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Objective@#Congenital Mullerian duct malformations are a challenging group of conditions for surgeons and need surgical experience and skill. Accordingly, the aim of this study is to present the diagnosis, surgical management, and clinical implications of congenital uterovaginal abnormalities. @*Methods@#Between 1980 and 2015, 8 patients with congenital uterovaginal abnormalities were diagnosed. In one patient a unique case of an unusual horseshoe shaped double uterus communicating via a transverse canal along with agenesis of the cervix and vagina was noted, and utero-vaginal agenesis was diagnosed in 6 patients. Complete androgen insensitivity syndrome with its female phenotype associated with bilateral testicular tissue in the inguinal canal with an accompanying absence of the ovaries, uterus, uterine tubes, vagina, and an imperforate hymen, was diagnosed in one patient. Clinical examination of all the patients revealed well-developed secondary sexual characteristics. A modified McIndoe vaginoplasty procedure was the surgical treatment common to all patients to treat vaginal agenesis. The surgery was performed by a consultant (Dr. K.G. Paul) using the standardized surgical technique. @*Results@#An unusual Mullerian duct anomaly, uterus bicornisacollis, was successfully corrected by uteroplasty and a new cervix was constructed. Complete vaginal agenesis was corrected by a modified McIndoe vaginoplasty technique. None of the patients had any significant post-operative complications. @*Conclusion@#Knowledge of congenital uterovaginal abnormalities diagnosed in this study is essential for surgeons, clinical anatomists, radiologists, and morphologists who may increase the success of their diagnostic evaluations and surgical approaches to the region.
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Objective@#Congenital Mullerian duct malformations are a challenging group of conditions for surgeons and need surgical experience and skill. Accordingly, the aim of this study is to present the diagnosis, surgical management, and clinical implications of congenital uterovaginal abnormalities. @*Methods@#Between 1980 and 2015, 8 patients with congenital uterovaginal abnormalities were diagnosed. In one patient a unique case of an unusual horseshoe shaped double uterus communicating via a transverse canal along with agenesis of the cervix and vagina was noted, and utero-vaginal agenesis was diagnosed in 6 patients. Complete androgen insensitivity syndrome with its female phenotype associated with bilateral testicular tissue in the inguinal canal with an accompanying absence of the ovaries, uterus, uterine tubes, vagina, and an imperforate hymen, was diagnosed in one patient. Clinical examination of all the patients revealed well-developed secondary sexual characteristics. A modified McIndoe vaginoplasty procedure was the surgical treatment common to all patients to treat vaginal agenesis. The surgery was performed by a consultant (Dr. K.G. Paul) using the standardized surgical technique. @*Results@#An unusual Mullerian duct anomaly, uterus bicornisacollis, was successfully corrected by uteroplasty and a new cervix was constructed. Complete vaginal agenesis was corrected by a modified McIndoe vaginoplasty technique. None of the patients had any significant post-operative complications. @*Conclusion@#Knowledge of congenital uterovaginal abnormalities diagnosed in this study is essential for surgeons, clinical anatomists, radiologists, and morphologists who may increase the success of their diagnostic evaluations and surgical approaches to the region.
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Context: The incisive papilla as a guide for complete dentures. Aims: To evaluate incisive papilla as a guide to maxillary anterior teeth position for complete dentures. Settings and Design: To measure the linear distances from the incisive papilla to the maxillary central incisors in Odia population and compare it to other ethnic groups. Subjects and Methods: The subjects were selected following inclusion & exclusion criteria. The impressions of maxillary & mandibular arches were taken and poured with die stone to produce the cast. The incisive papilla & incisors were marked on casts with a pencil. The photographs of casts were traced on an acetate tracing paper. The anterior-most points of maxillary incisors, anterior, middle & posterior-most points of incisive papillae were marked on the tracing as A, I1,M, I2 respectively. The A to M and A to I2 distances were measured, analysed and compared with Caucasians, Southern Chinese, and Dravidians. Statistical Analysis: Independent sample “t” test and Analysis of Variance followed by the post-hoc Bonferroni test were used. Results: A sample of 100 subjects in the age group of 20 to 40 years with was selected. The A to M measurements of Odia population differed significantly from Caucasians but were similar to Southern Chinese population. The A to I2 measurements of Odia population differed significantly from Caucasians & Dravidians but were similar to Southern Chinese. Conclusion: The linear measurements from incisive papilla to maxillary incisors of the Odia population are similar to that of Southern Chinese but differ significantly from Caucasians and Dravidians.
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Abstract@#Introduction: Work-related road traffic crashes (RTC) are a significant global public health challenge due to the seriousness of its consequences. Injured workers who have survived work-related RTC are advised to go for rehabilitation after they have been treated physically by healthcare providers. Reintegrate as soon as possible into the working community able avoid long periods of sick leave. Return to work (RTW) rate have been used extensively in many previous studies as an indicator of rehabilitation outcomes on the working capacity of injured workers. The objective of this study was to compare RTW rate after rehabilitation for injured workers who received physical rehabilitation only (control group) and physical rehabilitation plus outcome-focused intervention (intervention group). Methods: Eligible 200 workers who were involved in work-related RTC and agreed to participate in SOCSO RTW Program were identified and invited to be part of this study. Sociodemographic, employment and injury-related questions were distributed. Results: This study finding showed majority (79.5%) of the respondents were aged 25 years old or older, male (86.0%), married or divorced (63.5%), and attained secondary and below education level at secondary or below (66.0%). More than half of injured workers consisted of blue-collar workers (69%), had fracture injury (93.0%), and had injury to their lower limbs (48.5%). RTW rate was higher in the intervention group (received physical rehabilitation and outcome-focused intervention) compared to the control group (received physical rehabilitation only). Conclusion: RTW rate for work-related RTC was higher with outcome-focused intervention, in addition to physical rehabilitation.
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Pisces are commonly used to study the effects of metals, including copper on the environment. However, until now only scant information is available about the responses induced by waterborne copper during early life stages and housekeeping gene expression in fishes. In the present study, we evaluated acute toxicity of copper sulphate on larvae of Catla catla and also the stability of expression of three housekeeping genes, beta-actin (β-actin), glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and elongation factor 1 alpha (EF1α). The results have shown increased mortality of Catla catla larvae with the increased concentration of copper sulphate. The median lethal concentration (LC50) of copper sulphate at the end of 96 h exposure was 1.032 ppm. During the challenge test of copper sulphate, the minimal coefficient of variation (CV) and stability index were observed for GAPDH and maximum for β-actin indicating minimum variation of GAPDH and maximum variation of β-actin. With the results, it can be concluded that GAPDH is most stable during copper sulphate challenge test on Catla catla larvae, followed by EF1α and β-actin.
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Background: The Perceived Stress Scale-10 (PSS-10) is widely used to assess stress perception. The aim of this study was to translate the original PSS-10 into Malay and assess the reliability and validity of the Malay version among nurses. Methods: The Malay version of the PSS-10 was distributed among 229 nurses from four government hospitals in Selangor State. Test-retest reliability and concurrent validity was conducted with 25 nurses with the Malay version of the Depression Anxiety Stress Scales (DASS) 21. Cronbach’s alpha, confirmatory factor analysis (CFA), intraclass correlation coefficient and Pearson’s r correlation coefficient were used to determine the psychometric properties of the Malay PSS-10. Results: Two factor components were yielded through exploratory factor analysis with eigenvalues of 3.37 and 2.10, respectively. Both of the factors accounted for 54.6% of the variance. CFA yielded a two-factor structure with satisfactory goodness-of-fit indices [x2/df = 2.43; comparative fit index (CFI) = 0.92, goodness-of-fit Index (GFI) = 0.94; standardised root mean square residual (SRMR) = 0.07 and root mean square error of approximation (RMSEA) = 0.08 (90% CI = 0.07–0.09)]. The Cronbach’s alpha coefficient for the total items was 0.63 (0.82 for factor 1 and 0.72 for factor 2). The intraclass correlation coefficient (ICC) was 0.81 (95% CI: 0.62–0.91) for test-retest reliability testing after seven days. The total score and the negative component of the PSS-10 correlated significantly with the stress component of the DASS-21: (r = 0.61, P < 0.001) and (r = 0.56, P < 0.004), respectively. Conclusion: The Malay version of the PSS-10 demonstrated a satisfactory level of validity and reliability to assess stress perception. Therefore, this questionnaire is valid in assessing stress perception among nurses in Malaysia.
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Physical activity reduces risk of non-communicable diseases. Physical activity prevalence is low due to barriers to physical activity. This study was conducted to translate the Barrier to Physical Activity (BPA) questionnaire into Malay and assess the reliability and validity of the translated version among nurses. The Malay version of BPA was developed after translating the English version of BPA through back to back translation process. The Malay BPA was distributed among 306 volunteered nurses from 5 government hospitals in Selangor state. Factor analysis, Cronbach’s alpha test and test – retest reliability was conducted to determine psychometric properties of BPA. Chronbach’s alpha coefficient was 0.79 for perceived benefits items and 0.51 for perceived barrier items (overall was 0.73). The ICC was 0.88 (95% CI: 0.78-0.93) for test-retest testing after 7 days. Two factors components were yielded through exploratory factor analysis with eigenvalues of 3.9 and 2.0 respectively. Both the factors accounts for 31.4 % of the variance. Factor 1 included 14 items and explained 19.9% of the variance. Factor 2 consisted of 5 items and explained 11.5% of variance. CFA yielded two factor structures with acceptable goodness of fit indices [x2/df = 23.99; GFI = 0.82, SRMR = 0.09; PNFI = 0.49 and RMSEA = 0.10 (90%CI = 0.09-0.11)]. The Malay version of BPA had demonstrated satisfactory level of validity and reliability to assess barriers to physical activity. Therefore, this questionnaire is valid in assessing barriers to physical activity among working population.
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Background: In Bihar State, proportion of fully immunized children was only 19% in Coverage Evaluation Survey of 2005. In October 2007, a special campaign called Muskaan Ek Abhiyan (The Smile Campaign) was launched under National Rural Health Mission to give a fillip to the immunization program. Objectives: To evaluate improvement in the performance and coverage of the Routine Immunization Program consequent to the launch of Muskaan Ek Abhiyan Intervention: The main strategies of the Muskaan campaign were reviewing and strengthening immunization micro-plans, enhanced inter-sectoral coordination between the Departments of Health, and Women and Child Development, increased involvement of women groups in awareness generation, enhanced political commitment and budgetary support, strengthening of monitoring and supervision mechanisms, and provision of performance based incentive to service providers. Methods: Immunization Coverage Evaluation Surveys conducted in various states of India during 2005 and 2009 were used for evaluation of the effect of Muskaan campaign by measuring the increase in immunization coverage in Bihar in comparison to other Empowered Action Group (EAG) states using the difference-indifference method. Interviews of the key stakeholders were also done to substantiate the findings. Results: The proportion of fully immunized 12-23 month old children in Bihar has increased significantly from 19% in 2005 to 49% in 2009. The coverage of BCG also increased significantly from 52.8% to 82.3%, DPT-3 from 36.5 to 59.3%, OPV-3 from 27.1% to 61.6% and measles from 28.4 to 58.2%. In comparison to other states, the coverage of fully immunized children increased significantly from 16 to 26% in Bihar. Conclusions: There was a marked improvement in immunization coverage after the launch of the Campaign in Bihar. Therefore, best practices of the Campaign may be replicated in other areas where full immunization coverage is low.
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Background: The Perceived Stress Scale 10 (PSS-10) is a validated and reliable instrument to measure global levels of perceived stress. This study aims to assess the internal consistency, reliability, and factor structure of the Malay version of the PSS-10 for use among medical students. Methods: The original English version of the PSS-10 was translated and back-translated into Malay language. The Malay version was distributed to 242 Bachelor of Medical Science students in a private university in Malaysia. Test–retest reliability was assessed in 70 students. An exploratory principal component factor analysis with varimax rotation was performed. Reliability was tested using the intraclass correlation coefficient (ICC). Results: All 242 students participated in the initial questionnaire study (validity and factor structure), and 70 students participated in the test–retest reliability of the study. Exploratory factor analysis yielded 2 factors that accounted for 57.8% of the variance. Cronbach’s alpha coefficients for the 2 factors were 0.85 and 0.70, respectively. The reliability test showed an ICC of 0.82 (95% CI: 0.70, 0.89). Conclusion: The Malay version of the PSS-10 showed adequate psychometric properties. It is a useful instrument for measuring stress among medical students in Malaysia.
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Background: Stress may affect students’ health and their academic performance. Coping strategies are specific efforts that individuals employ to manage stress. This study aimed to assess the perception of stress among medical students and their coping strategies. Methods: A cross-sectional study was conducted among 376 medical and medical sciences undergraduates in Management and Science University in Malaysia. Stress was assessed by a global rating of stress. Sources of stress were assessed using a 17-item questionnaire. The validated Brief COPE inventory was used to assess coping strategies. Results: The majority of respondents were females (64.4%), aged 21 years or older (63.0%), and were Malays (68.9%). Forty-six percent felt stress. The most common stressor was worries of the future (71.0%), followed by financial difficulties (68.6%). Significant predictors of stress were smoking (OR = 2.9 , 95% CI 1.3–6.8, P = 0.009), worries of the future (OR = 2.1 , 95% CI 1.3–3.4, P = 0.005), self-blame (OR = 1.3, 95% CI 1.1–1.5, P = 0.001), lack of emotional support (OR = 0.8, 95% CI 0.7–0.9, P = 0.017), and lack of acceptance (OR = 0.8, 95% CI 0.6–0.9, P = 0.010). Students used active coping, religious coping reframing, planning, and acceptance to cope with stress. Conclusion: Stressors reported by the students were mainly financial and academic issues. Students adopted active coping strategies rather than avoidance. Students should receive consultation on how to manage and cope with stress.
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The Kosi floods of Bihar in 2008 led to initial rapid displacement followed by rehabilitation of the affected population. Strategically planned phase-wise activity of supplementary as well as primary measles vaccination combined with a variety of other interventions proved to be successful in preventing outbreaks and deaths due to measles. While 70% supplementary measles vaccination coverage was achieved in relief camps, the coverage of primary measles doses in the latter phases was dependant on accessibility of villages and previous vaccination status of eligible beneficiaries. The integrated diseases surveillance system, which became operational during the floods, also complemented the vaccination efforts by providing daily figures of cases with fever and rash. The overall response was not only successful in terms of preventing measles mortality, but also provided vital lessons that may be useful for planning future vaccination responses in emergency settings.