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Breastfeeding is a traditional practice that comes ' naturally' to Indian mothers. This study sought to assess the prevalence of lactation insuffi ciency and to fi nd out the association between prevalence of lactation insuffi ciency among primipara mothers with selected background variables. This descriptive cross-sectional study was conducted in a selected maternity hospital of South India between May'ndash;July 2020. A total of 103 moth0ers in the post-natal wards were selected. Lactation insuffi ciency was assessed using LATCH scoring system. Data were analysed using descriptive and inferential statistics. Majority of the mothers (53, 52.48%) were in the age group 26-30 years; 56 (54.37%) studied higher secondary; 93 (90.29 %) received information on breastfeeding; 61 (59.23%) had least favourable and 42 (40.77%) had favourable LATCH scores. Chi square revealed no signifi cant association between lactation insuffi ciency and selected background variables among mothers. To conclude, there is a need to strengthen nurse-led lactation support to achieve successful breastfeeding practices.
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Background: Effective implementation of the near-miss concept will help analyze the high-risk group and strengthen the entire healthcare setup for enabling favorable outcome.The present study aims to assess the features of near-miss obstetric cases reporting to government tertiary hospital in order to propose significant interventions to save the high risk group of patients. Methods: The present study was conducted among patients admitted in labour room including referred, emergency and booked admissions. Women with severe complications of pregnancy / labour/ puerperium irrespective of gestational age as per the WHO near miss criteria were identified and studied. The first step in implementing the near-miss approach was to systematically identify women with severe complications of pregnancy. Results: Most common direct complicating factor being hemorrhage 26%, eclampsia 18.7%, sepsis 9.8%, rupture uterus 4% (rupture uterus was present in 2 cases of grandmultipara and 3 cases had more than 2 previous LSCS) and obstructed labour 3.2%. Among the indirect causes anaemia 34.1% was leading cause. Out of this iron deficiency anaemia was seen in 88% cases and 12% cases had other types of anaemia like megaloblastic and thalassemia minor. Respiratory disease 4%, liver disease 5.7% (mainly hepatic encephalopathy) and heart disease 1.6% (1 patient had dilated peripartum cardiomyopathy and 1 patient was revived from sudden cardiac arrest). Conclusion: The most common direct cause for maternal near miss is hemorrhage. Although hemorrhage is the leading cause of maternal death worldwide but postpartum hemorrhage is highly unpredictable and poses a major challenge to obstetricians. Eclampsia and severe preeclampsia are one of the easiest identifiable and avoidable factors for preventing maternal death. Health care providers like ASHA workers and ANMs who have first contact with the antenatal women should be trained to tally and read the dipstick test results and inform the doctor accordingly.
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Introduction: WHO maternal near miss approach is astandardized method which is implemented in 3 steps i.e.baseline assessment,situation analysis and interventions forimproving health care. Hence, present study was undertakento identify and evaluate the occurrence and causes of severematernal morbidity i.e. near miss cases.Material and Methods: The present study was conductedin the department of Obstetrics and Gynaecology, RajindraHospital, Patiala over a period of one and a half year. Thestudy was conducted on the patients admitted in labourroom including referred, emergency and booked admissions.Women with severe complications of pregnancy / labour/puerperium irrespective of gestational age as per the WHOnear miss criteria were identified and studied.Results: Distribution of cases according to clinical criteriainclude maximum cases of loss of unconsciousness formore than 12 hours i.e. 18.7%, shock 13.8%, clotting failure13%, respiratory rate <6/min or >40/min in 8.1%, oliguria in7.3% and jaundice with severe preeclampsia in 5.7% cases.Distribution of near miss cases according to laboratorycriteria, and oxygen saturation<90% for >60 min in 14.6%cases. 5.6% cases with acute thrombocytopenia and serumbilirubin >6 mg/dl and serum creatinine >3.5% in 0.8% cases.Conclusion: The need for identifying the patient’s conditionand deciding for the referral on time and to the right centre isa critical step towards saving a maternal death. The core ofthe health system should emphasize on ‘when to refer’ and‘where to refer’ policy. Referral should be on time so that anyuntoward incident can be averted and referring a patient to atertiary care centre where all the emergency back up facilitiesare available like ICU, 24 hour Blood bank services, apexobstetrical intervention and inter departmental expertise andcare. The problem of initial assessment, problem identification,management plan and follow-up of cases depends on a verycrucial task of history taking.
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Dermoid cyst (cystic teratoma) showing well differentiated derivatives of all three germs cell layers, is a benign germ cell tumour. Ovaries remain the commonest site. Paravaginal dermoid cyst is a rare occurrence. Pre-operative diagnosis is usually difficult in majority of cases. They constitute less than 4% of all extragonadal teratomas. A 28-year old, P2L2 female presented with paravaginal cyst, 10×10cms, non-tender, soft swelling, cystic in consistency occupying posterior and left part of rectovaginal septum. Trans vaginal excision of cyst under regional anaesthesia done. Cyst was ruptured while excision showing putty material with tuft of hairs. A retrospective diagnosis of mature teratoma/paravaginal dermoid cyst was made on histopathological examination. Paravaginal dermoid cyst, a benign cystic teratoma is a very rare occurrence. Transvaginal excision of dermoid cyst under anaesthesia remains treatment of choice. Retrospective diagnosis on histopathological examination remains confirmatory as it may be missed on sonography if teeth are not present in dermoid cyst.
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Given background sparsity of country-specific literature evidence, and the pervasive unhealthy lifestyle habits such as tobacco, alcohol use, and high sugar consumption among fishermen, the aim of this study was to assess the oral health status and associated lifestyle factors among Malaysian fishermen in Teluk Bahang, Penang. Subjects and Methods: In an analytical cross-sectional design, we used simple random sampling technique to select 242 multiracial Malaysian male fishermen aged between 18 and 75 years from five fishing villages located at Gurney Drive, Tanjong Tokong, Tanjong Bungah, Batu Ferringhi, and Teluk Bahang to participate in this study. During four consecutive weekends in January 2017, we conducted face-to-face interviews with participants using a pre-validated, interviewer-administered WHO oral health questionnaire. We categorized participants as having “good” or “poor” oral health based on a mean cutoff score of 14. Multivariate regression models were fitted to assess the oral health status and associated lifestyle factors among the study population, using SPSS version 22. Results: We achieved a response rate of 97.6%. Overall, the prevalence of poor oral health in this study was 47.5%. “Income” (RM/month), “type of fishing,” “additional occupation,” “age” (years), “frequency of pies, buns consumed,” and “frequency of sweets, soft drinks consumed” were significant predictors of oral health status among the fishermen. Conclusion: Poor oral health is relatively highly prevalent among the fishermen in our study. The oral health status of fishermen in Teluk Bahang was consistent with the national average and significantly associated with their sociodemographic and lifestyle factors. Targeted interventions are required to arrest and reverse this trend.
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Background:Maternal mortality is an important indicator of a woman’s health. Even though MMR has reduced dramatically death from hemorrhage remains prominent even in developed countries. Abruptio placentae is an acute obstetrical emergency. Methods: This study was done in the Department of Obstetrics and Gynecology Government Medical College and Rajindra Hospital Patiala to assess clinical and coagulation profile of patients presenting with abruptio placentae and analyze maternal and fetal outcome. Result: A total of 73 patients with abruptio placentae were studied, giving an incidence of 3.09%.Of these 76.7% patients were in the age group of 21-30 years. (60%) were either nulliparous or primiparous. (65.75%) patients belonged to rural area with no regular antenatal checkup. The 90.41% patients belong to lower socio- economic status and 56% were iIIiterate. The mean gestational age in our study was 34.5 weeks and classical presentation of bleeding per vaginum associated with pain was seen in 54.7%. Most common associated risk factor found to be hypertension (58.9%), followed by PROM (13.7%) and trauma (2.74%). Conclusion: The main complications observed were shock, DIC and PPH. There was only one maternal death in our series; Mode of delivery was Vaginal in 53 Cases (72.60%) and LSCS in 20 (27.40%) Perinatal mortality was observed in 40 patients (54.79%).
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Objective: To compare the effect of sublingual versus vaginal misoprostol on preoperative cervical priming in first trimester abortion. Material and methods: One hundred women seeking first trimester abortion were randomized into either sublingual or vaginal groups of 50 each. They were given 400 μg misoprostol via sublingual or vaginal route for cervical priming three hours before the procedure. The outcome measures assessed were cervical dilatation before surgery, duration of procedure, intraoperative blood loss and preoperative side effects. Results: Subjects in the sublingual group achieved significantly higher mean cervical dilatation compared to vaginal group (8.34 ± 0.62 mm vs 7.60 ± 0.67 mm, p = 0.0001). The mean duration of procedure for sublingual group was significantly lower compared to the vaginal group (2.62 ± 0.64 minutes vs 3.17 ± 0.71 minutes, p = 0.0001). The mean intraoperative blood loss was found to be more in sublingual group as compared to vaginal group (34.90 ± 10.90 ml vs 32.90 ± 7.42 ml), but the difference was not significant (p = 0.286). The sublingual group experienced more preoperative side effects such as pain, bleeding, nausea and shivering as compared to vaginal group. Conclusion: Sublingual misoprostol is more effective and convenient route than vaginal misoprostol for preoperative cervical priming in first trimester abortion.
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OBJECTIVES: Efficient identification of subject experts or expert communities is vital for the growth of any organization. Most of the available expert finding systems are based on self-nomination, which can be biased, and are unable to rank experts. Thus, the objective of this work was to develop a robust and unbiased expert finding system which can quantitatively measure expertise. METHODS: Medical Subject Headings (MeSH) is a controlled vocabulary developed by the National Library of Medicine (NLM) for indexing research publications, articles and books. Using the MeSH terms associated with peer-reviewed articles published from India and indexed in PubMed, we developed a Web-based program which can be used to identify subject experts and subjects associated with an expert. RESULTS: We have extensively tested our system to identify experts from India in various subjects. The system provides a ranked list of experts where known experts rank at the top of the list. The system is general; since it uses information available with the PubMed, it can be implemented for any country. CONCLUSIONS: The expert finding system is able to successfully identify subject experts in India. Our system is unique because it allows the quantification of subject expertise, thus enabling the ranking of experts. Our system is based on peer-reviewed information. Use of MeSH terms as subjects has standardized the subject terminology. The system matches requirements of an ideal expert finding system.
Subject(s)
Abstracting and Indexing , Bias , Data Mining , Expert Systems , India , Medical Subject Headings , Online Systems , Professional Competence , Vocabulary, ControlledABSTRACT
To evaluate the adnexal masses with conventional gray scale and color Doppler flow imaging and to assess their diagnostic reliability to differentiate benign and malignant adnexal masses. We evaluated 30 patients with adnexal mass. Morphological characterization of the mass was done using Sassone score. Color Doppler parameters noted down in each patient and Caruso vascular score was also used. The results were compared with surgical/ pathological and/or follow up scans. Using sonomorphological score [Sassone] overall reliability of differentiating adnexal masses had sensitivity of 91.7% and specificity of 77.7%. Using Caruso score alone we had sensitivity of 83.3% and specificity of 88.9%. Using Sassone and Caruso score together we had sensitivity of 90.9% and specificity of 93.3%. In evaluation of adnexal masses combining both sonomorphological and color Doppler scores which gave higher specificity and positive predictive value [PPV] than using individual score alone