Reaching Community Through School Going Children for Sickle Cell Disease in Zankhvav Village of Surat District, Western India

Objectives: The objective of the study was to explore a method to reach the community via school going adolescents for screening tribal people for Sickle Cell disease. Methodology: A cross-sectional study was conducted in a total of 1023 school going adolescents for Sickle Cell Disease screening by Dithionite Tube Turbidity (DTT) test with subsequent Hemoglobin Electrophoresis for confirmation among those testing positive for DTT. They were then advised to get their family members tested for the same. Results: 24.41% of school going adolescents tested positive by DTT test. 152 family members of those positive school children came forward for testing. On performing the DTT test on the family members, 53.94% tested positive. Out of those who tested positive, 61% belonged to Vasava caste; 36.6% belonged to Chaudhari caste followed by Gamit and Dhodhia Patel. On the subsequent Hemoglobin electrophoresis, 52.63% of the family members were found to be positive for Sickle Cell Trait and 1.97% tested positive for Sickle Cell Disease. Conclusions: School going children can be an effective medium to approach the community for the screening of Sickle Cell Disease

Sickle cell disease status among school adolescents and their tribal community in South Gujarat

Objectives: to create awareness, to screen samples of school adolescents and then to reach their community through them by doing surveillance for sickle cell disease. Design: Field based cross-sectional study. Settings: St Xavier`s high school and Vanraj high school of Umarpada taluka of Surat district. Subjects: School adolescents, their parents and friends. Method: After taking permission from school authority, blood samples of 948 school adolescents were taken for DTT test and then for electrophoresis. Blood samples of motivated parents and friends of those adolescents found positive for DTT was taken in subsequent visit and results were communicated to them. Results: Blood samples of 948 school adolescents, out of 1081 were tested for DTT test. It was positive in 242 samples, giving a prevalence of 25.5% for sickle cell disease. On subjecting the positive blood samples to electrophoresis, the proportion of sickle cell trait and sickle cell disease was found to be 92% and 8% respectively. Then electrophoresis was done in 64 parents and friends, 24 (37.5%) of them were found positive of which, 14 (58%) were having sickle cell trait and 10 (42%) having sickle cell disease. Conclusion: approaching community can be possible through school adolescents for conduction of surveillance of sickle cell anemi

Syöpää sairastavan lapsen pelot

Tässä opinnäytetyössä on selvitetty syöpää sairastavan lapsen pelkoja. Opinnäytetyö on tuotettu kirjallisuuskatsauksena ja aineisto on käsitelty induktiivisen sisällönanalyysin keinoin. Opinnäytetyömme aineistoksi valikoitui viisi tutkimusartikkelia. Työn tavoitteena on kehittää hoitotyötä kokoamalla tutkittua tietoa syöpää sairastavan lapsen peloista ja lisätä näin hoitohenkilökunnan tietoisuutta niistä. Työn tulokset ovat hyödynnettävissä myös hoitotyön koulutuksessa, alan ammattilaisille ja syöpää sairastavan lapsen läheisille. Aihe on tärkeä, jotta hoitohenkilökunta osaa tiedostaa lasten pelkoja. Pelkojen tiedostaminen mahdollistaa pelkojen lievittämisen, ehkäisyn sekä mahdollistaa hoitohenkilökuntaa auttamaan lapsen turvallisesti pelottavan asian yli. Opinnäytetyömme päätuloksena on syntynyt syöpää sairastavan lapsen pelon osa-alueet. Keskeisimpien tulosten perusteella voidaan sanoa, että syöpää sairastavat lapset pelkäävät tulevaisuutta, hoitotyön toimintoja, syövän vaikutusta kehoon, tuntemattomia asioita ja ihmisiä sekä lapsilla ilmenee muita pelkoja.This thesis contains fears of a child who are suffering from cancer. The thesis is produced as a literature review and using an inductive content analysis. Five research articles was selected to our thesis. The aim in this thesis is to develop nursing care by collecting research data on fears of a child who are suffering from cancer and thereby increase the awareness of the medical staff. The results of the work are also useful to extraordinary income including education, nursing, professional use and to next of kin. The subject is important that the medical staff is able to be aware of children's fears. Being aware of fears allows alleviation, prevention, treatment and helps nurses to assist the child safely over frighteningly matter. Main results of this thesis are divisions of fears of child who are suffering cancer. According to main results it can be said that the children who are suffering from cancer are afraid of the future, nursing activities, the impact of the disease on the body, unknown things and people and children have other fears

A case of acrodysostosis: a rare primary bone dysplasia

Acrodysostosis is a rare skeletal dysplasia characterized by brachydactyly, facial dysostosis and nasal hypoplasia. Diagnostic approach to this disorder is based on clinical, radiological and hormonal assays. We present a case of 11-year-old female child who presented with the complaint of short stubby hands and feet since birth and facial dysmorphism. Her skeletal survey revealed typical radiographic features of acrodysostosis. Hormonal assays did not reveal any significant abnormality. In this case report, we would like to highlight the clinical and radiological features of this disorder which could be helpful in diagnosis of this rare disease

Prime labeling in the context of subdivision of some cycle related graphs

A prime labeling on a graph G of order n is a bijection from the set of vertices of G into the set of first n positive integers such that any two adjacent vertices in G have relatively prime labels. The results about prime labeling of wheel, helm, flower, crown and union of crown graphs are very well-known. In this paper we obtain prime labeling of various graphs resulting from the subdivision of edges in these graphs.Publisher's Versio

Finite Element Modelling of Pulsatile Blood Flow in Idealized Model of Human Aortic Arch: Study of Hypotension and Hypertension

A three-dimensional computer model of human aortic arch with three branches is reproduced to study the pulsatile blood flow with Finite Element Method. In specific, the focus is on variation of wall shear stress, which plays an important role in the localization and development of atherosclerotic plaques. Pulsatile pressure pulse is used as boundary condition to avoid flow entry development, and the aorta walls are considered rigid. The aorta model along with boundary conditions is altered to study the effect of hypotension and hypertension. The results illustrated low and fluctuating shear stress at outer and inner wall of aortic arch, proximal wall of branches, and entry region. Despite the simplification of aorta model, rigid walls and other assumptions results displayed that hypertension causes lowered local wall shear stresses. It is the sign of an increased risk of atherosclerosis. The assessment of hemodynamics shows that under the flow regimes of hypotension and hypertension, the risk of atherosclerosis localization in human aorta may increase

Clinical study of feto-maternal outcomes in cases of gestational diabetes mellitus

Background: To study of prevalence of gestational diabetes mellitus in the community, demographic parameters like age, gestational age at diagnosis, parity, complications related to gestational diabetes mellitus, and plan the management of gestational diabetes mellitus and to reduce the maternal and perinatal morbidity and mortality.Methods: In this prospective observational study we included 50 patients with gestational diabetes mellitus were studied for feto-maternal outcome. The study was conducted from October 2018 to October 2020 at department of Obstetrics & Gynaecology, B. J. Medical college and Civil Hospital, Ahmedabad.Results: Total 50 cases of gestational diabetes mellitus were studied. It was observed that gestational diabetes mellitus were more common in elderly age group (60%), multigravida patients wer more commonly involved (48%). Past history of gestational diabetes melllitus was present in 42.2% of cases, 74% of cases required insulin for glycemic control,64% cases required delivery by caesarean section, maternal complications like preeclampsia (10 cases), polyhydramnios (22), uteroplacental insufficiency (4), macrosomia, sudden intrauterine death (3) and operative delivery were more common. 6 neonates developed respiratory distress syndrome, 10 developed hypoglycemia, and 13 neonates required NICU admission, 6 neonates underwent perinatal mortality.Conclusions: Gestational diabetes mellitus has become a global public health burden. Gestational Diabetes Mellitus is one of the leading causes of morbidity and mortality for both mother and infant worldwide. Early detection of gestational diabetes mellitus, timely referral, frequent antenatal visits, management of the identified cases at tertiary centres can lead to decreased maternal and fetal morbidity and mortality

Palm-coein classification of abnormal uterine bleeding and clinicohistopathological correlation

Background: The aim was to categorize women with AUB as per the PALM-COEIN classification system as this is a step towards cause based diagnosis and focused management of patients. The acronym PALM-COEIN comes from arranging basic categories of the classification system. The PALM group comprises the structural entities, which can be measured visually or by using imaging techniques and histopathology. The COEIN group comprises the non- organic types which cannot be defined by imaging or histopathology.Methods: The study comprised 350 women of reproductive age with AUB for minimum 3 month time span. It describes and observes AUB in amount, interval and frequency for women attending out-patient Gynaecology department of C. U. Shah Medical College and Hospital, Surendranagar (Gujrat) over a period of 1year from November 17 to October 18. They were assessed on the basis of structured history, physical examination, local pelvis examination, investigations, USG findings and endometrial histopathological report. Cause of AUB was determined and treatment was given to the patient as appropriated by categorization done in agreement with the PALM-COEIN classification.Results: The most prevalent cause of AUB was ovulatory dysfunction (n=99, 28.2%). Next common cause was leiomyoma (n=90, 25.7%), followed by endometrial causes (n=52, 14.5%), adenomyosis (n=30, 8.5%) not yet classified (n=32, 9.7%), malignancy and hyperplasia (n=28, 8.1%), polyp (n=9, 2.5%), iatrogenic (n=7, 2.2%) and coagulopathy (n=1, 0.3%).Conclusions: The PALM-COEIN classification helps to practically as certain because of AUB, and there by effectively adopt the correct treatment for AUB patients

Fetomaternal outcome in breech delivery

Background: Breech Presentation is the commonest of all malpresentations. Vaginal delivery of the breech presentations at term is associated with a much higher perinatal mortality and morbidity than that of vertex presentation. The objectives of the present study are to know the common causes leading to breech presentation. Further, to compare the different management protocols and outcome in different types of breech presentation.  Also, to know the perinatal morbidity and mortality associated with different types of breech presentation nd comparison of perinatal morbidity and mortality with vaginal delivery against cesarean section.Methods: This is a retrospective study of randomized 100 cases of pregnant women in labour with breech presentations after 28 weeks or more attending C U Shah Medical College, Surendranagar, over a period of May 2012 to April 2014.Results: Out of 100 patients breech presentation was more common in booked patients and multigravida. In primi and multigravidae patients, caesarean delivery was more compared to assisted breech delivery. Perinatal outcome was good in majority of the patients in both extended and complete breech with an incidence of 94% and 88% respectively. perinatal outcome was good in caesarean section with 100% compared to assisted breech delivery 93%.Conclusions: The balanced decision about the mode of delivery on a case by case basis as well as conduct, training and regular drills of assisted breech delivery will go a long way to optimize the outcome of breech presentation like ours. Delivery of breech fetus when labor and delivery is supervised and or conducted by experienced obstetrician lowers maternal morbidity, neonatal morbidity and mortality

Fetomaternal outcome in patients of decreased fetal movements after thirty-four weeks of gestation

Background: Maternal perception of decreased fetal movements is a cause of concern and common reason for visits to the antenatal clinic or delivery room. Several studies have shown that a reduction or cessation of fetal movements may result in poor pregnancy outcome and magnified increased risks of serious perinatal morbidity and mortality. Aim and objectives were to determine the correlation between decreased daily fetal movement counts, NST, USG and Colour Doppler with maternal and fetal outcome. Methods: This study was a prospective observational study, conducted in department of obstetrics and gynecology at Surat municipal institute medical education and research medical college from January 2020 to June 2021. Results: The study group consisted of 83 patients between 34 to 40 weeks of gestation with Decreased fetal movements. 60.24% patients belonged to age group between 21-25 years. 60.22% patients were multigravida.87.95% patients were full term, 59.09% patients presented between 12-24 hours of duration with complain of decreased fetal movements. In view of NST results, 72.29% patients had reactive-NST. In ultrasonography, 27.10% had AFI <5 cm and 72.90% had AFI >5 cm & all patients had normal color Doppler study.  60 patients had induced labor. 68.67% patients delivered vaginally. 42.10% of vaginal deliveries, 80% of Instrumental vaginal deliveries and 75% of LSCS had Meconium-stained liquor. 81.92% babies had APGAR score of >7 at birth. 84.33% had birth weight more than 2.5 kg 68.18% babies were admitted in NICU due to Meconium aspiration syndrome, followed by respiratory distress syndrome in 18.18% and birth asphyxia in 13.63% babies. Conclusions: Decreased fetal movement is a frequently occurring antenatal presentation, associated with poor perinatal outcomes. Daily fetal movement counts are very effective, cheap and reliable method to diagnose fetal compromise early. Methods like NST, USG and Colour Doppler study are helpful in the identification of causes and timely management of the patient with decreased fetal movements and helpful to diagnose the fetus at risk and their timely delivery