Birth preparedness and complication readiness among women attending Immuno-Prophylaxis Centre, Dr. S. C. Government Medical College, Nanded

Background: As signatory to United Nation’s Sustainable Development Goals, India is striving hard to achieve these goals by end of 2030, especially for goal number 3 with targets related to maternal and child health. Birth-preparedness and complication-readiness (BPCR) is a tool to promote maternal and neonatal survival. This study was conducted to assess the perception and practices of recently delivered women on BPCR with its correlates.Methods: Hospital-based cross-sectional study was conducted at Immuno-prophylaxis centre of Dr. Shankarrao Chavan Government Medical College, Nanded, Maharashtra. Women attending IPC along with their baby within two to four months of delivery for immunization of their babies during the month of March 2014 constituted study subject of this study. After obtaining informed consent, data was obtained on socio-demographic characters like age, caste, religion, education, parity, ANC registration and questions regarding birth preparedness and complications readiness in their last pregnancy.Results: Total 117 women found to be eligible as study subject. Overall BPCR index of the study population was 67.28. Proportion of women who received first antenatal check-up within first trimester, four or more antenatal checkups, saved money for childbirth and had institutional delivery were 87.18%, 86.32%, 51.28% and 100% respectively. Around 23.08% women had knowledge of at least 3 key danger signs of pregnancy while only 19.65% identified blood donor. Awareness regarding danger signs of pregnancy and arrangement for blood donor was found poor in comparison to other indicators in study subject.Conclusion: There is need of increasing awareness regarding BPCR so that perception and practices in the community increased.

A Study on Normal Variations in Electrocardiogram in the Adults

ackground:We have conducted this study on 400 normal healthy adults, males were 288, Females were 112 and the age group is 20 to 50 years. Electrocardiogram were taken after careful history and clinical examination and after ruling out any cardiac abnormality and other conditions also. The diseases particularly respiratory, electrolyte and endocrinal abnormalities will causes ECG changes. We have excluded symptomatic persons in the study. Aims and Objectives: To study the pattern of Rate, Rhythm, QR's Duration, PR interval, QT duration and ST. T changes which occurs in normal individuals and their relation to age. Material and Methods: In our study we have included 400 normal healthy subjects out of 400, 288 were males, 112 were female. We have taken the 12 lead ECG with standardization of 10mm. Results: Sinus Bradycardia is observed in 4 persons, tachycardia is observed in 16 subjects. Incomplete RBBB was observed in 8 subjects. Conclusion: Healthy individuals may have so many variations in ECG which were considered as with in Normal limits, so understanding normal ECG and deviations in normal individuals is very important to interpret the disease states and treating them.

Student-Led Seminars as a teaching-learning method- effectiveness of a modified format.

Background and objectives: Student-led seminars (SLS) are being used as a teaching-learning method for undergraduate medical students in the Gulf Medical University, Ajman. Student feedback, however, ranked SLS as a poor teaching-learning method. Objectives were to assess effectiveness of a modified format for student-led seminars in the undergraduate medical curriculum. Methods: SLS was modified into a presentation followed by a quiz, to make it more interactive and student centred. The new format was implemented midway in the academic year. Student perceptions regarding SLS sessions were surveyed using an anonymous questionnaire and scored using a likert-like scale. Statistical significance (p < 0.05) was tested using the Wilcoxon signed ranked test using the SPSS19 software. Results: The new format was reported to be significantly more interesting, interactive, fun and made them feel more like a team. High number of students reported ―gained new knowledge‖, ―enjoyed learning through seminars‖, ―learnt new things from my colleagues in the seminar group‖ and ―enjoyed working with my colleagues for my seminar‖. Scores for ―improvement in communication skills‖, ―learnt to make a formal scientific presentation‖ and ―gained self-confidence after presenting the seminar‖ were also high. Conclusions: Since the main use of SLS as a teaching-learning method in Gulf Medical University, Ajman is to inculcate self-learning, peer-learning, teamwork and communication skills, the new format is significantly better at achieving the outcomes.

Two-Stage Surgical Management of Multilevel Symptomatic Thoracic Haemangioma Using Ethanol and Iliac Crest Bone Graft

This article presents a 56-year-old obese female who presented with back pain and progressive weakness in her lower limbs for three months. She was bed-ridden for one week before reporting to our hospital. Plain radiographs showed vertical striations in multiple vertebrae classical of haemangioma. Magnetic resonance imaging (MRI) spine revealed multiple thoracic and lumbar vertebral haemangiomas. Extra osseous extension of haemangioma at T12 was causing spinal cord compression. Two-stage surgery was performed with absolute alcohol (ethanol) injection followed by pedicle screw fixation and decompression with tricortical iliac crest bone graft into the vertebral body. Postoperatively rapid neurological improvement was seen. After three weeks, she could walk independently. One year later, computed tomography showed complete incorporation of bone graft and maintained vertebral body height. MRI showed complete resolution of the cord edema at T12. These findings indicated diminished vascularity of the tumor.

Two-Stage Surgical Management of Multilevel Symptomatic Thoracic Haemangioma Using Ethanol and Iliac Crest Bone Graft

This article presents a 56-year-old obese female who presented with back pain and progressive weakness in her lower limbs for three months. She was bed-ridden for one week before reporting to our hospital. Plain radiographs showed vertical striations in multiple vertebrae classical of haemangioma. Magnetic resonance imaging (MRI) spine revealed multiple thoracic and lumbar vertebral haemangiomas. Extra osseous extension of haemangioma at T12 was causing spinal cord compression. Two-stage surgery was performed with absolute alcohol (ethanol) injection followed by pedicle screw fixation and decompression with tricortical iliac crest bone graft into the vertebral body. Postoperatively rapid neurological improvement was seen. After three weeks, she could walk independently. One year later, computed tomography showed complete incorporation of bone graft and maintained vertebral body height. MRI showed complete resolution of the cord edema at T12. These findings indicated diminished vascularity of the tumor.

Students' and faculty's perceptions of early patient contact [EPC] program in a university teaching hospital in United Arab Emirates

The Early Patient Contact [EPC] program was introduced as an elective posting for the first year MBBS students in the University in 2010. The objective of the study was to determine the perceptions of medical students and faculty about EPC program. The study sample included 50 first year MBBS students of GMU, Ajman in the academic year 2010-11 and 2011-12 and who consented for EPC posting and faculty members of GMC Hospital. Faculty and Student's feedback were obtained through separate questionnaire's at the end of EPC posting based on Likert scales [SA, A, U, D, SD]. Analysis of responses showed that students perceived EPC program increased their motivation to pursue medical profession [98%], realize the importance of documentation [94%], helped them understand the practical challenges [96%] and helped realize the importance of professional conduct [94%]. Students opined that EPC program made classroom teaching more relevant [80%]. Majority of students recommended EPC to be a part of regular curriculum [76%]. All the faculty felt that EPC makes classroom teaching of communication skills more relevant and makes student's realize the importance of professional conduct. They emphasized the importance of documentation [86%]. The faculty was satisfied with the conduct of the program. Students and faculty had positive perceptions about EPC program due to its influence on student motivation, professionalism and better communication skills

Making fair, fairer - Implementing the FAIR-ER principles of education in an integrated curriculum

When an integrated organ system based curriculum was adopted by the University for its Medical School, curricular changes had to be implemented in the Clinical Clerkship phase called Phase 3. To design an effective educational strategy using certain principles of education such as Feedback, Active learning, Individual learning and Relevance [FAIR] together with Evaluation and Reflection. [FAIRER] The first batch of the Integrated Curriculum students of the MBBS program formed the study population. Certain principles of education such as Feedback, Active learning, Individualisation of learning and relevance that have been advocated for use to enhance learning, together with continuous evaluation and Reflection were applied in educational strategies for the implementation of the Integrated Curriculum Implementing the Integrated Curriculum for the Clinical phase of the MBBS program offered a tremendous opportunity to apply the F-A-I-R principles of education together with E-R that is Evaluation and Reflection. The scores obtained during the summative assessment and the positive student response validated the enhancement of learning objectively and subjectively

Effect of early patient contact program on performance in examination on communication skills

Good communication is the most important thing, it takes a long time to develop and it is difficult to master. The objective of the present study is to assess whether early patient contact [EPC] program had an effect on performance in examination on communication skills. Summary of work: The study sample included 123 first MBBS students of GMU, Ajman during academic years' 2010-118and 2011-12. The students who consented for EPC posting as elective during Communication Skills Course constituted group A and rest of the students constituted Group B. Group A had 50 students and Group B had 73 students. A validated, pilot-tested Van Dalen et al. 'paper-and-pencil test' and OSCE stations were used to evaluate all the students' clinical communication skills. The data was analysed using SPSS 19. Summary of The mean scores for Group A who underwent EPC and Group B who did not undergo EPC were 81.13% and 73.19% in OSCE, 63.02% and 61.31% in paper-and-pencil' test and 67.2 1% and 64.28% in total scores obtained respectively. The difference in mean scores was statistically significant in the case of scores obtained in OSCE [p < 0.01]. All other differences observed were not statistically significant. EPC program helps students to acquire better communication skills as seen by scores obtained in communication skills test especially in the OSCE. Take home message EPC program should be introduced in first year of medical school to improve communication skills of students

Unilateral conjunctival ulcer due to Stenotrophomonas maltophilia infection.

We report a case of unilateral conjunctival ulcer due to Stenotrophomonas maltophilia infection in an immunocompetent individual. A 44-year-old male presented with complaints of pain and yellowish discharge in the right eye for one week. Patient underwent complete ophthalmic evaluation and relevant laboratory investigations. Anterior segment examination revealed localized conjunctival and episcleral congestion with conjunctival ulceration on the bulbar conjunctiva in the right eye. Gram's stain revealed gram-negative bacilli. Culture and sensitivity revealed S. maltophilia and responded well to topical moxifloxacin with systemic co-trimoxazole therapy.

Blunt abdominal trauma with pseudomyxoma peritonei

Trauma is a common cause of morbidity and mortality. Timely surgical intervention in a hemodynamically unstable patient can save life. This case reports an adult of 27 year age who sustained blunt abdominal injury. During evaluation and simultaneous management fast deteriorating circulatory status prompted exploratory laparotomy. A tributary of middle colic vein was the reason for blood loss which was ligated. Further inspection of the bowel revealed complete transection of the jejunum which was repaired. An interesting finding was an incidentaloma; a hard, fixed mass arising from the appendix region which was subsequently diagnosed as pseudomyxoma peritonei and right hemicolectomy was done at another elective surgery. The case highlights thorough inspection of abdominal cavity in all cases as unusual / rare pathologies may be discovered incidentally.

Profile of patients with granulomatous mastitis presenting to a university teaching hospital in UAE: a case series

Objective: To highlight the profile of five patients diagnosed as having granulomatous mastitis by histopathological examination

Materials and Methods: This presentation is a case series of patients, diagnosed as idiopathic granulomatous mastitis by histopathological examination of excised specimens

The total number of cases included in the report was five females over a 4-year period from 2005 to 2009

Results: The mean age of the patients was 29.6 years and the duration of symptoms varied from three weeks to four months. All the patients presented with a palpable mass in the breast, and two patients had associated pain and one had a bloody nipple discharge

The average size of the excised masses was 3.8 cm x 3.1 cm. Four out of the five patients diagnosed to have breast abscess or segmental mastitis had taken a course of antibiotics. One patient had a persistent wound sinus which subsided with ATT and the rest of the patients had no post-operative complications

Conclusion: Idiopathic Granulomatous Mastitis [IGM] is a relatively rare disease which mimics the common breast disorders in the reproductive age group including malignancy

Profile of patients with granulomatous mastitis presenting to a university teaching hospital in UAE: a case series

To highlight the profile of five patients diagnosed as having granulomatous mastitis by histopathological examination. This presentation is a case series of patients, diagnosed as idiopathic granulomatous mastitis by histopathological examination of excised specimens. The total number of cases included in the report was five females over a 4-year period from 2005 to 2009. The mean age of the patients was 29.6 years and the duration of symptoms varied from three weeks to four months. All the patients presented with a palpable mass in the breast, and two patients had associated pain and one had a bloody nipple discharge. The average size of the excised masses was 3.8 cm x 3.1 cm. Four out of the five patients diagnosed to have breast abscess or segmental mastitis had taken a course of antibiotics. One patient had a persistent wound sinus which subsided with ATT and the rest of the patients had no post-operative complications. Idiopathic Granulomatous Mastitis [IGM] is a relatively rare disease which mimics the common breast disorders in the reproductive age group including malignancy

Opinion of nurses regarding breast cancer screening programs.

Aim: Found to be effective in its treatment. The increased incidence of breast cancer supports the implementation of breast cancer screening programs. The present study evaluates the opinion among nurses regarding breast cancer screening programs in United Arab Emirates (UAE). Materials and Methods: The study population included 154 nurses practicing at different hospitals in United Arab Emirates (UAE), all nurses who participated in the breast cancer awareness programme organized by Gulf Medical University, Ajman, UAE. A self-administered, pretested, structured, close-ended questionnaire was used for data collection. Statistical Analysis was performed using Predictive Analytic Software (PASW 17). Results: The participants' age ranged between 20 and 59 years. Fifty percent of the participants strongly agreed with the early detection of breast cancer by performing breast self examination. Thirty-nine percent were of the opinion that women aged 40 years and older should have a mammogram every year and continue to do so and 25.3% strongly felt that women in their 20s and 30s should have clinical breast examination as part of their periodic health examination by health professionals. 33.8% of the respondents strongly agree on providing information on the benefits and limitations of BSE to the female population. Twenty-six percent of the participants strongly agree that women at high risk should get magnetic resonance imaging and mammogram done every year. Conclusion: The present study indicates the need for providing workplace training programs thus equipping them with better knowledge and enhancing their service among the general population.

Foot ulcers among diabetic patients visiting surgery department in a university teaching hospital in Ajman, UAE

Diabetes is a very common lifestyle-related metabolic disease in UAE. UAE has the second highest prevalence of diabetes worldwide. Foot problems are one of the commonest reasons for hospital admission among diabetics. The major risk factors for foot disease are peripheral neuropathy, peripheral vascular disease, poor vision and foot deformities. Development of foot ulceration is preventable. To assess the frequency of foot ulcers among diabetic patients visiting the surgery department in a university teaching hospital in Ajman, UAE especially in relation to gender, nationality and age. This hospital-based retrospective record analysis was conducted for patients with diabetes mellitus visiting department of surgery for a period of 8 years from 2002 to 2010. Among the diabetic patients recruited for this study, 75% were males and 25% were females. Among these diabetic patients, 76.3% of male patients were diagnosed with foot ulcers as opposed to 23.8% of female patients. It was witnessed that majority of diabetic patients were from Asia [53.1%] and Middle East [33.8%] whereas African [12.3%] and European [0.8%] patients made up a minority. Diabetic foot ulcers were reported more in Asian patients [57%] compared to patients from Middle East [29.1%]. The age of majority of the diabetic patients in this study was the range of 30 to 70 years and diabetic foot ulcers were most prevalent in the age group 50 to 59 years [42.5%] and least prevalent in the age group 20 to 29 years [5%]. Asian middle-aged male diabetics are most likely to have foot complications. It is important to educate all diabetic patients about the importance of self-examination of both feet, and physicians should routinely examine the feet of all diabetic patients, which would go a long way in preventing development of foot ulcers

Solitary skin nodule in a young male: a case of cutaneous leiomyosarcoma

A case of cutaneous leiomyosarcoma in a young male is reported and literature reviewed. A 31-year old Asian male presented to the Dermatology OP with the complaint of a solitary swelling in the posterior aspect of the upper third of left thigh. On examination a skin colored nodule of about 1.6 cm diameter was found. It was dome-shaped, firm to hard, fixed to the skin and tender. An excision biopsy was done and the specimen was sent for HPE study. The result of biopsy was reported as cutaneous leiomyosarcoma. Cutaneous leiomyosarcomas are uncommon malignant soft tissue tumors which arise from the smooth muscles of the skin, the superficial type from arectorpilori muscle and the deep from the vascular wall of the capillaries. They comprise about 2-3% of soft tissue sarcomas. Our patient was an apparently healthy male who wanted to remove a small swelling in the thigh which had recently appeared. There were no remarkable clinical features to make a clinical diagnosis of cutaneous leiomyosarcoma. It was only when the skin biopsy was done that the histopathological examination revealed a cutaneous leiomyosarcoma. Hence a histopathological examination is most useful and necessary for the diagnosis of soft tissue tumors. The prognosis of the condition can be predicted using criteria laid down by Jenson et al. Long term follow up is necessary because of the risk of recurrence and metastasis

Lipid profile of patients with and without diabetic foot ulcers

To compare the lipid profile of patients with and without diabetic foot ulcers visiting surgery department in a university teaching hospital in Ajman, UAE. This hospital-based retrospective record analysis was conducted for patients with diabetes mellitus with or without foot ulcers visiting department of surgery during a period of eight years, from 2002 to 2010. Lipid parameters included were total cholesterol, HDL, LDL, VLDL. Among the diabetic patients recruited for this study, 75% were males and 25% were females. The mean HDL value for diabetic patients with foot ulcers was 37.3 +/- 8.3 whereas that for the non-foot ulcer patients was 31.3 +/- 7.9. The difference observed was statistically significant [p<0.05]. The mean value for the total cholesterol level was in the safe range for both non-foot ulcer and foot ulcer patients as they were both under 200. The mean total cholesterol was higher for diabetic patients with foot ulcer. Similar patterns can be seen for the LDL and VLDL with mean values for non-foot ulcer group being 102.1 and 35.5 and for foot ulcer group being 103.3 and 48.2 respectively, revealing that the mean is higher for diabetic patients with foot ulcer. The mean values for triglycerides were 207.4 and 186.1 for non-foot ulcers and foot ulcer patients respectively, which does not follow the pattern like the other values but this may be due to diet control. The mean values of all lipids except triglycerides were higher for the diabetic patients with foot ulcer group than those without but the only value which was statistically significant was HDL levels. This could be attributed to inability to adhere to an exercise regime due to the presence of foot ulcers. The differences observed in levels of total cholesterol, LDL, VLDL and triglycerides between the two groups were not significant

Knowledge, opinion and practice of hand washing among medical students in Ajman, UAE

Thorough hand washing during patient contact significantly reduces transmission of infections. It is a simple, effective and cheap method of preventing infections. Hand washing practice, an important component of universal work precautions, should be imbibed as a habit and way of life among medical students for them to be safe practitioners of the future. The objective of this study was to assess knowledge, opinion and practice about hand washing among medical students during patient contact. Medical students in all five years registered during the academic year 2009/10 participated in this cross sectional study. A structured, open-ended, self-administered, piloted questionnaire was used. Chi-square test was used to assess associations. About 96.4% of students understood the importance of washing hands to prevent infections. 78.5% of students always and 21.1% occasionally washed hands after touching patients; 89.7% always and 1.8% occasionally washed hands after contact with blood and body fluids. Knowledge and attitude about hand washing is satisfactory among medical students; nevertheless hand washing workshops need to be conducted at regular intervals to further improve hand washing compliance among medical students as per universal work precaution protocol

Effect of urinary ph and specific gravity in urolithiasis

This retrospective descriptive study was conducted to explore the role of urine pH and specific gravity in the formation of urinary stones among ultrasonographically proven urolithiaisis patients who reported to the Department of Surgery and Urology of Gulf Medical College Hospital and Research Centre [GMCHRC], Ajman, United Arab Emirates [UAE]. Patient's age, gender, anatomical sites of the stone and biochemical parameters were obtained from case records. One way Analysis of Variance [ANOVA] was used to find whether the mean specific gravity and pH changed according to anatomical sites of stone and different seasons. The analysis of variance showed that there is no statistically significant difference in urine pH between patients with stones in different anatomical sites. On comparing specific gravity of urine samples between patients with stones in different anatomical sites, a statistically significant difference [p<0.05] was observed. Duncan's multiple range test showed mean significant difference in the ranges of pH and specific gravity among patients with stone in urinary bladder compared to all other sites with a decrease in the pH and increase in the specific gravity [p<0.05]. On testing the correlation between pH and specific gravity using Pearson correlation, a statistically significant [p<0.001] negative correlation of-0.3 was obtained. The study identifies an association between pH and specific gravity in urinary stone formers

Mystique of Bezoars

We present a case report documenting an unusual case of small bowel obstruction due to phytobezoar which required exploratory laparotomy in a middle aged man with history of peptic ulcer surgery done two decades before. Bezoars are large conglomerates of vegetable fiber, hair or concretions of various substances in the gastrointestinal tract and patients with gastric surgery are at increased risk of development. The advent of acid reducing drugs and H. pylori eradication therapy has led to dramatic reduction in the need for surgical treatment of uncomplicated peptic ulcer. Thus, gastrointestinal bezoars are encountered less frequently than in the past but still may be a complication following gastrectomy for malignant disease, a procedure still undertaken frequently in regions where the disease is endemic. Whilst uncommon it is of interest to gastroenterologist and general surgeons as well as general practitioners who see patients with a previous history of gastric surgery

Apolipoprotein E Polymorphism In Two Populations Of Andhra Pradesh.

Apolipoprotein (apo) E genotypes were determined on 182 subjects of Kshatriya and 38 subjects of the Mala populations of Andhra Pradesh. Five genotypes (2/3, 2/4, 3/3, 3/4, 4/4) in the Kshatriya and three genotypes (2/3, 3/3, 3/4) in the Mala, representing three common alleles (e2, e3 and e4 allele frequencies were 0.052, 0.852 and 0.096 for the Kshatriyas and 0.040, 0.921 and 0.040 for the Malas, respectively). No significant difference was observed between these two populations for apolipoprotein (apo) E polymorphism. The genotypic distribution of apoE was at Hardy-Weinberg equilibrium in these two populations. Wide ranges of differences were observed in allele frequencies between populations of the world.