Intestinal Injury in Illegal Abortion – A Case Report
Abstract— Unsafe abortion represents a preventable yet major cause of maternal mortality and morbidity in India. Majority of these unsafe abortions are carried out by untrained persons and in unhygienic environment so leads to complication requiring tertiary care. Unsafe abortions are more common in countries with restricted abortion laws than the countries allow abortions. It is mainly observed in low socio-economic and especially in rural areas of developing countries. It is usually carried out by sharp metallic instrument, a common practice by untrained personnel. They do not have proper training and knowledge of anatomy of reproductive organs leading to various complications like infection, bleeding and even perforation of uterus. Uterine perforation, some time involve urinary bladder or intestine also. Intestinal injury, although a rare complication but not rare in India, occurs when uterus is perforated through its posterior wall. Here, a case of unsafe abortion with a posterior uterine wall perforation, injury to the illeum and septic peritonitis and its consequences and preventive measures were discussed. It was found that as in this present case lack of education, social stigma attached to abortion, female feticide and law to restrict abortion compelled her to seek illegal methods for termination of pregnancy by unskilled personnel. So to prevent these unsafe abortions proper health education, awareness about various methods of contraception and easy accessibility to safer methods of abortion should be promoted.
Key words: Maternal mortality, Unsafe abortion, Intestinal injury, Uterine wall perforation
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Aspirin Resistance: A Review
Abstract— Aspirin is valuable medicine used for the prevention and treatment of coronary artery disease. Its antithrombotic mechanism is believed to be inhibition of the biosynthesis of thromboxane (and thus palatelet activation) by inactivation of platelet cyclooxygenase-1 (COX-1). But in significant number of patients clotting occurs despite of taking regular Aspirin resulting in Aspirin resistance. Aspirin resistance in different studies varied from 8% to 45%. This Aspirin resistance is either of due to inadequate intake of Aspirin, Concurrent intake of certain NSAIDS, Concurrent cigarette smoking, certain diseases like Diabetes and Arteritis, Increased platelet sensitivity to collagen and ADP, Biosynthesis of thromboxane, Increased turnover and vascular endothelial cells, Over expression of COX-2 in RNA, Generation of β2-iso PGF2 alpha binds to thromboxane receptors, Polymorphism in Ia/IIa, Ib/V/IX and IIb/IIIa receptors, COX-1, COX-2 thromboxane-A2 synthatase or other arachiodonate metabolism enzymes, Factor XIII etc. It can be diagnosed by Bleeding time, Selection-P. over expression, measurement of urinary concentration of the metabolite II-dehydrothromboxane B2 indicate the level indicate the level of TXA2 generation etc. Its resistance may lead to acute coronary syndrome, Acute Myocardial Infraction and/ or cardiovascular death in these coronary artery disease patients. Combining with other antiplatelet agents with other precautions like avoid concurrent use of NSAIDS, avoid cigarette smoking, taking proper dose of aspirin etc may prevent Aspirin resistance.
Keywords— Aspirin Resistance, Atherothrombotic vascular event, Acute Myocardial Infraction
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A Point Prevalence assessment of depression by back depression inventory (BDI) scale and its relation with Psycho-wellness as per Modified MINI Scale (MMS)
Abstract— Depression is a major cause of morbidity worldwide. Although there are various studies were conducted in developed country but in India there is paucity of studies regarding depression in medical students who are more prone to have stress. So this study was conducted to study depression in medical students of SMS Medical College, Jaipur (Rajasthan) India. For study purpose 1st MBBS students were screened through Modified Mini Scale (MMS) to found out suspects of depression i.e. red and orange zone of psycho-wellness. Then Back Depression Inventory (BDI) Scale was administered in identified medical students of red and orange zone of psycho-wellness. Depression was found in 30.5% of medical students, out of which 21% had moderate to severe depression. Depression was found to be associated with psycho-wellness of student.
Key words: Depression, post-traumatic stress disorder (PTSD), MMS, BDI, Medical students
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Quality of Life of Glaucoma Patients with its Socio-demographic and Clinical Associates
Abstract— Medical Glaucoma is a major cause of blindness. It affect quality of life of patients. So the present study was carried out in ESI Hopital, Jaipur with the aim to assess quality of life of glaucoma patients as per WHOQOL-Bref. Along with assessment of quality of life of patients various socio-demographic and clinical associates of this quality of life was also found. It was observed that quality of life of glaucoma patients was lowered in all four domains i.e. Physical, Mental, Social and Environmental. Among socio-demographic variables, quality of life was not found to be associated with sex and marital status but it was found more poorer in elder age groups and low socio-economic status. Among clinical variables its quality of life of glaucoma patients was not found to be associated with papillary reaction, Anterior chamber depth (ACD), type of glaucoma and duration of glaucoma but it was found more poorer in glaucoma patients with pain, congestion and defective visual equity. Quality of life was significantly lowered in sever glaucoma. Glaucoma patients should be educated to realize the severity of the disease and importance of the adherence to daily treatment.
Key words: Glaucoma, Quality of Life, WHOQOL-Bref
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Psychiatric Morbidity Profile of Elderly residing in a Metropolitian City
Abstract—Elderly population is increasing due to demographic shift in favor of geriatric population. This age group is susceptible for many health problems which have a significant impact on their quality of life. So this cross-sectional study was carried out from September 2009 to August 2010 on 1620 elderly residing in Municipal corporation area of Jaipur city with the aim to find out psychiatric morbidity profile of elderly population. Study population consist of 1620 elderly with M:F ratio 0.95. More than three fourth (82.4%) of elderly were found to have at least one medical problem. From these, majority (54.32%) of elderly have psychiatric problems. So this geriatric group requires more attention by policy makers.
Key words- Psychiatric Problem, Elderly, Geriatric, Matropolitian City, Urban Area.
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Seasonal variation in Non Neonatal Tetanus: 7 years Retrospective Record based Study
Abstract—Non-neonatal tetanus (NNT) is a public health problem because of inadequate immunization and awareness in population. But it is not given due weightage so there is scarcity of studies regarding NNT. This present retrospective study was conducted in Isolation ward of SMS Medical Hospital, Jaipur weith the aim to study the seasonal variation of NNT if exist. A record based cross-sectional study of tetanus patients admitted since 1st Jan 2004 to 31st Dec 2010 in isolation ward of SMS Hospital, Jaipur, Rajasthan. Seasonal variation of admitted tetanus patients and its association on outcome of patients was analysed. It was found that post monsoon season has significantly higher number of cases admitted in each year of 7 years of study period so it may be associated with occurrence of tetanus which needs further exploration through studies. Although minimum cases were admitted in winter but CFR of tetanus was observed significantly higher in winter season.
Key words- Non-Neonatal Tetanus (NNT), Seasonal Trend, Case Fatality Rate