A psycho-social study on genito-urinary fistula.

This study was done on a series of 132 vesico-vaginal fistula (V.V.F.) cases to assess the social factors that are related to this morbidity and its psycho-social effects on them. About 54% of the respondents developed VVF as an outcome of their first pregnancy and none of them had a living child. Of this 39% were in the age group of 15-20 years. About 68% were illiterate and 22% had received formal education for up to 5 years. Fifty two per cent of the subjects had a family income of up to Tk. 1,000 only per month. Almost all were Muslims (94.7%). Of the respondents 64.6% had home delivery by TBA and 72% had history of prolonged labour. Fifty six per cent of the subjects did not like to avail the health facilities of the nearby clinic/hospital. Lack of privacy, objection from husband/family and conduction of delivery by male doctor were mentioned as causes for not availing the facilities by this large group. Indifferent attitude of husband and in-laws, expressed willingness of husband for taking another wife, disturbed socio-psycho-sexual life and deterioration of general health were the after effects of the morbidity at individual, conjugal and community level of the respondents.

Psychosomatic effects of permanent sterilization.

A follow-up study of 300 tubectomy and 300 vasectomy cases was conducted in the urban, semiurban and rural areas of Mymensingh district. Psychosomatic effects of these individuals were recorded through interviews using a pretested questionnaire. Results indicated that illiterate, economically insolvent and persons having children up to 2 to 3 years of age were the clients. Growing size of the family was the main concern for adopting sterilization. Professional motivators were found more effective in motivating vasectomy cases. In both groups there was no significant change in libido. In case of vasectomy 99% were found sexually active by the 30th post-operative day while 52% of the tubectomy cases were sexually active by the six weeks of post-operative days. From this study it appears that further in-depth study might be necessary in probing more insight of the psychosocial basis of sterilization and effects thereof.

Iron-deficiency anaemia in pregnancy: (biochemical investigations of iron-deficiency and nutritional status).

Biochemical investigations on iron deficiency and nutritional status were carried out in a group of 130 women in the second or third trimesters of pregnancy and in 42 control non-pregnant women. The important findings were: 1. Anaemia was present in 46.1% of pregnant women in comparison with 19% in non-pregnant women. It was found to be more prevalent in the third trimester of pregnancy. 2. Iron deficiency with and without anaemia, as judged from serum transferrin saturation (%) was evident in 59.2% of pregnant women with an incidence of 70.3% in the third trimester of pregnancy. 3. Serum albumin, gamma globulin and A/G ratio were found to be decreased in pregnancy whereas serum levels of alpha-2 and beta globulins were elevated. The results have been discussed.