Background:Blood transfusion is a life-saving measure in various medical and surgical emergencies. Transfusion medicine, apart from being important for the medical treatment of each patient, also has great public health importance.Objectives:The present study was conducted to estimate the prevalence of transfusion transmitted infections in voluntary blood donors at a rural tertiary care teaching hospital in western Maharashtra, India.Materials and Methods:All voluntary donors reporting to the blood bank were screened for HBsAg, Hepatitis C Virus (HCV), HIV and Syphilis by using the appropriate enzyme-linked immunosorbent assay. HIV infection was confirmed using a standard immunoblotting technique. Hepatitis B Virus (HBV) was tested for surface antigen (HBsAg) and HCV by the immunechromatographic method. The Venereal Disease Reference Laboratory (VDRL) test was used for estimation of syphilis infection. The study was designed for a duration of two years between January 2009 to December 2010. Medical reports of the donors were accessed from the hospital records and analyzed.Results:A total of 5661 voluntary blood donors were screened, of which 5394 (95.28%) were males and 267 (4.72%) were females. The overall seroprevalence of HBV and HCV were 1.09% and 0.74% respectively; for HIV and syphilis the seroprevalence was estimated to be 0.07% for each.Conclusion:Blood is still one of the main sources of transmission of infections. HIV, hepatitis B, hepatitis C viruses and syphilis are prevalent among voluntary donors in rural India.

Background:Tuberculosis (TB) is the most common serious opportunistic infection in HIV positive patients and is the manifestation of AIDS in more than 50% of cases in developing countries. TB can occur at any time during the course of HIV infection.Aim:To describe the socio-demographic profile and prevalence of pulmonary tuberculosis (HIV/TB co-infection) among HIV positive patients been attended at the antiretroviral therapy clinic (ART) clinic at tertiary care teaching hospital of western Maharashtra, India.Materials and Methods:A cross-sectional study was carried out at the ART clinic of Pravara Rural Hospital, Loni, from June 2011 to May 2012. A total of 1012 HIV positive patients, who attended ART clinic, receiving ART treatment during the study period, were included in the analysis. The statistical analysis was performed using SPSS software (Version 17.0).Results:This study showed 1012/172 (17%) prevalence of pulmonary tuberculosis among HIV positive patients, of which 87 (50.58%) were males and 85 (48.42%) were females. Low CD4 count (< 50/μl) had statistically significant association with HIV/TB co-infection as compared to HIV infection only (P < 0.0001).Conclusion:The study showed that 17% of HIV infected persons had tuberculosis co-infection. More strategic preventive measures that enhance body immunity among HIV patients are highly needed as early as possible before they develop active tuberculosis.

Background:Health research training is an essential component of medical education and a vital exercise to help develop physician research skills.Objectives:This study was carried out to assess the knowledge, attitude, and practices towards health research amongst the postgraduate students of Pravara Institute of Medical Sciences University of central India.Materials and Methods:A cross-sectional study was carried out from August to October 2012. A total of 116 postgraduate students were interviewed. Knowledge, attitude, and practices related to health research were assessed using a predesigned, pretested and validated questionnaire. Results were analyzed in the form of percentage and proportions whenever appropriate.Results:In present study, the concept of research hypothesis was known to only 18.9% of the postgraduate students, whereas 17.2 and 21.5% students knew the full form of MEDLARS and MEDLINE respectively. Majority (91.4%) students believed that patient outcome improves with continued medical research and 70.7% are willing to participate in workshop for research methodology. Lack of time due to vast curriculum of postgraduate subjects (59.5%), lack of research curriculum (25%), and inadequate facilities (25.8%) were stated as major obstacles for pursuing research.Conclusion:Postgraduate students have inadequate knowledge, but have positive attitudes towards health research. Postgraduate training and research facilities at the institution need to undergo major transformation in order to encourage meaningful research by postgraduate trainees.

Background:The rate of primary cesarean section (CS) is on the rise. More and more women report with a history of a previous CS. A trial of vaginal delivery can save these women from the risk of repeat CS.Aims:The study was conducted to assess the safety and success rate of vaginal birth after CS (VBAC) in selected cases of one previous lower segment CS (LSCS).Materials and Methods:The prospective observational study was carried out in a tertiary care teaching hospital over a period of two years. One hundred pregnant women with a history of one previous LSCS were enrolled in the study.Results:In the present study, 85% cases had a successful VBAC and 15% underwent a repeat emergency LSCS for failed trial of vaginal delivery. Cervical dilatation of more than 3 cm at the time of admission was a significant factor in favor of a successful VBAC. Birth weight of more than 3,000 g was associated with a lower success rate of VBAC. The incidence of scar dehiscence was 2% in the present study. There was no maternal or neonatal mortality.Conclusion:Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas.

Zinc is an essential element whose significance to health is increasingly appreciated. In 1961 essentiality of zinc for humans was recognized. A systematic literature search was done to identify relevant studies investigating the role of zinc in human health. This review concerns the importance of zinc in health and the consequences of its deficiency. Zinc deficiency leads to complications of pregnancy and childbirth, low birth weight and poor growth in childhood, reduced immunocompetence, and increased infectious disease morbidity. Pregnant women with zinc deficiency are at risk of premature labour and miscarriages, inefficient labour and delivery, stillbirths, lower mental ability of the child, retarded foetal growth and low immunity of both mother and baby. Zinc can reduce the duration, severity and incidence of diarrhoea in children. Zinc deficiency was indicated as a risk factor for immune deficiency and susceptibility to infection in the elderly. Zinc is used in preventive trials and treatment of diarrhoea, pneumonia, common cold, respiratory infections and malaria. Sufficient zinc is essential in maintaining immune system function. Supplementation of zinc and with other micronutrients may be beneficial during periods of greatest vulnerability such as early childhood, pregnancy and elderly. Ensuring adequate levels of zinc intake should be a key component in efforts to reduce illness.

Background: Preeclampsia and eclampsia have been recognized as clinical entities since the times of Hippocrates. Pregnancy induced hypertension (PIH) is one of the commonest disorders associated with the increased risk of maternal and fetal complications. It is reported in the world literature that the incidence of eclampsia is on the decline, but still a menace in developing countries. Objectives: To study the maternal and foetal outcome in pregnancy induced hypertension. Material and Methods: A prospective randomized study was carried out from February 2009 to January 2010 in the Department of Obstetrics and Gynecology of Pravara Rural Hospital, Loni, India. A total of 100 pregnant women with PIH were enrolled in the study. A pre-tested interview tool was used to collect necessary information such as detailed history, clinical examination findings and investigations performed. Results were analysed using SPSS 13.0 Results: In the present study, the overall incidence of PIH was 8.96%, which includes preeclampsia in 7.26% and eclampsia in 1.70%. Preterm labour was the commonest maternal obstetrical complication observed in 18% of mild PIH and 48% of severe PIH cases. Prematurity was the commonest foetal complication seen in 17.99%, 47.62% and 52.63% of mild PIH, severe PIH and Eclampsia cases respectively. Conclusion: Pregnancy induced hypertension is a common medical disorder seen associated with pregnancy in the rural population, especially among young primigravidas, who remain unregistered during pregnancy. Maternal and fetal morbidity and mortality can be reduced by early recognition and institutional management.

Background: The period of infectiousness of a new sputum smear-positive pulmonary tuberculosis case is important in determining the risk of exposure faced by the community. Early detection and effective treatment of TB case reduces the period of transmission and the risk of exposure of the community. It is for this reason that the delay in TB diagnosis and treatment should be minimal to control disease transmission and patient suffering. Aims & Objective: To measure delays in diagnosis and treatment of pulmonary tuberculosis, and to identify and assess the risk factors associated with these delays. Material and Methods: A cross-sectional study was conducted of all new smear-positive pulmonary TB patients diagnosed between January 2012 and June 2013 at RNTCP clinic. The time from the onset of symptoms to first health care consultation (patient delay) and the time from first health care consultation to the date of TB diagnosis (health system delay) were analysed. Bivariate and logistics regression were applied to analyse the risk factors of delays. Results: A total of 122 patients with a mean age of 29.9 years were included in the study. Mean total delay between the onset of symptoms and treatment initiation was 53.42 days (median 50, range 14-128), with a mean patient delay of 29.24 days (median 25, range 5-94) and mean health system delay of 21.7 days (median 17, range 3-93). The mean treatment delay was 2.48 days (median 2, range 1-6). Factors independently associated with total delay were cough symptom (OR 3.36, P = 0.038), completed secondary school (OR 0.41, P = 0.018), good knowledge of TB symptoms (OR 0.39, P = 0.011), first visit to a public health facility (OR 0.45, P = 0.044), sputum testing at first health care consultation (OR 0.46, P = 0.048) and stigma attached to TB disease (OR 2.89, P = 0.021). Those associated with patient delay were male sex (OR 0.42, P = 0.020), large family size (OR 2.30, P = 0.027), completed secondary school (OR 0.43, P = 0.025) and good knowledge of TB symptoms (OR 0.45, P = 0.029); while those associated with health system delay were first visit to a public health facility (OR 0.31, P = 0.006), sputum testing at first health care consultation (OR 0.22, P = 0.001), number of health care consultations (OR 4.41, P < 0.001) and pre-diagnosis health care cost (OR 3.35, P = 0.001). Conclusion: Health system delay was an important problem in the area studied, with patient delay being of most concern.

HIV infection represents a major public health problem for both developing and developed countries as it has grown to pandemic proportions worldwide. Spectrum of clinical presentation of HIV can vary with geographical distribution, socioeconomic and cultural environment. The aim of this study was to examine the socio-demographic characteristics, clinical presentations of HIV/AIDS patients, opportunistic infections and the possible risk factors for acquiring HIV infection. A cross sectional study was conducted from March to September, 2011 at an antiretroviral therapy (ART) centre of a rural tertiary care hospital, situated in Maharashtra state of India. History and physical examination was done and recorded on a pre-designed schedule which included the socio-demographic and clinical profile of the patients. More than half of the subjects were in economically productive age group and male patients 166 (53.4%) outnumbered the female patients 145 (46.6%). There was a predominance of patients from rural locations nearby the present ART centre. The patients were having low level of literacy and were from the lower middle and lower socio-economic classes. Among the spouses of male patients, 65 (44.8%) were HIV positive and among the spouses of female patients, 52 (35.7%) were HIV positive. Commonest mode of acquiring the infection was through heterosexual contact. Tuberculosis (62%) was the most common opportunistic infection. As per the WHO staging, 132 (42.5%) patients were in stage 3. Combination of behavioral risk factors and unawareness is responsible for rapid spread of HIV/AIDS. People with high-risk behavior and spouses of affected patients need to be educated for primary and secondary prevention.