Background: India is a developing country and it is growing rapidly in all aspects of life. Health status of population has improved and hence the life expectancy. Women are affected positively by this improvement and their life expectancy has become longer than men. Women all over the world now have to spend almost 1/3rd of their lives in menopausal years. Therefore, menopause now is a concerning matter to maintain and improve women's health. Methods: This analytical study was conducted for a period of 1 year in postmenopausal women attending outdoor in Department of Obstetrics and Gynaecology Sultania Zanana Hospital, Gandhi Medical College, Bhopal, Madhya Pradesh, India. The instrument used in this study was structured questionnaire consisting of 19 items in Hindi language, developed on the basis of the objective of the study. Results: In the present study, 32.72% of menopausal women had knowledge of menopausal symptoms. 39.09%, 52.72% and 22.72% knew that menopause increases risk of cardiovascular, osteoporosis and breast cancer respectively. 28.18% think menopausal women should consult a physician, only 4.54% of menopausal women are aware of HT. 64.55% of menopausal women perceive menopause as loss of youth. 67.28% think menopausal psychological symptoms affect quality of life. 57.28% think that menopause means end of sexual life. 30% think that menopause is associated with maturity and experience. 46.27% think that absence of menstruation in the postmenopausal period is a relief. 39.10% think physical changes of menopause are inevitable and hence acceptable. 29.09% had consulted a physician at the onset of menopause. Conclusions: Our study shows that majority of women have a negative outlook towards menopause considering as a loss of youth and higher susceptibility towards health problems. This shows that the awareness towards menopause should be increased by IEC (information, education, and counseling), so as to help these women to live their postmenopausal years more healthy and active.
Objective A prospective cohort study in a teaching hospital to assess the efficacy and safety of neoadjuvant chemotherapy in the treatment of locally advanced carcinoma cervix. Method Neoadjuvant chemotherapy in the form of cisplatin 75 mg/m 2 and paclitaxel 135 mg/m 2 on day 1 and repeated at 14 days' interval for up to a maximum of three courses. Results Neoadjuvant chemotherapy in cervical cancer was effective in the downstaging of the disease. Downstaging was observed in 19.23 % of patients after two cycles and in 50 % of patients after three cycle of NACT. Operability increases to 33.3 and 38.4 % after two and three cycles of NACT, respectively. Complete pathological response was observed in 37.5 % of patients after NACT. No significant adverse effect in the feasibility of surgery was observed. Conclusion The present study showed that neoadjuvant chemotherapy was an effective and well-tolerated mode of therapy with significantly less morbidity and mortality.
Original Research ArticleStudy to assess knowledge attitude and practices of antenatal care among antenatal women attending outdoor clinic in tertiary care hospital Neetu Ahirwar* INTRODUCTIONIntroduction: Antenatal care is defined as a comprehensive antepartum care programme that involves co-ordinated approach to medical care and psychosocial support that optimally begins before conception and extends throughout antepartum period. Antenatal care (ANC) is a key strategy to decreasing maternal mortality in low-resource settings. ANC clinics provide resources to improve nutrition and health knowledge and promote preventive health practices.Pregnant mothers contribute to a major vulnerable and priority group in any community, no less in India. According to the census 2011, maternal mortality rate in India accounts to an enormous figure of 212. 1 Major causes include hemorrhage, obstructed labor, hypertension and other conditions. 2 The reason being lack of proper antenatal care coverage and lack of awareness among mothers particularly from rural parts of India, contributing the major population, about the need of early ABSTRACT Background: Maternal mortality rate in India continues to be a national challenge despite of the various measures taken by the Indian government, Non profit organizations in and outside the country including the World Health Organization. To find out the gaps between the providers and beneficiaries we tried to find out what actually prevents our pregnant women to seek Regular Antenatal Care by evaluating their knowledge, attitudes and practices towards antenatal care. Methods: All antenatal women attending outpatient clinic of department of obstetrics and gynae Gandhi medical college Bhopal over a period of one year were included in the study. Study group was of unbooked antenatal women and control group consisted of booked women at the hospital. All subjects were given a predesigned, pretested questionnaire to fill in their local language and the data thus obtained was analysed statistically. Results: 86.16% subjects visited ANC clinic during first trimester, 66.33% knew correctly about frequency of antenatal visits, 97.50% knew about Tetanus immunization. Likewise, 78.33% had positive attitude towards antenatal checkups and early registration. Similarly, 70.4% took adequate antenatal care, 93.33% took iron folic acid tablets. Conclusions: Thus, the study shows that the knowledge, attitude and practice of antenatal care is good in the booked subject the same is not the case in unbooked subjects coming to the hospital with complications or being referred to the hospital.
Extrauterine abdominal pregnancy is extremely rare and is frequently missed during antenatal care, despite the routine use of obstetrics ultrasound. A 23 year old primigravida at 39 weeks of gestation was admitted to the department on December 2, 2012, in routine hour with transverse lie with oligohydramnios. On examination her vitals and laboratory investigation were within normal limits. One of the ultrasonographic scanning done by radiologist at 35 wk. 3 days gestation demonstrated a single live intrauterine fetus of CGA 33 wk. 1 day with transverse lie, fundal gr II placenta and AFI-10 cm. Ultrasonography done at the department on the day of admission demonstrated single live intrauterine fetus with transverse lie and AFI-3.8 cm and EFW 2.4 Kg and placenta was right anterior.. She was planned for elective caesarean section on account of transverse lie and oligohydramnios at term. At laparotomy the following findings were made: Secondary abdominal pregnancy arising from right tubal ectopic rupture and making pseudogestational sac with meconium stained liquor. Omentum, right tube and ovary were adhered to sac. The uterus and left tube and ovary were healthy and normal. Other abdominal organs were normal. A 1.5 Kg live male baby with good Apgar score and incompletely formed mandible extracted from pseudogestational sac. There was significant bleeding from pseudogestational sac and patient went in shock during intraoperative period. One unit whole blood transfused during intraoperative period. Placenta was adherent to the pseudogestational sac so Psudogestational sac was removed with placenta in situ and right sided salpingo-oophrectomy was also done due to their adherence. Hemostasis was secured. The patient and baby progressed well and were discharged on the seventh postoperative day.
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