Résumé
Background: The current treatment of haemophilia is replacement of factor VIII or IX which is effective till development of inhibitor against factors. There has been no study on factor VIII inhibitors in Southern Odisha using Nijmegen朆ethesda assay. This study was planned with objectives to screen factor VIII inhibitors in hemophilia-A patients, to do quantitative estimation of it using Nijmegen-Bethesda assay and to explore factors associated with development of inhibitors. Methods: This cross-sectional study was carried out from September 2016 to August 2018 in Department of pathology, MKCG medical college, Berhampur. Haemophilia-A patients coming to MKCG medical college and registered Haemophilia-A cases under Haemophilia society of Berhampur were included. Patients denying consent and having multiple clotting factors deficiencies were excluded. 1.8ml blood was collected. Mixing study was done to screen factor VIII inhibitors and then in positive cases inhibitors level measured by Nijmegen-Bethesda method. All data were analysed using SPSS (version 16.0).Results: 70 cases of Hemophilia-A patients were studied. Majority (50%) were with severe hemophilia-A. 7 patients developed inhibitors where 3 were high and 4 were low responders. Inhibitor level ranged from 0.8 to 64 Nijmegen-Bethesda units. Patients with severe hemophilia A, more than 10 transfusions and who switched to receive recombinant FVIII from other blood products developed inhibitors which were significant.Conclusions: Severity of hemophilia, increase frequency of transfusion and switching of blood products significantly increases chances of inhibitor development and hence intensive inhibitor screening is needed in these cases. Quantification of inhibitor is needed to monitor treatment and to manage bleeding episodes effectively.
Résumé
Background: Sickle Cell Disorder (SCD) is a major health problem in India. After introduction of High-Performance Liquid Chromatography (HPLC) in MKCG Medical College, this study is first of its kind to describe haemoglobin variants of SCD. The aim of the study was to document haematological profile and pattern of haemoglobin variants in SCD patients.Methods: A Hospital based cross sectional study was conducted in Pathology department, MKCG medical college from October 2018 to May 2019. Sickle cell patients were included and patients in Sickle cell crisis or transfused with blood in last 3 months were excluded. Hematological indices were measured by Sysmex XT 2000i blood analyzer. Quantification of hemoglobin variants was done by HPLC. All data were analyzed using SPSS and Independent t-test was applied.Results: In this study 100 heterozygous and 116 homozygous cases were reported. In homozygous cases Hb were significantly low and MCV, MCH, RDW-CV were significantly high than heterozygous. Hb level was significantly lower in homozygous children. Hb F was significantly higher in children and homozygous cases. A significant positive correlation was seen between Hb and RBC in both cases.Conclusions: In homozygous cases moderate anaemia (microcytic hypochromic to normocytic hypochromic) with High Hb F and in heterozygous cases mild anaemia (microcytic hypochromic) dominated the haematological profile. Children were significantly more anaemic than adults in homozygous cases. Anisocytosis was significantly more in homozygous cases and pediatric age group. Average fetal Haemoglobin variant (Hb F) was significantly more in homozygous cases and lower in adult group in both homo and heterozygous cases.
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Background: Anganwadi centres (AWCs) remain hub for promoting nutrition in children. For an effective functioning of programs, Anganwadi workers (AWWs) need to have a sound knowledge and perception regarding under-nutrition. A qualitative study (Focus Group Discussion) was conducted with aim to assess perceptions and knowledge of AWWs regarding under-nutrition in 6 domains like about term under-nutrition in children, its causes, identification of it, its community management, advices to be given to parents and knowledge of program related to under-nutrition in their locality.Methods: 2 Focus group discussions (each consisted of 12 members and took around 40-45 minutes) were conducted in December 2018 among AWWs of Berhampur through purposive sampling. One author played role of facilitator who carried out discussions, another acted as recorder who took notes and sociograms were recorded by another author. Audio-visual recordings were done. Data were analysed and a report was created based on grounded theory.Results: Participants had fair knowledge of term under-nutrition. They had good knowledge of causes of under-nutrition in children and knew how to identify. But none of them had proper knowledge of community management of malnutrition (CMAM) in children. Though most of them have knowledge of screening of malnourished children and referral to Nutritional rehabilitation centre, they were unaware of other key components of CMAM. Many AWWs didn’t know much about programs for combating malnutrition; however they were well acquainted with ICDS and VHND.Conclusions: Quality training programs and more sensitisation should be done for Anganwadi workers. Specific training on CMAM should be carried out for them.
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Background: India accounts for 25% of total deaths from cervical cancer. Screening for cervical cancer reduces mortality by early detection and treatment. So, a study was conducted among rural women of Ganjam district with the objective to know knowledge, attitude and practice of cervical screening among them.Methods: A community based cross sectional study was conducted from January to February 2019 among ever married women of more than 30 years of age residing in villages of Chhatrapur block of Ganjam district. Sample size was calculated to be 280 by formula Z2pq/l2. Multistage random sampling and PPS method were used to select participants. A semi-structured questionnaire was used to collect data and all data were analysed in SPSS.Results: Among 280 participants, though 70.7% had heard about cervical cancer, only 32.5% knew that there are tests for screening. Only 13.2% of participants said that Pap smear test was to be taken regularly. However, majority didn’t know who should undergo screening test and what age tests should be started. Main source of information for them was health worker (39%). Only 14.6% had any type of cervical screening in their lifetime. The main reason for not going for screening was ignorance (53.9%) followed by thinking tests are not needed unless any symptoms appearedConclusions: Proportion of participants with proper knowledge and awareness regarding cervical cancer screening was low which led to poor uptake of screening. So, awareness regarding cervical cancer screening should be increased. Health camps and education programs should be conducted regularly.
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Background: Globally approximately 830 women die from pregnancy and child birth every day. Most of deaths can be prevented by proper planning like birth preparedness and complication readiness (BPCR). The aim of study was to assess awareness and practice regarding BPCR among pregnant women and recently delivered women and to identify socio-demographic factors affecting it.Methods: A community based cross sectional study was conducted from September to December 2018 in villages of Chhatrapur block of Ganjam District among pregnant women (completed 24 weeks) and recently delivered women (12 months) regardless of newborn outcome. Sample size was calculated to be 96. Multi stage random sampling was adopted and PPS (Probability proportional to size) method was used. A questionnaire was used which contained socio-demographic information and set of 11 indicators to determine BPCR index. All data were analysed in SPSS.Results: BPCR index was 44.6% and it was higher (61%) in recently delivered women. 26% can be said to be well prepared and 45.8%, 27%, 32.3%, 37.5% knew at least one key danger sign in pregnancy, delivery, post partum and about new born respectively. A significant association was found between maternal education, age and pregnancy with awareness regarding BPCR.Conclusions: BPCR index in study area was low and a low proportion of participants were well prepared. Awareness about danger signs was quite low. So health workers at grassroots level should be encouraged to explain BPCR components to women and educational activities should be carried out to promote women to make plan a priori.