Knowledge and practice regarding menstrual hygiene in rural adolescent girls of Nepal

OBJECTIVE

This study was done in the adolescent girls to evaluate the knowledge and practice on different aspects of menstrual hygiene.

METHODS

One hundred and fifty adolescent girls of age 13-15 years from 3 schools of Shivanagar and Patihani village development committees of Chitwan district were involved in this study. Altogether 27 questions were asked to each of them.

RESULTS

During our study, we found that they were not properly maintaining the menstrual hygiene. Only 6.0% of girls knew that menstruation is a physiologic process, 36.7% knew that it is caused by hormones. Ninety-four percentages of them use the pads during the period but only 11.3% dispose it. Overall knowledge and practice were 40.6% and 12.9% respectively.

CONCLUSION

Although knowledge was better than practice, both were not satisfactory. So, the girls should be educated about the process and significance of menstruation, use of proper pads or absorbents and its proper disposal. This can be achieved by giving them proper training and health education (by teachers, family members, health educators, and media) so that there won't be any misconception to the adolescent girls regarding menstrual hygiene.

Genetic parameters for direct and maternal effects on body weights of Muzaffarnagari sheep

Estimates of co(variance) components were obtained for weights at birth, weaning and 6, 9 and 12 months of age in Muzaffarnagari sheep maintained at the Central Institute for Research on Goats, Makhdoom, Mathura, India, over a period of 28 years (1976 to 2003). Records of 5530 lambs out of 169 rams and 1631 ewes were used for the study. Analyses were carried out by restricted maximum likelihood (REML), fitting six animal models, including various combinations of maternal effects. Heritability estimates for weight at birth, weaning and 6, 9 and 12 months of age were 0·09, 0·21, 0·06, 0·10 and 0·14, respectively. Maternal heritability of body weight declined from 0·07 at birth to 0·02 at weaning. The maternal permanent environmental component contributed 10 to 11% to the total variance for all traits except weight at 12 months. A significant large negative genetic correlation was observed between direct and maternal genetic effects on weaning weight, suggesting the presence of antagonistic environmental, as well as perhaps genetic, effects in daughter and dam. Results suggest that maternal additive effects were only important in early stages of growth, whereas a permanent environmental maternal effect existed at all ages up to 9 months, probably as a carry-over effect of maternal influences present at weaning. Modest rates of genetic progress appear possible for all weights, but the presence of an antagonism between direct and maternal effects on weaning weight would complicate attempts to improve both by selection.

Effect of mercury and organomercurials on cellular glucose utilization: a study using resting mercury-resistant yeast cells

AIMS

Mercury compounds are highly toxic to all types of living cells. Isolated yeast strains of Rhodotorula rubra showed high and low resistance pattern towards mercury and organomercurial compounds. To investigate the basis of differential sensitivity of these two types of strains, glucose utilization was measured in the presence of mercury compounds.

METHODS AND RESULTS

Glucose utilization process remained unaffected in resting cells of highly Hg(2+)-resistant strain in the presence of HgCl(2) but not in the presence of phenylmercuric acetate and thimerosal. However, HgCl(2) significantly affected glucose utilization in the case of low-resistant cells. The Hg-retaining ability of the cell wall of highly Hg(2+)-resistant yeast strain was greater than that of the weakly Hg(2+)-resistant strain. The spheroplast-bound Hg(2+) was also significantly less in the highly Hg(2+)-resistant strain than in the weakly Hg(2+)-resistant strain.

CONCLUSIONS

Glucose uptake machinery was not affected in the presence of toxic metal ions in the case of high-resistant strains. But in the case of low Hg(2+)-resistant strain, glucose transport system may be affected either by inactivation of sensor proteins containing -SH group associated with glucose uptake.

SIGNIFICANCE AND IMPACT OF THE STUDY

Cell wall of mercury-resistant yeast cells may play an important role in heavy metal bioremediation process.

Role of topical negative pressure in pressure ulcer management

The literature suggests that topical negative pressure can be an effective treatment for severe pressure ulcers. However, research is needed on its effects on variables such as dressing change frequency, quality of life, pain relief and cost-effectiveness.

Comparison of cartilage scoring and cartilage sparing otoplasty – A study of 203 cases

The Edinburgh experience of different methods of otoplasty techniques in 203 patients (406 ears) over a five-year period is reviewed.

MATERIALS AND METHODS

The patients were divided into three groups - Group A (anterior cartilage scoring), Group B (cartilage sparing in the fashion of posterior suturing) and Group C (posterior suturing refined with posterior fascial flap). Demographic details, operation technique, operation time, grade of the surgeon, suture materials, early and late complications, recurrence and revision rates, patients' and physicians' comments at the follow-up clinic were retrieved from the case notes. The pre- and the post-operative photographs were assessed by a blinded lay observer and a physician and scored on a visual analogue scale. Median follow-up was 11 months.

RESULTS

The recurrence rate was 11.0%, 8.0% and 4.8% in Groups A, B and C, respectively (p = 0.0214). Complications were more common in Group A (8.8%) and Group B (7.9%) compared to Group C (1.2%) (p = 0.0208). The cosmetic result was judged best in Group C. In our experience, cartilage-sparing otoplasty refined with the post-auricular fascial flap results in significantly reduced complication rate and improved aesthetic outcome.

Treatment of small congenital nevocellular naevi using a combination of ultrapulse carbon dioxide laser and Q-switched frequency-doubled Nd-YAG laser

This report describes treatment combining Ultrapulse CO(2) laser and Q-switched frequency-doubled neodymium:yttrium-aluminum-garnet (Nd-YAG) laser for a number of congenital nevocellular naevi (CNN). The Ultrapulse CO(2) laser removes the superficial component, which contains most of the color, preserving the integrity of the reticular dermis. At a later stage, any residual color is targeted using the Nd-YAG laser. To date, a total of 10 histologically proven CNNs have been treated at the Laser Suite. The median age of the patients was 18 years (range, 13-24 years). All the patients were white females. The patients accepted for treatment had relatively small lesions (mean surface area, 352 mm(2); range, 50-1,092 mm(2)), but the lesions were either cosmetically sensitive or located in an anatomically critical area in which excision could result in a scar that would be unpredictable. The median follow-up period was 24 months. The overall results have been satisfactory, with reduction of color and no significant scarring. The minor textural and pigmentary changes were acceptable to the patients.

Do malnutrition and nutritional supplementation have an effect on the wound healing process?

Although nutrition is an extrinsic factor regulating wound healing, nutritional supplementation for the modulation of wound healing remains experimental. Evidence on the efficacy of supplementation in animals and humans is reviewed.

Unplanned admissions following ambulatory plastic surgery--a retrospective study

INTRODUCTION

Admission for overnight or longer hospital stay from a day-case unit is an unwelcome event. This audit was designed to identify the incidence of unplanned admissions and also to detect the potential factors for such overstays.

PATIENTS AND METHODS

Details of plastic surgical day-case patients were obtained from the hospital records for a period of 6 months (February 2002 to July 2002).

RESULTS

The total number of unplanned admissions was 28 (3.55%). High rates were recorded in patients above the age of 80 years, male patients and body mass index > 30 kg/m2. Duration of surgery (> 45 min) and waiting time in the day surgery unit (> 2.5 h) had significant correlation with the overstays. Grade of the surgeon was not an important determinant factor. Of procedures which resulted in an unexpected admission, the most frequent were otoplasty (8.4%; n = 71) and fasciectomy for Dupuytren's contracture (14.5%; n = 41). Unexpected admissions were also high following rhinoplasty and nipple reconstruction but the total number of operations performed were not significant (n = 12 in each group). Overall, the cause of the overstays were mostly surgical (71.4%) followed by anaesthetic (28.5%) and social (7.1%).

DISCUSSION

With an overall unplanned admission rate of 3.55%, our unit is close to the national standard of 2-3%, as advocated by The Royal College of Surgeons of England. Postoperative bleeding (60%) was the most important surgical reason for overstays followed by intravenous antibiotics, wound drainage, excessive duration of the procedure and additional, unplanned procedures. Among the anaesthetic factors, postoperative pain was the leading cause (62.5%) followed by nausea, vomiting and adverse anaesthetic reaction.

CONCLUSIONS

The reasons for unplanned admissions are multifactorial and merit appropriate patient selection and proper estimation of the disease process.

Experience with different treatment modules in hidradenitis suppuritiva: a study of 106 cases

BACKGROUND

Hidradenitis suppuritiva, a disease of the apocrine sweat glands, has always been a challenging area to the plastic and reconstructive surgeon. The aetiology is idiopathic and medical treatment offers temporary relief only. Radical surgical excision, therefore, is the mainstay of active management.

AIM

To present and evaluate a series of 106 patients of hidradenitis suppuritiva treated in the regional plastic surgery unit of southeast Scotland between January 1990 and December 2000.

PATIENTS

Median age at onset was 36 years (range 17-70 years). The patients were predominantly females (88.78%) and heavy smokers (98.1%). Median age before active surgical intervention was six years (range 1-30 years). The patients were divided into a mild group (n=64) and a severe group (n = 42). All patients had broad-spectrum antibiotics and multiple incision and drainage procedures before referral from general practitioners, dermatologists or general surgeons. One hundred sites were managed by primary closure (mostly in the 'mild' group); 29 resurfaced with split skin grafts and 14 with local, fasciocutaneous or musculocutaneous flaps (mostly in the 'severe' group). Median postoperative follow-up period was three years (range 1-7 years).

RESULTS

In the 'primary closure' series, recurrence rate requiring at least one secondary operation was 69.88%. There was no recurrence, no serious complications and no revision operations in the 'graft' and the 'flap' series.

CONCLUSION

A high index of suspicion is required before contemplating primary closure in hidradenitis suppuritiva, even in the ' mild' variety. This condition should always be treated aggressively by radical excision of all hair-bearing areas and reconstructed with a graft or a flap.

Propagation of stress fracture of the patella

Anterior knee pain in athletes is common and usually self limited. There should be a high index of suspicion and low threshold for special imaging in cases with acute onset and specific tenderness. The risk of propagation of stress fracture of the patella in athletes is highlighted. The case report presented illustrates the potential sequence of events.