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Background: The objective of the study was to do diagnostic comparison of ultrasonography, hysteroscopy and histopathological examination in evaluation of abnormal uterine bleeding.Methods: An observational prospective study is conducted amongst 219 married women between age of 25 years to 59 years with Abnormal uterine bleeding admitted for diagnostic hysteroscopy at Obstetrics and Gynecology Department, Apollo Hospital, Bilaspur, Chhattisgarh from November 2022 to October 2023. Statistical analysis was assessed by chi square test.Results: Myoma is best diagnosed by Sonography. The exact size, shape, type of fibroid and location can be accurately diagnosed by USG. Endometrial hyperplasia, endometrial polyp, submucous fibroid, growth, septum, flimsy adhesions, focal lesions and intracavitary intrauterine lesions are best diagnosed by hysteroscopy. Endometrial carcinoma is best diagnosed by histopathology.Conclusions: Hysteroscopy has important role in diagnosis of intrauterine and endocervical canal abnormalities. Addition of hysteroscopy with histopathological examination of endometrial and cervical biopsy sample along with transvaginal ultrasonography enhances the accuracy of diagnosis. Use of hysteroscopy, ultrasonography and histopathology were not competitive rather complementary for diagnosing patients with abnormal uterine bleeding. Diagnostic tools like ultrasonography, hysteroscopy and histopathology helps in accurate, early diagnosis of endometrial and cervical cancer which prevents further damage and further spread and metastasis of disease to adjacent tissues/ organs. Early diagnosis and cure increases life expectancy and decreases morbidity and mortality.
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Background: Vault prolapse usually follows vaginal or abdominal hysterectomy and is usually associated with cystocele, rectocele and enterocele. Diagnosis is made clinically but magnetic resonance imaging can better detect enterocele than clinical finding.Methods: It was a prospective study over 3 years, so women presenting with vault prolapse, in which grading of vault prolapse was made clinically and by pelvic organ prolapse quantification (POPQ). Magnetic resonance imaging was performed for all cases to quantify prolapse and compare findings of MRI and POPQ with intraoperative findings of prolapse.Results: Mean age, parity, BMI were 58.4 years, 3.5, 22.71kg/m2 respectively. Most patients (75%) had vaginal hysterectomy while 25% had abdominal hysterectomy. Symptoms were pressure in lower abdomen and perineum (55%), bulge and feeling of mass descending in perineum (100%) and chronic constipation (60%). The type of prolapse was cystocele (100%), rectocele (100%), vault prolapse (100%) and enterocele (45%). MRI had agreement with intraoperative findings in 65% cases in cystocele, 45% cases in vault prolapse, 50% in rectocele but had much higher agreement of 88.8% for enterocele. While POPQ had higher agreement with intraoperative findings for cystocele (80%), vault prolapse (98%), rectocele (80%) but had poorer agreement for enterocele (66.6%).Conclusions: This study demonstrated that MRI was inferior in diagnosis of cystocele, rectocele and vault prolapse than POPQ but was superior in identification of enterocele than POPQ.
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Congenital frontal bone defects are rare and are often incidentally diagnosed. We present a case of a 7-year girl who presented with frontal scalp swelling post-trivial trauma in school. Computed tomography of the brain revealed Extradural hematoma in the frontal region in the midline with overlying bony defects in the frontal bone and scalp hematoma.
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Pyoperitoneum, apart from bowel perforation, can occur due to gynecologic causes like ruptured pyometra or ruptured tubo-ovarian abscess. Earlier, the management of pyoperitoneum included broad-spectrum antibiotics and emergency laparotomy with or without a hysterectomy and bilateral saphingo-oophorectomy. A higher rate of surgical complications like bowel or bladder injury was noted with surgery, and future fertility was also compromised in these patients. Later on, treatment strategies improved to laparoscopic drainage of pus with antibiotics without extensive surgery. However, such cases can be managed with an even more minimally invasive approach by image-guided pigtail drainage. In this report, we describe two cases of pyoperitoneum that were managed successfully with pigtail insertion and continuous drainage of pus along with antibiotics obviating the need for anaesthesia and surgery. It seems to be a promising approach for pyoperitoneum in a hemodynamically stable patient, not showing any features of severe sepsis.
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Alexander disease is a rare, progressive debilitating disorder that affects the nervous system and causes significant neurological problems and developmental delays. The symptoms of Alexander disease vary depending on the type and severity of the disorder, but they typically include developmental delay, intellectual disability, seizures and progressive neurological problems such as spasticity, weakness and ataxia. The proband is a case of a 9-month-old boy presenting with macrocephaly and neuroregression. Magnetic resonance imaging (MRI) revealed hyperintense signal in white matter with predominant involvement of frontal white matter, ventriculomegaly and involvement of basal ganglia, brainstem and cerebellum. The diagnosis was confirmed on genetic analysis. Alexander抯 disease is a rare neurodegenerative condition that characteristically presents with macrocephaly and high T2 signal in frontal white matter in infants.
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Background: Abuse, especially of children, is a widespread problem. It is crucial to be aware of the warning signs of child abuse and neglect and take preventative measures. The World Health Organisation estimated that 1 billion children (Aged 2-17 yrs) had been victims of violence in 2017. In 2014, UNICEF said that sexual abuse affected 120 million children worldwide. Mental and physical health may be permanently damaged. Objective was to assess the knowledge and to evaluate the effectiveness of the play and learn strategies (PALS) regarding prevention of child abuse among pre-schooler and their mothers.Methods: This study employed the "One group Pre-test, Post-test" pre-experimental design. Non-probability purposive sampling was used. The sample includes 100 mothers and 100 preschoolers. A pre- and post-test self-administered knowledge questionnaire was employed. Data were examined using descriptive and inferential statistics to meet study aims.Results: Present study indicates considerable pre-test knowledge level (p<0.05) among students. After intervention (Play and learn technique), preschoolers' post-test knowledge score improved to 7.86 from 5.16. The mean post-test knowledge score of mothers was 17.6 following intervention, compared to 5.93 pre-test. Education improves preschoolers' and mothers' post-test child abuse prevention knowledge, according to research.Conclusions: Investigators found toddlers prone to child maltreatment. Play and learn performed well to teach kids about child abuse prevention.
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Brinjal (Solanum melongena) is an important Solanaceae family vegetable, which is grown all around the world. It is affected by various fungal, bacterial, viral, nematode diseases but it is a major host for root-knot nematode, Meloidogyne javanica. Hence, for effective management of root-knot nematode experiment was conducted in field condition using the culture filtrate (3gm/kg soil) of bio-agents (viz., Trichoderma viride, Trichoderma harzianum, Purpureocillium lilacinum, Pochonia chlamydosporia and Pseudomonas fluorescens). The findings of the experiments revealed that, when compared to the control, all of the tested bio-agents considerably improved plant development characteristics and decreased nematode populations. Among the tested bio-agents T. viride was found most effective treatment with improve plant growth characters as well as in reducing nematode population over other treatment in field condition.
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Introduction: Squamous cell carcinoma (SCC) of the head and neck is the eighth most common malignancy in the world, which exhibits poor survival due to the high rate of loco regional LN metastasis. Malignant tumors of epithelial origin often metastasize to the RLNs. Micrometastasis (MM) represents tumor deposits measuring less than 2 mm in diameter. It is very difficult to diagnose MM by routine histopathological examination. So detection of MM by immunostaining using Pancytokeratin will yield a greater incidence of positive cervical lymph node MM. Aim: To detect the presence of MM in clinically negative lymph nodes. Material and Methods: In this study clinically and histopathologically confirmed cases of SCC with neck dissection (n=30), retrieved from the department of oral and maxillofacial pathology. Demographic data and Grading of OSCC were collected . Results: The cytokeratin expression was positive in 2 cases (11.8%) and negative in 28 cases (88.2%). The obtained ‘p’ value was 0.47, which is not statistically significant. Reactive changes in lymph nodes of different grades of OSCC were observed using H&E stain, among the nodes studied, the chief pattern noted was lymphocyte predominance. Thus, with this small sample size it is difficult to attain more reliable results. Further studies are required to be done, using more reliable methods and larger sample size for accurate detection of MM in lymph nodes of OSCC.
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Purpose: To describe a professionalism survey tool and its use to assess knowledge of medical professionalism in ophthalmology training programs in Central India. Settings and Design: Multi?center survey study. Methods: A validated 33?question, scenario?based survey addressing professionalism attributes was administered at five centers in central India. The attributes tested included “personal characteristics,” “physician–patient relationships,” “workplace practice and relationships,” and “socially responsible behaviors.” A mean attribute score (%) was calculated and compared to “gold standard” responses by a group of expert senior ophthalmologists (100% agreement for responses). Results: A total of 225 participants completed the survey; 124 residents, 47 fellows, and 54 consultants (98.4% response rate). The total mean attribute score was 80.7 ± 9.1 (min 16.67, max 100). There was variation in the mean attribute score by professionalism attribute (P < 0.001), and a trend toward higher mean attribute scores for consultants compared to trainees across all attribute groups. The scores for “personal characteristics” (93 ± 9.7) and “physician?patient relationship” (82 ± 15.8) were the highest, whereas scores for “socially responsible behaviors” (73.9 ± 18.6) and “workplace practices” were low (72 ± 13). Conclusions: There is a generally high level of professionalism knowledge among ophthalmologists in central India. The results suggest that experience does impact knowledge of professionalism. Potential for improvement in professionalism exists in around "workplace practices", and around "socially responsible behaviors". These findings may serve as a valuable discussion starter and teaching tool to enhance professionalism in ophthalmology training programs.
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Purpose: The objective of this study was to identify the association between fetal hemoglobin (HbF) concentration, blood transfusion, and retinopathy of prematurity (ROP) in preterm infants. Methods: This was an observational, prospective study. A total of 410 preterm infants born with <36 weeks gestational age and <2.0 kg birth weight in a tertiary care center of central India for a period of 1 year were included in this study. Clinical data were obtained from case notes. HbF of infants was measured in the blood sample using high?performance liquid chromatography at the first visit and after 1 month follow?up and was analyzed statistically. Dilated fundus examination was done as per ROP screening guidelines, and ROP was classified as per the International Classification of Retinopathy of Prematurity (ICROP), 2021. The study subjects were divided into two groups based on the status of ROP. The relationship among HbF, blood transfusion, and ROP was evaluated in both the groups. The relationship between other clinical characteristics and various neonatal risk factors was also studied between the groups. Results: A total of 410 preterm infants were included in this study, of which 110 infants had ROP (26.8%). Blood transfusion was found to be significantly associated with the development of ROP. Higher fraction of HbF (%) was associated with a lower prevalence of ROP. HbF was also inversely related with the severity of ROP. Conclusion: Replacing HbF by adult hemoglobin during blood transfusion may promote the development of ROP. Conversely, maintaining a higher percentage of HbF may be a protective factor against ROP.
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In our daily lives, we have to perform multiple tasks in different areas. This leads people to two paths: carrying out the task as soon as possible or postponing it; the latter being part of the tendency to delay the start or completion of a task. This act also known as procrastination. procrastination is the characteristic or behavioural propensity to put off or delay completing a task or making decisions. Procrastination behavior is very common and a serious problem in the era we live in. Academic procrastination appears to be common in academic environments as students frequently put off their obligations without good reason and submit their work right up until the deadline. All levels of kids are impacted, and it may lead to major problems including declining grades and decreased wellbeing. The notion of academic procrastination, reasons why it occurs, negative effects of academic procrastination and several methods for dealing with it are all discussed in this article. It is suggested that some programs should be devised and executed to teach task-oriented coping strategies to students. For this one should reflect on the reasons why you procrastinate, your habits and thoughts that lead to procrastinating
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Rogers syndrome (Thiamine responsive megaloblastic anaemia-TRMA) occurs due to defect in the SLC19A2 gene. SLC19A2 and SLC19A3 genes encode THTR1 and 2 respectively, which are thiamine transporter proteins. The SLC19A2 gene is expressed in the inner ear cells, ?-islet cells, and hematopoietic stem cells; consequently, the typical clinical trial of TRMA is diabetes, TRMA, and sensorineural hearing loss. This syndrome, eponymously called Roger’s syndrome is rare. Mode of inheritance of TRMA is autosomal recessive. Clinical presentation as recurrent stroke is extremely rare. We present a case of a five-year-old boy who had recurrent large artery territory cerebral infarcts, with no other identifiable underlying cause of stroke. During current admission, no underlying etiology could be identified for cerebral infarct. On workup, a preliminary diagnosis of TRMA was made and thiamine supplementation was instituted. Gene analysis confirmed the diagnosis. The child was a product of non-consanguineous marriage. There was history of early childhood demise of two older siblings within five years of age due to diabetic ketoacidosis (DKA). TRMA is a rare autosomal recessive syndrome that manifests as a typical triad with diabetes, hearing loss and megaloblastic anaemia. The treatment is with high dose thiamine supplementation that can alleviate symptoms of diabetes and megaloblastic anaemia. Onset and progression of hearing loss may be delayed with treatment. Some cases may present with recurrent stroke as in the proband.
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Background: The prevalence of skin diseases has increased over the last few decades, and they contribute to a significant burden on health-care systems across the world. Aims/Objective: This report looks at the burden of skin and subcutaneous diseases in terms of years lived with disability and age-standardised years lived with disability in India using the Global Burden of Disease Study results from 2017. Methods: Data were obtained from the Global Burden of Disease online interactive tool. Updated estimates of the world’s health for 359 diseases and injuries and 84 risk factors from 1990 to 2017 are available in this interactive tool. Results: Years lived with disability due to skin and subcutaneous diseases accounted for 4.02% of the total years lived with disability in India in 2017. There was an increase of 53.7% in all age standardised years lived with disability for all the skin and subcutaneous diseases from 1990 to 2017. Among skin and subcutaneous diseases, dermatitis contributed maximum years lived with disability (1.40 million; 95% uncertainty interval, 0.82–2.21) in 2017, followed by urticaria (1.02 million; 95% uncertainty interval, 0.06–1.44) with percentage increases of 48.9% and 45.7% respectively. Conclusion: The burden due to infectious skin diseases (e.g., scabies, fungal skin disease and bacterial skin disease) and non-infectious diseases (e.g., dermatitis, urticaria and psoriasis) has increased over the past three decades, however the age-standardised years lived with disability for leprosy, scabies, fungal infections, sexually transmitted infections and non-melanoma skin cancer (basal cell carcinoma) has decreased. The high burden of skin and subcutaneous diseases demand that they be given due importance in the national programmes and health policy of India.
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The unprecedented outbreak of COVID-19 in India turned out to be pandemic that affects the whole world and paralyzes economic activities. The widespread of this epidemic has not only threatened human health but also production, economy, social functioning, education, etc. In this critical pandemic situation, a large number of the population are fighting for their lives and economic challenges for survival. It has seriously affected the Indian economy as well. The objective of this paper is to explore the available COVID-19 statistics and understand the impacts in India caused by covid-19 pandemic.
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Background: Prelabour rupture of membrane is defined as a rupture of membrane before onset of labour and in the absence of uterine contraction. When it occurs before 37weeks it defined as a preterm PROM. One of the most common complication is preterm delivery approximately 7-10% and account for 1-2% of foetal death. Most commonly associated with subclinical UTI.Methods: A prospective study was conducted from (June 2021-June 2022) at a tertiary health care hospital. All female with spontaneous rupture of membrane after 28weeks of gestation.Results: In present study total 200 cases taken and incidence of department was 6.76%,varies between 2% to18% commonly involved age groups belongs to 20-24 years, at 35 -36 weeks (52%) and with high vaginal delivery rate (approximately) with average baby weight between 2.1-2.5 kg with more than 7 APGAR score, more in multigravida.Conclusions: Incidence of prelabour rupture of membrane can be reduced by early diagnosis of subclinical UTI in antenatal visits.
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Background: Objective of the study was to identify and analyse the etiology of thrombocytopenia in pregnancy and review the evaluation of thrombocytopenia and its outcome in pregnancy.Methods: Retrospective study conducted at D. Y. Patil Hospital, Kolhapur, Maharashtra, India, from January 2021 to January 2023, in the Department of Obstetrics and Gynecology. All the antenatal women admitted in the ward of obstetrics and gynecology with platelet count less than 1 lakh/cubic cc were included in the study. Thorough evaluation for the cause of thrombocytopenia and outcome of the patient were collected and results were analyzed.Results: Out of 3319 deliveries, 100 patients had platelet counts less than 1 lakh. Overall, in the present study, Gestational thrombocytopenia (38%) is the most common cause of low platelets in pregnancy, followed by pre-eclampsia (20%) and DIC (16%). The rest of the etiologies rarely cause thrombocytopenia in pregnancy (<10%).Conclusions: Despite thrombocytopenia is a common abnormality in pregnancy, it seldom leads to life-threatening complications by itself. By contrast, a significant thrombocytopenia associated with medical conditions can have serious maternal-fetal consequences and requires appropriate management. The management of thrombocytopenia focuses on the underlying cause/etiology which is challenging because there are many potential causes, some directly related to the pregnancy and some unrelated. Cause directed therapies, if promptly administered, may significantly improve the maternal and fetal outcomes. Study intended to evaluate the wide spectrum of causes for thrombocytopenia in pregnancy and its outcome. Preeclampsia with or without HELLP syndrome is found to be very important cause of severe thrombocytopenia and attributed with maternal complications. while the perinatal outcome of gestational thrombocytopenia and immune thrombocytopenic purpura is basically favourable.
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Introduction : Medical errors in Healthcare is now a global concern and patient safety is become a significant priority. Despite the escalating need for patient safety curriculum in Medical Education, few Medical Schools have a structured training in place. We did this study to evaluate the attitudes of Indian Medical Students towards patient safety. Methods : This was a descriptive, cross-sectional, questionnaire based study done over 6 months among cohorts of 2nd and 3rd year Medical Students. The Attitudes to Patient Safety Questionnaire-III was used. The responses were noted using a 7-point Likert scale. Mean scores were analysed for 9 domains consisting of 26 items and compared for the two groups using Students 't' test. The sample was set at 95% confidence interval. p < 0.05 was considered statistically significant. Results : Total of 190 students participated, 70 second year and 120 third year students with response rate of 46.6% and 80% respectively. Both groups showed positive response for domains of working factors as an error cause, team functioning and error inevitability. Lowest score was received for professional incompetence as an error and disclosure responsibility. There was a significant difference between the two groups in one domain and 6 individual items. Discussion : The results of the study reveal that there is a need to include structured patient safety curriculum in Undergraduate Medical Education which was strongly acknowledged by the participants. Non-technical skill training would help student develop positive attitudes towards teamwork, error reporting and disclosure responsibility
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Modern technology has become an integral part of the daily lives of the new generation in the fast- changing 21st century. As a result of instant access to digital information and communication technologies via mobile phones and the internet, this generation is called the 'Digital Generation'. Without understanding real love and association with family and friends, they con?ne themselves to the digital world. People with high emotional intelligence (EI) feel a sense of association and belongingness. A person's emotional intelligence is their ability to comprehend and cope with dif?cult and complex situations in life. By overcoming stress, EI can enhance productivity. An analysis of the relationship between Emotional Intelligence and Academic Stress is presented in this paper
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Background: Nikshay Poshan Yojana (NPY) was launched in 2018 aiming to provide nutritional incentive of INR 500 per month to all tuberculosis (TB) patients till they complete their treatment. Aim of present study is to determine the number (proportion) of patients being treated for tuberculosis who received the bene?ts of NPY and to explore the ways incentives were utilized by the patients.Methods: This cross-sectional study was conducted in two tuberculosis units of North India from June 2022 to Dec 2022. All newly diagnosed TB patients registered and receiving treatment in these two Units were included in the study. Defaulters, relapse, failure and multidrug-resistant TB cases were excluded. Data was collected from Nikshay portal. All the patients were contacted telephonically to know whether the incentive was utilized for nutrition.Results: Total 189 patients were included in the study. All patients received benefit under NPY. But only 26 (13.7%) received incentive in scheduled time. Out of 189 patients 56 refused to give telephonic interview about the utilization of incentives. Out of 133 patients who gave interview 85 (64%) patients utilized incentive entirely for nutrition.Conclusions: Government should assure timely availability of funds so that patients can be benefitted timely particularly during initial months of their treatment. Also, there is a need of counselling of patients receiving treatment for tuberculosis about the importance of nutrition in their treatment so that they can utilize financial incentive for nutrition.
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Background: A sound knowledge about vaccination against coronavirus disease-2019 (COVID-19) among health professionals is of great importance in spreading right information to general population. Aim of the study was to find the level of knowledge, attitude and practice (KAP) of health professionals towards COVID-19 vaccination.Methods: This observational study based on questionnaire done in two district hospitals of North India. Following questionnaire’s content validity, printouts of questionnaire were distributed among the healthcare workers. The assessment was made by a scoring scheme for KAP. The statistical analysis done using SPSS software and Spearman’s rank co-relation used to calculate the correlation between KAP.Results: Total 300 subjects participated in study. Social networking platform was the major source for acquiring information about COVID-19 vaccination among paramedical staff while the source of knowledge for doctors was mainly scientific websites.62.67% had moderate knowledge, 88% had positive attitude towards vaccination and 73% showed good practice. There was significant difference of KAP towards vaccine between doctors and paramedics.Conclusions: In most of health care workers level of knowledge towards COVID-19 vaccination was found to be moderate and attitude was predominantly positive. Adequate knowledge and positive of health professionals are very important for increasing the acceptance of vaccination in general population.