Patient safety indicators for England from hospital administrative data: case-control analysis and comparison with US data

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.The Healthcare Commission received a small grant from the Health and Social Care Information Centre to support the initial recoding work

A maternity unit in Gozo a hundred years ago

The present paper reviews the hospital confinements which occurred at Victoria Hospital in Gozo during the period 1876-1893. These hospital confinements are shown to have been generally restricted to needy women from the lower socio-economic strata. The lower socio-economic status of these mothers, together with the fact that these mothers were more likely to have significant medical and/or obstetric problems, resulted in higher perinatal and maternal mortality rates than those reported for the general population in Gozo and Malta. These observations are in conformity with the maternity care situation in European establishments.peer-reviewe

Clinicopathological correlation of infective vaginal discharges in non pregnant sexually active women of reproductive age group in a tertiary care centre of Western UP

Background: The aim was to study the etiology of infective vaginal discharges prevalent in our area and to study its association with PID. Methods: A total of 500 patients were recruited for study attending Gynae OPD and presenting with vaginal discharge. After detailed history taking and physical examination three sterile vaginal swabs were taken from the posterior fornix and sent for culture of Candida and Trichomonas on Saborauds Dextrose Agar and Kufperberg media respectively and one was used for smear for gram’s staining to diagnose Bacterial vaginosis by Nugent’s scoring.Results: In this study, prevalence of BV, Candida and Trichomonas vaginalis was found to be 146 (29.2%), 106 (21.2%) and 15(3%) respectively out of 24 cases had mixed infections while no organism was found in 257 cases (51.4%). Candida infection was found to be significantly associated with presence of other complaints such as itching, burning micturition, dyspareunia etc (p1 abortions(p=0.015), presence of urogenital complaints (p5) (p5 (p=0.004).Conclusions: Bacterial vaginosis and candidiasis are the most common causes of infective vaginal discharges in our community than trichomoniasis

Physician Financial Incentives and Cesarean Delivery: New Conclusions from the Healthcare Cost and Utilization Project

This paper replicates Gruber, Kim, and Mayzlin’s (1999) analysis of the effect of physician financial incentives on cesarean delivery rates, using their data, sample selection criteria, and specification. Coincident trends explain much of their estimated positive relation between fees and cesarean utilization, which also falls somewhat upon the inclusion of several childbirth observations that had been inadvertently excluded from their estimation sample. The data ultimately indicate that a $1000 increase, in current dollars, in the reimbursement for a cesarean section increases cesarean delivery rates by about one percentage point, one-quarter of the effect estimated originally.

AYURVEDIC CONCEPT OF LEUCORRHOEA: SWETA PRADARA

Gynecology is the medical practice dealing with the health of the female reproductive system literally means the science of women. Woman has a unique existence in the universe created by the God. Womens health is the pivot not only for the healthy and happy status for her family, rather to the whole society or even to the nation at large. All women have experienced some short of vaginal discharge in her life span. White vaginal discharges along with the other symptoms like feeling of weakness, pain in the back and calves, loss of vital fluids, pruritis on and around the vulva, thighs and thigh joints etc., comes under the heading of Leucorrhoea, which is described as Sweta Pradara in Ayurvedic classics. In Samhitas all gynecological disorders comes under the headings of Yonivyapada. No any description of Sweta Pradara has been described by scholars of Brihatrayee. For abnormal white vaginal discharges, the word Sweta Pradara has been described in texts during and after medieval period

A Case Study on Yonivrana (Vaginal Ulcer)

Vaginal infections are a burning problem in today’s era. Vaginal discharges serve an important housewife function in the female reproductive system. It affects the whole reproductive as well as general health of the women. Ayurvedic texts have descried about various Sthanik Chikitsa for Yonigata Rogas. Despite wide range of treatment modalities in contemporary medicine search for safe option, non-surgical, effective and without any adverse effect is needed. This article describes the case report of 35yrs old woman who was complaining of vaginal discharge, itching at vagina. It was observed that Sthanika Chikitsa along with oral medications has provided significant relief in all symptoms

Chromobacterium violaceum associated with recurrent vaginal discharge among apparently healthy females in Ekpoma, Nigeria

Seven hundred and two high vaginal swab samples of apparently healthy adult females with recurrent vaginal discharge were collected and analyzed at Searchlight Medical Diagnostic Centre, Ekpoma between July 2003 and August 2005. Isolation, identification and antibiogram of isolates were done using standard Microbiological techniques. Randomized Block Design and Completely Randomized Design at (α = 0.1) were used to test the statistical significance of results. While occupational distribution of isolates was not statistically significant, age and response of bacterial isolates to antibiotics used were statistically significant. Total number and percentage prevalence of bacteria isolated include: 297(42.4%) Chromobacterium violaceum, 156 (22.2%) Escherichia coli and 139 (19.8%) Staphylococcus aureus. Chromobacterium violaceum was 81.8% sensitive to ofloxacin, and 12.8% to Ceftriazone. Escherichia coli and S. aureus were 70.5% and 71.9% sensitive to sparfloxacin respectively. Though source of infection of C. violaceum in Ekpoma was not very clear, soil and water contamination and other risk factors were hypothesized. A high index of suspicion is required for diagnosis. Surveillance with improved diagnostic facilities can increase awareness among health care providers on this form of infection. Appropriate systemic antimicrobial therapy to halt progression of infection is mandatory, even when the infection appears to be localized

The Impact of Medical Liability Standards on Regional Variations in Physician Behavior: Evidence from the Adoption of National-Standard Rules

I explore the association between regional variations in physician behavior and the geographical scope of malpractice standards of care. I estimate a 30–50 percent reduction in the gap between state and national utilization rates of various treatments and diagnostic procedures following the adoption of a rule requiring physicians to follow national, as opposed to local, standards. These findings suggest that standardization in malpractice law may lead to greater standardization in practices and, more generally, that physicians may indeed adhere to specific liability standards. In connection with the estimated convergence in practices, I observe no associated changes in patient health

Absorbent particles, especially catamenials, having improved fluid directionality, comfort and fit

Absorbent articles, especially sanitary napkins, contain fibers with intra-fiber capillary channels. In-use, the capillary channel fibers direct menses to a storage layer, thereby minimizing product failure and staining of undergarments. The capillary channel fibers can protrude into, or through, a topsheet to provide very aggressive transport of vaginal discharges

Perception and correlates of excessive vaginal discharge in rural women

Background: Vaginal discharge is one of the most common symptoms of gynecological morbidity. Vaginitis is the most prevalent cause. Gynecological disorders have substantial impact on female health and behaviour. Recent evidence suggests that the association between the complaint of vaginal discharge and the presence of Reproductive Tract Infections is weak. Women who are overanxious, introspective or suffering from fears of venereal disease and cancer tend to exaggerate the complaint of vaginal discharge into something pathological. The objective of the study was to study rural women’s perception and health care seeking behaviour regarding excessive vaginal discharge. To study various psychological and biological correlates of excessive vaginal dischargeMethods: This was a community based cross sectional study, conducted in the rural field practice areas under the Department of Community Medicine, Christian Medical College, Ludhiana. House to house surveys were conducted with semi-structured questionnaire and GAD 7 (Generalised Anxiety Disorder) scale, using systematic random sampling.Results: 160 rural women were interviewed to collect data. Of them, 27.5% reported having excessive vaginal discharge. There was no association observed between menstrual hygiene methods and excessive vaginal discharge (p= 0.77). Association couldn’t be observed with selection of barrier and other non-barrier methods of contraception (p= 0.09) either. Statistically significant association was observed between presence of anxiety and vaginal discharge (p=0.01).Conclusions: All vaginal discharges are not pathological. Causative factor of excessive vaginal discharge may not be infections always. There was a statistically significant association between anxiety and perceived vaginal discharge