Role of mean corpuscular volume as screening test for thalassaemia in pregnant women at Isra University Hospital Hyderabad

To see the sensitivity, specificity, positive and negative predictive value of mean corpuscular volume [MCV] in screening for beta thalassemia minor in pregnant women attending antenatal clinic at Isra University Hospital [IUH] Hyderabad. This validation study was conducted at the department of obstetrics and gynecology Isra University Hospital Hyderabad from 1st November 2004 to 30th October 2005. Women were interviewed using a pre designed questionnaire regarding their demographic profiles and Gestational age at the time of presentation. On their first antenatal visit MCV were checked as less than or equal to 70 fl on complete blood picture. HbA2 level were assessed by Hemoglobin electrophoresis to find out the carrier of beta thalassaemia minor. The data was analyzed on SPSS vr 15. This study showed that MCV is a good screening test for beta thalassemia minor. Out of 100 screened subjects 53% had MCV less than 70 fl or equal to 70 fl. Positive MCV test [<70 fl] showed a sensitivity of 79% and specificity of 30% in screening for beta thalassaemia trait. The positive and negative predictive values were 56% respectively. Our study showed that MCV is 79.9% sensitive and 30% specific and positive and negative predictive value is 56% in detection of beta thalassaemia minor. It was found to be a good screening tool in pregnant women for beta thalassaemia. This test can be adopted in future as part of evaluation for sub fertility in all young women

Rural practice preferences among medical students in Ghana: a discrete choice experiment

Objective To determine how specific job attributes influenced fourth year medical students' stated preference for hypothetical rural job postings in Ghana.Methods Based on discussions with medical student focus groups and physicians in practice and in the Ministry of Health; we created a discrete choice experiment(DCE) that assessed how students' stated preference for certain rural postings was influenced by various job attributes: a higher salary; free superior housing; an educational allowance for children; improved equipment; supportive management; shorter contracts before study leave and a car. We conducted the DCE among all fourth year medical students in Ghana using a brief structured questionnaire and used mixed logit models to estimate the utility of each job attribute. Findings Complete data for DCE analysis were available for 302 of 310 (97) students. All attribute parameter estimates differed significantly from zero and had the expected signs. In the main effects mixed logit model; improved equipment and supportive management were most strongly associated with job preference (a = 1.42; 95 confidence interval; CI: 1.17 to 1.66; and a = 1.17; 95CI: 0.96 to 1.39; respectively); although shorter contracts and salary bonuses were also associated. Discontinuing the provision of basic housing had a large negative influence (a = .1.59; 95CI: .1.88 to .1.31). In models including gender interaction terms; women's preferences were more influenced by supportive management and men's preferences by superior housing. Conclusion Better working conditions were strongly associated with the stated choice of hypothetical rural postings among fourth year Ghanaian medical students. Studies are needed to find out whether job attributes determine the actual uptake of rural jobs by graduating physicians