BackgroundThe extent to which reproductive tract infections (RTIs) are associated with poor menstrual hygiene management (MHM) practices has not been extensively studied. We aimed to determine whether poor menstrual hygiene practices were associated with three common infections of the lower reproductive tract; Bacterial vaginosis (BV), Candida, and Trichomonas vaginalis (TV).MethodsNon-pregnant women of reproductive age (18–45 years) and attending one of two hospitals in Odisha, India, between April 2015 and February 2016 were recruited for the study. A standardized questionnaire was used to collect information on: MHM practices, clinical symptoms for the three infections, and socio-economic and demographic information. Specimens from posterior vaginal fornix were collected using swabs for diagnosis of BV, Candida and TV infection.ResultsA total of 558 women were recruited for the study of whom 62.4% were diagnosed with at least one of the three tested infections and 52% presented with one or more RTI symptoms. BV was the most prevalent infection (41%), followed by Candida infection (34%) and TV infection (5.6%). After adjustment for potentially confounding factors, women diagnosed with Candida infection were more likely to use reusable absorbent material (aPRR = 1.54, 95%CI 1.2–2.0) and practice lower frequency of personal washing (aPRR = 1.34, 95%CI 1.07–1.7). Women with BV were more likely to practice personal washing less frequently (aPRR = 1.25, 95%CI 1.0–1.5), change absorbent material outside a toilet facility (aPRR = 1.21, 95%CI 1.0–1.48) whilst a higher frequency of absorbent material changing was protective (aPRR = 0.56, 95%CI 0.4–0.75). No studied factors were found to be associated with TV infection. In addition, among women reusing absorbent material, Candida but not BV or TV - infection was more frequent who dried their pads inside their houses and who stored the cloth hidden in the toilet compartment.ConclusionThe results of our study add to growing number of studies which demonstrate a strong and consistent association between poor menstrual hygiene practices and higher prevalence of lower RTIs.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3384-2) contains supplementary material, which is available to authorized users.

The transcervical retropharyngeal approach to the craniovertebral junction provides direct access to the lesion and avoids the potential bacterial contamination of the oral and pharyngeal cavity. It also prevents the development of persistent fistulae. Posterior stabilization should be performed directly after anterior neural decompression, while the patient remains under anesthesia, to prevent neurological deterioration before subsequent posterior fixation. This technique also is helpful for early mobilization of patients. The aim of surgical treatment should be to obtain biopsy tissue and to perform radical excision of epidural granulation tissue/abscess and infected bone using microsurgical technique. Antituberculous medication must be continued for 18 months with four drug regimens, and continuous monitoring of drug toxicity should be performed throughout the course of treatment.

Hypophyseal tuberculomas are often mistaken for pituitary adenomas. The finding of a thickened pituitary stalk in contrast magnetic resonance imaging scans may be useful for the differentiation of these lesions from pituitary adenomas. Direct radiosurgery is not an appropriate primary treatment method for pituitary adenomas and is principally restricted to elderly, medically unfit patients with microadenomas and patients with residual or recurrent tumors after microsurgery. It is contraindicated for patients who exhibit a thickened pituitary stalk in contrast magnetic resonance imaging scans.

This paper explores the impact of local government policies and urban plans on home-based workers. It presents recent national data on the size and composition of home-based work in developing countries as well as findings from two recent field studies of urban home-based workers in several Asian cities/countries. The research findings highlight that homes often double as workplaces, especially for women workers, and that slums are domains of significant economic activities. Reflecting these twin facts, as well as the demands of home-based workers, the paper makes the case that city governments and urban planners need to integrate home-based workers and their livelihood activities into local economic development plans. It also argues that city governments need to extend basic infrastructure to the homes-cum-workplaces of home-based workers, as well as transport services to the settlements where they live and work. The paper provides some promising examples of where and how this has been done, largely in response to effective advocacy by organizations of home-based workers.

✓ The authors present an unusual case of intramedullary arachnoid cyst diagnosed in a patient after the lesion was resected. A wide decompressive surgery was performed and the lesion removed. Histopathological findings were consistent with the diagnosis of arachnoid cyst. Postoperatively the patient exhibited marked improvement in neurological status. To the best of the authors' knowledge, there is no case report of intramedullary arachnoid cyst reported in the literature. With the advent of newer neuroimaging modalities such as magnetic resonance imaging the number of cases of intramedullary arachnoid cysts encountered in the future may increase.

Oligohydramnios at term in the absence of maternal and fetal complications poses a dilemma in management. It is one of the major indications for antenatal surveillance and induction of labour. There is a growing body of evidence that oligohydramnios in the absence of maternal or fetal risk factors ('isolated' oligohydramnios) is not associated with an adverse perinatal outcome. In this study, we surveyed the management of isolated oligohydramnios at term in a tertiary referral maternity unit. Out of 92 women who were scanned at term, 22 (24%) women had isolated oligohydramnios. A greater tendency to intervene in such cases was noted with 10 (45%) women having labour induced, while one (4.5%) had an elective caesarean section. Emergency caesarean section rates were also higher in the oligohydramnios group (13.5%) than in a low risk group (6%). There was no increased perinatal morbidity when compared with pregnancies managed expectantly.

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