Clinicopathological evaluation of abnormal uterine bleeding in perimenopausal women

Background: Abnormal uterine bleeding is considered as one of the most common and challenging problem presenting to the gynecologist. It is responsible for as many as one third of all outpatient gynaecological visits. This study was carried out in the department of Obstetrics and Gynaecology, Assam Medical College and Hospital, Dibrugarh to evaluate clinically gynaecological causes and the endometrial pattern of abnormal uterine bleeding in perimenopausal women.Methods: This is a retrospective study of 148 perimenopausal women with complain of abnormal uterine bleeding in the age group ranging from 40-50 years for a period of one year from 01 November 2014 to 30 November 2015. The age, parity, menstrual complaints were noted and clinical diagnosis with ultrasound report and histopathological reports (of endometrial tissue) were analyzed. Finally the histopathological report of the hysterectomy specimen was correlated.Results: Menorrhagia was the commonest complaint. AUB was seen more in multiparous women (64.8%). Fibroid uterus was the commonest cause which is 52.7% followed by DUB 41.2%, adenomyosis 4.7%, and uterine malignancy 1.3%.Conclusions: Clinicopathological evaluation of AUB showed that fibroid uterus followed by DUB is the most common cause in perimenopausal women. Occurrences of endometrial hyperplasia increases in perimenopause which is of great value as it is a forerunner of carcinoma

Intraoperative surgical difficulties encountered during repeat caesarean section in a tertiary care centre in Northeast India

Background: Caesarean section is the commonest obstetric operative procedure worldwide. The potential perioperative problems in repeat caesarean section include adhesions, increased blood loss, prolonged operative time, injuries to adjacent structures, hysterectomy etc. These increase with increase in caesarean section number.Methods: Hospital based observational study, conducted at Dept. of Obstetrics and Gynaecology, Assam Medical College, from July 2019 to June 2020 with the aim to study intraoperative difficulties encountered during repeat caesarean section. Cases were grouped into two main groups based on number of prior caesarean sections. A detailed history, clinical and intraoperative findings of all pregnant women undergoing repeat caesarean section were noted. Results were tabulated and analysed.Results: Out of 400 women with prior caesarean section who underwent repeat caesarean. 321 had 1 prior caesarean and rest had 2. Among the cases cephalopelvic disproportion was the commonest (43.25%) indication and obstructed labour was the least common (0.25%). Common complications were adhesions (38.25%), thinned lower uterine segment (27%), advance bladder (19.50%), uterine dehiscence (14.75%), excess blood loss (12.75%), extension of uterine incision (8.25%), uterine rupture (1%), placenta accrete (0.75%), and bladder injury (0.5%). Intraoperative complications like adhesions, uterine dehiscence, delivery and operating time were significantly higher in women with 2 prior caesarean section compared to 1 prior caesarean section (p<0.001).Conclusions: Women with caesarean scar are at high risk in subsequent pregnancies particularly in a country like India where antenatal care is often neglected. Best technique to reduce multiple potential complications of repeat caesarean section is to reduce the rates of primary and repeat caesarean sections whenever possible

An assessment of the perception of secondary school students towards Vocational Education and Training in Arumeru district in Tanzania.

The study's main objective was to assess the perception of secondary school students towards vocational education and training in Arumeru District in Tanzania. In addition, the study was guided by the following specific objectives; to determine the perception of secondary school students towards vocational education and training in Arumeru district, to identify the channels through which secondary school students access information about vocational education and training in Arumeru district and to determine the challenges facing students to join VET after secondary school education in the Arumeru district. A descriptive research design was adopted. The researcher adopted simple random sampling techniques. The sample size was 120 respondents, which included; 21 respondents from Bishop Danning Secondary, 2 from Ilboru PC Centre, 25 from Mshikamano PC centre, 23 from Sinoni PC Centre, 21 respondents from Enaboishu secondary school, 5 Secondary Schools Heads and 4 VET Colleges Principals. Research questionnaires were used as the primary data collection instruments. Data collected were analyzed using SPSS version 20. The findings indicate that most of the respondents strongly agreed that they received information about vocational education from; their churches, newspapers, friends, and social media. The study concluded that there is a need for more career information to be provided to the VET learners as attitude change takes quite some time. The study recommended that there is a need for the government and the relevant stakeholders to come up with a policy framework that clearly shows how a student can transition from the path of VET to further education. Keywords: Secondary School Students, Education, Perception, Vocational Education and Training

Hepatitis B Vaccine Administration Prior to Discharge

https://scholarlycommons.baptisthealth.net/se-2022-smh-bpf/1013/thumbnail.jp

Importance of Northeast India as a cultural and trade link between India and Southeast Asia

Master'sMASTER OF ART

Child health care - changed roles and needs of digital development

Bakgrund: Den svenska barnhälsovården är frivillig och kostnadsfri, och de flesta svenska familjer följer programmet. Den är dock inte jämlikt fördelad över landet och kan därför behöva utvecklas med fler digitala element och bli mer familjefokuserad. Många, särskilt kvinnor, beskrivs behöva mycket stöd under övergången till föräldraskap och uppskattar professionell hjälp för att hantera känslomässig och psykosocial stress. Familjefokuserad omvårdnad ligger till grund för omvårdnadspraktiker inom barnhälsovården, vilket innebär att specialistsjuksköterskan skapar vård tillsammans med familjen och tar vara på alla kompetenser på bästa sätt. Att involvera föräldrarna i utvecklingen av barnhälsovården är därmed av yttersta vikt. Syfte: Det övergripande syftet var att utröna hur föräldrar och Barnavårdscentralensspecialistsjuksköterskor (BVC-sjuksköterskor) uppfattar och använder Internet som en källa för hälsokompetens, samt att utvärdera effekten av en digital pilotinterventionutvecklad i samarbete med föräldrar med målet att minska föräldrastress, öka hälsolitteracitet och tillfredsställelse med barnavårdscentralen (BVC). Metoder: Kvalitativa (I, III), mixade (II) och kvantitativa (IV) metoder baserade på intervjudata, gruppdiskussioner och frågeformulär användes i de fyra studierna som syftade till att; I) beskriva BVC-sjuksköterskors erfarenheter och åsikter om föräldrars internetanvändning, II) beskriva hälso- och barnutvecklingsrelaterade sökmönster på internet hos föräldrar till friska barn och hur informationen användes i kontakter med barnhälsovården (BHV), III) beskriva föräldrars behov och förväntningar på digitalt stöd i samband med barnhälsovård, och slutligen IV) utvärdera effekten av en digital pilotintervention riktad till föräldrar, avseende föräldrars stress och eHälsolitteracitet. Kvalitativa data analyserades med hjälp av kvalitativ innehållsanalys och kvantitativa data med beskrivande och jämförande statistiska metoder. Resultat: Studie I visade att föräldrars internetanvändning påverkade BVC-sjuksköterskors arbete på olika sätt. Internet ansågs underlätta vård, tillgång och tillhandahållande men kunde också komplicera den professionella rollen och prestationen, vilket innebar att de upplevde ett imperativ för en förändrad roll som BVC-sjuksköterskor. I studie II framkom att föräldrar i mycket hög grad sökte på Internet efter hälsorelaterade ämnen, och resultaten belyser också frågan om svårigheterna att bedöma källornas pålitlighet. Studien visade också att Internet kunde stärka föräldrarna med ny kunskap och stödja deras förmåga till egenvård, men att denna kunskap å andra sidan också oroade dem och gjorde dem osäkra i sin föräldraroll. Studie III, som rapporterade om föräldrars behov av och förväntningar på digitalt stöd, visade att de ville bli mer självständiga i sitt föräldraskap men fortfarande behövde stöd och meningsfulla relationer. Viktiga aspekter, förutom förbättrad tillgänglighet som efterfrågades var ökad tillit långsiktiga relationer och stärkt oberoende. Studie IV visade att den digitalasupport-intervention inte gav de effekter på föräldrastress och e-hälsolitteracitet som förväntades, även om tendenser kunde identifieras. Detta ansågs främst bero på en alltför kort genomförandeperiod med alltför få deltagare, då det visades att endast en femtedel av familjerna i interventionsgruppen använde supporten, resten tycktes intebehöva den eller hade kanske ännu inte upptäckt nyttan av den. Slutsats: Den digitala eran utmanar både föräldrar och BVC-sjuksköterskor. Digitalt stöd som utvecklas tillsammans, dvs där BVC-sjuksköterskor och föräldrar i samarbete kommer överens om hur, när och om vilka ämnen denna typ av stöd och kommunikation ska omfatta, kan dock upplevas som meningsfullt. Ett genomförande i större omfattningskulle öka tillgängligheten, samtidigt stärka föräldrarnas egenmakt och leda till mer långsiktiga relationer med andra föräldrar. Implementerat klokt bland fler deltagare och över längre perioder är det möjligt att den digitala supporten också kan ha mer positiva effekter på tillfredsställelse med BHV samt på minskad föräldrastress och ökad eHälsolitteracitet.Background: Swedish child health care is voluntary and cost-free, and 99% of Swedish families follow the program. However, it is not equally distributed across the country and therefore needs to be developed to include more digital elements and become more family focused. Many, particularly women, need much support during the transition to parenthood and appreciate professional help to manage emotional and psychosocial stress. Family-focused care is the assumption underlying nursing practice within child health care, which means to co-create care with the family, making the most of all competencies. Involving parents in child health care development is therefore of utmost importance. Aim: The general aim was to examine how parents and child health nurses apprehend and use the Internet as a source for improved health competence, further, to evaluate the effects of a digital pilot intervention developed together with parents to reduce parental stress, improve eHealth literacy and satisfaction with child health care. Methods: Qualitative (I, III), mixed (II), and quantitative (IV) methods based on interview data, group discussions and questionnaires were used in the four studies that aimed to; I) describe child health nurses’ experiences and opinions of parent Internet use, II) describe health and child development related Internet search patterns of parents of healthy children and, how the information was used in contacts with child health care, III) describe parents’ needs and expectations of digital support in the context of child health care, and lastly IV) evaluate the effects of a digital pilot intervention directed to parents, concerning parental stress and eHealth literacy. Qualitative data were analyzedusing qualitative content analysis and quantitative data with descriptive and comparative statistical methods. Results: Study I showed that parents’ Internet use influenced child health nurses’ work in various ways. Internet was seen as facilitating care, access, and provision but also complicated their professional role and performance, which implied that they experienced an imperative for a changing role as child health nurses. In study II, it was shown that parents, to a very high degree, searched the Internet for health-related topics, and the results also highlighted the problem of determining the trustworthiness of sources. The study also indicated that the Internet could strengthen parents with new knowledge and support their self-care capacity. However, on the other hand, this knowledge also worried them, making them insecure in their parental role. Study III, reporting on parents' needs and expectations of digital support, showed that they wished to become empowered in parenthood but still needed support and meaningful relationships. Important aspects, besides improved accessibility that were requested were improved parental confidence, longer-term relationships and strengthened independence. Study IV, which evaluated the effects of a pilot intervention,demonstrated limited effects on parental stress and e-Health literacy, even if tendencies were identified. This was mainly seen as related to a short intervention periodwith too few participants since only a fifth of the families in the intervention group used the intervention. The others did not need it or maybe had not discovered its benefits yet. Conclusion: The digital era challenges both parents and child health nurses. However, digital support developed together, where child health nurses and parents in collaboration agree on how, when and regarding which topics this kind of support and communication should embrace could be experienced as meaningful. It would probably increase accessibility and parental empowerment and lead to longer-term relationships with other parents. Implemented wisely in larger samples and over more extended periods will probably also in a higher degree improve satisfaction with child health care, eHealth literacy and parental stress

FLAVONOIDS NUTRACEUTICALS IN PREVENTION AND TREATMENT OF CANCER: A REVIEW

The objective of the study was to discuss the preventive and treatment of cancer from flavonoids nutraceuticals from our daily dietary source. There has been increasing interest in the research of flavonoids from dietary sources, due to growing evidence of the versatile health benefits of flavonoids through epidemiological studies. Numerous biological activities have been reported. Some clinical trials or meta-analyses have suggested positive associations between flavonoid intake and human health, Several findings have proven that dietary flavonoids to have anticancer properties. Flavonoids due to their nontoxicity in nature and vast, broad aspect of its benefits in biological activities have been intensively studied for their health benefits also added to its abundant availability in our daily diets, for example, green leaves, fruits, red wine, and tea vegetables