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Volume-19 (2020);
No. 3 (July-September)
Published on December 20, 2020
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2020;3:1
Original Article |
Emon UD, Ndukaku CN, Ojong-Alasia M, Ogabi BB.
Perceived Consequences of Home Deliveries on Mothers and Babies' Health in Anantigha Community, Calabar South Local Government Area, Cross River State. |
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Abstract: The study was conducted to identify the perceived consequences of home deliveries on mothers' and babies’ health in Anantigha Community, Calabar South Local Government Area, Cross River State. Four (4) objectives with corresponding research questions were formulated to guide the study. This study was a cross-sectional research design. After data collection, the sample size consisted of 279 mothers who were selected using the purposive sampling technique. A structured questionnaire was used to obtain data. The data collected was analyzed using simple frequencies, percentages, bar charts, and Pearson product-moment correlation statistical analysis. Findings in this study revealed that 115 (41.2%) women gave birth at home while 129 (46.2%) and 35 (12.6%) gave birth in health centers and hospitals respectively. Results further showed that: family and maternal income, the distance of the health center from a mother's home, cost of hospital care, attitude of health care workers and culture, and traditional norms were factors perceived to leads to home deliveries. Moreover, 79(28.3%) participants indicated that excessive blood loss was a consequence of home deliveries while 96 (34.4%), 58 (20.8%), and 46 (16.5%) participants each listed maternal death, maternal birth injuries and shock as health consequences of home deliveries. Similarly, 94 (33.7%) mothers indicated that stillbirths could result from home deliveries while 111 (39.8%), 46 (16.5%) and 28 (10.0%) mothers indicated: neonatal death, poor immunization practices and childhood abnormalities as consequences of home deliveries respectively. A test of the hypothesis revealed a significant relationship between the incidence and perceived consequences of home deliveries on mothers' health. Result significant at P < 0.05 r-cal = 0.25, r-critical = 0.18. Based on the findings of the study, it was recommended among others that adequate information be provided on the importance of appropriate delivery service use for pregnant women.
Key words: Perceived consequences, Home delivery, Mothers, Pregnancy, Labour, Birth complications |
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2020;3:2
Original Article |
Lukpata FE, Nwakwue NC, Lukpata OH, Tangban EA, Anagor CR, Mgbekem MA.
Women Status and Access to Maternal Healthcare Services in Primary Healthcare Facilities of North Ukelle, Yala Local Government Area of Cross River State. |
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Abstract: Introduction: Access to skilled maternal health services has been recognized as a panacea to poor maternal health outcome. However, poor access to skilled maternal health services prevail and this is worrisome because of the corresponding poor maternal health outcomes. This study examined women's status and access to maternal health services in primary healthcare facilities of North Ukelle. Methods: A cross sectional survey design was adopted for this study while a validated questionnaire with a reliability co-efficient of 0.67 was administered to obtained data. A multistage sampling technique was used to select 390 women who had been pregnant within twenty four (24) months prior to the survey. Both descriptive and Chi square techniques were applied to analyze data using SPSS 21.0. Result: Findings from this study showed low access, as only 176(45.1%) accessed maternal care in the primary healthcare facilities. Decision for care was taken by husbands alone for 152(39%) respondents and the influence of low decision autonomy was conspicuous as husband's decision determined place of registration for maternal care in 254 (65.1%) respondents. Access to health facility based care increased with higher level of education. Interestingly, women involved in trading 72(18.5%) accessed care more than civil servants 43(11.0%). Chi square analysis showed no significant association between occupation and access. Conclusion: Based on these findings, free secondary education for the girl-child is suggested, as this will empower her to take healthcare decisions and negotiate care options. Flexible maternal care periods such as evenings and weekends should be adopted to accommodate working class women with tight time schedule.
Key words: Women status, Decision autonomy, Access, Maternal health services |
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2020;3:3
Original Article |
Jha V, Dinesh TA, Abhijath V, Nair P.
Measuring Operational Efficiency of Highly Specialised Clinical Laboratories at a University Teaching Hospital– A DEA Approach. |
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Abstract: Purpose: Evaluation of the efficiencies of clinical laboratories is a must for the laboratory and hospital managers. It facilitates an understanding of the current situation of the ongoing processes and allows for targeted measures. The study aims to analyse and measure performance efficiency of highly specialised clinical laboratories at a University teaching hospital and to recommend ways to improve performance in the areas of inefficiency. Methodology: A retrospective study was done and data from 4 highly specialised clinical laboratories were collected and entered in MS Excel. Data Envelopment Analysis was used to assess relative efficiency of theses laboratories on a 15 months data pool. Results: Relative efficiency scores for Cytogenetics lab, Molecular Biology, Molecular Oncology and Virology labs were 100%, 100%, 14.4% and 44.6% respectively with the input orientation approach and 100%, 84.3%, 75.7% and 87.5% respectively with the output orientation approach. Conclusion: DEA serves as a useful healthcare analytical tool to evaluate relative efficiencies of clinical laboratories in hospitals. It is important to pay attention to efficiency evaluation as it is necessary in solving the problem of limited and unbalanced medical resources.
Key words: Efficiency, Laboratories, Performance, Data Envelopment Analysis, Resources |
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This Article |
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2020;3:4
Original Article |
Lobo FD, Pooja KS, Khadilkar UN, Aishwarya R.
Histopathological Study of Endometrial Polyps and its Association With Cancer: Experience from a Tertiary Care Center in Coastal India. |
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Abstract: Aim: Morphologic examination of endometrial polyps and assess the occurrence of endometrial cancer. Materials & Methods: One hundred sixty cases of endometrial polyps received at the department of Pathology of a tertiary care hospital over 31 months i.e., from January 2014 and July 2016 were analysed. The clinical data was retrieved from the medical records department. Results: Out of the 160 cases of endometrial polyps, 94.4% of the endometrial polyps were non neoplastic & 5.6% were neoplastic. The mean age of presentation of non-neoplastic polyps was 45 years (21-76 years) & neoplastic polyps was 52 years (42-62 years). The mean size of non-neoplastic polyp was 2.4 cm (0.5-9 cm) & neoplastic polyp was 4.5cm (1.5-9cm). The non-neoplastic polyps were benign endometrial glandular polyp (83.7%), leiomyomatous polyp (2.2%), adenomyomatous polyp (1.1%) & stromomyoma (0.5%). The neoplastic polyps encountered were endometrial carcinoma type 1 (1.67%), endometrial carcinoma type 2 (0.5%), endometrial stromal sarcoma (1.67%), adenosarcoma (0.5%) & malignant mixed mullerian tumor (0.5%). Post-menopausal bleeding was seen in 27% of patients. Immunohistochemistry was performed in 3 of the cases. Tamoxifen induced endometrial polyp were seen in 1.67%. Conclusion: Endometrial polyps are rarely associated with malignancy, as most of them are hyperplastic glandular polyps. Multiple risk factors such as age, multiparity, tamoxifen usage show higher association with malignancy. Post-menopausal bleeding cases needs to be thoroughly evaluated for presence of endometrial malignancy. Histopathological evaluation of resected polyps proves the nature of the disease.
Key words: Endometrial Carcinoma, Endometrial polyps, Malignant mixed mullerian tumor, Post-menopausal bleeding, Stromal sarcoma |
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2020;3:5
Original Article |
Shekhawat KS, Chauhan A, Nair PMS, Mehendale AV, Prathap S, Shaji A.
Geographic Distribution of Dental Problems and Utilization of Dental Services from the Perspective of a Private Dental College in Kasaragod District, Kerala. |
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Abstract: Introduction: For effective formulation of oral health policies it is important to understand the magnitude of oral health/diseases in a community keeping in mind various factors that influence utilization of dental services.
Objective: To estimate geographic distribution of dental problems and factors affecting utilization of dental services from secondary data of patients visiting a private dental institute in Kasaragod District, North Kerala.
Methods: Data from 2498 patients was extracted and categorized according to age, gender, chief complaints, delay (time gap) in utilization of dental services and area of residence. Distance from area of residences and to the dental institute was calculated for individual patients categorized according to gram panchayats, block panchayats and municipalities. The distance was mapped according to block panchayat. The data was analyzed using chi-square test for age group, gender and time taken to utilize dental services.
Results: Majority of patients belonged to age group of 21 – 30 years and males were more than females. Dental caries was common dental problem followed by dental pain in all block panchayats and municipalities. Patients reported from distances as far as 50 km. There was a significantly higher utilization of dental services by males in all age groups except females in the age group of 31 – 50 years (P = 0.001) and only 13.7 percent utilized dental services within one week of dental problem with more males than females (P = 0.04) Conclusion: Males utilized dental services more than females and majority were in age group of 21 – 30 years. About 85.5 percent of patients reported from within a radius of 30 km. Data from private sectors can be used to describe the dispersion of dental problems in a community, thereby providing more comprehensive view of magnitude of dental problems.
Key words: Geographic distribution, Dental problems, Dental Caries, Utilization, Inequality |
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This Article |
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2020;3:6
Original Article |
Hamedani SMMG, Alvandipour M, Zahmatkesh A, Motlagh AS.
The Effect of Talc Powder on Seroma Formation Following Incisional Hernia Repair Surgery with Mesh. |
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Abstract: Background: Seroma formation is one of the complication after incisional hernia repair with mesh. We hypothesized that application of talc powder before skin closure in patients undergoing tension-free incisional hernia repair by mesh would decrease seroma formation after surgery. Method: A multi-centric, double-blind randomized controlled trial of 120 consecutive patients who underwent incisional hernia repair with onlay technique, and randomly assigned into 'mesh' group and 'mesh plus talc' group between 2016 and 2019. Results: Patient demographic characteristics did not differ significantly. Seroma formation was the main complication after surgery. There was statistically significant difference between the groups concerning seroma formation (20% in mesh group vs. 1.6% in mesh plus talc group, p<0.05), and length of drainage (4.08 days in mesh group vs. 2.02 days in mesh plus talc group, p<0.05). Post-operative complications including cellulitis, wound infection, intra-abdominal abscess, nausea and vomiting, and hypersensitivity were significantly different between two groups. Conclusion: Application of talc powder after mesh fixation to the fascia is safe in incisional hernia repair surgery to prevent seroma formation and reduce the duration of drainage.
Key words: Incisional hernia, Seroma, Talc powder, Mesh repair |
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This Article |
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2020;3:7
Original Article |
Joseph R, Saranya LMT, Sreehari R.
Psychological Help, Self-Esteem and Achievement Motivation Among Preadolescents in Children Homes. |
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Abstract: Context: Poor quality of home environment during childhood, absence of significant people in life and poor socioeconomic status leading to compromising facilities can have a negative impact on self-esteem and other psychological factors. Aim: To understand the psychological help needed and available in children homes, the relationship between self-esteem and achievement motivation among preadolescents with difficult situations. Method: An exploratory study was conducted at children homes in Kerala and preadolescents were selected through random sampling. Coloured Progressive Matrices (CPM) was used to screen children’s intellectual capacity. For a sample of 30, a semi-structured interview was done individually, administered Self-Esteem Inventory (SEI) and Achievement Motivation Inventory (AMI). Pearson correlation, Independent sample t test and ANOVA were used for statistical analysis. Qualitative analysis was done for understanding the nature and effect of psychological help provided. Results and conclusion: Significant relationship between self-esteem and achievement motivation was found. There is no difference in self-esteem and achievement motivation based on gender and sociodemographic factors in the sample. Qualitative analysis showed children’s need for psychological assistance, their dissatisfaction and feeling of missing out with the current psychological services and the possible help that could be provided for them.
Key words: Psychological help, Self-esteem, Achievement motivation, Preadolescents, Children homes |
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2020;3:8
Review |
Nyathi D, Ndlovu J, Phiri K, Sibanda M.
Dynamics of Parent-Adolescent Communication on Sexual and Reproductive Health in Sub-Sahara: A Focus on Barriers and Policy Implications. |
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Abstract: Communication of sexual matters between the parents and adolescents has been seen as one of the strategies that could play a cardinal role in encouraging adolescents to be responsible and delay sexual debut or avoid unprotected sexual intercourse. The increasing rate of teenage pregnancies and new HIV/AIDS infections among adolescents in Sub-Saharan Africa makes the phenomenon worth analysis. The purpose of this paper is to interrogate the dynamics of parent-adolescent communication on sexual and reproductive health in Sub-Sahara. Specifically, the paper focuses on barriers to communication between parents and adolescents on sexual and reproductive health and its policy implications. It emanates from the paper that communication on sexual and reproductive health at household level is triggered by death of a relative from a sexual related illness, suspicion on sexual activity, radio programmes and in some instances fliers. Literature engagement reveals that communication between parents and adolescents on sexual and reproductive health is made difficult by economic factors (poverty, lack of privacy and low self-esteem), household demographics (age, sex, class, death), socio-cultural factors (beliefs and religious values) as well as social media. We argue that there is need to use broadcast media to come up with radio and television programmes that create family environments in which sexual and reproductive health issues are discussed. We also recommend that government departments and Non-Governmental Organisations concerned with sexuality issues need to undertake studies that can help dismantle taboos, prejudices and stereotypes that impede sexual and reproductive health communication between parents and adolescents.
Key words: Parent-adolescent, Communication, Sexual and reproductive health, Barriers, Sub-Sahara |
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2020;3:9
Short Report |
Banerjee R.
The Need for Forensic Anthropological Facilities in India for Human Decomposition Research. |
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Abstract: In the recent past, several human decomposition facilities have been established to systematically study how the human body decomposes under different environmental conditions. However, as of today's date, India lacks such infrastructure and relies completely on animal analogues for decomposition research. A discussion regarding the establishment of a dedicated human decomposition research facility in India has been presented and its potential benefits for forensic science education and research in the long run has been argued in this article.
Key words: Forensic anthropology, Decomposition, Human Taphonomy Facility, Human cadavers |
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2020;3:10
Short Report |
George AM, Leena KC.
Experiences of the Women Using Menstrual Cup on Free Will – A Qualitative Inquiry. |
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Abstract: Background: Menstrual cup is a least preferred sanitary option by the Indian women. Even though there are studies on the experience of women using menstrual cups, little research has been conducted among the women who use menstrual cup on a free will. The current study explored the experiences of the women using menstrual cup independently without any program interventions. Materials and methods: A generic qualitative approach was adopted. The data was collected through semi-structured interview of 22 women who were using menstrual cups for a minimum of three consecutive cycles. The data was analyzed using inductive thematic analysis. Results: Ten sub themes emerged and were categorized under four main themes. Firstly the experiences that led to the use of menstrual cup with sub-themes: excessive menstrual bleeding, discomfort with the previous menstrual absorbent and problem in its disposal, secondly experiences during the initial use of menstrual cup with two subthemes: emotional feelings and difficulties with the insertion and removal, thirdly experiences while getting adapted with menstrual cup with sub-themes: getting familiarized with the cup and peer and social media influence and finally experiences with the subsequent use of menstrual cup with sub themes: caution taken while using menstrual cups, differences felt from the previous menstrual absorbent and problems faced while using the menstrual cup. Conclusions: Women in the present study found it comfortable and convenient to use the menstrual cups but they faced difficulties during the initial use and adaptation.
Key words: Women, Menstrual cup, Experience |
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2020;3:11
Case Report |
Jayanthi C, Dehuri P, Giridhar CM.
Cystic Primary Ovarian Malignant Mixed Mullerian Tumour. |
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Abstract: Primary carcinosarcoma of the ovary is a rare, challenging malignancy of the female genital tract. Preoperative diagnosis of this tumor is seldom made as it mimics epithelial ovarian tumors. We report a case of 45 years multiparous lady who underwent staging laparotomy to disclose smooth surface left ovarian cystic mass with minimal solid areas. Histopathologically a biphasic tumor with malignant epithelial and mesenchymal component was seen. Explicit diagnosis of primary ovarian carcinosarcoma was established using immunohistochemical marker study. Primary mixed Mullerian tumor of the ovary has to be considered in the differential diagnosis of predominantly cystic ovarian lesion with minimal solid areas. Regular followup and close monitoring of the patient is required to understand the behavior of this exceptional tumor.
Key words: Carcinosarcoma, Cystic mass, Staging laparotomy |
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2020;3:12
Case Report |
Sukumar CA, Tomar S, Rai S, Saravu K.
Pseudohypoparathyroidism: A Diagnosis That Traverses Specialities. |
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Abstract: Pseudohypoparathyrodism (PHP) is a rare , genetic disorder with variable presentation. This case report describes a young male who presented with a pathological fracture of the right humerus with spontaneous dislocation of the right shoulder joint. On evaluation, hypocalcemia, normal phosphate levels with raised parathormone levels were seen. PHP was suspected as a phenotypic manifestation of short stature, genu valgum and brachydactyly were noted. Genetic testing revealed GNAS was pending. Patient was initiated on treatment with oral calcium supplements and calcitriol. This case report stresses the importance of early recognition of the typical biochemical abnormalities in PHP as a wide spectrum of phenotypic variability is seen in these patients.
Key words: Pseudohypoparathyroidism (PHP), Albright’s hereditary osteodystrophy(AHO), Parathyroid hormone resistance, GNAS gene |
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2020;3:13
Case Report |
Covantev S, Belic O.
Suprascapular Notch and Suprascapular Foramen: When Neurology Meets Anatomy. |
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Abstract: Ossification of ligamentous structures during lifetime is a relatively frequent phenomenon in the human body. One of the most common causes of suprascapular nerve entrapment is complete ossification of the superior transverse ligament or ossification of the anterior coracoscapular ligament. In cases when only the coracoscapular ligament is ossified the foramen coexists with a notch. This particular type of anatomy is rare and there have been only a few cases described in the literature. This type of anomaly can lead to nerve entrapment and pain, weakness of the shoulder with progressive atrophy of the supraspinatus and infraspinatus muscles. We present a rare anatomical case report of a suprascapular foramen and notch with a brief review of their etiology and clinical significance..
Key words: Suprascapula notch, Suprascapular foramen, Suprascapual nerve |
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