Awareness, acceptance and hesitancy regarding human papilloma virus vaccine among nursing students of a rural medical college of Maharashtra

TCMS-Vol. 2 (2022), Issue 4, pp. 32 – 38 Open Access Full-Text PDF
Aitalwad Deepmala, Jogdand Mohini, Mali Sandeep, Aghav Shridhar and Amar Raj

Abstract: Introduction: Human papillomavirus causes many diseases like genital warts, sexual transmitted diseases; cervical cancer. Human papilloma virus vaccine is available for adolescent girls. Though it is effective its use has not increased. Therefore, the current study is designed to determine the awareness, acceptance and hesitancy among nursing students.

Objectives: To study awareness about HPV vaccine and to assess the acceptability and hesitancy regarding HPV vaccine.
Materials and Methods: A cross-sectional study conducted among first year to last year nursing students studying in a rural medical college, Ambajogai. A pretested self-administered structured questionnaire was used for collecting data. Information regarding sociodemographic characteristics, awareness, acceptability, willingness to take the vaccine and spreading information to community were interviewed and recorded. Study period was from 1st July 2022 to 31st August 2022.
Results: Out of 180 students, study carried among 169 those who gave consent and presented at time of study. Among them 27% were 15- 20 years of age group and 73% were in the age group 20-25 years. Most of them belongs to middle (43.7%) and upper middle (36.6%) socioeconomic class. Out of total participants 22.5% were males and 77.5 %were females. 7.7% were married and 92.3% were unmarried. 27.8% were heard about HPV and HPV vaccine.
Conclusion: This study has indicated that very few participants were aware about HPV vaccine. Hesitancy can be reduced by providing proper knowledge about safety and side effects of HPV vaccine.
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Study of hemoglobin levels among pregnant women in different trimesters at a tertiary hospital

TCMS-Vol. 2 (2022), Issue 4, pp. 26 – 31 Open Access Full-Text PDF
Sradhamoni Kumbang, Archana Khanikar, Rumi Konwar and Siddhartha Sankar Konwar

Abstract: Background: Pregnancy increases the demand for nutrients and hemoglobin. Besides these, physiological changes in blood parameters also occurs during pregnancy. Anemia in pregnancy is a serious condition contributing to increased maternal and fetal morbidity and mortality. Present study has been undertaken with the knowledge of hemoglobin values and its distribution in different trimesters of pregnancy.
Material and Methods: Present study was single-center, prospective, comparative, parallel-group, observational study, conducted in pregnant women attended the ANC OPD or admitted in antenatal ward and sixty healthy non-pregnant women of same age group.
Results: The mean hemoglobin value was \(12.23\pm1.32 gm\) % throughout pregnancy. In control group the mean value was \(12.59 \pm 2.50 gm\)%. Statistically significant variation was observed between control and each trimester of pregnancy \((p<0.05)\). Significant difference observed between 1st and 2nd trimester \((p < 0.05)\) and 2nd and 3rd trimester \((p < 0.05)\). When compared between 1st and 3rd trimester, difference was not significant \((p>0.05)\) Hemoglobin values are lower in pregnant cases as compared to non-pregnant subjects \((p<0.05)\). Lowest hemoglobin value is observed in 2nd trimester in maximum number of cases. Mean hemoglobin level was found lower in pregnant women with gravidity more than 1 as compared to primigravidae.
Conclusion: A significant association was observed between hemoglobin level and trimester of pregnancy. High occurrence of low hemoglobin level in pregnant women was found belonging to lower socioeconomic class. Maternal hemoglobin value decreases with increase in gestational age.

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COVID 19 associated mucormycosis: A curse in pandemic

TCMS-Vol. 2 (2022), Issue 4, pp. 18 – 25 Open Access Full-Text PDF
Dhruvika Rathva, Mayursinh Dodia, Atisha Modi and Saudhan Desai

Abstract: Aims: Mucormycosis is an acute invasive fungal infection which is rare, opportunistic and can potentially cause fatal complications. This study aimed to evaluate demographic data, disease presentation, medical &/or topical, surgical treatment.
Material and methods: Total twenty five patients with mucormycosis treated at tertiary care hospital in Gujarat during three months duration from May to July 2021. After detailed history thorough Ear, Nose and throat examination was performed. Along with local examination, ophthalmologic and neurologic examination performed in every case. After Functional endoscopic sinus surgery, tissue sent for histopathologic examination.
Results: Twenty five patients diagnosed with Mucormycosis, 18(72%) patients were males and 7(28%) were females. All 25(100%) had past history of COVID 19 infection and Diabetes Mellitus. Out of 25, 23(92%) patients were treated with intravenous or oral steroids and 2(8%) patients were not treated with any steroids. MRI paranasal sinuses with orbit with brain cuts performed for all 25 patients after suspicion of mucormycosis. 12(48%) patients had Sinonasal involvement, 11(44%) were Rhino-orbital involvement, and 2(8%) had Rhino palatal involvement. All 25(100%) patients were given Injection Amphotericin B for 3-4 weeks according to response. 6(24%) Patients were also given Oral Posaconazole. We performed Functional endoscopic sinus surgery in 23(92%) patients. In two (8%) cases Sinus surgery performed along with Maxillectomy. All 25(100%) cases on histopathology confirmed of Mucormycosis.
Conclusion: Prognostic factors we observed in our study were involvement of rhino-orbito-cerebral disease shows poor prognosis. Good Diabetes control showed early recovery. Early identification and early treatment improves prognosis as well as survival rates.

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Pap smear: Are we choosing wisely? An observational study of clinicopathologic variables of patients undergoing Pap smear examination

TCMS-Vol. 2 (2022), Issue 4, pp. 12 – 17 Open Access Full-Text PDF
Vani Swapnil Garde

Abstract: Background: Cervical cancer is a major cause of mortality in women. Pap smear is a screening test used in the screening of cervical cancer. There are well defined guidelines regarding its use. It should be offered to all sexually active women between the ages of 30-65 years, irrespective of whether or not they are symptomatic. Moreover, those women who have undergone hysterectomy for reasons other than cervical cancer or precancerous lesions, do not require this test.
Materials and methods: We undertook an observational study to describe the age, presenting complaint, previous history of hysterectomy and reason for hysterectomy in women undergoing Pap smear testing in a private super speciality hospital in Central India in the past 3 years.
Objectives: The objective of this study was to examine how closely the aforementioned guidelines were being followed, so as to deduce how wisely were we choosing the women to whom the test was being offered.
Results: This study found that a significant proportion of tests were being offered to women who did not need them. And more importantly, we were missing the opportunity to screen women who presented with non gynaecologic complaints in our hospital.

Conclusion: Hence we present the findings of this study to reassert the role of Pap smear as a screening test, the primary goal of which is to identify high grade precancerous lesions of the cervix; and to sensitizesensitise specialist physicians other than gynaecologists to offer Pap smear to women presenting with complaints unrelated to the genitourinary tract: so that we can choose wisely as to who should and who should not get the test.
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A clinico-pathological study of colonic biopsies

TCMS-Vol. 2 (2022), Issue 4, pp. 8 – 11 Open Access Full-Text PDF
Alka Dixit Vats and Anubhav Garg

Abstract: Background: To assess clinico-pathological study of colonic biopsies.
Materials and methods: One hundred ten colonic biopsies obtained from Gastroenterology department were collected in 10% neutral buffered formalin processed and embedded with the mucosal surface being uppermost. 4\(\mu\) thick serial sections were prepared and stained with H&E. Detailed study of the sections was done under light microscope and diagnosis rendered accordingly.
Result: Age group 11-20 years had 8, 21-30 years had 22, 31-40 years had 40, 41-50 years had 24 and >50 years had 16 cases. The difference was non- significant (\(P> 0.05\)). Most common clinical features were constipation seen in 36, bleeding PR in 28, bleeding PR weakness in 17, diarrhea in 16 and diarrhea \(+\) pain abdomen \(+\) weakness in 14 patients. The difference was non-significant (\(P> 0.05\)). Non-neoplastic lesions were 74. These were as non-specific colitis in 22, ulcerative colitis in 16, acute inflammation in 14, hyperplastic polyp in 10, inflammatory polyp in 6, retention polyp in 4 and endometriosis in 2 cases. Neoplastic benign lesions were 25. Benign spindle cell lesion was in 3, tubular adenoma in 15, villous adenoma in 5 and tubulovillous adenoma in 2 cases. Neoplastic malignant lesions were well differentiated adenocarcinoma seen in 4, moderately differentiated adenocarcinoma in 6, poorly differentiated adenocarcinoma in 2 and signet ring cell carcinoma in 1 case.
Conclusion: Colonoscopy is a simple and a safe procedure. It helps in assessing the lesions clinically and confirming histopathologicaly through guided biopsy. Colonoscopic biopsies also play a key role not only in diagnosis, but also in follow up and treatment.

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Major bacteriological isolates and their antimicrobial susceptibility trends in ICU of a tertiary care hospital: A prospective observational study

TCMS-Vol. 2 (2022), Issue 4, pp. 1 – 7 Open Access Full-Text PDF
Kirti Ahuja, Prateek, Meena Singh, Anil Kumar Verma, Pranav Bansal and Sanjay.

Abstract:Bacterial bloodstream infections are important causes of morbidity and mortality, globally. The aim of the present study was to determine the bacterial profile of bloodstream infections and their antibiotic susceptibility pattern among the patients admitted to ICU at a tertiary care hospital.This prospective study was conducted over a period of eighteen months. Inclusion criteria comprised of patients admitted to ICU who belonged to either gender and were in the age group of 15-60 years. Over the course of study, 30 out of total 140 blood culture samples were identified to be culture positive (18 GNB and 11GPB). The most common Gram-positive isolate was Staphylococcus spp (26%) while Escherichia coli was the most common gram negative isolate (36%).Escherichia coli expressed highest resistance to all the drugs but sensitivity to Meropenemand Polymyxin B was 72% and 90%, respectively. High degree of resistance was noted to cephalosporins and piperacillin -tazobactam, among all the groups. The study indicated high level of antimicrobial resistance among Gram negative bacilli, esp E.Coli and justifies the need for antimicrobial stewardship to prevent development of further resistance.

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