Dhwani Mehta

Witnessing Multigravida, Grand Multigravida and Great Grand multigravida pregnancy is very usual and common in the Kacchch district of Gujarat, India. Kachchh happens to be the largest District of India with majority of population living in the rural area who are illiterate and believe in the norm of “Home delivery: Safe delivery”. In the era of 20th century where a majority of us are happy with normal labour conducted by a skilful obstetrician at the hospital with the simultaneous assessment by the paediatrician there occurs a significant population nesting in rural corners who still abide by the traditional birth practices with “The Normal Dia Labour” unaware of its aftermath. A 59 year old, Widow, Female Patient P5L2D3 with all full term normal vaginal delivery conducted at Home presented to G.K. General Hospital (the only tertiary referral centre in the entire district) with inability to pass urine and with something coming out per vaginum. On examination it was a case if long standing procidentia with decubitus ulcer with purulent exudation and simultaneous contamination of it with pus and faecal matter from the surrounding rectal prolapse. Surgical correction by vaginal hysterectomy and repair of rectal prolapse was done with building up of perineum - a surgery which was a difficult nut to crack for the Gynaecologists and Surgeons. With increased parity and poor interval spacing with improper perineal support during the labour, the perineum becomes lax and the ligament and supports of the uterus become asthenic, flaccid. This shall present with pelvic organ prolapse in the peri-menopausal age, menopausal and post-menopausal age group. The ladies in the rural Indian setting believe it to be a social stigmata and thus rarely these cases reach the hospital for intervention. Keywords: Multigravida, Procidentia, Rectal prolpase, Decubitus ulcer, Cystocoele, Vaginal hysterectomy, Perineum.

Objective: To determine the prevalence and oral effects of betel nut habit among high school in Ahmedabad, Gujarat, India. Materials and Methods: Study was carried out in 4000 high school children from different zones of Ahmedabad city. Demographic details and clinical data with their socio economic status and chewing habit were recorded. Results: 912 teenagers had habit of only betel nut chewing of different brands with overall prevalence of 22.8% and habit was more prevalent in boys as compared to Girls. More than 50% of boys the habit was initiated at the age of 13 years and habit were common in middle and high class groups of teenagers which were highly significant. Brand III was more favorite in high class group while brand I and brand II were favorite in middle and poor class group of teenagers. Teenagers of south zone where of poor and middle class group resided were more prone to habit. 70% of them preferred brand I and II while brand III was somewhat equally preferred in other 3 zones which were highly significant. Betel nut chewer shows extrinsic stains and dental decay and Brand III chewer had more deleterious effect on teeth as compared to brand I and II. Conclusion: This study confirmed the need for a preventive motivation in school children not to initiate betel nut habit and alarm them the potential health risks and effects on aesthetics of this substance by conducting the educational school health programs at regular intervals. Keywords: Age at initiation, Betel nut, High school children, Prevalence, Socio economic status

Background: Current research was carried out to evaluate the severity score such as PSI, SMART-COP and CURB-65 for the capability to forecast the requirement for mechanical ventilation and inotropic support for adult patients. Materials and Methods: Current observational research was carried out in subjects admit with CAP. The evaluation utensils utilized were the CURB-65 score, PSI, and the SMART-COP scores, particularly planned to forecast the necessity for intensive respiratory and vasopressor support. In general result with CAP was too evaluated. Results: Statically significant was observed in sensitivity and specificity for CURB-65scoresinmechanical ventilation and inotropic support. Fifty nine participants have been mandatory required mechanical ventilation and 41 preferred inotropic supports during their hospital stay. Conclusions: CURB 65 and PSI scores, even if extensively utilized for forecasting death in big inhabitants, they are not as much of precise for forecasting results. Keywords: Community-acquired pneumonia; Cross-sectional study; Sensitivity; Specificity.

Introduction: Diseases of respiratory tract are non curable diseases; however there can be increase in quality of life of individual with different types of treatment which leads to major air passages dilatation and shortness of breath improvement is achieved. It was in this context that the current study was undertaken to know the prevalence of chronic respiratory diseases in a rural area of Gujarat District in West India among people aged 20 years and above. Material and Methods: the individual above the age of 20 years in the selected area and who agreed to participate in the study were included in the study. A sample size of 1900 were included in the study. There was administration of modified British medical research council to all the individuals included in the study for the diagnosis of bronchial asthma cases and chronic bronchitis. Results: There were 1000 males and 900 females in the study. Majority of the population were in the age range of 20 – 39 years. The crude prevalence of chronic bronchitis was estimated to be 5.64% for males as compared to 2.23% for females. The prevalence of bronchial asthma in the current study was estimated at 2.10%. Discussion & Conclusion: The reason for the higher prevalence found in the present study is the probable, the majority of the individuals did not use the cleaner fuels in the domestic kitchens. This is found to be common practise in the rural kitchens of North Gujarat. Keywords: Gujarat, Population, Prevalence, Respiratory Disorders.

Background: There are very less studies that have evaluated the respiratory health troubles with the police employees in India. The aim of present study is to measure the occurrence of the respiratory morbidities in the police personnel in Bhuj district and also to evaluate the factors which are associated with the respiratory problems among them. Methodology: The present study was performed at four traffic police stations in Kutch district, which were selected randomly and incorporated in the research. The individuals with the previous history of asthma, TB, COPD, surgeries, cardiac failure and chest injuries were debarred as of the research. All the persons satisfying the addition protocols were incorporated in the study. Results: Chronic cough was observed among 6% of the personnel. Chief problem with the participants originates to be phlegm. Frequent wheezing was reported in 10% and chronic wheezing in 4%. Grade 1 dyspnoea was found in 18% of total subject and grade 2 was reported in 9% of total individuals. Conclusions: Frequency of the respiratory illness in police personnel in the Kutch district was elevated contrast to the common inhabitants. Keywords: COPD; Phlegm; Respiratory; TB.

Background: The aim of current research were to investigate the result of halo therapy on to the improvement of results of lung function testing and the presence of relieving symptoms. Methodology: Two Hundred COPD patients were integrated in the research. There were occurrences of signs like chronic cough, sputum production and dyspnoea, for longer duration of time. Demographic data were documented. FVC, FEV1 and the FEV1/FVC were measured using spirometer. Results: Both groups show not significant dissimilarity in the smoking component testing. Also no statistical significant difference was observed between two groups regarding arterial oxygen saturation fall of six minutes walking among both groups. There were significant association of FEV1/FVC between two groups. Conclusions: It was concluded that there is effect of halotherapy on various parameters which were taken in the study. Keywords: Chronic obstructive pulmonary disease; Forced expiratory volume; Smoking; Spirometry.

Introduction: Computerized tomography (CT) is considered the gold standard for preoperative evaluation of PNS diseases for appropriate patient selection for functional endoscopic sinus surgery. The present study was aimed to evaluate the spectrum of PNS diseases on CT and correlate their clinical and histopathological findings. Materials & Methods: After fulfilling the necessary criteria for enrollment, 100 patients with PNS diseases were included in the study. Patients who have failed medical management i.e., prolonged course of broad spectrum antibiotics for 3 weeks and trial of corticosteroid nasal spray, were included in the study. Patients with revision surgery were excluded from the study. Results: The most common CT diagnosis was found to be chronic sinusitius (57/100), followed by fungal sinusitis (28/100) and lastly 10 cases of nasal polyp. The entire specimens were sent for histopathological examination. Discussion & Conclusion: CT helps to delineate the anatomy of nose and sinuses, and drainage pathways of sinuses preoperatively. It is helpful in evaluating the site and extent of sinus pathology. Preoperative CT enabled the surgeon to visualize the drainage pathways, anatomical and critical variants in PNSs thus allowing effective management of the patient. However, a potential pitfall was its inability to accurately differentiate in cases of fungal sinusitis and high‑density secretions. Keywords: CT, Paranasal Sinus, Pathologies, Biopsy, Histopathology.