Comparative study of occurrence of postpartum low back and pelvic pain (LBPP) after normal delivery versus caesarean section (CS) following spinal anaesthesia and its rehabilitative management

2016-03-13T18-22-34Z
Source: International Journal of Therapies and Rehabilitation Research
ANIL KUMAR JOSHI, CHITRA JOSHI.
Introduction and hypothesis: Low back and pelvic pain is very commonly encountered ailment in pregnancy and post-partum in women of childbearing age group. It can account for around half of the women of childbearing age. The pathophysiology of low back pain during pregnancy and postpartum is still poorly understood. Methods: The study was to compare low backache after normal delivery and after caesarean section following spinal anaesthesia, and its persistence after pregnancy. Moreover women were educated to regain the pre-pregnancy state uneventfully. Results: Postpartum backache at 1 month incidence in our study was 49%. Remission of pain occurred in 51% at 1 month and 78% at 6 months in caesarean section group, while in the normal vaginal delivery group 55% at 1 month and 85% in the 6th month had remission of pain. Conclusions: Women who had caesarean section with spinal anaesthesia had more chances to develop low back pain than women with normal vaginal delivery. Pre-pregnancy state can be achieved by supervised exercise regime.


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Clear Cell Sarcoma of Cervical Cord Region: An Unusual Anatomical location

2016-03-13T03-34-06Z
Source: The Southeast Asian Journal of Case Report and Review
Sweety Gupta, Ravi Shankar, Nitin Leekha, Prekshi Choudhary, Sudarsan De.
Introduction: Clear cell sarcoma of soft tissue (CCSST) is a rare tumor accounting for less than 1% of all sarcomas. The most common location is extremities. We report an extremely rare case of CCSST of cervical cord region. Case Presentation: A 44 year old male patient presented with complaints of right neck swelling and pain cervical spine region radiating to right arm. Lymph node biopsy showed metastatic clear cell sarcoma of soft part (melanoma of soft part). Whole body PET CT scan reported metabolically active enlarged right posterior cervical lymph node and hypermetabolic focal lesion in right side of spinal canal The intraspinal tumor was unresectable so patient received External Beam Radiotherapy. Follow up MRI after six months reported stable disease. Conclusion: CCSST is a rare tumor and our patient had tumor location in cervical cord region which is an unusual location. In surgically inoperable case like this, radiotherapy may be considered as treatment option and it has resulted in symptom-free survival in this patient till date.


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Quantitative Evaluation of Community Based Rehabilitation programme using the WHO Guidelines in a rural area in Bangalore District, Karnataka, India

2016-03-13T00-38-17Z
Source: International Journal of Health and Rehabilitation Sciences (IJHRS)
Dr. Deepthi N Shanbhag, MD.
Background: Community Based Rehabilitation was a concept which though thought of in early 80s was formalised as a guideline for any rehabilitation programme by the WHO in 2004 in collaboration with UNESCO AND ILO. Purpose: To assess to quantitatively evaluate a community based rehabilitation programme in the target area in terms of the 5 components of CBR as per WHO guidelines in rural Bangalore district, Karnataka, India. Materials and Methods: The study was conducted in 13 villages covering a population of 10,000 in a rural area in Southern India. A pretested interview schedule on CBR was administered by a to the caregiver or the Persons with Disability (PWDs). The rehabilitation needs of the PWDs were quantified using scores for each CBR component. The maximum scores attainable were: Health-10, Education-12, Livelihood-10, Empowerment-18 and Social-16. After 5 years of implementation of the CBR programme, a midterm evaluation was carried with the same assessment forms and similar scoring pattern Results: There were 78 PWDs assessed in 2006. 32(41%) were adults and 46(59%) were children with disability. They were assessed after 5 years in 2011 (Post CBR).It was seen that among adults there was significant difference (p


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Low alcohol consumption increases the risk of impaired glucose tolerance in patients with non-alcoholic fatty liver disease

Abstract

Background

Fatty liver disease is associated with glucose intolerance and hepatic insulin resistance. However, there are distinct etiologies for alcoholic versus non-alcoholic fatty liver disease (NAFLD), and it is unknown whether alcohol consumption influences the onset of glucose intolerance in fatty liver disease patients. Therefore, we investigated the relationship between fatty liver disease and the onset of impaired fasting glucose (IFG) with respect to alcohol consumption.

Methods

The records of 6804 Japanese subjects were reviewed to identify those meeting the criteria for IFG. Male and female subjects were classified into five and four groups, respectively, based on average alcohol consumption (g/week). IFG onset was defined as fasting plasma glucose levels ≥110 mg/dl.

Results

In the non-drinker, >0–70 g/week, >70–140 g/week, >140–210 g/week (men only), and >210 g/week (men only) or >140 g/week (women only) groups, 7.3, 6.7, 6.4, 9, and 6.4 % of men and 2, 1.7, 3.1, and 3.2 % of women, respectively, developed IFG. Fatty liver was positively associated with the onset of IFG in men of the >0–70 g/week group (adjusted hazard ratio [aHR], 2.808; 95 % confidence interval [CI] 1.605–5.049, p < 0.001) and women of the >70–140 g/week group (aHR, 4.193; 95 % CI, 1.036–14.584, p = 0.045) after adjusting for previously reported IFG risk factors. No associations were observed in the other groups.

Conclusions

A small amount of alcohol consumption is a significant risk factor for the onset of IFG in NAFLD patients; onset risk differs according to the amount of alcohol consumption.

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Could ‘Aunties’ Recruit Pregnant Indigenous Women Who Smoke Into a Trial and Deliver a Cessation Intervention? A Feasibility Study

Abstract

Objective Māori (indigenous New Zealand) women have the highest smoking prevalence rates in New Zealand and whilst pregnant. We hypothesized that community health workers ('Aunties') could find pregnant Māori women who smoke, recruit them into a study and deliver an acceptable cessation intervention. The aim of the study was to test the feasibility of such an intervention. Method A community health organization was engaged to, using a participatory approach, conduct a feasibility study. Participants were ten Aunties and the pregnant women the Aunties recruited. The Aunties advised their participants to abstain from smoking, offered a Quitcard (for subsidized nicotine replacement) or referral to local cessation providers. A booklet on healthy eating for pregnancy was given and discussed and the Aunties offered help if needed to register with a lead maternity carer (LMC). All women completed a baseline questionnaire. Semi-structured follow up face-to-face interviews were conducted with a subsample of women and hospital birth records were examined. Descriptive statistics were produced using quantitative data. Qualitative data was deductively analysed. Results During 4 months eight Aunties recruited 67 pregnant women who smoked, 88 % were Māori, 84 % were of low socio economic status and 73 % had up to high school education. Only 36 % of the recruited women had registered with an LMC. The participants described the Aunties as supportive, nice and non-judgmental. The only criticism was a lack of follow up. Aspects of the intervention that the Aunties thought worked well were knowing and being involved with their community, and being able to give a gift pack to the participating women. Insufficient follow up was one aspect that didn't work well. The infant's birth record was found for 54 % of the participants. Conclusion Aunties were able to identify and recruit pregnant Māori women who smoked. The study method and intervention were acceptable to Aunties and participants and it was feasible to collect data from the participants' hospital birth records. Based on this study, with a similar number of Aunties recruiting, it would take 2 years to recruit over 300 participants, which would be sufficient for a stronger controlled trial.

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Access to Money and Relation to Women’s Use of Family Planning Methods Among Young Married Women in Rural India

Abstract

Objectives The social positioning (i.e. social status and autonomy) of women in the household facilitates women's access to and decision-making power related to family planning (FP). Women's access to spending money, which may be an indicator of greater social positioning in the household, may also be greater among women who engage in income generating activities for their families, regardless of women's status in the household. However, in both scenarios, access to money may independently afford greater opportunity to obtain family planning services among women. This study seeks to assess whether access to money is associated with FP outcomes independently of women's social positioning in their households. Methods Using survey data from married couples in rural Maharashtra, India (n = 855), crude and adjusted regression was used to assess women's access to their own spending money in relation to past 3 month use of condoms and other forms of contraceptives (pills, injectables, intrauterine device). Results Access to money (59 %) was associated with condom and other contraceptive use (AORs ranged 1.5–1.8). These findings remained significant after adjusting for women's FP decision-making power in the household and mobility to seek FP services. Conclusion While preliminary, findings suggest that access to money may increase women's ability to obtain FP methods, even in contexts where social norms to support women's power in FP decision-making may not be readily adopted.

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Association Between Low Dairy Intake During Pregnancy and Risk of Small-for-Gestational-Age Infants

Abstract

Background Inadequate maternal nutrition is regarded as one of the most important indicators of fetal growth. The aim of this study was to analyze the associated risk of having a small for gestational age (SGA) infant according to the mother's dairy intake during the first half of pregnancy. Methods A prospective cohort study was performed using 1175 healthy pregnant women selected from the catchment area of Virgen de las Nieves University Hospital, Granada (Spain). SGA was defined as neonates weighing less than the 10th percentile, adjusted for gestational age. Factors associated with SGA were analyzed using logistic regression models. Population attributable fractions of SGA according to dairy intake were estimated. Results Dairy intake among women who gave birth to SGA infants was 513.9, versus 590.3 g/day for women with appropriate size for gestational age infants (P = 0.003). An increased intake of dairy products by 100 g/day during the first half of pregnancy decreased the risk of having a SGA infant by 11.0 %, aOR = 0.89 (0.83, 0.96). A dose–response gradient between dairy intake and SGA was observed. Conclusions An inadequate intake of dairy products is associated with a higher risk of SGA. Our results suggest a possible causal relation between dairy intake during pregnancy and the weight of the newborn, although we cannot discard residual confounding. These results should be further supported by properly designed studies.

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