Evaluation of the Outcome of Modified Open Sandwich Technique and Conventional Composite Resin Restoration: For Managing Class II Cavity of Primary Molars Among 4- 8 years Old Children

Background: Dental caries is the most prevalent disease in humans, especially during early childhood. The restoration of such an extensive carious lesion should be done properly to reestablish their anatomy and hence their masticatory, phonetic, esthetic, and space-maintainer functions in the dental arches. Composite resins are the most commonly used tooth-colored restorative material, but many difficulties occur particularly when used directly in posterior restorations. The objective of the study was to compare the clinical effectiveness of the Modified Open Sandwich Technique and Conventional Composite Resin Restoration for managing class II caries on primary molars. Material & Methods: This was a randomized control trial and was conducted in the Department of Pedodontics, Faculty of Dentistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period from October, 2021 to September, 2022. In our study we included 68 patients with proximal dental caries of primary molars with reversible pulpitis. The patients were divided by using random sampling technique into two groups – Group A (The modified open sandwich technique, n=34) and Group B (The conventional composite resin restoration, n=34). Results: In total 68 patients from both the groups completed the study. In our study we found mean±SD of age was 5.37±1.24 years. 76.5% of cases of the modified open sandwich technique restorations were & 82.4% of the conventional composite resin restoration were < 6 years. Mandibular primary molars were 64.7% and 53% for the modified open sandwich technique and conventional composite resin restoration respectively. Conventional composite resin restorations showed 32.4% postoperative sensitivity and the modified open sandwich technique restorations showed 11.8%. After 12 months of follow-up, no secondary caries developed. Good marginal adaptation in 100% of cases were found in the modified open sandwich technique and 88.2% for conventional composite restorations. Conclusion: In our study we found that postoperative sensitivity developed more in conventional composite restorations in comparison to the modified open sandwich technique. Initially marginal adaptation showed better in the modified open sandwich method technique. So, conventional and modified open sandwich composite resin techniques were acceptable for primary molar teeth considering secondary caries and marginal adaptation

Clinical and Laboratory Characteristics of Infertile Women with Premature Ovarian Insufficiency

Background: Premature ovarian insufficiency (POI) is the preferred term for the condition that was previously referred to as premature menopause or premature ovarian failure. The condition differs from menopause in that there are varying and residual ovarian functions. This study aimed to analyze the clinical characteristics of infertile women with premature ovarian insufficiency. Material & Methods: This prospective study was conducted at the OPD of Impulse Fertility Center, Impulse Hospital, Dhaka, Bangladesh. The study was conducted for a period from January 2022 to December 2022. A total of 23 patients who received outdoor treatment during the study period were purposively selected as sample size. A purposive sampling technique was followed in this study. After approval by the Ethics committee of the Hospital, informed consent from the respondents was obtained after explaining the purpose of the study to them. To be included in the study, respondents should have met the classical definition of infertility defined by the WHO as the inability of a sexually active non-contraceptive using woman to have a live birth after 12 or more months of regular sexual intercourse without a malefactor. Women who had male-factor infertility were excluded. In this study live birth was used as a measure of proven fertility (Because couples desire children, not simply pregnancies, infertility affects couples regardless of whether the etiology lies in conception or the progression of the pregnancy). All the necessary laboratory investigations were done. A questionnaire was developed and data were collected by interviewing the patients and some data were collected from the laboratory results. Data were processed and analyzed by SPSS 19 version. Results: All patients had normal puberty, and menarche occurred at ages 11–15, followed by a regular menstrual cycle. Women who presented with oligomenorrhea were younger than patients with infertility. The mean period of oligomenorrhea before diagnosis was 0.9 years in the oligomenorrhea group and 1.8 years in the infertility group. The mean age when the infrequent periods started was 28 years in the group with oligomenorrhea and 29 years in the group with infertility, and their anthropometric characteristics were not different. In most patients, the FSH levels on day 3 of their menstrual cycle were less than 25?mU/ml. FSH levels >25?mU/ml were confirmed in two patients with oligomenorrhea and five patients in the infertility group. AMH levels were low than 1.0?ng/ml (considered to be in poor ovarian reserve ranges: from 0.13 to 1.0?ng/ml in patients with oligomenorrhea and from 0.13 to 0.9?ng/ml in the infertility group. Transvaginal ultrasound-determined AFC on menstrual cycle days 4–8 was accessed in all patients. We consider AFC?<?6 small follicles (diameters 3–9?mm) as a low ovarian reserve indicator. The lowest AFC (one small follicle) was noted in one infertile patient with oligomenorrhea. Conclusion: This study concluded that the subjects usually present with menstrual irregularity (oligomenorrhea) or infertility, and after proper evaluation, their poor ovarian reserve can be confirmed and an occult form of POI established. women who presented with only oligomenorrhea were younger than infertile patients; therefore, menstrual irregularity may be the earliest clinical symptom of occult POI.

Low Dose Aspirin for Primary Prevention of Adverse Pregnancy Outcome

Background: Pregnancy is associated with various complications such as pre-eclampsia, SGA, preterm birth etc. Low dose aspirin is a possible medication to minimize these adverse outcomes. The aim of this study was to evaluate the use of low dose aspirin for primary prevention of adverse pregnancy outcome. Material & Methods: This cross-sectional study was conducted in department of Gynaecology, North Bengal Medical College Hospital, Mirjapur Bkash Hospital, Mirjapur, Tangail, Bangladesh, during the period from June 2021 to August 2022. Total 200 pregnant women were included in this study. Results: In this study, the mean (±SD) age of the study subjects were 25.12 ± 5.49 years and 25.00 ± 4.83 years in LDA group and control group, respectively. There was no statistically significant (p>0.05) difference in age between the groups. The rate of caesarean section was higher in control group (68%) compared to LDA group (59%) but there was no statistically significant (p>0.05) difference among the groups. In our study, 8% pregnant women in LDA group and 19% pregnant women in control group had gestational hypertension, pre-eclampsia was seen in 6% and 13% pregnant women in LDA group and control group, respectively, preterm birth was seen in 8% and 17% pregnant women in LDA group and control group, respectively, SGA was seen in 19% and 32% pregnant women in LDA group and control group, respectively, and fetal distress was seen in 2% pregnant women in both LDA group and control group. There were statistically significant (p<0.05) differences in complications except fetal distress. Mean (±SD) neonatal birth weight was 2.88±1.03 kg and 2.74±0.85 kg in LDA group and control group, respectively and there was no statistically significant (p>0.05) difference. Conclusion: We found that low dose aspirin could significantly reduce the risk of adverse outcomes, especially for pre-eclampsia, SGA and preterm birth.

Healthy aging and care of the older adult with chronic disease: a qualitative needs assessment in 14 eastern and southern Caribbean islands / Envejecimiento saludable y atención de las personas mayores con enfermedades crónicas: evaluación cualitativa de las necesidades en 14 islas del Caribe oriental y meridional / Envelhecimento saudável e atenção à pessoa idosa com doença crônica: avaliação qualitativa das necessidades em 14 ilhas do Caribe oriental e meridional

ABSTRACT The objectives of this qualitative needs assessment were to assess perceived needs of health and social services professionals in the Caribbean Region to enhance services supporting healthy aging and care of older adults and to assess perceived facilitators and barriers to increasing capacity to serve their aging populations. The assessment, informed by the Consolidated Framework for Implementation Science, was conducted in 14 islands in the eastern and southern Caribbean. The results demonstrated need for education of professionals and the general population about the prevention and treatment of non-communicable diseases (NCDs), assessment and services for individuals with dementia, Alzheimer's disease, depression, and harmful alcohol use, all of which pose significant challenges for older adults. Education of health and social services professionals, families, and the public on the risk factors for NCDs and common mental and physical health problems is critical. Barriers to implementation of educational programs include lack of community awareness and resources within the islands. The needs assessment findings are foundational to planning educational interventions. These will be developed by local health providers with the collaboration and support of external resources including those of the Pan American Health Organization/World Health Organization Collaborating Centre in Gerontological Nursing Education.

Resumen Los objetivos de esta evaluación cualitativa de las necesidades fueron evaluar las necesidades que perciben los profesionales de la salud y de los servicios sociales en el Caribe a fin de mejorar los servicios de apoyo al envejecimiento saludable y el cuidado de las personas mayores, así como evaluar los factores percibidos como facilitadores y como obstáculos para mejorar su capacidad de atender a la población que está envejeciendo. La evaluación, basada en el marco consolidado para la ciencia de la implementación, se realizó en 14 islas del Caribe oriental y meridional. Los resultados mostraron la necesidad de capacitar a los profesionales y educar a la población en general acerca de la prevención y el tratamiento de las enfermedades no transmisibles (ENT), la evaluación y los servicios para las personas con demencia, alzhéimer, depresión y problemas de consumo nocivo de alcohol, todos los cuales plantean importantes desafíos para las personas mayores. Es imprescindible capacitar a los profesionales de la salud y de los servicios sociales, así como educar a las familias y al público en general sobre los factores de riesgo de las ENT y los problemas de salud mental y física más habituales. Entre los obstáculos a la aplicación de los programas educativos se encuentran la falta de concientización de la comunidad y la falta de recursos en las islas. Los resultados de la evaluación de las necesidades son fundamentales para planificar las intervenciones educativas, que serán formuladas por los prestadores de atención de salud locales con la colaboración y el apoyo de recursos externos, incluidos los del Centro Colaborador de la Organización Panamericana de la Salud/Organización Mundial de la Salud en Educación en Enfermería Gerontológica.

RESUMO Os objetivos desta avaliação qualitativa das necessidades foram avaliar as necessidades percebidas do pessoal da saúde e dos serviços de assistência social na região do Caribe, visando a melhorar os serviços de apoio ao envelhecimento saudável e de atenção às pessoas idosas e determinar os facilitadores e as barreiras percebidos, com vistas a melhorar a capacidade de prestar assistência às populações idosas. Esta avaliação foi realizada com base na Consolidated Framework for Implementation Science em 14 ilhas do Caribe oriental e meridional. Os resultados obtidos demonstraram que é necessário prover conhecimento aos profissionais e à população geral sobre a prevenção e o tratamento de doenças não transmissíveis, e a avaliação de pessoas com demência, doença de Alzheimer, depressão e uso prejudicial de álcool e os respectivos serviços, visto que são enormes desafios enfrentados pelas pessoas idosas. É fundamental que o pessoal da saúde e dos serviços sociais, os familiares e o público em geral conheçam os fatores de risco para doenças não transmissíveis e os problemas comuns de saúde mental e física que afligem a população idosa. A falta de sensibilização da comunidade e a escassez de recursos são barreiras à implementação de programas educacionais. As conclusões desta avaliação servem de base para o planejamento de intervenções educacionais a serem desenvolvidas localmente pelo pessoal da saúde, com a colaboração e o apoio de entidades internacionais, como o Centro Colaborador da Organização Pan-Americana da Saúde/Organização Mundial da Saúde para Educação em Enfermagem Gerontológica.

Facile Titrimetric Assay of Lysophosphatidic Acid in Human Serum and Plasma for Ovarian Cancer Detection

Herein, an instrument free facile acid-base titrimetric methodology is reported for lysophosphatidic acid (LPA) measurement in serum and plasma samples for ovarian cancer detection. The concept is based on the titrimetric method in which alkaline solution was titrated with free fatty acid. Free fatty acid is generated due to action of the lysophospholipase to LPA. A phospholipid derivative known as LPA can function as a signaling molecule. A glycerol backbone serves as the foundation for phosphatidic acid, which also has bonds to an unsaturated fatty acid at carbon-1, a hydroxyl group at carbon-2, and a phosphate molecule at carbon-3. Free fatty acid and glycerol-3-phosphate are formed when LPA reacts with lysophospholipase. The formation of free fatty acid depends on the concentration of LPA. The standard graph of known concentrations of LPA, LPA spiked serum and LPA spiked plasma was plotted. The concentration of LPA in unknown serum and plasma were calculated from the standard graph. The limit of detection of LPA in spiked serum and plasma samples via titrimetric assay was calculated as 0.156 μmol/L. A patient's chance of survival may be outweighed by an early diagnosis of ovarian cancer.

Study of antidiabetic activity of two novel Schiff base derived dibromo and dichloro substituted compounds in streptozotocin-nicotinamide-induced diabetic rats: pilot study

Abstract Schiff bases are aldehyde-or ketone-like chemical compounds in which an imine or azomethine group replaces the carbonyl group. Such compounds show various beneficial biological activities, such as anti-inflammation and antioxidants. The present study addresses comprehensiveevaluation of antidiabetic effect of two novel dibromides and dichlorides substituted Schiff bases substituted Schiff bases (2,2'-[1,2-cyclohexanediylbis (nitriloethylidyne)]bis[4-chlorophenol] (CNCP) and 2, 2'-[1,2-cyclohexanediylbis(nitriloethylidyne)]bis[4-bromophenol] (CNBP) with two different doses, high (LD) and low (LD) in streptozotocin and nicotinamide induced diabetic rats. The rats were separated into normal, untreated, treated and reference groups. Except for the normal group, diabetes traits were induced in the rest animals. Insulin level was measured, and the effect of the compounds on biochemical parameters of liver function and lipid profile were evaluated. High glucose and decreased insulin level are observed in the groups. The histological evaluation confirms that the hepatic architecture in the treated animals with a low dose of CNCP is quite similar to that of the normal hepatic structure and characterized by normal central vein, hepatocytes without any fatty alterations and mild red blood cell infiltration. CNCP (LD) and CNBP (HD) are more successful in enhancing cell survival in the diabetic rat's liver and can be responsible for causing much healthier structure and notable morphology improvement.

Role Of Primary Healthcare Centers In Rural Health Services Of The Bishnupur District, Manipur

The geographical area and the total population of Manipur shows that the majority are rural areas with higher rural population. People residing in rural areas are more prone to different kind of illness and diseases as compared to urban residents. Therefore, providence of healthcare services are vital to rural peoples. The state Governments, Health Department or the concerned authorities need to survey and takes up certain steps for the easier availability of the healthcare services and also the quality of facilities and services provided in the rural areas

PARATHYROID ADENOMA: A RARE TUMOUR CASE REPORT

Parathyroid adenoma is a rare tumour and are generally small size (< 2 cm) and <1gm weight. Giant adenomas are infrequent, are mostly elucidated as > 3.5 gm weight, along with few reports weights up to 110 gm. Parathyroid adenoma are usually found with primary hyperparathyroidism syndrome which is common, seen as third most common endocrine disorder. In this study a case of 52-year-old lady was refereed with complain of neck swelling, lethargy and generalized drowsiness. The results obtained from laboratory revealed increased serum calcium and increased parathyroid hormone. There is no significant history of renal stone, renal dysfunction or any family history of endocrinal tumours. Ultrasonography revealed a composite nodule with cystic and solid elements. Focused surgical neck exploration was performed with removal of 4 gm adenoma . Microscopic examination showed, encapsulated lesion formed of chief cells of parathyroid organized within network of capillaries. The most exact mechanism for localizing a Parathyroid Adenoma is altogether MIBI scan along with neck ultrasonography. Surgical excision with monitoring of parathyroid hormone screening during operation is the recommended conductance. Need for the intraoperative Parathyroid hormone monitoring is debatable in Parathyroid adenoma due to accuracy of preoperative imaging.

Histopathological Analysis of Biopsy Cases Processed at Diagnostic Centers of PAF Faisal And Masroor Hospital - A Prospective Study

Background: Histopathological patterns help to define the orientation as well as the duration of disease. The findings identified through this tool aids in the identification and selection of treatment modality as well as provides a prognostic assessment of the condition. Methods: A prospective study design was opted for this research. A total of 221 patients from either gender, ages between 31 to 38 years, undergoing different types of surgical procedures were en rolled from the Faisal and Masroor Base Hospital, Karachi Pakistan. After receiving consent, a biopsy specimen was taken and transferred to the laboratory for staining and further processing for histopathological examination. Results: The major findings i solated among specimens constituted of samples from the Appendix; 67.87% (150/221) followed by stomach; 18.10% (40/221). Among the appendix specimens, 82% (41/221) patients were suffering from acute appendicitis and the remaining had peri - appendicitis. Ami d the stomach specimens 65% (26/221) patients were diagnosed with (Mild) Chronic Superficial Gastritis, followed by 20% (8/221) patients with H - Pylori associated (Mild) Chronic Superficial Gastritis and the remaining were normal gastric antrum and chronic gastritis with partial villous atrophy. Conclusion: By using histopathological examination, the outcome of many diseases can be determined at an earlier stage thereby assisting in lowering the levels of morbidity and mortality among the population. In our research we were able to distinguish a variety of infections among different areas/ organs of the body.

Efficacy of Various Treatment Modalities on Patientrelated Outcome in Hospitalized COVID-19 Patients –A Retrospective Study

Background: The outbreak of coronavirus disease 2019 (COVID-19) caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in China, in December 2019, and was declared a pandemic by WHO on March 11, 2020. The treatment is evolving and is mostly supportive in nature. Material and methods: This was a single-center retrospective study that included confirmed COVID-19 cases treated at our institute (a tertiary care hospital in Jammu and Kashmir, India), between March 2020 and December 2020. Patients with age more than 18 years were included in the study. Results: On evaluating the effect of various drug therapies used in management of COVID-19 patients of all severity, use of remdesivir and famotidine was associated with significantly higher odds of survival. In subgroup of patients with severe disease, use of systemic steroids was associated with significantly higher odds of survival in addition to remdesivir and famotidine. In patients with severe COVID-19 illness, likelihood of survival was significantly higher in those who received combination of systemic steroids plus remdesivir compared to steroids and remdesivir alone. Conclusion: Steroids were effective in severe COVID-19 illness and the combination of steroids and remdesivir was more effective in severe illness. There is a need to undertake more large scale prospective randomized trials to determine the most effective drug therapies to treat the sick patients and prevent worsening of mild cases.

Attitude and perception towards vaccination against poliomyelitis in Peshawar, Pakistan

ABSTRACT OBJECTIVE: This research aimed to quantitatively assess the general public's awareness, attitude and perception of polio and its vaccination in Peshawar KPK, Pakistan. METHODS: We conducted a survey-based study to understand the surge in polio cases from 2015 to 2019 in the Peshawar city of the Khyber Pakhtunkhwa (KPK), Pakistan. A pre-tested questionnaire-based study was conducted in 2019 to assess the attitude and general perception of residents of Peshawar KPK towards polio vaccination. RESULTS: Out of 241 country-wide polio cases, 63 (26.1%) polio cases were reported in Peshawar city from 2015-2019. The questionnaire revealed that individuals between 18-30 years of age had sufficient knowledge (65.1%) about polio. Male and female participants had equal awareness (~ 43%). Participants with higher education (45.9%), those with better financial status (49.5%), individuals with children < 5 years of age (46.4%), and those who had experience of a polio patient (63.1%) had better knowledge. Participants inhabiting the central city were better aware (50.5%) of polio than individuals living in the outskirts. CONCLUSION: The data indicated that poor knowledge and negative attitudes of people towards polio vaccination are the main causes of the polio eradication program's failure. Moreover, religious beliefs, unchecked migration between the Pak-Afghan border, and lack of knowledge about polio vaccination are identified as critical barriers to polio eradication.

COVID-19 infection during pregnancy - maternal and perinatal outcomes: a tertiary care centre study

Background: With the exponential increase in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) worldwide, an increasing proportion of pregnant women are now infected during their pregnancy. The knowledge gained from previous human coronavirus outbreaks suggests that pregnant women and their fetuses are particularly susceptible to poor outcomes. The aim of this study was to summarize the maternal and perinatal outcomes of pregnant women infected with COVID-19 during their pregnancy.Methods: Eligibility criteria included pregnant women positive for COVID-19 as detected by real-time polymerase chain reaction (PCR) or dual fluorescence PCR-confirmed SARS-CoV-2 infection.Results: A total of 38 pregnant women positive for COVID-19 as confirmed by RT-PCR, were included in the study. 21% cases had preterm deliveries and LSCS was the preferred mode of delivery in 23 of 38 i.e., 60.5% cases. There was a tendency for low Apgar score at birth, higher rates of fetal distress, meconium, NICU admissions. There was one IUD and one neonatal death. The treatment patterns of COVID-19 infection among pregnant women during their pregnancy or following delivery was mostly supportive in the form of oxygen and antibiotic therapy.Conclusions: Although the majority of mothers were discharged without any major complications, severe maternal morbidity as a result of COVID-19 and perinatal deaths were reported. Vertical transmission of the COVID-19 could not be ruled out. Pregnant infected women had different symptoms, and they were given mostly supportive treatments than the general infected population. Careful monitoring of pregnancies with COVID-19 and measures to prevent neonatal infection are warranted.

Cholestasis of pregnancy: effects on maternal and fetal outcome

Background: Intrahepatic cholestasis of pregnancy (ICP) typically occurs in late pregnancy affecting 1.5-2% pregnancies. Limited data is available regarding its fetal and maternal implications. This study aims to assess the impact of ICP on maternal and fetal outcome.Methods: A total 200 patients with pruritus in later half of pregnancy were studied over a period of 18 months out of which 135 were diagnosed as ICP. Clinical and biochemical parameters like serum aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total protein, and gamma glutamyl transferase was recorded. Maternal and fetal outcome was noted in the form of LSCS rate, preterm births, fetal distress and neonatal ICU admissions.Results: In this study, most common symptom was pruritus. Most of cases had onset of symptoms between 32-36 weeks. High LSCS rates were seen among cases. Intrapartum complications viz. meconium staining of amniotic fluid (57.8%), preterm delivery (11.9%), fetal distress (42.2%) were significantly higher in study population and there was high incidence of NICU admissions (49. 6% neonates) among cases mostly due to meconium aspiration and prematurity.Conclusions: ICP increases maternal morbidity and is associated with adverse perinatal outcome viz. increased risk of fetal distress, preterm births and sudden IUD at term as evidenced in this study. A timely intervention at 37-38 weeks will reduce the adverse outcomes.

Analysis of urine as an indicator of specific body conditions in pregnant women in rural mountainous region

Background:Urinalysis is a procedure for examining physical properties, particulate matter, cells, casts, crystals, organisms and solutes. Urinalysis is a routine screening and diagnostic tool used to identify infections including renal, urological, liver disease, diabetes mellitus and urinary tract infection (UTI). Urinalysis can be used to screen, glucose, leucocytes, nitrite and blood. Although urinalysis is an effective screening tool it should not be used in isolation to guide treatment because false positives, for example, nitrites, and false negatives, for example, glucose, can occur if the sample is contaminated or left to stand for too long. UTI is among the leading reasons for treatment in adult primary care medicine, accounting for a considerable percentage of antibiotic prescriptions. Aim of this study is to identify the markers of urinary tract infection by urine routine microscopic analysis in pregnant women.Methods:This was a two months prospective study from June 1st 2019 to July 31st 2019. Urine samples of 72 pregnant women coming routinely to OPD of GMC,Doda were examined by physicaland biochemical analysisby microscopy methods.Results:Majority of samples were pale yellow with turbid appearance. Protein was present in most of the samples whereas glucose was present in a minor number of samples. Microscopy revealed increase in pus and epithelial cells count in most of the samples while bacteria were present in almost half of the samples.Conclusions:To conclude from the present study that appearance, presence of protein, pus cells, epithelial cell and bacteria, all taken together can serve as a strong indicator of UTI.

Knowledge and Awareness of Cervical Cancer and Screening Practices among Nurses at Lahore General Hospital, Pakistan

Objective:To determine the knowledge and awareness regarding screening practices of cervical cancer among nurses at Lahore general Hospital, Lahore, Pakistan.Materials and Methods:This cross-sectional, interview based study was conducted on 250 nurses at Lahore general Hospital, Lahore, Pakistan. The duration of this study was one year from 2017 to 2018. All the cases underwent interview based information regarding cervical cancer.The questionnaire was applied to assess the knowledge, awareness and screening practices about cervical cancer among nurses. Data was collected via self-made proforma.Results:Most of the study participants were less than 35 years. 72% nurses were married and 28% were unmarried. Most of the study participants 96% knew that cervical cancer is the abnormal growth of cervical cells and few were unaware regarding it. According to causes of cervical cancer 70% to 75.6% participants agreed that early marriage and multiple sex partners are the causative factors of cervical cancer, while others relate it to smoking, infection and hereditary causes. Most of the nurses 42.8% answered that cervical cancer can occur at menopausal age while 25.5% opted for any age. 75.6% to 95.5% nurses were in the favor of scanning, pap smear test and cervical biopsy methods. 34% of the participants said that it is a preventable disease via vaccination, early diagnosis and safe sex activities.Conclusion:It was concluded that nurses had satisfactory knowledge regarding screening practice of cervical cancer at Lahore general Hospital

A study of maternal outcome in first trimester bleeding

Background: The outcome of first trimester vaginal bleeding is a matter of debate. Vaginal bleeding is common and potentially alarming symptom in early pregnancy. First trimester bleeding is a common occurrence. It has been estimated to occur in 15-25% of all pregnant women. Objective of this study was to evaluate the various maternal outcomes in women with first trimester bleeding.Methods: This prospective observational study was conducted in the postgraduate department of obstetrics and gynecology, SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir, India. The study included 200 pregnant women presented with first trimester bleeding. All the women were followed prospectively till delivery and early postpartum period for various outcomes such as preterm delivery, PROM, PPROM, anemia, oligohydramnios, placental abruption, placenta previa and postpartum hemorrhage.Results: Out of 200 patients studied, 19% patients aborted. Ectopic and molar pregnancy was seen in 5% and 1.5% patients respectively. Out of 74.5% patients who continued pregnancy, maternal complications included anemia (52%), PROM (14.09%), oligohydramnios (6.71%), placenta previa (5.37%), PPH (4.03%), PPROM (2.68%), preeclampsia (2.01%), gestational hypertension (1.34%), abruption and post-datism (0.67% each).Conclusions: From the results of this study, it can be concluded that first trimester bleeding can be a predicting factor in terms of mother and infant consequences of pregnancy and it is necessary to increase the knowledge of pregnant women in this regard for closer care.

Atraumatic spontaneous swelling of sternoclavicular joint: a case report

Atraumatic spontaneous swelling of the Sternoclavicular Joint (SCJ) is not very common in elderly women. The SCJ is an integral part of the shoulder girdle that connects the upper limb to the axial skeleton. Trauma, degeneration, infections and other disease processes that affect synovial joints are the common causes of swelling of the SCJ. Here authors report a case of nontraumatic spontaneous anterior subluxation of the sternoclavicular joint in 66-year-old women without any underlying pathology who presented with sudden onset of a nontender swelling in the suprasternal area. The patient was treated conservatively and remained asymptomatic throughout 6 months follow up.