Reproductive health problems and their awareness among adolescent girls: a clinical study

Background: The adolescent girls constitute a heterogeneous group who are at risk of various reproductive and gynecological problems. A number of health schemes are already aimed at targeting the needs of this special population. This study was aimed at identifying the special needs of this population group in respect of medical and reproductive health so as to provide a feedback for ongoing health schemes.Methods: This study was a cross sectional analytical study conducted among adolescent girls attending various government and public schools in Lucknow city and adolescent girls presenting to Gynecology OPD of Queen Mary’s Hospital for various complaints in a span of one year from June 2007 to June 2008. After taking consent, the girls were subjected to a questionnaire consisting of epidemiological parameters and questions regarding menstruation, pregnancy, birth spacing, contraception, abortion, RTI/STD, sex education. This data was later analysed. Those presenting to the OPD of Queen Mary Hospital were subjected to further examination and tests depending on their complaints.Results: A total of 1127 adolescent girls in the age group of 10-19 consented and were included in the study. Awareness regarding the contraceptive methods available was present in only 57.8%. 14% (164) girls were aware of reproductive tract infections and sexually transmitted diseases. However, 61% (687) girls were aware about HIV/AIDS in particular. The mean age at menarche was 11.9±1.0 years. 21.5% had some menstrual problem. There were 34 cases of teenage pregnancy.Conclusions: Our study revealed substantial lacunae in the knowledge and attitude of young adolescent girls towards reproductive and sexual health. Despite various targeted health programs from the government, there is a still a need to further our efforts to improve access to health care and adopt methods to improve awareness regarding the health issues of adolescents.

Utilization, Manpower and Information Management of the Blood Transfusion Services in a Large New Rural Based Tertiary Care Centre

Background:We present our experience in utilization, manpower and information management with paucity of resources in a large academic medical centre, situated in a most backward, least literate, remote pocket of the Haryana state in India. Methods:1> Electronic and manual database with their analysis. 2> Previous literature.Results:Budget provided is very low, so cost containment is very significant in our BTS (Blood Transfusion Service). Conclusion:The combinations of therapeutic and diagnostic roles necessitate a multi-pronged approach to utilization management in the BTS. This study will be very helpful for organized approach in a newly stabilizing BTSes of remote areas of other developing countries.

ABO and Rhesus (D) Blood Group Distribution among Blood Donors in Rural South Haryana (Mewat-Region): A 5 Years Retrospective Study

Background: In India, geographical distribution of blood groups and Rhesus (D) factor varies across the country. The aim of this study is to examine the distribution of these groups among voluntary blood donors at a large academic medical centre; SHKM which is situated in a rural, most backward, least literate, remote pocket of south (Mewat-region) Haryana state in India. Methods: A retrospective study was conducted using 5 year data (August 2013–December 2017) from a regional blood bank in rural south (Mewat-region) Haryana of India. Records of 16,121 voluntary blood donors were reviewed. Results: The distribution of ABO blood group was; blood group O (29.69%); blood group A (22.37%); blood group B (37.72%) and blood group AB (10.22%). A significantly higher proportion of Rhesus (D) positive than Rhesus (D) negative in blood group A and AB (respective p-values are .018 and .089). Conclusion: The sequence of ABO distribution among the rural population in south (Mewat- region) Haryana of India is; B > O > A > AB, with males as the predominant donors.

Spectrum of lymph node lesions on cytology in rural Haryana: a retrospective analysis.

Background: Fine Needle Aspiration Cytology (FNAC) is a simple, rapid, cost effective and reliable technique which can be used as a routine outpatient department (OPD) procedure and first line of investigation in diagnosing a variety of superficial and deep lesions. Lymphadenopathy is of great clinical significance and the underlying cause may range from a treatable infectious etiology to malignant neoplasms. In this study, we describe the diagnostic utility of FNAC in the assessment of lymph node lesions with an emphasis on the diagnosis of non-neoplastic, benign and malignant neoplastic processes. Cytomorphological patterns of tuberculous lymphadenitis were also observed. Methods: This was a retrospective study and a total of 736 patients including all age groups and both sexes presenting with palpable or deep lymph nodes in FNAC clinic of our institute over a period of 2 years were included in our study. FNAC was conducted with 22-24 Gauge disposable needles attached to 20c.c syringes. Smears were fixed in 95% ethyl alcohol and stained with Papanicolaou stain. Leishman stain was done on air dried smears. Ziehl- Neelsen (ZN) staining was done wherever required. Results: Out of 736 aspirations from lymph nodes, the most frequent cause of lymphadenopathy was found to be Tuberculosis with 419 cases (56.92%). The next frequent diagnosis was reactive lymphadenitis with 193 cases (26.22%) followed by metastatic lymphadenopathy in 47 cases (6.38%). A diagnosis of lymphoproliferative disorder was rendered in 20 cases (2.71%). In 10 cases (1.35%) FNAC was inconclusive. Conclusion: In our study, the predominant cause of lymphadenopathy was tuberculous lymphadenitis, seen in more than half of total cases, followed by reactive lymphadenopathy and malignant neoplasms. FNAC was helpful in establishing the diagnosis in 98.65% of the cases.

Pulmonary blastomycosis on autopsy: a rare case report.

A case of pulmonary blastomycosis on autopsy in a middle aged male from rural background is presented herewith. Blastomycosis is a pyogranulomatous disease caused by the dimorphic fungus blastomyces dermatitidis. Blastomycosis is endemic in regions of North America that border the Great Lakes. It is one of the great mimickers in medicine. Pulmonary blastomycosis has a broad range of clinical presentations, varying from completely asymptomatic pulmonary infiltrates to diffuse and massive parenchymal involvement that can lead to Acute Respiratory Distress Syndrome (ARDS). Human infection occurs when soil containing microfoci of mycelia is distributed and airborne conidia are inhaled. If natural defences in the alveoli fail to contain the infection, lymphohematogenous dissemination ensues. Diagnosis is based on culture and direct visualization of round, multinucleated yeast forms that produce daughter cells from a single broad- based bud. Most of the cases of blastomycosis reported in India are imported from the endemic areas of the World except a few authochthonous cases in North India.

Fibromatosis of the breast--a case report.

A case of fibromatosis of the breast in a 30 years old female is described. Only a few cases have been previously reported. It is anticipated that fibromatosis of breast behaves in a similar fashion to fibromatosis occurring in other sites. It is a locally aggressive lesion which exhibits a high incidence of local recurrence following incomplete excision.

Immunohistochemical study of the expression of epidermal growth factor receptor in benign prostatic hypertrophy, prostatic intraepithelial neoplasia and prostatic carcinoma.

The present study provides an analysis of immunohistochemical expression and localization of epidermal growth factor receptor (EGFR) in formalin fixed paraffin embedded specimens of prostate. Thirty-five cases each of benign prostatic hypertrophy (BPH) and prostatic carcinoma and 30 cases of prostatic intraepithelial neoplasia (PIN) were taken up for study. Streptavidin biotin peroxidase method was employed for immunohistochemical staining. EGFR positivity was observed in all the cases (100%) of BPH and PIN and in only 10 cases (28.5%) of prostatic carcinoma. In both BPH and PIN the basal cells revealed significantly higher intensity and percentage cell positivity than the luminal cells. Intensity and percentage of positively stained basal cells in BPH was higher than PIN basal cells but the difference was not statistically significant. The intensity and percentage cell positivity of BPH basal cells and PIN basal and luminal cells were significantly greater than the epithelial cells of prostatic carcinoma. Presently, the significance of variable expression of EGFR in various types of prostatic lesions is unknown.