National Journal of Medical and Allied Sciences

4-8

Authors: Sinha A, Seth BC, Ali MH, Mondal K, Bhattacharya R

Background: Tetanus is an important cause of morbidity and mortality in developing countries though it is rare in developed countries. Individual and social consciousness ‘about the care of wound and need of immunization are the prime factors for prevention. Knowledge about the need of active and passive immunization for wound is still not encouraging. Materials and methods: This one year study was conducted among the patients admitted at IDBG Hospital, Kolkata with tetanus. Site of entry, incubation period, on-set time, clinical presentation, complication and outcome were measured. The socio economic status, age and sex distribution, seasonal variation, consciousness about the preventive measures among family members or relatives were analyzed. Results: Among total 134 patients, 39 died (29.10%). Male : female ratio was 1.43 : 1, mean and median age of presentation was rural-urban ration was 4.36 : 1, 73.13% was below poverty level and 26.86% was above, poverty level. Most of the patients were admitted in the months of January, April and July. Wound of entry were 52.40% in lower limbs, 20.89% were in upper limbs, 11.94% in the ear and 11.94% were unknown. Immunization status was complete in 11.19%, in-complete in 75.37% and never taken in 13.43%. No cases were taken immunoglobulin. Awareness about the need of active and passive immunization among patients above 10 yrs were 50% and 0.1% respectively, among family members or relatives were 62.23% and 0.1%. Conclusion: Tetanus is a preventable disease and to prevent it, more awareness in the society is needed. Teaching of proper wound care and immunization are to be emphasized among the common people and health care delivery staffs. The need of booster dose is to be stressed. Key words: Clostridium Tetani, APL-Above proverty line, BPL-Below proverty line, Trismus, Rigidity

15-19

Authors: Khan GAN, Ishrat N.

Background: Preeclampsia is a disorder characterized by development of hypertension to the extent of 140/90 mm Hg or more with proteinuria after 20th week of pregnancy in a previously normotensive and non proteinuric woman. Physiologically blood pressure is controlled by autonomic nervous system (ANS) so study of ANS during pregnancy plays a significant role to extract some vital information which may be helpful to deal with pregnancy induced hypertension (PIH) or Preeclampsia. The main objective of our study was to compare the maternal time domain indices of Heart rate variability (HRV) changes between normal pregnancy and preeclamptic pregnancy. Methods: Fourty eight subjects (33 of normotensive pregnant women i.e, control group and 15 preeclamptic pregnant women i.e, study group) of more than 20 weeks pregnancy were recruited from the obstetrics & gynaecology department of JNMC, AMU, Aligarh. Physical examination was done and anthropometric measurement like height & weight were taken. Urine test was conducted to every pregnant woman for urine albumin and we designated the pregnant women as preeclamptic women on the basis of definition. The collected data was statistically analysed using HRV analysis software. Results: No significant difference in body mass index was observed between the two groups. Systolic blood pressure and Mean arterial pressure of study group was significantly higher than control group. Values of all the components of time domain analysis of HRV were significantly decreased among the preeclamptic women than normotensive pregnant women. Conclusion: The present study indicates that the contribution of anthropometric parameters to the blood pressure changes in pregnancy is negligible. Significant decrease in all the three components of time domain indices was observed in preeclamptic pregnant women than normotensive pregnant women which indicates that parasympathetic tone was decreased in preeclampsia. Vagal withdrawal and sympathetic exaggeration may be the possible cause of preeclampsia in pregnant women. Keywords: Preeclampsia, heart rate variability, pregnancy, autonomic nervous system

24-28

Authors: Kaur S, Srivastava AK, Martolia DS, Midha T.

Background: Family planning programmes have always been focused on the female counterpart. This has led to the perception that family planning is largely a woman's business, with the man having a negligible role. Given the degree of male domination in Indian society, involving them and obtaining their support to the cause, family planning is of prime importance in our country. This study was conducted to assess the level of male participation in family planning in the population of urban slums of Kanpur city. Material and Methods: This cross-sectional study involved one urban slum of Kanpur selected by simple random sampling technique. All the 185 eligible couples residing in the study area were interviewed after obtaining the informed consent. A pre-designed and pre-tested questionnaire was used as the study tool. Results: Women had greater knowledge of OCPs(97.9%) and Copper T(86.2%) as compared to men who knew barrier methods(97.8%).The couple protection rate was 36.8%. About 23.8% were using spacing methods whereas 12.9% were using terminal methods. Men showed greater preference towards adoption of family planning methods by females such as OCPs(97.8%), Copper T(96.7%) and tubectomy(73.6%). Vasectomy was the least preferred method of family planning (2.2%) among males. Husband (73%) was the decision maker for adoption of family planning methods in majority of the households. The decision regarding number of children was made by husband in most of cases (48.1%) followed by in-laws(43.2%). Conclusion: Male domination was evident in decision making regarding family planning and number of children in the family. Therefore, family planning measures must be directed towards the male counterpart to make them more effective. Key words: Male participation, family planning methods

35-38

Authors: Gupta P, Anjum F, Sachan B, Srivastava JP, Zaidi ZH

Introduction: AIDS is a major emerging public health problem in India. According to an estimate by WHO for Southeast Asia, India accounts for over two-thirds of all human immunodeficiency virus infected individuals in the region. 35% of all reported AIDS cases are among the age group of 15-24 years, indicating the vulnerability of the younger population to the epidemic. The study was conducted to assess the current level of knowledge, attitude and practices about prevention of HIV/AIDS among school students in Lucknow District and to suggest measures to prevent HIV/AIDS. Materials and Methods: This cross sectional study was conducted among students of 10th to 12th standard of Lucknow, India over a period from July to October 2011. Both boys and girls were enrolled for the study that were present at the time of data collection. Results: A total of 215 students were studied out of which 113 were boys and 102 were girls. Majority of the students, both girls (78%) and boys (82%) knew that avoiding sex with a prostitute is the best way to prevent HIV/AIDS. Majority agreed that it can be prevented from condoms (82.3% girls, 85.8% boys), by avoiding sex with prostitutes (68.6% girls, 69% boys) and by unuse of untested blood (54.9 % girls, &73.4% boys). Nearly 36% of girls and 43% of boys thought that it is a curable disease. Conclusion: The awareness about methods of prevention of HIV/AIDS was low. Although the students have favourable attitude towards persons infected with HIV/AIDS they were not aware of the fact that it is not a curable disease. The school authorities and the other concerned should come forward to design awareness campaigns for the benefit of the students so as to help them develop proper understanding of HIV/AIDS, its spread and prevention. Key words: HIV, AIDS, school students, knowledge, attitude, prevention

43-47

Authors: Sadhukhan SK, Khan S,Chatterjee C, Sinha RN

Introduction: Lifelong Compliance to Hypertension treatment is essential to avoid complications. Objectives: To find out the treatment pattern of hypertension in a rural community of West Bengal and to detect the compliance to hypertension treatment and its outcome. Material & Methods: A Community based cross-sectional study was conducted in a village (Dearah), in Singur Block, Hoogly district of West Bengal. By house to house visit, every adult person of the village ≥ 18 years was contacted and their BP measured by standard techniques. A total of 311 persons with hypertension were interviewed by a pre-tested semi structured schedule. Data was analyzed by standard statistical methods (frequency distribution table, proportion) and suitable statistical tests. Results: Only 37% of the hypertensives were aware of their BP and 30% treated. Majority (about 80%) were treated by allopathic general practitioners. Medicines (100%) and Salt restricted diet (96.8%) were the main advices received. Stated compliance was better for investigations. Financial problem was the major reason for noncompliance to drugs and investigations. Overall, only 17% of the treated hypertensives had their BP controlled with significant sex difference favouring males. Conclusions: Present study highlights the poor situation regarding hypertension awareness, treatment compliance and control in a rural community of West Bengal. Key Words: Hypertension; treatment; compliance; rural community

57-59

Authors: Ranjan A, Prasad A, Jha S.

Fetus in fetu is a rare condition that has been defined as the presence of one of the twins in the the body of another. It is most frequently located in retroperitoneal area; however, it has been reported in the other location as well. We are reporting a case of 30 years adult male who presented with pain abdomen and vomiting. All the routine hematological and radiological investigations were done, patient underwent laparotomy and was diagnosed as intrahepatic teratoma. Intra hepatic fetus in fetu is extremely rare and has not been reported in adult male previously. Key words: Fetus in fetu, intrahepatic teratoma

64-66

Authors: Ranjan A, Jaiswal P, Jha S.

Globally , increasing breast cancer incidence rates, improved prognosis, and growing life expectancy have resulted in an increasing number of women at risk of developing a bilateral primary breast cancer. We are reporting a case of synchronous bilateral invasive ductal carcinoma of breast in a young female. A 28 years old female presented in surgery outdoor department of Indira Gandhi Institute of Medical Science Patna with complaint of lump in her left breast with enlarged left axillary lymph nodes. There was no significant family history of breast carcinoma. The patient was diagnosed with invasive ductal carcinoma of breast on fine needle aspiration cytology and trucut biopsy. At the time of admission, ultrasound of whole abdomen and right breast were normal. After 5 months, patient presented with lump in upper quadrant of right breast and was diagnosed as invasive ductal carcinoma on fine needle aspiration cytology. Key words: Synchronous breast cancer , metachronous breast cancer, infiltrating ductal carcinoma, modified radical mastectomy.