Awareness regarding reproductive tract infections among married women in the rural area of Surendranagar

Background: High levels of gynaecological morbidity, especially reproductive tract infections and sexually transmitted infections may turn out to be fatal if not treated properly. The objectives of this study were basic awareness about disease and association with socio-economic findings, awareness regarding disease occurrence and transmission, symptoms, complications of disease; HIV prevention.Methods: Various community based studies carried out in the different regions world showed the prevalence of reproductive tract infections 36-84%. The sample size of study as per statistical calculation (4pq/l2, where p = 50, q = 100-p and l = 10% of p) came out to be 400. Method of sampling - Prior enlisting all villages of Surendranagar district, one village was selected randomly.Results: Basic awareness about disease was 64.0%; 82.2% of women narrated symptoms. 42.00% of women had no idea regarding its complications. Knowledge regarding HIV prevention was 59.50%.Conclusions: Effective strategies for the early diagnosis and treatment should be made

A prospective study among cases of the pancytopenia on the basis of clinic-hematological analysis and bone marrow aspiration

Background: Pancytopenia is consequence of many haematological condition with an extensive differential diagnosis. A prompt intervention is required to avoid complications. The severity and the underlying pathology determines the management and prognosis. Present study was conducted to assess the etiology, clinical profile and bone marrow morphology of pancytopenia.Methods: A prospective study was carried out among 50 consecutive patients with pancytopenia. Blood samples of the patients were analyzed for complete blood count and peripheral smear along with presence and absence of immature cells and abnormal cells. In bone marrow examination, morphology of all cells lineage, cellularity, parasite and abnormal cells were scrutinized. Trephine biopsy was done if indicated. Special investigations were done to confirm the diagnosis.Results: Among the 50 cases studied, age of the patients ranged from 1 to 70 years with a slight male predominance. Most common age group 11-20 years. Most of the patients presented with generalized weakness and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. The commonest marrow finding was hyper cellularity with megaloblastic erythropoiesis. The commonest cause for pancytopenia was megaloblastic anemia.Conclusions: The present study concludes that hematological investigations along with other supportive tests are helpful to diagnose or to rule out the causes of pancytopenia. Megaloblastic anemia is commonest cause of pancytopenia in most Indian and subcontinent studies. Substantial number of patients had reversible etiology. Hence complete work up including clinical details with hematological examination along with bone marrow study will lead to early and proper diagnosis and management

A cross sectional study on the prevalence of reproductive tract infections amongst married women in the rural area of Surendranagar district

Background: In the recent years, the issue of gynaecological problems of poor women in the developing countries has been receiving increasing attention. High levels of gynaecological morbidity, especially reproductive tract infections and sexually transmitted infections may turn out to be fatal if not treated properly. Objectives of current study were to find out the prevalence of reproductive tract infections amongst married women, to co-relate the disease with certain socio demographic variables and to assess the awareness about reproductive tract infections in the study population. Methods: Sample size - Various community based studies carried out in the different regions world showed the prevalence of reproductive tract infections 36-84%. The sample size of study as per statistical calculation (4pq/l2, where p =50, q=100-p and l= 10% of p) came out to be 400. Method of Sampling - Prior enlisting all villages of Surendranagar district, one village was selected randomly. After random selection the village found was Khodu. Results: 56.5% of women reported either one or more symptoms of reproductive tract infections; vaginal discharge (29.7%) was the commonest symptom. Basic awareness about disease was 64.0%; Maximum prevalence of reproductive tract infections (62.90%) was found in the age group of 25-34 years.Conclusions: There is a significant association between socio-economic class, educational status and women having symptoms of reproductive tract infections.

Health seeking attitude of women regarding reproductive tract infections in a rural area of Surendranagar district

Background:In the recent years, the issue of gynaecological problems of poor women in the developing countries has been receiving increasing attention. High levels of gynaecological morbidity, especially reproductive tract infections and sexually transmitted infections may turn out to be fatal if not treated properly. The objective of this study was to assess the health seeking attitude of women regarding reproductive tract infections, to elicit the past history pertaining to it, to assess the personal hygiene measures relevant to it. Methods: Various community based studies carried out in the different regions world showed the prevalence of reproductive tract infections 36-84%. The sample size of study as per statistical calculation (4pq/l2, where p =50, q=100-p and l= 10% of p) came out to be 400. Prior enlisting all villages of Surendranagar district, one village was selected randomly. After random selection the village found was Khodu. Results: 75.3% of women narrated treatment was necessary; 44% told that preferably to be taken from doctor and 24.7% told treatment should not be taken because of social and personal reason. 56.5% of women having one or the other kind of symptom of reproductive tract infections. Women with poor menstrual and personal hygiene has got 2.5 times chances of reproductive tract infections (OR= 2.35, CI= 1.374-4.01, P value: 0.001). Thus the overall prevalence in our study is 56.5%. On statistical analysis it was found that women who used clothes were two times more symptomatic as compared to women who used sanitary pads, a significant association between women having symptoms of reproductive tract infections and their sexual history. The present study showed 61.94% of women had taken treatment which shows that the health seeking behavior had improved. Conclusions: Women who used sanitary pads during menstrual periods had lower prevalence. Women with complaints of dyspareunia, bleeding during and or after intercourse and history of forceful intercourse had maximum prevalence of reproductive tract infections. 19.8% of women gave past history of reproductive tract infections and out of that 15.16% of women had taken treatment for it. Regarding health seeking attitude of symptomatic women, 61.94% of women had taken treatment and majority of them had taken treatment from doctors. This implies that health intervention measures directed towards reducing morbidity from reproductive tract infections need not focus mainly on treatment of reproductive tract infections but rather on disease preventing strategies

Diabetic foot resulting in amputation: our experience

Background: The aim of our study was to early diagnosis of diabetic foot so that the complications can be prevented, to control the systemic infection and prevent the complications, to study the effectiveness of regular dressing in diabetic foot so as to prevent the local spread of infection and the ulcer and to conclude that early diagnosis, care and proper meticulous treatment of diabetic foot can prevent amputation. Methods: The present study was prospective, observational and longitudinal. Protocol of the procedure was formed along with Performa, Patient Information Sheet, Informed Consent Form and approval from Ethical Committee. The present study was carried out in surgery department of C.U Shah medical college, Surendranagar; Gujarat state. The study was carried out from 1st August 2011 to 30th September 2013. A total of one hundred patients admitted in surgery ward with diabetes type 1 or 2 with ulcer on foot having grade 1 or 2 of Wagner’s classification without any other co morbid condition. These patients undergo daily dressing with various dressing solutions according to their ulcer characteristics. All the patients given diet/oral hypoglycaemic drug/insulin for control of diabetes. Antibiotics given according to the infective status of the patients. Patients were either completely treated, went under skin grafting or ended up with amputation were recorded.Results: Of 100 cases studied, youngest patient was 32 years and oldest was 80 years of age. Highest number of cases was found in the age group 61-70 years (30%). Of the 100 cases studied in this series 36 (36%) patient were having Wagner’s class 1 ulcer and 64 (64%) patient having class 2 ulcers. Of 100 cases, various surgical treatment given to the patients according to the ulcer. In that 65(65%) debridement, 20 (20%) Incision & drainage, 10 (10%) STG, 5 (5%) fasciotomy. Most of the patients were undergone basic surgical procedure which is debridement on the 7th day follow up, out of 100 cases 70 patients came for follow up. Out of 70, all patients having healing ulcer. Out of 70 patients, 15(21.43%) patients were underwent STG on 15th day and other 55 (71.57%) patients having healing ulcer advised daily dressing with follow up after 1 week. Out of 30 patients, 3 (10%) patients underwent amputation on 7th day of follow up. On the 15th day new 5 (16.67%) patients underwent amputations, so total number of amputation done till date was 8 (26.67%). On 21st day, new 7 (23.34%) patients were underwent amputations and total number of amputations till date were 15 (50%). On 30th day, new 15 (50%) patients underwent amputations.Conclusions: Foot ulceration in diabetic patients is a resource consuming, disabling morbidity that often is the first step towards lower extremity amputation. Prevention is the best treatment.

A prospective study on morphological alteration of megakaryocytes amongst megaloblastic anemia cases along with their clinic-haematological manifestations

Background: Megaloblastic anemias are hematologic disorders in which abnormal DNA synthesis causes blood and bone marrow disorders. The cause of thrombocytopenia in megaloblastic anemia has been postulated as hypoproduction in some studies, whereas ineffective thrombopoeisis has been proposed in other. Objective was to study spectrum of clinic-hematological features in megaloblastic anemia and comparative bone marrow aspiration study of thrombocytopenia secondary to megaloblastic anemia, hypoproduction and hyper-destruction. This study was done to understand the various megakaryocytic alterations in hematological disorders presenting with thrombocytopenia due to different mechanisms.Methods: Total 85 cases of thrombocytopenia included in the study. Bone marrow finding in 33 cases of thrombocytopenia of megaloblastic etiology were compared with 34 cases of marrow proven hypo productive thrombocytopenia (aplastic anemia, acute leukemia) and 19 cases of hyper destructive thrombocytopenia (immune thrombocytopenia).Results: Most common age group presenting megaloblastic anemia is 11-20 year, with male to female ratio is1.2:1, most common complaint were generalized weakness and fever. In megaloblastic anemia 24.33%, 60% and 15.67% of the cases shows increase, decrease and normal megakaryocytes respectively. Dysplastic megakaryocytes were observed in 24.3%, 27% and 20.5% of the cases of megaloblastic anemia, acute leukaemia and immune thrombocytopenic purpura respectively.Conclusions: Both hypoproduction and ineffective thrombopoiesis are the underlying path mechanisms in megaloblastic thrombocytopenia as evidenced by the marrow findings. We hereby infer that megaloblastic thrombocytopenia is to be included as a separate category apart from hypo proliferative and hyper destructive groups. The presence of dysplastic megakaryocyte should not prompt an interpretatio