized, double-blind clinical trial
Authors: Yadav Ramakant , Shukla S. K.
Published: September 2017

Background: Migraine is a common health problem in children and adolescents. This study compares the efficacy and safety of propranolol and topiramate in preventing migraine among children and adolescents.Methods: Seventy-six patients (10-18 years of age) with migraine without auras defined by the 2004 International Headache society criteria were included in a prospective double blind clinical trial were allocated to receive propranolol (0.5-2mg/kg per day) or topiramate (1-2mg/kg per day). The primary outcome measure was reduction in 50 % or more headache days in comparison to baseline headache frequency per month. Secondary outcome measures were headache related disability, migraine intensity and duration. Efficacy measures were recorded at the baseline and at 12 weeks of prophylactic treatment.Results: In this study total of 76 patients with mean age of 12.43 years were evaluated, 40 in the propranolol group and 36 in the topiramate group. At the 12-week, the percentage of patients who had a relative reduction of 50% or more in the number of headache days were 67.5% patients in the propranolol group and 75.0% patients in the topiramate group. The monthly migraine frequency, headache related disability, intensity and duration were significantly decreased in both the propranolol and topiramate groups when compared to the baseline. No significant difference was observed between these two groups in term of reduction of frequency, headache related disability, severity and duration of attack. Fatigue, hypotension and exercise induced asthma were main side effects in propranolol group and weight loss, fatigue and loss of appetite, paresthesias in topiramate group.Conclusions: Propranolol and topiramate were found effective and safe for the prevention of paediatric migraines.
Health care seeking behaviour of women during pregnancy in rural south India: a qualitative study
Authors: Vincent Antony , Keerthana K. , K. Damotharan , Newtonraj Ariarathinam , Bazroy Joy , Manikandan Mani
Published: September 2017

Background: Antenatal care is an important indicator in any health system. Through our study we intended to assess the perception of pregnant women regarding health seeking behaviour and awareness about complications during pregnancy. Methods: A qualitative study was carried out in August 2016, among the 41 pregnant women over 27 weeks of gestation in a rural area of south India. Women were selected randomly from the routine surveillance system maintained by Pondicherry Institute of Medical Sciences – Rural Health Training Centre, Chunampet, Kancheepuram District. Interviews audio recorded. After verbatim, manual coding and analysis was done based on pre decided eight themes. Results: In general all the antenatal women aware of the importance of regular antenatal check up. Knowledge regarding complications and danger sign was not adequate. Most of the women in rural area seek care in government facility due to its availability, accessibility and affordability. Decision making in health care is mostly taken by their husbands. Transportation has been identified as a barrier in seeking health care. Conclusions: Although few of the antenatal mothers in the study population were aware about some complications of pregnancy, but in general knowledge among most of the women was inadequate. There is a need for creating awareness among the antenatal mothers about common complications in pregnancy. On the other hand, the notion of routine care seeking during the antenatal period seems to be well rooted among the study population which is a very good sign. It is a good opportunity and is foundational to all other interventions relating to betterment of antenatal care in the community.
Knowledge, attitude and practices of women towards breast cancer in the field practice area of urban health training centre, Aurangabad, Maharashtra
Authors: Paunikar Apeksha P. , Khadilkar Hrishikesh A. , Doibale Mohan K. , Kuril Bina M.
Published: September 2017

Background: Breast cancer accounts for 19-34% of all cancer cases among women in India. There is a high mortality as patients usually present at an advanced stage because of lack of awareness and nonexistent breast cancer screening programs. So the aim of study is to know knowledge, attitude and practices (KAP) of women towards breast cancer in the field practice area of urban health training centre (UHTC). Methods: A cross sectional study included 140 women of age ≥15 years residing in field practice area from October 2016 to January 2017. From four wards in the field practice area, equal samples were drawn from each ward. Data was collected using questionnaires designed to elicit socio-demographic information and knowledge, attitude and practices of these women towards breast cancer. Data analysis was done by Open Epi. Results: Out of 140 women interviewed, 78.57% mentioned at least one of the symptoms of breast cancer but only 37.86% identified painless lump as a symptom. Only 46.43% mentioned any one of the risk factors. More educated and younger age women were more knowledgeable about risk factors. 44.29% participants were aware of early detection measures but very few were actually practicing SBE, CBE. CBE was most common tool identified for detection. Conclusions: Women do have KAP deficits of breast cancer. So community oriented awareness generation programs to educate women about breast cancer, to promote early detection of breast cancer and to bring about the desirable behavioural change among women is needed.
A study on swine flu (H1N1) awareness among college students of Valsad city
Authors: Baria Hinal Govind , Solanky Priti , Shah Hitesh , Patel Ravikant
Published: September 2017

Background: The aims were to study knowledge, perceptions and beliefs regarding swine flu among college students and to study any difference in knowledge between science and commerce students. Methods: A cross sectional study conducted in Science and Commerce College of Valsad city from June-July 2015. Simple random sampling technique used. Total 400 students were randomly selected from both the colleges. The study was started after obtaining the verbal and informed consent from both the college authorities whereas verbal and informed consent was taken from each student. Data collection done by using predesigned, pretested, bilingual language (English and Gujarati) semi structured questionnaire. Students who were present and had given consent to participate in the study been included and those who are absent and not willing to participate are excluded from study. Data were presented in percentages and p value was calculated by Chi-square test. Results: 63.18% and 53.73% commerce, 86% and 84.5% science knows causative agent and other name of swine flu respectively and difference is statistically highly significant. More than 60% of science and commerce students reported cough/sneezing as modes of transmission. 57% science and 40% commerce correctly answer symptoms of swine flu. Television (>35%) was major source of information in both groups. Conclusions: Although students are aware of swine flu but correct knowledge about swine flu is lacking in both the groups. Knowledge regarding key points such as frequent hand washing, avoiding crowding places, vaccine and treatment availability, which is much important during epidemics and pandemics as precautionary measures, was lacking in both the groups.
Knowledge and practice regarding diabetes and hypertension among elderly patients attending medicine out-patient department at Guru Nanak Dev Hospital, Amritsar
Authors: Kaur Jasleen , Singh Harpreet , Kalra Riya Kaur , Kaur Dania
Published: September 2017

Background: According to the WHO fact sheet 2015, non-communicable diseases kill 38 million people each year globally. This preliminary study was undertaken in order to bring about healthy ageing. Methods: It is an observational study on 100 patients above 60 years of age belonging to the rural/urban community coming to the medicine OPD on a walk-in basis in the Government Medical College, Amritsar. Results: Out of the total 100 patients, 56 were male and 44 were female. Their awareness level was recorded on a self-designed questionnaire. Although 70% of the patients had one or the other disease under study (i.e. diabetes mellitus, hypertension), yet surprisingly their knowledge was limited to the symptoms they suffered from rather than the disease per se. Conclusions: As inferred from this study, the knowledge of the geriatric group about these diseases is limited, so there is an urgent need to create awareness among the patients and their family members as prevention will be far better than the cure in the long run.
Assessment of quality of life and activities of daily living among geriatric population in Bengaluru city
Authors: Ahmed Mohamed Tanveer , Jadhav Jyothi , Sobagaiah Ranganath Timmanahalli , . Vishwanatha
Published: September 2017

Background: Developing countries including India are in epidemiologic health transition resulting in increased life expectancy and increase in geriatric population. Geriatric population is considered the most vulnerable population. Many factors such as age, income, education, environment have a significant impact on quality of life. Hence our study aims at assessing the Quality of life and activities of daily living among geriatric population in Bengaluru city. Methods: A cross sectional study was carried out for a period of 3 months - August to October 2016 among 250 geriatric study participants residing in the slums of Bangalore. Data was collected using WHOQOL-BREF scale and Katz Index of Independence of Activities of Daily Living by interview method. Results: Out of 250 study participants, males were 127 (50.8%) and females were 123 (49.2%). Quality of life was found to be average with a mean score of 50.02 (11.13) and with a least score of 44.55 (12.54) for environmental domain. Conclusions: Significant association was found between quality of life and factors like age, functional capacity, education and environment. Improving access of elderly to health facilities, providing health education, psychological support, and modification of environment helps to improve the quality of life among aged population.
Health seeking behavior of farming community in rural area of Titabor block in Jorhat district
Authors: Rahman Syeda Jesmin , Das Bishnu Ram , Nath Gunjan
Published: September 2017

Background: Numerous factors are associated with the access and utilization of health care services. These factors along with the preferences of the farmers are responsible for the health seeking behavior of farming community. This study aims to understand the health seeking behavior of the farmers and the factors influencing their behaviour in a rural block of Assam. Methods: A community based cross sectional study was done in a rural block of Jorhat district, Assam among a sample of 400 farmers. A pre designed pretested proforma was used to collect the data. Information was obtained on the demographic variables, health seeking behavior and the factors that may affect health seeking behavior. Results were analyzed using percentage and proportions. Results: The study revealed that respiratory tract infection (54.25%) was the most common cause of morbidity among farmers followed by musculoskeletal problems (23.25%) and gastrointestinal tract ailments (11.75%). Majority of the farmers preferred the government health facilities (62%) than the private practitioners (17%) for seeking treatment. Around 64% respondents sought health care only when their health conditions were severely affected. Financial constraints (43.25%) and lack of time (29.25%) was observed to be major impediment in utilization of health care services. Children were given most priority in seeking treatment at the time of illness (68.75%). Conclusions: Government health care facilities were preferred by most respondents due to low cost of services. Behavior seeking healthcare was mostly influenced by financial constraints.
Screening 35 million for hypertension and diabetes mellitus through public system: experiences of Tamil Nadu, India
Authors: Selvavinayagam T. S.
Published: September 2017

Background: Non communicable diseases (NCDs) is one of major public health challenge to be handled across the world particularly in low and middle-income countries. Government of Tamil Nadu in partnership with World Bank attempted to tackle this issue. Our State’s experience in implementing NCD control program from piloting and then expanding it to entire state with learning’s are described in this article.Methods: A comprehensive NCD control program with four major interventions namely clinic, school, community and workplace based interventions covering hypertension and diabetes that was implemented successfully through public health system in Tamil Nadu is elaborated.Results: The program yielded a magnificent performance in screening around 4 crore persons and the challenges in implementing the program covering human resources, drugs and reagents logistics, protocols, awareness creation, data capturing and effective monitoring etc. are highlighted.Conclusions: This knowledge in implementing NCD control program in Tamil Nadu will be useful to other states in India as well as in other low and middle-income countries in planning their NCD programs.
Awareness of use of artificial colourants in sweets preparation and their harmful effects
Authors: Suryanarayana Ravishankar , Chandrappa Muninarayana , R. Santhosh
Published: September 2017

Background: Colour is the first notable feature of a food and often directly influences the choice of food by increasing the taste threshold, appeal and acceptability.There are natural and few traditional colours but many of the shop keepers, restaurant and processed food manufacturers prefer artificial colours. The sweet manufactures do not realize adverse health effects of colourants. The present study was undertaken to assess the awareness of use of colorants in sweets and its harmful effects among consumers and shopkeepers.Methods: A cross sectional study was conducted. A sample of 96 consumers and 20 shopkeepers across the Kolar town were randomly selected and interviewed to collect information on awareness regarding artificial colourants, permissible limits and their harmful effects by using pre-tested semi structured proforma. Data analyzed by using SPSS statistical software version 22.Results: 16.8% of the consumers did not have the knowledge regarding the artificial colorants. 42.6% of the consumers were aware of the toxic metals in colourants and 46.5% knew the harmful effects. Among shopkeepers only 15% and 10% of them had the awareness regarding the toxic metal present and their harmful effects respectively. Majority (75%) of the shopkeepers knew the permissible limits for usage of colourants. Consumers and shop keepers knew that artificial colorants can cause damage to bladder, Kidney, thyroid, brain, immune system, nerve cell development, hyper activity and genotoxicity.Conclusions: The consumers were aware of artificial colorants, various toxic metals present and their harmful effects. There is a need to increase awareness among shopkeepers regarding presence of toxic metals and their harmful effects.
Assessment of bio medical waste management practices of staff nurses according to newer guidelines in a teaching hospital of rural Vadodara, Gujarat
Authors: Bariya Bhavesh R. , Chauhan Grishma D. , Jadeja Aarti , Jain Meet
Published: September 2017

Background: The healthcare services while providing curative, promotive or preventive services inevitably produce waste which may be hazardous to health of patients and hospital staff as well as to the environment. The bio medical waste (management and handling) rules were recently updated by Government of India notification 2016. The present study was carried out to observe and assess the BMW management Practices among staff nurses in a teaching hospital of Vadodara district.Methods: A cross sectional study was carried out to assess BMW management practices in the hospital using BMW Checklist. Observation was the predominant method for data collection.Results: Segregation of BMW at the site of generation was found in 72.73%. Sharp and non-sharp infectious waste was correctly segregated in 72.73% and 100% of areas respectively. Bio medical Waste was found covered in bins, but overfilled in 81.82%. In 6 out of 11, BMW was kept beyond 48 hours. IV set, bottles, syringes, latex gloves, catheters etc. were cut by scissors before disinfection in 45.45%. Staff nurses were using gloves while handling syringe and needles in 10 out of 11 places.Conclusions: Staff nurses were knowledgeable about segregation of BMW, but storage and pretreatment of BMW before its final disposal needs to be improved. An orientation programme about newer guidelines may improve the current practice.
Hypothyroidism in surgically treated T4 hypopharyngeal and laryngeal cancers
Authors: Janardhan Deepak , Varghese Bipin T. , Iype Elizabeth Mathew , Thomas Shaji
Published: September 2017

Background: Total laryngectomy in laryngohypopharyngeal cancers, both in primary setting and salvage scenario, include variable amounts of thyroid resection. Although considerable proportion of these cases undergo total thyroidectomy, with an intention of wider surgical clearance, histopathological examination for thyroid infiltration, very often indicate that such resections are generally out of proportion to the actual oncological requirement.

Methods: Forty three patients undergoing total laryngectomy with no prior thyroid dysfunction, from April 2014 to 2016, at our centre, were prospectively studied for post treatment, thyroid function with tests done at 6th month. Overt and occult hypothyroidism was correlated with extent of thyroid preserved intraoperatively.  

Results: Of 43 patients studied, 82% had extralaryngeal spread, and 16% of them showed thyroid gland infiltration. Only 7% were patholog1ically correlated for gland infiltration. Among those who had hemithyroidectomy, clinical hypothyroidism was seen in 20% primary and 85% salvage cases by 6th month of post treatment period.

Conclusions: In clinicoradiologically favourable scenarios, thyroid preservation attempt helps to augment the neopharynx closure line and to preserve the parathyroids. Anatomical preservation however doesnot guarantee thyroid function, which needs regular follow up to avoid post-operative complications and better QOL.