Cranial Index In North Indian Crania (Predominantly Haryanavi).

Shape of crania is seen by measuring cranial index in 150 (115 male and 35 female) crania. Crania were obtained from the department of Anatomy, Pt. B.D. Sharma PGIMS Rohtak. In males, 91.07 % crania were found dolichocephalic while in females 97.14% crania were dolichocephalic. Few crania were found mesocephalic (6.25% in males and 2.85% in females) in both sexes. None of female crania was seen as brachycephalic. Percentage obtained in present study is quite different from any other population studied as most of the crania were dolichocephalic. So it can be used as a tool to identify crania of this region.

Ultrasonically guided percutaneous drainage of breast abscess.

Percutaneous drainage of abscess under ultrasound guidance is a well established modality. Its use in breast abscess has still not found wide application. The present study on 25 consecutive cases of breast abscess with success rate of 84% is an attempt to recommend routine use of this modality wherever the facilities exist.

Practice of standards in female sterilisation.

During training of trainers (TOT) courses organised for medical personnel of Haryana Civil Medical Services (HCMS) by COE Medical College, Rohtak, 55 doctors involved in female sterilisations were interrogated regarding practices in counselling, informed decision, asepsis, surgical procedure, operative and postoperative care and follow-up of the clients accepting sterilisation as contraception. Counselling was the responsibility of auxiliary nurse cum midwife (ANM) lady health volunteer (LHV)/other paramedical workers as viewed by 89.1% participants whereas 85.4% thought that the registration clerk should take the informed consent. Eligibility criteria were always adhered to by 10.9% participants. Asepsis and sterilisation of instruments, etc, were maintained by operation theatre (OT) attendant or OT nurse as answered by 90.9% doctors. Skin preparation was done by a solution containing cetrimide and chlorhexidine alone by 70.8% doctors. The ligation and excision was the method practised by all. Catgut suture was used by only 43.6% doctors. Twenty-six maternal deaths were reported by 20 participants during their whole career. There were 7 deaths on the table, all with laparoscopic sterilisation. Peritonitis with septicaemia was the major cause of death in majority of cases. To ensure high quality and safety of voluntary surgical contraception, programmes must establish a system to ensure that standards are maintained.

Vesicovaginal fistulae: a 12-year study.

Repairs in 49 cases of vesicovaginal fistulae were performed during the last 12 years. Obstetric cause for vesicovaginal fistulae was noted in 81.63% cases and the most important being obstructed labour (73.46% cases). Repair was successful in 71.42% cases. Factors favourable for success were a non-obstetric fistula, small size fistula (< 10 mm) and absence of fibrosis. Repair operations were performed mainly by vaginal flap technique. The fistulous track was not excised. Polyglactin suture gave the best results.

Influence of intraumbilical oxytocin on the third stage of labour.

In this study the effect of intraumbilical oxytocin on duration and amount of blood loss in third stage of labour was studied. Pregnant women were randomized into 2 groups of 50 each. Group I <study group> was managed actively with 10 units of oxytocin diluted in 20 ml saline given through umbilical vein immediately after cord claming and Group II <control group> managed traditionally with oxytocin infusion 10 units in 250 ml of dexrose saline at rate of 125 ml/hr given after delivery of baby. In the study group there was a statistically significant decrease in duration of third stage of labour <1.48 min vs 3.27 min>, fall in haemoglobin <1.2 g/dl vs 1.96 g/dl> and fall in haematocrit <3.88% Vs 7.20%<. It was concluded that intraumbilical oxytocin appears to be a useful, safe and practical method for active management of third stage.

Evaluation of sepsis screen for diagnosis of neonatal septicemia.

Fifty clinically suspected cases of neonatal septicemia were studied for evaluating the role of sepsis screen. Sensitivity and specificity of C-reactive protein test, micro-ESR, gastric aspirate cytology for polymorphs and toxic granules in neutrophils were studied singly and in combinations of two and three tests. Positive blood culture was obtained in only 20% cases, thereby underlying the need for a sepsis screen in the diagnosis of neonatal septicemia, especially in areas where adequate micro-biological facilities are lacking.

Detection of Chlamydia trachomatis antigen by enzyme immunoassay in patients with pelvic inflammatory disease.

In 27 out of the 60 women clinically suspected to have pelvic inflammatory disease (PID) studied, the C. trachomatis antigen titre was found to be higher than the cut-off value. Since the presence of C. trachomatis antigen was detected in 45 per cent of women, it is suggested that all the PID patients may be investigated by ELISA to confirm the role of C. trachomatis as the etiological agent.

Postcaesarean wound infection: a review of risk factors.

In a prospective study of 431 cases delivered by caesarean section, wound infection developed in 54 (12.52%) cases. In 2.55% cases, infection was deep with drainage of purulent material. The factors associated with a high risk of wound infection were anaemia, multiple pelvic examinations, prolonged rupture of membranes and handling by dai. General ward cases had a significantly higher wound infection rate than the private ward cases.

Placental pathology in pre-eclampsia eclampsia syndrome.

Quantitative analysis of placental pathology was carried out on 20 placentae from various grades of pre-eclampsia eclampsia syndrome and 20 placentae from control group. Placental weights were lower in the study group. The gross abnormalities noted were the placental infarcts, retroplacental haematoma and calcification. The striking villous lesions observed in the study group were cytotrophoblastic cell proliferation, thickening of villous basement membrane and paucity of vasculosyncytial membrane and these findings correlated well with the severity of maternal disease. These vascular villous lesions were considered secondary to uteroplacental ischaemia.