Background: Cervical cancer is one of the commonest cancers among women which cause morbidity and mortality worldwide. Though, it is a preventable disease, most of the women with cervical cancer present in advanced stage due to lack of knowledge about the disease and screening among general population. The objective was to assess the level of knowledge and explore attitude towards cervical cancer screening among female nursing staff.Methods: A cross sectional, questionnaire based study was conducted on 34 female nursing staff in a tertiary care hospital of Uttarakhand, India in the month of January 2015. With the help of predesigned questionnaire, information was collected regarding demographic profile, knowledge about cervical cancer and attitude towards screening techniques.Results: In this study, 79% of the respondents had knowledge about screening methods for cervical cancer and 91% had knowledge about HPV vaccine. Though 82% of them were aware of pap smear and 89% had good attitude towards it, 85.29% respondent knew about colposcopy as one of the screening technique for cervical cancer. None of the respondent had undergone a pap smear themselves.Conclusions: The study showed that, female nursing staff had average knowledge and positive attitude towards cervical cancer screening. They were not aware of the routine screening guidelines and had limited understanding of different types of cervical cancer screening techniques. Hence, it is recommended that routine training should be given on regular basis to all the health care providers.
A 22-year-old second gravida presented to the antenatal clinic at 28 weeks of gestation with frequent fainting attacks (2-3 episodes/day), palpitations and dyspnea (New York Heart Association Functional Classification II). Her pulse rate was 40 b.p.m. A 12-lead electrocardiogram and 24-h Holter revealed complete heart block. A transvenous permanent pacemaker (ventricular demand rate-responsive), paced at a rate of 60 pulses/min, was successfully implanted. A multidisciplinary approach was taken and the patient delivered a healthy baby boy of 2.8 kg at 38 weeks. She remained asymptomatic and was discharged in good condition. Management varies from expectant management to temporary pacemaker insertion to permanent pacing during pregnancy. In a young patient with sinus bradycardia, the primary criterion for a pacemaker is the concurrent observation of a symptom (e.g., syncope) with bradycardia (e.g., heart rate 35-40 b.p.m. or asystole for 3 s). Symptomatic pregnant women should always be counseled for a permanent pacemaker.
Context: Cervical cancer is the most common cancer among women in India and ranked fourth worldwide. The long precancerous stage of cervical cancer provides a window period for screening and early detection. Evaluation of knowledge and attitude towards them is important for effective implementation of screening programmes especially in a low resource setting. No such studies have been conducted in this region where estimated incidence rate of cervical cancer is quite significant. There is no provision available for mass or regular screening for cervical cancer in the state as well. Aims: To assess the knowledge, attitude and practice towards screening of cervical cancer among women visiting the outpatient clinic. Settings and Design: A cross-sectional descriptive Knowledge Attitude Practice, (KAP) study including the women who visited the outpatient clinic of All India Institute of Medical Sciences, Rishikesh. Methods and Material: The principal investigator interviewed 400 women (18 to 65 years) over three months, with a structured validated pre-tested questionnaire. Informed consent was obtained. Statistical analysis used: The mean age and knowledge-attitude score with standard deviation was calculated using MS Excel. Mann-Witney test was used to compare scores between plains and hills. Results: Ninety three percent (372/400) of the respondents had no knowledge regarding cervical cancer. The remaining 7% (28/400) had a mean score of 35.60% (9.97/28). There was no significance in the difference in mean scores between respondents from plains and the hills. Only 3.25% (13/400) respondents had knowledge about Pap smear as a screening technique but none had undergone the test voluntarily. Conclusions: The awareness about cervical cancer and its screening is extremely poor. There is a dire need to generate awareness as accessibility, logistics and education already pose a negative impact in making implementation of screening programmes effective in this low resource setting with a high incidence of cervical cancer.
India at present has 145,779 active coronavirus disease (COVID) cases and 8884 deaths. Being the largest tertiary care health facility under Delhi Government, our center was designated as a 2000 bedded dedicated COVID hospital. In addition to establishing areas for COVID management, COVID Obstetrics and Gynecology area requires a dedicated set up for delivering women, an operating room, and a neonatal care unit. A phased evacuation plan begins by curtailing non-emergency services and postponing elective surgeries, this process may take longer for obstetrics than other specialties on account of labor and postnatal care. The percentage reduction in the number of elective obstetric and gynecological surgeries was 73% and further fell by 98% (n = 4; category C, D) over a period of 1 month of the evacuation phase, whereas the reduction in emergency cases was only 15% (n = 200) in the beginning and fell to 89%. During the surge phase of COVID, we were able to increase the inpatient surge capacity by 8% (n = 100) as the bed occupancy increased exponentially from 30% to 88%. The start of evacuation of the facility until the endpoint of the surge marks the most dynamic phase of establishing a COVID facility during a pandemic. Pre-event planning for surge capacity at the inception of such pandemics should be based on the local and regional policies which depend on the competing demands of resources to maintain sustainability. These logistical demands are dynamic and vary as the pandemic progresses through its phases.
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