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Background: Domestic violence against women has serious health consequences for women. Prior research indicates its pervasive nature, albeit with wide variations in its prevalence across different settings. We examined the prevalence, pattern and predictors of domestic violence against women. Methods: Our community based, cross sectional, mixed methods study included 827 ever married women aged up to 60 years, from Delhi (India), selected through cluster sampling followed by systematic random sampling. Data were collected during 2010 to 2011 using structured questionnaires and in-depth interview guide. Statistical analysis was carried out using Stata 11.0 (College Station, Texas, USA) and thematic analysis for qualitative data obtained on in-depth interviews.Results: The life time prevalence of psychological, physical and sexual violence was 43.4%, 27.2 % and 26.4 % respectively; and when measured over past 12 months it was 37.6%, 19.3% and 20.3% respectively. ‘Any form of violence’ emerged as a sizeable category with a lifetime prevalence of 43.4%, and 37.8% in past one year. In most instances, the acts of violence were continuing and were perpetrated by husband. Violence was significantly higher among women having low neighborhood support (OR: 2.71, 95% CI: (1.39, 5.27), negative dowry effect (OR: 19.93, 95% CI: (10.36, 38.35) and alcoholic husband (OR: 2.12, 95% CI: (1.46, 3.09), whereas family support was protective against violence (OR: 0.31, 95% CI: (0.20, 0.49).Conclusions: The prevalence of domestic violence in Delhi is considerably high. There is need to use multipronged approach including effective and sustainable public health interventions to address the violence.
ABSTRACT
BACKGROUND: The transversus abdominis plane (TAP) block is an effective technique to block the thoracolumbar nerves innervating the anterolateral abdominal wall. This study was conducted to evaluate the analgesic efficacy and opioid consumption with the use of perineural buprenorphine or dexamethasone in TAP blocks after unilateral inguinal hernioplasties. METHODS: This prospective, randomized, double-blinded, placebo-controlled study enrolled 93 patients scheduled for unilateral inguinal hernioplasty, followed by an ultrasound-guided TAP block. The participants were randomized into 3 groups (31 patients each). Group L received 20 ml 0.25% levobupivacaine + 1 ml normal saline (NS); group LB, 20 ml 0.25% levobupivacaine + 0.3 mg (1 ml) buprenorphine; and group LD, 20 ml 0.25% levobupivacaine + 4 mg (1 ml) dexamethasone. The patients were observed postoperatively for 24 h for first rescue analgesic requirement, total rescue analgesic consumption, and pain scores on the numeric rating scale (NRS). RESULTS: The time to first rescue analgesic requirement was significantly longer in Group LB than in groups LD and L (688.87 ± 36.11 min, 601.45 ± 39.85 min, and 383.06 ± 36.21 min, respectively; P < 0.001). The mean total tramadol consumption in the first 24 h was the lowest in group LB (P < 0.001, L vs. LB / LD). Groups LB and LD displayed significantly lower NRS scores than group L (P < 0.001 both). CONCLUSIONS: Levobupivacaine with perineural buprenorphine in a TAP block after unilateral open inguinal hernioplasty facilitates prolonged analgesia and reduced requirement for rescue analgesics compared to perineural dexamethasone, without significant side effects.
Subject(s)
Humans , Abdominal Wall , Analgesia , Analgesics , Buprenorphine , Dexamethasone , Hernia, Inguinal , Herniorrhaphy , Prospective Studies , Tramadol , UltrasonographyABSTRACT
BACKGROUND@#The transversus abdominis plane (TAP) block is an effective technique to block the thoracolumbar nerves innervating the anterolateral abdominal wall. This study was conducted to evaluate the analgesic efficacy and opioid consumption with the use of perineural buprenorphine or dexamethasone in TAP blocks after unilateral inguinal hernioplasties.@*METHODS@#This prospective, randomized, double-blinded, placebo-controlled study enrolled 93 patients scheduled for unilateral inguinal hernioplasty, followed by an ultrasound-guided TAP block. The participants were randomized into 3 groups (31 patients each). Group L received 20 ml 0.25% levobupivacaine + 1 ml normal saline (NS); group LB, 20 ml 0.25% levobupivacaine + 0.3 mg (1 ml) buprenorphine; and group LD, 20 ml 0.25% levobupivacaine + 4 mg (1 ml) dexamethasone. The patients were observed postoperatively for 24 h for first rescue analgesic requirement, total rescue analgesic consumption, and pain scores on the numeric rating scale (NRS).@*RESULTS@#The time to first rescue analgesic requirement was significantly longer in Group LB than in groups LD and L (688.87 ± 36.11 min, 601.45 ± 39.85 min, and 383.06 ± 36.21 min, respectively; P < 0.001). The mean total tramadol consumption in the first 24 h was the lowest in group LB (P < 0.001, L vs. LB / LD). Groups LB and LD displayed significantly lower NRS scores than group L (P < 0.001 both).@*CONCLUSIONS@#Levobupivacaine with perineural buprenorphine in a TAP block after unilateral open inguinal hernioplasty facilitates prolonged analgesia and reduced requirement for rescue analgesics compared to perineural dexamethasone, without significant side effects.
ABSTRACT
Pneumatoceles have been described as a complication of staphylococcal pneumonia in children. But the management of large [>1 cm] bilateral bronchopleural fistula [BPF] in a child on positive pressure ventilation is a challenge for the intensivist. Bronchoscopy is an efficient method to close small BPFs [1-3 mm]; independent lung ventilation cannot be used in patients with bilateral lung involvements; high frequency ventilation is of limited value in patients with distal and parenchymal disease; surgical management is deferred in patients with severe hypoxia and active chest infection. Extracorporeal membrane oxygenation is the only treatment modality left but its availability is limited to a few centers only