Awareness of cord blood banking among pregnant women in semi urban area

Background: Hematopoietic stem cells (HSCs) are multipotent stem cells, derived from bone marrow, peripheral blood and umbilical cord. These HSC are accepted method of treatment for various disorders. Cord blood can be stored either in private or public bank. Awareness about cord blood banking among semi urban and rural population is less compared to urban population. The aim of our study is to evaluate the awareness of cord blood banking among pregnant women in semi urban area and to evaluate their willingness for donating to public blood bank.Methods: This is a cross sectional study done among 365 pregnant women attending antenatal OPD in Obstetrics and Gynecology department of SMVMCH, Puducherry.Results: Forty five percent of pregnant women had knowledge about uses of umbilical cord blood usage during pregnancy. Only 5 % of pregnant women knew about cost of stem cell storage. Less than 1% knew about availability of public cord blood banking. After informing about availability of public cord blood storage 72% of pregnant women were willing to donate to public bank.Conclusions: Knowledge about cord blood banking is lacking among pregnant women. Especially majority of them are unaware of public cord blood banking. Private banking will be useful for those with family members affected with diseases amenable to HSC transplantation. More support from government and private organizations are required, which will help in better functioning of public cord blood bank services

Awareness of labour analgesia among antenatal women in semi urban area

ABSTRACTBackground: Women’s experience of pain during delivery varies greatly. Various pharmacological and non- pharmacological methods of labour analgesia are available. In spite of availability of various methods, even now women deliver with severe pain without adequate pain relief. The aim of the study was to determine the awareness of pregnant women about labour analgesia in semi urban setting.Methods: This cross sectional study was done among 256 pregnant women attending antenatal out-patient in obstetrics and gynecology department. Antenatal women who were planned for elective cesarean section were excluded from the study.Results: Out of 256 women 89.8% had no idea about usage of pain relief in labour. Only 10.2% had some idea about pain relief in labour. In previous delivery, 38.9% experienced severe pain, 58.4% experienced moderate pain and only 2.7% experienced mild pain. Some form of analgesia was administered to 89.9% of women. In spite of analgesia being given for majority, more number of women experienced moderate and severe pain (97.3%). On analyzing various factors, order of pregnancy, income and occupational status had statistically significant influence on knowledge about labour analgesia.Conclusions: There is a lack of knowledge among pregnant women about pain relief. Due to hectic work in labour room setting in India, it may be difficult to provide one to one care. Non-pharmacological methods should be popularized for pain relief. Usage of some form of pain relief will help in improving quality of care during labour and better outcome of mother and baby

A rare case of immune-related pseudotumor of ovary mimicking ovarian malignancy

IgG4-related disease (IgG4-RD) is a chronic inflammatory condition affecting various body organs. However, genital tract involvement is rarely reported. A 40 years old reproductive-age woman presented with a solid abdominopelvic mass of 20 weeks size. CECT revealed a large multiloculated solid cystic lesion arising from right adnexa with multiple enlarged lymph nodes and omental thickening with gross right-sided hydroureteronephrosis suggestive of ovarian malignancy stage III. Surprisingly, tumor markers were normal. Intraoperatively, we noticed a 15×15 cm right ovarian mass encasing the right ureter all around and constricting it. The mass was densely adherent to recto-sigmoid and right pelvic wall, which mandated extensive surgery. Histopathological examination with immuno-histo-chemistry (IHC) suggested the diagnosis of IgG4-RD of ovary. Awareness about its occurrence in ovary will help in arriving at the diagnosis which may influence the extent of surgery. Lymphoplasmacytic infiltration with fibrosis in histopathological examination warrants IHC analysis for achieving a diagnosis

E-learning as a tool to impart knowledge of surgical procedures in the undergraduate medical teaching

Background: E-learning is in a budding stage in developing countries. As present-day students are gadget-friendly, introducing a surgical e-learning module may create interest and help in understanding the surgeries easily. This study aimed to determine the effectiveness of E-learning in improving the knowledge component of surgical procedures for undergraduate students and to analyze students’ feedback regarding its usefulness. Methods: This quasi-experimental study was conducted among 67 final-year MBBS students, who had completed 1 week of operation theatre (OT) posting in obstetrics and gynecology. Recording of videos for must-know surgeries in gynecology was done. Video editing and audio description of surgical steps were done. A YouTube channel was created and surgical videos were uploaded. Links to 2 surgical videos and additional teaching materials were uploaded to the college learning management system daily for 2 consecutive weeks. A telegram group was formed for posting questions daily. Pre-test and post-test were conducted and the results were analyzed. Results: The mean marks obtained in the pre-test were 6.567±1.9 and the post-test was 15.22±2.5 (Paired t test p=0.0001). Students mentioned that combining OT posting with an e-learning module helped them to build their knowledge of surgical procedures. Telegram quizzes helped them to increase their understanding of surgeries. 34 students wanted e-learning module to be conducted on other topics also. Conclusions: E-learning is highly effective in improving knowledge component of surgical procedures for undergraduate students. E-learning can be made more effective by adding formative assessment. Combining surgical e-learning module with operation theatre posting can enhance knowledge and understanding

Evaluation of complications of abdominal and vaginal hysterectomy

Background: Hysterectomy is one of the most common surgical procedures performed by the gynaecologist.  It can be performed by vaginal and abdominal route. Gynaecologic surgeons worldwide continue to use the abdominal approach for a large majority of hysterectomies that could be performed vaginally despite well-documented evidence that vaginal hysterectomy has better outcome. Aim of our study is to compare vaginal route versus abdominal route of hysterectomy in terms of intra operative and post operative complications.Methods: A retrospective study was done in 229 women who had undergone hysterectomy (176 abdominal hysterectomies and 53 vaginal hysterectomies) from January 2010 to July 2012. Information on the indications, operative procedures, and complications were extracted and analysed.Results: The mean duration of surgery in VH group was 79.6 min and that of TAH group was 99.2 min. The mean blood loss was also more in case of TAH group than that of VH group (215ml vs. 167ml). Bladder injury occurred in 1 case in VH (1.9%) and in 4 cases in TAH (2.3%). Ureter injury occurred in 1(0.6%) case in TAH group. Wound infection developed in 10 cases of TAH group whereas only one case in VH group developed vault infection.Conclusions: Vaginal hysterectomy is associated with quicker recovery, early mobilization, shorter hospitalization, less operative and post operative morbidity when compared to abdominal hysterectomy

Awareness of labour analgesia among antenatal women in semi urban area

Background: Women's experience of pain during delivery varies greatly. Various pharmacological and non- pharmacological methods of labour analgesia are available. In spite of availability of various methods, even now women deliver with severe pain without adequate pain relief. The aim of the study was to determine the awareness of pregnant women about labour analgesia in semi urban setting. Methods: This cross sectional study was done among 256 pregnant women attending antenatal out-patient in obstetrics and gynecology department. Antenatal women who were planned for elective cesarean section were excluded from the study. Results: Out of 256 women 89.8% had no idea about usage of pain relief in labour. Only 10.2% had some idea about pain relief in labour. In previous delivery, 38.9% experienced severe pain, 58.4% experienced moderate pain and only 2.7% experienced mild pain. Some form of analgesia was administered to 89.9% of women. In spite of analgesia being given for majority, more number of women experienced moderate and severe pain (97.3%). On analyzing various factors, order of pregnancy, income and occupational status had statistically significant influence on knowledge about labour analgesia. Conclusions: There is a lack of knowledge among pregnant women about pain relief. Due to hectic work in labour room setting in India, it may be difficult to provide one to one care. Non-pharmacological methods should be popularized for pain relief. Usage of some form of pain relief will help in improving quality of care during labour and better outcome of mother and baby. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000): 2612-2617

Effect of vaginal pH on efficacy of dinoprostone gel for labour induction: a cross-sectional study

The purpose of this study was to assess the effect of vaginal pH on efficacy of intracervical dinoprostone gel (PGE2) for labour induction, progression and induction delivery interval. A cross-sectional study was done among 150 term pregnant women planned for induction with unfavourable Bishop’s score ≤5. Women were categorised into two groups based on vaginal pH >4.5 and ≤4.5. Induction was done with maximum of three doses of PGE2 based on Bishop’s score, followed by oxytocin administration. Failed induction rate was 14.5%. There was no significant association between vaginal pH and Bishop’s score change after first gel application. There was no significant difference in failed induction rates, time from induction to active labour as well as induction delivery interval between two groups. Similarly, there was no significant association between oxytocin requirement and mode of delivery with vaginal pH. Intracervical PGE2 is an ideal route, unaffected by vaginal pH.Impact Statement What is already known on this subject? Prostaglandins are organic acids that have diminished solubility in aqueous solution with a low pH. The release of the drug could be altered by the acidity of vagina and this could result in variable clinical response. Vaginal pH may alter the efficacy of intravaginally administered prostaglandins through several potential mechanisms. What the results of this study add? There was no significant effect of change in vaginal pH on effectiveness of intracervical administered PGE2. There was no significant association between vaginal pH and time from induction to time women is entering into active labour as well as time from induction to delivery. Similarly, there was no significant association between mode of delivery and oxytocin usage with vaginal pH in labour. Intracervical PGE2 is an ideal route, unaffected by vaginal pH. What the implications are of these findings for clinical practice and/or further research? Further randomised studies are required comparing both vaginally administered PG inserts and intracervical PGE2 gels with vaginal and cervical pH, to directly compare their effectiveness in labour induction