294 research outputs found

    Hysterectomy: still a treatment of choice for pelvic pathologies in rural India

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    Background: Hysterectomy has always been a subject of controversy in India and increasing rate of unnecessary hysterectomies in young, premenopausal women is cause for concern regarding women’s health and rights. The aim of this study is to review and analyse cases of hysterectomy in a rural population and to correlate with underlying factors behind seeking hysterectomy as a treatment of choice for pelvic pathologies.Methods: This was an ambidirectional observational descriptive study in which 352 women were included who underwent hysterectomy between January 2016 to July 2017 in the Department of Obstetrics and Gynecology, Government Medical College Rajnandgaon and a tertiary care referral hospital of central Chhattisgarh, India.Results: Majority were between 31-50 years of age group, grandmultipara, uneducated, insured by National health insurance scheme.76.1% patients had attended medical college hospital to avail free services. 60.5% took prior treatment from unqualified/ unregistered/registered general practitioners. Erratic use /use of suboptimal dosage of hormones to stop abnormal uterine bleeding, nonspecific antibiotics to treat infection, incomplete treatment and poor compliance were possible reasons behind failure of previous treatments. Abnormal menstruation was the commonest presenting complaint observed in 75.2%. 72.4% patients refused to come for follow up and reasons were unavailability of transport facility, fear of losing job, loss of daily wages and financial constraints. Commonest indication for hysterectomy was symptomatic fibroid in 32.0%. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was the most common procedure done in 59.0%. The rate of hysterectomy came out to be 57.6% which is quite higher than that reported in other studies. Fever was the most common complication encountered in 0.80%.Conclusions: Despite the remarkable improvement in conservative management and media coverage, hysterectomy still remains the most preferred modality of treatment with excellent satisfaction for pelvic pathologies in rural India

    Resource management : a multiple case study of resource management in Swedish equine boarding businesses

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    The resource management in companies defines the competitive advantage and the profile of the products or services. With a better understanding of resource management, the companies may increase their success. A sector that is expanding is the equine sector in Sweden. The equine businesses have received increased attention both from the society and from researchers. However, literature regarding how these equine boarding businesses are managed is rare. The aim of this study is to create a deeper understanding of how equine boarding businesses in the Swedish equine sector manage their resources. To fulfill the aim, questions concerning the key resources in the equine boarding businesses and what the main role of these resources are, are answered. The theoretical framework consists of Resource-based view and the Business platform by Klofsten. A qualitative multiple case study has been conducted through semi-structured interviews with eleven horse boarding business managers. The gathered data has been analyzed through the theoretical framework. The results of this study indicate that there are several key resources in Swedish equine boarding businesses. Some of the key resources are motivation, education, and experience of the manager, his/her network, the location, the chosen price level, written agreements and leadership at the yard. The motivation, education and previous experience of the manager tend to affect the way the resource base of the business is composed. The motivation affects the orientation of the business which will determine how the resources are used. The conclusion is that companies in the equine boarding business, in similarity to companies in other sectors, manage their resources to achieve competitive advantage and success for their companies
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