A Study of Low Birth Weight and Associated Maternal Factors in A Rural Field Practice Area of a Medical College at Ahmedabad City of Gujarat

Introduction: In developed countries, about 50% of all Low-Birth-Weight new born are preterm. Low birth weight is also a leading cause of neonatal death and major risk factor for infant and under-five morbidity and mortality. Objectives: To find out prevalence of low birth weight& to determine the association of socio-demographic variables, maternal medical and obstetric risk factors with low birth weight. Methodology: Across sectional community-based study was conducted in a rural field practice area of a medical college. A total of 600 participants (mothers who delivered within 3 months) were included in the study. Results: The prevalence of LBW was found to be 17% in the current study. Statistically significant asso-ciation was obtained between age, education, occupation, socio-economic class of participants and birth weight of the child. The prevalence of LBW was found to be significantly high (51.7%) amongst children of those participants who consumed/used tobacco in any form. Conclusion: The prevalence of the LBW was found to be 17%. Extremes of reproductive age group, illit-eracy, occupation of labourer, SEC class IV, grand-multiparity, inadequate IFA consumption, short stat-ure, weight of mother and use of tobacco were found to be significantly affecting the birth weight and as-sociated with low birth weight.

A cross sectional study on the evaluation of MCH services provided by “ASHA” working at Urban Health Centers of Ahmedabad City, Gujarat

Introduction: National Rural Health Mission (NRHM) was launched by Indian Government with key feature of introduction of a new designated health care worker – “Accredited Social Health Activist” (ASHA) who acts as interface between community and public health system. Objectives: To assess knowledge about MCH related functions and to estimate status of support to beneficiaries by “ASHAs”, To Assess Quality of Home Based New Borne Care performed by ASHA and to find out impact of number of modular training rounds on knowledge and practices of ASHAs. Methodology: A cross-sectional study was conducted during February 2019 to December 2020 using a mixed approach, with a combination of quantitative and qualitative research methods after approval of institutional Ethics committee. All Urban Health Centres (UHC) under Municipal Corporation in Ahmedabad were covered. From each UHC, 2 ASHAs were selected by lottery method. So, total 144 ASHAs were selected from 72 UHCs. Performance assessment was done by direct interview with ASHA and their beneficiaries. Results: All 144 ASHAs were aware about responsibilities of Antenatal-women registration and Immunization. Nearly all ASHAs (99.3%) knew about task of PNC registration. Escorting to delivery and tertiary care centre, if complications arise was facilitated by 61.8% and 29.2% ASHAs respectively. Conclusion: All ASHAs were aware of their major responsibilities related to MCH and also providing same in their field area. Statistically significant association was observed between number of rounds for modular training undertaken by ASHAs and knowledge and practice of ASHAs in context to various components of MCH care.

A cross-sectional study on awareness regarding breast cancer and its screening techniques in field practice area of GMERS Medical College, Dharpur, Patan, North Gujarat, India

Background: Breast cancer is one of the most dangerous and lately diagnosed cancers which precipitate high number of morbidity and mortality. Breast cancer is now the most common cancer in most cities in India. To prevent its occurrence, women should be aware of early signs of it. Early detection can be done by different screening techniques such as self-breast examination, clinical examination, and mammogram. Objectives: The objectives of this study were as follows: (a) To assess the awareness regarding breast cancer and their screening techniques among women and (b) to find out the associated factors of breast cancer and their awareness among women. Materials and Methods: The study was carried out among 100 women selected by purposive sampling residing in the field practice area of Gujarat Medical Education and Research Society Medical College, Dharpur, Patan, during January 2019–March 2019 after approval of the institutional ethics committee. Self-tested semi-structured questionnaire was used after performing a pilot study. Results: Very few female had personal and family history of breast cancer. Awareness regarding breast cancer was found higher in educated as compared to illiterate. Working women had more knowledge regarding the issue than housewife. Awareness regarding how often breast self-examination (BSE) should be performed and what to look for while doing BSE was awareness regarding BSE as a screening tool was found only in half of the study participants. Conclusions: The study participants who had personal and family history of breast cancer were well aware of the clinical signs of breast cancer and its screening techniques. Literate and working women were having more knowledge regarding breast cancer. Overall awareness regarding the disease and its screening techniques was low in the study population.

Ascariasis as a cause of hepatic abscess: A report of 3 cases.

We receive around 60 cases of hepatic abscess in a year. The commonest diagnosis reached at the time of discharge is amoebic liver abscess. The diagnosis of amoebic liver abscess is mostly presumptive and thus the patients are usually given a mixed treatment with injection ceftriaxone and tablet metronidazole. Here we report three cases of hepatic abscess diagnosed recently, where ascariasis was the probable etiology. Ascariasis may be a much commoner cause of hepatic abscesses in this region than we think.

Patterns of organophosphorous poisoning attending a teaching hospital.

The objective of this was to study the pattern of patients of organophosphorous (OP) poisoning attending Kathmandu Medical College Teaching Hospital (KMCTH). This is a retrospective study of OP poisoning from hospital records were analyzed meticulously and data extracted. Data collected were: patient's demographics, motive for poisoning, type of OP poison, arrival time, time since ingestion, patient's vitals, predisposing factors, serum cholinesterase levels, treatment given, duration of hospital stay and mortality. A total of 47 patients of OP poisoning attended KMCTH from Aug 2003 to July 2005. 22(46.8%) cases were male and 25(53.2%) were female. The maximum number of patients were between the age of 20-40 (33-70.2%). Married patients outnumbered the unmarried (35/74.5% vs 12/25.5%). The most common motive for poisoning was suicidal, 41 cases (87.2%). Metacid (methyl-parathion) was the most commonly used OP compounds in 32 (68%) patients. Interpersonal marital relationship seemed to be the commonest predisposing factor, 23 cases (48.9%).The commonest time of presentation was between 6 pm-12 midnight. 7(57.4%) cases presented within 2 hours of ingestion of the poison. Serum cholinesterase level measured after full atropinisation was >50% of normal level in 17 cases (36.2%). 10 cases (21.3%) required respiratory support. Intermediate syndrome (IMS) was observed in 3 cases. Overall mortality occurred in 3 cases (6.4%). This study highlights the problem of OP poisoning in our region. Establishment of strict policies against the sale and availability of insecticides and pesticides which are freely available in the market is an effective way to control OP poisoning.

Odontogenic origin of necrotizing fasciitis of head and neck - a case report.

Necrotizing fasciitis (NF) of head and neck is a fulminant infection associated with necrosis of connective tissue which spreads along the fascial planes with high mortality rate. It is usually polymicrobial, odontogenic and occurs more frequently in immunocompromised patients. Because of the rarity of the disease, early diagnosis and early management is often delayed. We present a diabetic patient who developed NF of head and neck following tooth extraction. Because of vigorous teamwork he could be saved from the fatal disease but required extensive plastic repair. Every clinician should be aware of such a disease, particularly in immunocompromised patients and necessitates earliest diagnosis and intervention to save their life. Keywords: Necrotizing fasciitis, necrotizing soft tissue infections.

Seroprevalence of hepatitis "B" in Kathmandu Medical College Teaching Hospital (KMCTH).

A retrospective study conducted in patients attending Kathmandu Medical College Teaching Hospital (KMCTH) Sinamangal Kathmandu over a nine months period from April 2001 to December 2001. The aim of present study is to assess the seroprevalence of viral Hepatitis B in patients attending KMCTH. A total of 200 patients blood were examined for the presence of Hepatitis B virus infection, out of that 5 (2.5%) were found to be positive for Hepatitis B surface antigen (HBsAg) tested by immuno-chromatographic method. All the positive cases were found to be male age between 21 to 80 years and most of them 3 (60%) are young and productive age group (21-40 years).

Role of ultrasound in the evaluation of blunt abdominal trauma.

Twenty nine cases of intra abdominal injuries who became stable after initial shock were selected for ultrasound examination. Ultrasound detected intra-abdominal hematomas in 19/29 (65.51%). These cases were managed conservatively. The different types of hematomas encountered were renal, hepatic, splenic, retroperitoneal and parietal.