ABSTRACT
Introduction: Tattoo-associated complications are on the rise due to the popularity of decorative tattoos in recent years. The exact pathogeneses of various tattoo reaction patterns are still unclear, and their dermoscopic details are sparsely reported. Aim: We aimed to retrospectively study the clinical, dermoscopic and immunopathological details of patients with non-infectious, non-eczematous inflammatory tattoo reaction patterns in a tertiary care centre of East India. Method: The clinical, dermoscopic and pathological details of all the patients who had non-infectious, non-eczematous inflammatory tattoo reactions were collected. In all the cases, immunohistochemistry was done for CD1a, CD3, CD4, CD8, FoxP3, CD20 and CD56. Results: A total of five patients of skin phototypes IV and V and six tattoo reactions were analysed. Five lesions had reactions at the site of a black tattoo, and one at the site of red tattoo. Clinically, the patients presented with erythematous or blue-grey flat-topped to verrucous papules and plaques. Dermoscopic features were dominated by a central white to pink-white structureless area, a peripheral grey-white to bluish-white structureless area, white scales, comedo-like opening with keratotic plugging, milia-like cysts and shiny white structures. Pathologically, except for one lesion that only showed a lichenoid reaction pattern in the red tattoo, all had a combination of reaction patterns. Immunohistochemistry showed increased epidermal and dermal Langerhans cells, predominantly CD8 positive T cells in the epidermis and dermis, sparse dermal B cells and CD4 positive T cells, reduced T regulatory cells and a complete absence of CD56 positive NK cells. Limitations: Small sample size was the limitation of the study. Conclusion: The clinical morphology and dermoscopy may not differentiate between various types of non-infectious non-eczematous inflammatory tattoo reactions. The immunological profile supports a delayed hypersensitivity reaction due to contact sensitisation to tattoo pigment, and CD8 positive T cells play a central role in executing various pathological reaction patterns, both in the epidermis and dermis
ABSTRACT
Background & Objectives: HIV counselling and testing services are a key entry point to prevention of HIV infection, and to treatment and care of people who are infected with HIV. In Gujarat at present 308 ICTC are functioning out of them 19 are functioning in Bhavnagar District. ICTC team training produce skilled personnel who can identify their client problems, are well informed and can provide high quality HIV related services so the objective of this study is to study knowledge regarding HIV/AIDS & Counselling amongst staff of ICTC running in Bhavnagar District. Methods: This was a cross sectional study conducted among participant of ICTC team Training during April 2011-May 2011. Results: The knowledge of participant regarding HIV/AIDS and Counselling aspects improved significantly after intervention. Interpretation & Conclusion: The informative & educable intervention definitely has a positive effect on awareness levels which would eventually encourage expansion of knowledge & help in improve the skill of counselling and positive attitude towards the client coming at different ICTC centre and increase the service utilization by client so this type of inductive training for newly appointed health care workers and refresher training for health workers, who employed longer than one year should be organized on regular basis for effectively utilization of ICTC.
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Background & Objectives: India, with 1.22 billion populations, is the second most populous country in the world. India contributes 17.31% population in the world. Demographers expect India's population to surpass the population of China by 2030. Recent data of NFHS III revealed that 13% of married women have unmet need for family planning in India so this study was planned to estimate the prevalence of unmet need for Family Planning among married women of reproductive age residing at UHTC area Government Medical College Bhavnagar and to find out the determinants of unmet need for Family Planning in the study population. Methods: This was a cross sectional descriptive study conducted in UHTC catchment area of Government Medical College; Bhavnagar from August 2011 to October 2011. The calculated sample size was 140 (P=9.76, L=5%). A total 150 married women of reproductive age group (15-49 years) were interviewed for the same with their informed consent. The data were entered and analysed in software epi.info.3.5.1. Results: The prevalence of unmet need for Family Planning in UHTC catchment area was found to 18.7%. The unmet need was higher for temporary methods of Family Planning (10.0%), in the women age group of 20-29 years (71.5%), Illiterate (42.8%), Muslim women(42.8%), poor knowledge of contraception(82.1%), no advice on Family Planning (57.1%) and no male participation (75.0%). These entire variable were found to be associated with high unmet need for Family Planning (P<0.05). Interpretation & Conclusion: The present study concluded that the percentage of unmet need years, low education and also in Muslim religious women. To decrease unmet need family planning measures should be specifically directed toward this group of women. Health education and strategic behaviour change communication for appropriate target audience is requiring cope up unmet need.
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Background & Objectives: The desired impact of IMNCI is the reduction of mortality, morbidity and suffering, through assuring children’s access to quality health care in health facilities and improved case management at home. Maintaining the performance of health and village workers is essential to achieve this impact. So objective of this study is to assess IMNCI implementation in Bhavnagar district of Gujarat to strategize for accelerating effective implementation. Methods: A cross sectional study was carried out in March 2012 in Bhavnagar district. Four blocks of Bhavnagar district were purposefully selected out of seven blocks on the basis of immunization coverage of previous year. From each block one best PHC and from selected PHC one best sub-centre and one best Anganwadi were selected purposefully by solely on basis of perception of Medical Officer in charge PHC and BHO for implementation of IMNCI in their area in last one year. The purpose of adopting such method was to evaluate the performance of IMNCI implementation in centres (PHC, SC, AW) that was judged best by their supervisors. After selection, PHC, SC and Anganwadi centre were visited to assess the practice of IMNCI by ANM and Anganwadi Worker. Medical Officer, Health Supervisors and ICDS officers were interviewed to understand overall implementation process. For collecting data pre-tested and predesigned questionnaire was utilized. Results: Basic IMNCI training in Bhavnagar was completed in 90% of health and ICDS workers. More than 87.5% workers said that their knowledge, skill, confidence and credibility among community were increased after IMNCI training. Logistic and drugs supply were insufficient at sub centre and Anganwadi centre. Out of the total 80 filled IMNCI case sheets by the health and ICDS workers, 32(40%) were found accurately complete as the correctly filling of all the column (assessment and classification and treatment) in form considered as complete form. Accurate classification, management and advice of cases according to IMNCI guidelines were 62 (77.5%), 42 (52.5%) and 38 (47.5%) respectively as the accurate classification (assessment, classification and treatment) of the entire column in form correctly. Combination of one correct and other incorrect assessment or classification or treatment considered as partial accurate and inaccurate if all the column were not assessed or not classified or not given the treatment correctly. While observing actual practice of IMNCI, accuracy among health and ICDS workers was found in assessment 5(31.3%), Classification 8(50%) and treatment 7(43.8%). Supportive supervision and feedback mechanism were lacking at all level. Interpretation & Conclusion: Supportive supervision and feedback mechanism are key concern and must address. Proper logistic and drugs planning and management also main concern for IMNCI programme.
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Background & Objectives: The importance of maternal health services in reducing maternal and infant morbidity and mortality has received increasing recognition. Studies have shown that the uptake of maternal health care (MHC) in developing countries has significant consequences for both the safe transition of the mother through pregnancy and child birth, and the survival and health of the child during early infancy So the objective of this study is to examine the existing pattern of maternal health care utilization in Ahmedabad District. Methods: This was a cross sectional study done in Ahmedabad district during November 2010-december 2010. Results: Most of women were from the age groups 20 to 24 years. The iron folic acid tablet intake was found higher in urban women (82%) then rural women (66%). All over ANC visits given or taken were found more in urban area (84%) as compare to rural area (78%). While supplementary nutritional services are utilized more in rural area (64%). Almost equal number of institutional deliveries took place in both rural and urban area. The counselling regarding family planning and breast feeding were given more in urban area (81%). Interpretation & Conclusion: The analysis presented in this paper has enabled the examination of the differences in the maternal health care utilization between these very diverse sub-groups. Thus, it may be conclude that, there is a need for formulation of revised strategies for better and effective reach of maternal health care services in India as a whole.
ABSTRACT
Background & Objectives: The importance of maternal health services in reducing maternal and infant morbidity and mortality has received increasing recognition. Studies have shown that the uptake of maternal health care (MHC) in developing countries has significant consequences for both the safe transition of the mother through pregnancy and child birth, and the survival and health of the child during early infancy So the objective of this study is to examine the existing pattern of maternal health care utilization in Ahmedabad District. Methods: This was a cross sectional study done in Ahmedabad district during November 2010-december 2010. Results: Most of women were from the age groups 20 to 24 years. The iron folic acid tablet intake was found higher in urban women (82%) then rural women (66%). All over ANC visits given or taken were found more in urban area (84%) as compare to rural area (78%). While supplementary nutritional services are utilized more in rural area (64%). Almost equal number of institutional deliveries took place in both rural and urban area. The counselling regarding family planning and breast feeding were given more in urban area (81%). Interpretation & Conclusion: The analysis presented in this paper has enabled the examination of the differences in the maternal health care utilization between these very diverse sub-groups. Thus, it may be conclude that, there is a need for formulation of revised strategies for better and effective reach of maternal health care services in India as a whole.