A community based comparative study on gender perceptions among married (reproductive age) women of rural and urban areas of district Gautam Buddha Nagar

Background: The preference for a son over female offspring continues to be a prevailing norm within the ancient Indian family. Sons are expected to work within the fields, give bigger financial gain and look after parents. Additionally, in Indian patriarchal society, sons are a unit responsible for the preservation of the family name. The preference for a son and female feticide continues to be a prevailing norm in ancient Indian families (urban and rural) leading to declining sex ratio to an alarming level. With this background the following study was conducted in Gautam Buddha Nagar with the objective of finding out gender bias in rural and urban area.Methods: A study was carried out in rural and urban field practice area of the Department of Community Medicine, district Gautam Buddha Nagar of Uttar Pradesh. The study was conducted among 270 married women of reproductive age group. The women were interviewed using a semi structure questionnaire.Results: More than half of the respondents in the rural areas (57.7%) preferred son while in the urban areas, 43% of women preferred a son. The most important reason for preferring a son in the rural area was a support to the parents. While in urban area son was preferred because of the continuation of a family line.Conclusions: Preference for son was found to be high. Further amendments in the existing laws and quality education may help in breaking gender stereotypes and minimizing gender bias.

Hepatitis B Awareness Among Medical Students And Their Vaccination Status In A Medical College In Western Up.

Background:India is in the intermediate hepatitis B virus endemicity zone with hepatitis B surface antigen prevalence among the general population ranging from 2% to 8%.Health care professionals are at a high risk of getting .Hep B infection which can be prevented by strategies like vaccination, increasing awareness and following universal precautions. The present study was conducted on medical students (3rd Semester) to evaluate their knowledge regarding HBVand to know their vaccination status. Also along with data collection, students were educated about hepatitis B vaccine and about universal precautions before they start with their clinical postings.Methods:Cross sectional study was carried out on 3rd semester MBBS students (batch 2012-2013). All the students present on the day of data collection were included in the study and interviewed using pretested questionnaire. Data was analyzed using percentages. Results: Most of the students had good knowledge about disease and modes of transmission & prevention. Surprisingly only 56.6 percent were aware of high risk of transmission to health professional and doctors. Main source of information was media (85.4percent).Nearly 82% of the students were immunized and main reason among those unimmunized was unawareness about vaccine availability.Conclusions:It is recommended that Hepatitis B vaccination should be made available for all unimmunized students who enter medical profession. The orientation and sensitization programm should be held to create awareness regarding HBVinfection preferably at the time of admission into medical college ,else no later than start of their clinical posting.

Anesthetic challenges in minimally invasive cardiac surgery: Are we moving in a right direction.

Continuously growing patient’s demand, technological innovation, and surgical expertise have led to the widespread popularity of minimally invasive cardiac surgery (MICS). Patient’s demand is being driven by less surgical trauma, reduced scarring, lesser pain, substantially lesser duration of hospital stay, and early return to normal activity. In addition, MICS decreases the incidence of postoperative respiratory dysfunction, chronic pain, chest instability, deep sternal wound infection, bleeding, and atrial fibrillation. Widespread media coverage, competition among surgeons and hospitals, and their associated brand values have further contributed in raising awareness among patients. In this process, surgeons and anesthesiologist have moved from the comfort of traditional wide incision surgeries to more challenging and intensively skilled MICS. A wide variety of cardiac lesions, techniques, and approaches coupled with a significant learning curve have made the anesthesiologist’s job a challenging one. Anesthesiologists facilitate in providing optimal surgical settings beginning with lung isolation, confirmation of diagnosis, cannula placement, and cardioplegia delivery. However, the concern remains and it mainly relates to patient safety, prolonged intraoperative duration, and reduced surgical exposure leading to suboptimal treatment. The risk of neurological complications, aortic injury, phrenic nerve palsy, and peripheral vascular thromboembolism can be reduced by proper preoperative evaluation and patient selection. Nevertheless, advancement in surgical instruments, perfusion practices, increasing use of transesophageal echocardiography, and accumulating experience of surgeons and anesthesiologist have somewhat helped in amelioration of these valid concerns. A patient‑centric approach and clear communication between the surgeon, anesthesiologist, and perfusionist are vital for the success of MICS.

Minimally invasive cardiac surgery and transesophageal echocardiography.

Improved cosmetic appearance, reduced pain and duration of post‑operative stay have intensified the popularity of minimally invasive cardiac surgery (MICS); however, the increased risk of stroke remains a concern. In conventional cardiac surgery, surgeons can visualize and feel the cardiac structures directly, which is not possible with MICS. Transesophageal echocardiography (TEE) is essential during MICS in detecting problems that require immediate correction. Comprehensive evaluation of the cardiac structures and function helps in the confirmation of not only the definitive diagnosis, but also the success of surgical treatment. Venous and aortic cannulations are not under the direct vision of the surgeon and appropriate positioning of the cannulae is not possible during MICS without the aid of TEE. Intra‑operative TEE helps in the navigation of the guide wire and correct placement of the cannulae and allows real‑time assessment of valvular pathologies, ventricular filling, ventricular function, intracardiac air, weaning from cardiopulmonary bypass and adequacy of the surgical procedure. Early detection of perioperative complications by TEE potentially enhances the post‑operative outcome of patients managed with MICS.

Idiopathic left ventricular outflow tract pseudoaneurysm.

Left ventricular outflow tract (LVOT) pseudoaneurysm is a rare occurrence and may produce clinically unpredictable symptoms. A very few cases of LVOT pseudoaneurysm are reported and there has always been a predisposing factor in these reported cases such as history of infective endocarditis, myocardial infarction, prosthetic aortic valve replacement or chest trauma. Our patient did not have the above predisposing conditions. Intra operative transesophageal echocardiography helped patient management and guided the surgical team in securing and isolation of the aneurysmal sac from the LVOT.