Knowledge, attitude & practices about cervical cancer and screening among nursing staff in a teaching hospital.

Background: Estimated cervical cancer screening practice is very low and load of cases very high in India. The studies document that nurses play a crucial role of enlightening community about need and availability of Pap smear. It is important therefore to understand the perceptions and practices of nurses about cervical cancer and screening. Aims & Objective: To evaluate the Knowledge Attitude & Practices (KAP) of the Nurses on cervical cancer and screening. Material and Methods: A self-administered, structured, open ended and pretested questionnaire covering the general characteristics, KAP about cervical cancer and screening (Pap smear) was used to collect responses of nurses in a Teaching Hospital at Surat. The information thus collected was entered and analysed in Epi Info and Microsoft Excel software. Results: Responses from 200 female nurses were recorded and analysed. Majority (88%) were married; most common age of marriage being 21 to 25 years. Nurses linked multiple sexual partners (61%), sex at an early age (44%), Human Papilloma Virus infection (38.6%) and heredity (31%) to cervical cancer. Approximately 70% believed that Ca cervix is preventable, detectable and curable if detected early. Pap smear was recognized as major screening technique by 74% nurses. Major (84%) source of information was health professional. Eighty percent nurses never took cervical screening while 87.5% did not recommend it to others. Conclusion: For successful implementation of cervical screening program, the nurses should be targeted first by education and sensitization so that they can play pivotal role in developing the awareness, confidence and compliance of women.

Cervical fibroid with amenorrhoea.

Fibroid are benign common tumour in reproductive age group arises from smooth muscles cells of uterus. Incidence is about 30-50%, vary from sizes very small to big, may be one or multiple1. Fibroid usually presents with menorrhagia/menstrual irregularities, but Cervical Fibroid with amenorrhoea is very rare entity. Usually 30-40 % hysterectomy are done for fibroids. Degenerative changes can occur, hyaline is common, while in 0.5% Malignant changes may occur. While operating a huge tumour the anatomy gets disturbed , so due care for the surrounding structure is to be taken otherwise we may land up in complications. In these Huge cervical fibroid Abdominal hysterectomy was proceeded up to uterine vessels, then transverse incision was kept over the anterior vaginal wall of cervix after pushing the bladder down, & fibroid was held with myoma screw & enucleated. Then routine Hysterectomy was completed. Bilateral ureteric tracing done. So meticulous examinations with a suspicion is needed for diagnosis & management of such case.

Assessment Of feto maternal hemorrhage in antenatal period in Indian females – need of modifications in Anti D prophylaxis in India.

Objective: -To assess Feto maternal Hemorrhage in pregnant Indian Females. Method: - 516 consecutive antenatal patients attending the Fetal Medicine Department of Vadilal Sarabhai General hospital under NHL Municipal Medical College, Ellis Bridge, Ahmadabad were analyzed for Feto maternal Hemorrhage by Kleihauer Betke test after taking informed consent. Result: - All the 516 antenatal patients including those who underwent invasive procedures like Chorionic villus sampling, Amniocentesis, Amnioinfusion and Intrauterine blood transfusion had Feto maternal Hemorrhage less than 2 ml. Conclusion: - Study shows that Feto maternal hemorrhage in Indian women is very insignificant even after invasive procedures. Feto maternal Hemorrhage has special importance in Rh Negative Women, carrying an Rh positive fetus.FMH can lead to isoimmunization leading to a wide spectrum of antenatal and postnatal fetal complications ranging from anemia to stillbirth. Answer to this is Antenatal Anti –D prophylaxis which is not a standard practice in our setup due to high cost of Anti D. As we have found FMH to be less than 2 ml even a dose of 50 microgram can suffice if given at 26 and 32 weeks of gestation to prevent isoimmunization thus reducing the cost and encouraging the practice of Antenatal Anti D prophylaxis.

Study of management in patient with ectopic pregnancy.

Background: ectopic pregnancy has always challenged ingenuity of the Obstratrition and Gynaecologist by its bizarre clinical picture. If it is not attended in time, it may lead to maternal morbidity and mortality. It is one, which can mimic practically each and every gynaecological disorder as well as many surgical catastrophes Method: The present study consist of 60 cases of ectopic pregnancy from may 2007to September 2009 admitted at department of obstetrics and Gynaecology at our hospital. All data was collected in to pre designed structured Performa. Results: In present study 71.66% patients are in age group of 21-30 years of age, this may be because this time period is the maximum fertile period and use of contraception is infrequent and occasional. 80% of patients were or more then two parity. Out of 60 patient in 70.75% case aetiology was made out with majority case with infection. In only one patient was heaving post operative infection, suggested by presence o adhesion. Conclusion: Due to advance diagnostic technique, conservative treatment is also possible and with recent surgical technique, the morbidity and mortality is drastically reduced.