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Background: Overweight and increased Body MassIndex (BMI) have been among the major changes ingirls and is one of the likely factors affecting themenarche age. Aim and Objectives: To determinecorrelation of age at menarche with BMI in adolescentgirls of urban and rural schools of Vijayapura, NorthKarnataka. Material and Methods:Aprospective crosssectional study was conducted by Department ofObstetrics and Gynaecology, Shri. B. M. Patil MedicalCollege Hospital and Research Centre, BLDE (Deemedst thto be University), between 1 July 2019 to 29 February2020.Girls below the age of 19 years who had attainedmenarche were included. Height and weight weremeasured, and BMI was calculated. Statistical analysiswas carried out in SPSS software, version 23.0 andMicrosoft 2010. Correlation between age at menarcheand BMI was assessed in adolescent girls of urban andrural schools of Vijayapura. Results: The mean age atmenarche among adolescent girls of urban and ruralschools was about 13.6 ± 1.2 years. Among allparticipants, 60.2% were from urban area and 39.8%were from rural area. The mean age of the menarchewas 13.8 ± 1.2 in rural population and 13.5 ± 1.3 inurban population (p value <0.001). Among all studyparticipants, 48.3% had normal BMI; however, 29.8%,15.4%, 5.8% and 0.7% were underweight, severeunderweight, overweight, and obese respectively.Majority of girls had normal BMI in both urban (49.2%)and rural settings (47.0%). Conclusion: A statisticallysignificant association (p< 0.05) was noticed betweenonset of menarche and area of residence. There was aninverse correlation between BMI and age at menarche,although this was not statistically significant.
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Background: One of the complications of pregnancy which till today challenges the obstetrician is preeclampsia and its severe form of eclampsia. Objective of this study was to find out the complications and outcome of pregnant women with preeclampsia and eclampsia admitted in a tertiary referral center.Methods: Case records, in labor room, were scrutinized to find out the number and the outcome of pregnancy, in women admitted with preeclampsia or eclampsia in the year 2018.Results: Pregnant women admitted with preeclampsia or eclampsia numbered 2511 and, 109 women developed complications. Maternal complications, were more often seen in mothers, (62.4%) of female babies. Only 37.6% of mothers of male babies developed complications. Complications seen were Renal complications in 34.8%, Hematological complications in 33%, Neurological complications in 25.6%, Pulmonary complications in 16.5%, ophthalmological complications in 11% and Sepsis in 6.4% and MODS in 10%. Of total maternal deaths, 34% was caused by complications of preeclampsia or eclampsia. Major cause of maternal death was MODS and Pulmonary complications. Nearly, 62.3% of babies born had birth weight of 1.8 kg and nearly one-third of babies (26.6%) were dead born.Conclusions: The incidence of preeclampsia and eclampsia in our referral center for the year 2018 was 15%, and 4.3% of women developed complications, and 6% died, making preeclampsia and eclampsia the causative factor for 34% of total maternal deaths. Major maternal complications were Renal, Hematological, Neurological, Pulmonary and MODS. Complications of preeclampsia were more often present in 62.4% mothers of female babies in contrast to 37.6% of mothers of male babies. Nearly one-third of babies (26.6%) were dead born.
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Background: A normal delivery is what every woman wishes to have. The objective of this study was to find out the maternal and neonatal outcome and background characteristics of women delivering vaginally in a tertiary care center in Chennai, South India.Methods: For this one-year study, with power above 80%, Parturition records were selected by computerized random numbers, for a calculated sample size. Salient demographic features such as age, residential background and religion were noted. Details of obstetric history, past and current, delivery and baby details and admission to NICU were analyzed. Acceptance of postpartum contraception was noted.Results: A total of 338 women delivered vaginally. Majority of 63%, were from urban background. Late referrals were 19.2% of women,38.5% women had antenatal complications. Primigravida were 49.7%. Nearly 91.4% of women delivered naturally. Previous pregnancy loss was noted in 14.8%. Term deliveries were in 72% of women, and 2.7% of women delivered twins. Average birth weight among primi was 2.5kg and in multi it was 2.8 kg. There were no maternal deaths. Perinatal deaths of 2.96%, of which 90% were preterm births, and all among babies with birth weight below 1.5 kg.Conclusions: The larger majority of 91.4% of women had natural vaginal delivery. Primigravida were 49.7%, and 63% were from urban background. Antenatal complications, obstetric, medical or other complications were noted in 38.5 % of women. Most often observed complications were Gestational hypertension, Gestational diabetes, and Hypothyroidism. NICU care was required for 18% of babies. Preterm births were16.6%. Perinatal deaths were seen in 2.96% of babies. There were no maternal deaths.
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Background: Childhood obesity is a major contributor to the global burden of chronic diseases and is an important determinant of cardiovascular diseases, type II diabetes etc. This can largely be attributed to the transformation in the lifestyles of children. There is still lack of knowledge about obesity among high school children. Objective of this study was to assess the knowledge of risk factors of obesity among school children and to find out the knowledge of hazards and preventive measures of obesity among school children.Methods: A cross-sectional study was conducted among school students aged between 13-14 years from 9 randomly selected schools. The total sample included 480 students.Results: Out of 480 subjects 70.4% had heard about obesity, 62.3% were aware about the increasing prevalence of obesity among the youngsters, 26.7% thought unhealthy dietary factors and 29% thought mental stress were the main factors leading to obesity and non-communicable diseases. More than 75% students had correct knowledge of dietary factors associated with obesity like eating larger portion of food, eating fried foods, having junk foods. 51-75% of the students responded correctly for the factors i.e. using motorcycle for short distance.Conclusions: More than half of the students had knowledge of specific dietary and physical activity risk factors. Majority of the students identified high blood pressure, diabetes and heart problem as hazards of obesity. Only one third of the students knew preventive measures like adequate intake of fruits and vegetables, limiting unhealthy snacks and limiting screen time to prevent obesity.
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Background: Laparoscopic assisted vaginal hysterectomy (LAVH) is increasingly becoming popular. It's really a technique made to replace abdominal hysterectomy. The need of the hour is the minimal invasive surgery, early discharge from the hospital, early resumption of work, avoidance of disfiguring scar on the abdomen and cost-effectiveness of the procedure which are as important as cure of the disease. The objective of this study is to compare the effectiveness and safety of laparoscopic and vaginal hysterectomies for non-descent uteri (NDVH).Methods: The study was undertaken in the department of obstetrics and gynecology, Amrita Institute of Medical Sciences, Kochi for the period of one year. About 50 women in each group undergoing LAVH and NDVH for benign pelvic conditions were studied preoperatively, intra-operatively and post-operatively in detail for indications, operative time, intraoperative blood loss, duration of stay in hospital.Results: The mean operative time in LAVH was 240.6 minutes and in NDVH 168.3 minutes. Minimum duration of stay was in LAVH 3 days and in NDVH 4 days. Mean duration of stay in both groups was 6.4 days. Maximum duration of stay-15 days in both groups.Conclusions: LAVH is a better approach for a larger uterus whereas NDVH is preferable for a small uterus, not only for shorter operative time and minimal wound, but also for much lower costs.
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<p><b>OBJECTIVE</b>Paraplegia due to traumatic spinal cord injuries is one of the devastating effects of dorsolumbar vertebral fractures. Treatment modalities for such fractures, such as stabilization, have no effect on the neurological recovery. Thus, various pharmacological and biological treatment modalities have been used. The more recent trend of using autologous stem cells from the iliac crest has been used in some clinical trials with varying success. Thus, more clinical studies are required to study the effect of this novel approach</p><p><b>METHODS</b>This is a prospective hospital-based cohort study (level IV). The study was conducted in the Dept. of Orthopaedics, University College of Medical Sciences and GTB Hospital, Delhi from November 2010 to March 2012. Ten patients who had sustained traumatic dorsolumbar vertebral fractures with complete paraplegia were recruited for this study. Under suitable anaesthesia, at the beginning of surgery, 100 ml of bone marrow was aspirated. This was centrifuged and buffy coat isolated and then transferred into a sterile tube and sent to the operating room on ice packs. After surgical decompression and stabilization, the buffy coat isolate was injected into the dural sleeve at the site of the injury using a 21G needle. All the patients were evaluated for neurological improvement using the American Spinal Injury Association (ASIA) score and Frankel grade at 6 weeks and 3 months postoperatively.</p><p><b>RESULTS</b>The evaluation at 6 weeks showed some improvement in terms of the ASIA scores in 2 patients but no improvements in their Frankel Grade. The other 8 patients showed no improvements in their ASIA scores or their Frankel Grades. The current pilot study has shown that there has been no improvement in most of the recipients of the transplant (n=8). Some patients (n=2) who did show some improvement in their sensory scores proved to be of no significant functional value as depicted by no change in their Frankel Grades.</p><p><b>CONCLUSION</b>The outcome of current study shows that although this modality of treatment is safe for the patients, it provides no additional benefits on improvement of quality of life among these patients.</p>
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Humans , Bone Marrow Transplantation , Methods , Pilot Projects , Prospective Studies , Spinal Cord Injuries , TherapeuticsABSTRACT
Background & objectives: Community outbreaks of disease amongst nomadic populations generally remain undocumented. Following a reported increase in acute respiratory tract infections (ARI) in May 2011 in a nomadic population of Sangerwini in Jammu & Kashmir, India, we examined the patients with ARI symptoms and their nasal swabs were tested for influenza virus. Methods: Patients with ARI (n=526) were screened from May 14 to 23, 2011 and nasopharyngeal swabs collected from 84 with Influenza like illness (ILI) for bacterial cultures and influenza virus testing. Samples were tested for influenza A and influenza B by real time (RT)-PCR. Results: Twelve (14.3%) of the 84 patients tested positive for influenza B, compared to only one (0.9%) of 108 patients with ILI in a parallel survey performed in Srinagar during the same period, suggesting a localized outbreak in the isolated nomadic community. All presented with respiratory symptoms of less than seven days. Familial clustering was seen in 40 per cent (25% of influenza B positives). Average daytime temperatures ranged from 15-16oC compared to 22oC in Srinagar. Four patients developed pneumonia whereas others ran a mild course with a total recovery with oseltamivir and symptomatic therapy. Interpretation & conclusion: Our report of confirmed influenza B in this underprivileged nomadic population argues for routine surveillance with efforts to improve vaccination and infection control practices.
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Objective: To examine the validity of accelerometers for characterizing habitual physical activity patterns in Indian children. Design: Cohort study. Setting: Holdsworth Memorial Hospital, Mysore. Subjects: Children (N=103, mean age 6.6 years) selected from an ongoing birth cohort study. Methods: Physical activity was measured over 7 days using accelerometers (MTI Actigraph) and concurrent parent-maintained activity diaries. Actigraph counts per minute representing sedentary (<10), light (<400), moderate (<3000) and vigorous (≥3000) activity were determined using a structured activity session in a separate group of 10 children. In 46 children chosen for validating accelerometers, time spent in different activity levels according to diaries was determined. Energy Expenditure (EE) was calculated from diaries using a factorial method. Results: Ninety-eight children wore the monitor for ≥4 days. Total counts and time spent in different activity levels were similar in boys and girls (P>0.2). Among 46 children chosen for comparisons, time spent in sedentary (r =0.48, P=0.001), light (r=0.70, P<0.001) and moderate activities (r=0.29, P=0.054) according to diaries correlated with those derived from counts, and total Actigraph counts correlated with EE (r=0.42, P=0.004). Bland-Altman analysis showed systematic bias, and wide limits of agreement between these methods for time spent in different activity levels. Conclusions: Accelerometers are a well tolerated and objective way of measuring activity behavior in free-living children. Though accelerometer counts correlate with time spent in activity of varying intensity and energy expenditure derived from parent-maintained diaries, wide limits of agreement show that the limitations of accelerometers need to be recognized in interpreting the data that they generate.
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Two hundred and forty four girls with different hemoglobin levels were selected, of which forty-one were non-anemic. The rest were graded as mildly, moderately or severely anemic and supplemented with 60 mg of iron daily or twice weekly for twelve weeks. There was no significant difference in the increase in hemoglobin levels between daily and twice weekly-supplemented subjects at the end of the study. Unpleasant side effects of supplementation were experienced by 57.8% of the daily supplemented subjects as against 5.9% of twice weekly-supplemented ones. Twice weekly supplementation could be recommended for overcoming anemia in adolescent girls.
Subject(s)
Adolescent , Anemia, Iron-Deficiency/diagnosis , Developing Countries , Dietary Supplements , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Follow-Up Studies , Humans , India , Iron, Dietary/administration & dosage , Prospective Studies , Risk Assessment , Sampling Studies , Severity of Illness Index , Treatment OutcomeABSTRACT
Slow reduction in infant mortality rate in the last couple of decades is a major concern in India. State-level aggregate data from the National Family Health Survey 1992 and micro-level data on rural mothers (n=317) were used for examining the influence of female literacy on reduction of infant mortality through increased use of maternal and child health (MCH) services. Illiteracy of females was strongly associated with all variables relating to maternal care and also with infant mortality rate. States were grouped into best, medium, and worst on the basis of female illiteracy (about 11%, 48.5%, and 75% respectively). Infant mortality rate (per 1,000 livebirths) was significantly (p<0.01) higher among the worst group (90.99) than that among the medium (64.2) and the best (24.0) groups. Use of maternal health services increased in the worst to become the best groups for tetanus toxoid (from 48.0% to 84.4%), iron and folic acid tablets (36.6% to 76.2%), hospitalized deliveries (14.2% to 69.7%), and childcare services, such as vaccination (23.8% to 64.9%). Illiteracy of females had a more detrimental impact on rural than on urban areas. In the event of high female illiteracy, male literacy was beneficial for improving the use of services for reducing infant mortality rate. The micro-level study supported all major findings obtained for the national-level aggregate data. Programmes, like providing free education to girls, will yield long-term health benefits.
Subject(s)
Child , Child Health Services/statistics & numerical data , Child Welfare , Educational Status , Female , Humans , India/epidemiology , Infant , Infant Mortality , Male , Maternal Health Services/statistics & numerical data , Mothers/psychology , Social ClassABSTRACT
Hyperkalaemia is primarily a problem when whole blood is administered rapidly. However, it can happen with small amounts of old stored blood transfusions in infants and small children due to high K+ content of the old blood. We present a 2-year-old baby who developed intraoperative hyperkalaemia during a reduction cranioplasty for enlarged head, secondary to hydrocephalus resulting from posterior third ventricular choroid plexus papilloma. Intraoperatively the child had massive blood loss. While blood transfusion was being carried out rapidly [three weeks old blood]. the patient became haemodynamically unstable and showed ECG changes. Blood tests revealed a K+ of 6.9mmol/l and acidosis, which was treated with calcium, glucose and insulin