Role of Iron Deficiency in Chronic Diffuse Hair Loss

There are conflicting reports of association between iron deficiency and hair loss in the literature. So we conducted this study to evaluate the role of iron deficiency in chronic diffuse hair loss in women of reproductive age group. Serum ferritin, a marker of iron deficiency, was recorded in 150 consecutive patients of chronic diffuse hair loss (FPHL n=69, CTE n=81) and in healthy controls (n=100). The mean serum ferritin (SF) recorded was 9.87, 10.80, 10.30 and 11.20 ng/mL for FPHL, CTE, total patients (FPHL and CTE) andcontrol group respectively, and it did not show any significant difference between these groups. Number of patients who recorded a serum ferritin label of less than 10 ng/mL (normal range 10–126ng/mL) were 48 (69.51%), 51 (62%), 99 (66%) and 63 (63%) for FPHL, CTE, total patients and controls respectively, and this also did not reveal any significant difference between the groups. We did not find any association between low serum ferritin (iron deficiency) and chronic diffuse hair loss in women of reproductive age group

Incidence of post-operative (caesarean section) infectious morbidities in cleansing and non-cleansing group after povidone iodine vaginal cleaning

Background: Despite of wide spread use of prophylactic antibiotics and various antiseptic measures, post-operative infection remains one of the significant and serious complication of caesarean delivery contributing to high maternal morbidity and mortality. Objective was to study the incidence of post-operative infectious morbidities in patients with/without povidone iodine vaginal cleansing done prior to caesarean section.Methods: A prospective randomized control study was done in the department of obstetrics and gynecology of Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi.Results: Mean age of participants in group A is 26.22±2.47 years and in group B is 26.48±2.3 years. Majority women (84.0%) underwent emergency lower segment caesarean section (LSCS). (6.4%) women developed post-operative endometritis, out of which maximum (4.6%) belong to no vaginal cleansing group (B) compared to 1.8% in povidone iodine vaginal cleansing group(A), which is statistically significant (p=0.01). Over all (13%) women had post-operative fever, with significant difference among the two groups i.e. (8.6%) were in group B versus (4.4%) in group A (p=0.005).Conclusions: Povidone iodine vaginal cleansing prior to caesarean section is significantly effective in reducing post-operative infectious morbidities

Changing Profile of Leprosy in a Tertiary Care Hospital

WHO (World Health Organization) has fixed the target of zero grade 2 (G2D) deformity among pediatric leprosy patients and reduction of new leprosy cases with G2D to less than one case per million population, to be achieved by 2020. It has also mentioned the performing indicators to evaluate the progress of leprosy control program. We undertook this study to find out what changes the leprosy clinic at our hospital had witnessed in terms of the WHO performance indicators and whether we had progressed toward reaching the goal fixed by WHO. The important indicators such as number of new cases, percentage of MB cases, child cases, and G2D cases were examined from the year 2012-13 to 2016-17. Although a significant reduction in G2D cases, MB cases and child cases were noted, which is quite encouraging, yet the numbers of annual new cases detected remained almost static during the study period, indicating persistence of active transmission of infection and the need for augmented active surveillance (leprosy case detection campaign), contact tracing, community awareness, stigma reduction and training

Scenario of molar pregnancy in a tertiary care centre in Delhi, India

Background: Molar pregnancies represent a significant burden of disease on the spectrum of gestational trophoblastic diseases with incidence varying with geographic region. Aim was to review all molar pregnancies admitted at our institution and to study the incidence, clinical presentation, management, complications and outcome of molar pregnancies.Methods: An observational study was done in department of obstetrics and gynaecology at Dr. BSA Medical College and Hospital among women with molar pregnancy over two years.Results: The incidence of molar pregnancy of the institute was 1.05/1000 deliveries. 21- 25 years age group and nulliparous women constituted 28.1% of patients. Amenorrhea (100.0%) was the commonest presenting complaints followed by abnormal vaginal bleeding (90.62%). Anemia (37%) was the commonest complication followed by acute hemorrhage (31%) and hyperthyroidism (18%). Suction evacuation was done in 96.8% of patients and 87.5% required blood transfusion. Only 6.2% (2/32) of patients had post evacuation chemotherapy. None of the cases developed choriocarcinoma. Limitation of the study was that the incidence of subsequent pregnancies after complete treatment of molar pregnancies was not studied.Conclusions: Early diagnosis of complete molar pregnancy can change the clinical presentation, diagnosis, and treatment of molar pregnancy. There is need for early recognition, timely referral, prompt and proper treatment of this condition. Adequate follow-up of the patients and need for contraception should be reinforced

Maternal and fetal outcomes following the trial of vaginal delivery and elective repeat caesarean section in term pregnancy with one previous lower segment caesarean section in Dr. Baba Saheb Ambedkar Hospital: a prospective controlled study

Background: Before 1970s, the phrase “once a caesarean, always a caesarean” was a common norm. Now this phrase has been changed to “once a caesarean, always an institutional delivery”.Methods: This prospective controlled study was carried out in department of obstetrics and gynaecology, Dr. Baba Saheb Ambedkar Medical College and Hospital, Rohini, Delhi for a period of 7 months (October 19 to April 2020) and included 200 gravid women with previous one lower segment caesarean section (LSCS). The ethical committee approval for the study was taken.Results: The success rate of trial of labour after caesarean (TOLAC) in our study was 67%. It was concluded from this study that the percentage of woman having complications were maximum in failed TOLAC patients which was 69.70% followed by patients undergoing elective repeat caesarean delivery (ERCD) which was 59% followed by women having successful VBAC which was 8.96%. The percentage of neonate having complications were maximum in neonate of failed TOLAC patients which was 27.27% followed by neonate of patients undergoing ERCD which was 21% followed by neonate of women having successful VBAC which was 5.97%.Conclusions: TOLAC for a second delivery is a much-needed feasible option in developing countries to reduce the cost and morbidities of repeat caesarean deliveries

Does age and start of Ponseti treatment affect the functional outcome in club foot: A comparative study

Background: Idiopathic clubfoot is one of the most common and complex congenital deformities which are difficult to correct. Aims and Objectives: The present study was designed to assess the effectiveness and results of the Ponseti method’s early use in the treatment of idiopathic congenital talipes equinovarus (CTEV). Materials and Methods: Seventy-six feet in 50 patients of CTEV during the period of May 2019–May 2020 were studied. All the cases were treated by Ponseti technique. Children with idiopathic CTEV and age <1 year were included in our study. The severity of deformity was graded according to Pirani scoring system both at the beginning and at the end of treatment. Results: The mean age at presentation was 2.77 months. The mean initial Pirani score at time of presentation was 4.07, and at last follow-up was 0.13. We observed that 63 feet (82.89%) out of 76 feet required a percutaneous TA tenotomy along with plaster casting to correct the equines deformity. The mean total number of casts required to correct the deformity was 6.4. The mean duration of treatment from 1st plaster cast to cast for equinus correction was 8.4 weeks. About 94% of cases had a good outcome at last follow-up which was evaluated on the basis of Pirani score. The association of duration of treatment (weeks) with age and total number of cast with age has P=0.002 which was found to be significant. Conclusion: The Ponseti technique is a very safe, efficient, and acceptable economical treatment for the correction of CTEV that gives excellent results on conservative treatment and in most of the cases avoid surgical intervention if protocol followed as prescribed. If the age of the patient is higher at time of presentation, it requires a longer casting period and more number of casts to correct the deformity compared to younger children with the early presentation

Sirenomelia-the mermaid syndrome: a rare invariably fatal congenital anomaly in a term unsupervised pregnancy

Sirenomelia is a rare congenital anomaly with an incidence of 0.8 to 1 case per 1,00,000 births. The prognosis is grim due to associated genitourinary and gastrointestinal anomalies. Antenatal registration in the first trimester and timely ultrasound go a long way in detection of the anamoly when termination can be still be offered and the mental agony of giving birth to a term neonate with a fatal congenital anomaly can be avoided.

Broad ligament ectopic pregnancy: a dilemma to diagnose

Broad ligament ectopic pregnancy is a rare and serious form of extrauterine pregnancy with a high risk of maternal mortality. There are no specific clinical features. Ultrasonography may help in diagnosis but definitive diagnosis is made only during surgery. A 20-year-old woman with previous 2 abortions presented with acute abdomen. She had no history of amenorrhoea but there was history of two episodes of bleeding in the last month at an interval of 14 days, each episode lasting for two-three days. The last episode of bleeding was 10 days back. Her urine pregnancy test was done and it was positive. There was marked abdominal tenderness with guarding and rigidity. Per vaginal examination revealed marked tenderness in the right fornix and cervical motion tenderness, uterus size could not be assessed due to tenderness.  It was diagnosed as a case of ruptured ectopic pregnancy. Since she was haemodynamically unstable, emergency laparotomy was done. She had a right sided broad ligament ectopic pregnancy which had ruptured. The tissue was completely removed and haemostatic sutures were taken. High index of clinical suspicion, early diagnosis and prompt surgery is the key to management

Commitment for Anaemia Prevention is Associated with Adherence to Iron Supplementation and Iron Intake Among Pregnant Women

Anaemia during pregnancy is still a major problem in the world which can affect the health of the mother and foetus. The commitment of pregnant women to improve adherence to iron supplementation and eating iron-rich foods can prevent iron deficiency anaemia.This study aimed to identify the correlation between of commitment for anaemia prevention with adherence to iron supplementation and iron intake. Design: The study was a cross-sectional study with a population sample of 125 pregnant women who attended antenatal care at five community health centres in Surabaya. The study was conducted from August to October 2017.The statistical test results showed the commitment statements, “I maintain personal hygiene by frequently washing hands”had the highest score (4.38 ± 0.67) and “ Itake iron supplements regularly even if it causes nausea” had the lowest score (4.05 ± 0.84). Of the four statements about adherence to iron supplementation, “I take iron supplements regularly every day” had the highest score (4.35 ± 0.86) while ‘I take iron supplements along with orange juice or vitamin C drinks’ had the lowest score of 1.52 ± 0.87. There was a significant association between commitment for anaemia prevention and adherence to iron supplementation during pregnancy (r = 0.227; p = 0.011) and between commitment for anaemia prevention and iron intake (r = 0.432; p <0.001). Health workers need to conduct health education about the prevention of anaemia in every pregnant woman who attends antenatal care. Keywords: Commitment, Anaemia prevention, Adherence Iron Supplementation, Iron Intak

Factors that Affect the Mother in the Control of Their Child’s Fever

A fever is one of the signs and symptoms of disease that often occurs in childhood. Fever in children makes the mother frightened when facing her child’s health problems. The mothers assume that every child will develop a seizure fever. The purpose of this study was to find out the factors that influence the mothers when handling fever in the one of First Level Health Facilities in Jogoloyo, Sumobito and Jombang. The research design was cross-sectional. The population of mothers with toddlers totaled 420 respondents. The sample of 210 respondents was gathered using a simple random sampling technique. The independent variables were factors that influenced the mothers in managing fever in toddlers and the dependent variable was the frequency of fever. The results of the research show that 67% of the mother’s had good knowledge, the frequency of children with a fever was 45% and the mother’s who received advice from health workers was 87.3%. Good experiences from their family/friends made up 37.5%. Significant bivariate analysis was conducted on knowledge, the frequency of pain, advice from the health workers and their family/other people’s experiences with a p value < 0.05. Advice from health workers consisted of health education about how to handle fever in children. This can increase the mother’s handling of feverish children, therefore structured education is very beneficial for the mother. Keywords: maternal factors, fever management, toddle