Mamata General Hospital

A study to assess the knowledge and attitude regarding Child Abuse and its prevention among family members of the child who are attending Mamata General Hospital Outpatient Department, Khammam, Telangana, with a view to develop an information booklet on Child abuse and its prevention. Objectives were to describe the socio-demographic variables of family members, to assess the levels of knowledge and attitude scores regarding Child Abuse and its prevention among family members, to find out the association between knowledge and attitude scores of family members with their selected socio-demographic variables, to develop and distribute an information booklet regarding Child Abuse and its prevention to family members Methodology: A quantitative survey approach and Descriptive research design was used for this study. The study was conducted at Mamata General Hospital Outpatient Department, Khammam, Telangana. The sample comprised of 50 family members of the child age group between 21-50 years and sample was selected by Non-probability - Convenience Sampling Technique. The data was collected by Interview technique and tool used for the study was structured interview schedule. Results: The study findings shows that majority of family members levels of knowledge regarding child abuse among 50, Majority of them 37(74%) had adequate knowledge, 13(26%) had moderately adequate knowledge and none of them had an inadequate knowledge.The study findings shows that attitude scores regarding child abuse among 50 family members, all of them had a favorable attitude 50(100%) and none of them had an unfavorable and moderately favorable attitude. Chi square is not applicable for association between knowledge, attitude scores and selected socio demographic variables as the expected values are less than 5 at p value < 0.05 level. Hence only proportions are calculated Conclusion: The study concluded that majority of the family members had adequate knowledge and all of them had a favorable attitude but some of them had moderately adequate knowledge levels, which indicates that still there is a need to increase the knowledge levels of family members regarding child abuse and its prevention.

Abstract Introduction: Globally, about half of all induced abortions have been estimated to be unsafe, and have resulted in maternal death. Of these, 41% unsafe abortions have been reported in young women who are dependent on their parents for livelihood. They are often left in a vulnerable position and may have difficulty in making a decision regarding abortion. This study aimed to (a) characterize and map factors that influence abortion decision-making of adolescents and young women, and (b) identify the care and support they need in their decision-making process. Methods: We conducted a scoping review following the JBI method and PRISMA-ScR checklist. We comprehensively searched MEDLINE (PubMed), EMBASE, Cochrane Library, CINAHL, and PsycINFO, and hand searched publications in Google Scholar database between November 2021 and December 2021. The search included all English language qualitative and mixed-methods research articles published from 1976 to November 2021, and included participants aged 10-24 years. The CASP checklist was used as guide for the qualitative analysis. Nvivo was used to synthesize the findings. Results: There were 14 studies from 10 countries (N = 334 young women) that met the inclusion criteria. Three domains and 11 categories were included: Personal (Desire for self-realization and Unwanted pregnancy), Interpersonal (Parental impact, Reaction of partner, Roles of peers and friends, Existence of own child, and Lack of support), and Social circumstances (Sexual crime, Financial problem, Limitation of choice, and Underutilized healthcare services). Decision-making factors regarding abortions were also found across all three domains. Conclusion: The abortion decision-making of young women is influenced by various external factors regardless of country. Parents are especially influential and tend to force their daughters to make a decision. Young women experienced suffering, frustration, and lack of autonomy in making decisions based on their preference. This emphasizes the importance of autonomous decision-making. In this regard, healthcare services should be used. However, there are barriers to access these services. To improve such access, the following are required: staff training to provide women-centered care, counseling based on women’s needs, counseling including parents or guardians that is confidential and ethical, promotion of decision aids, and affordable accessible care.

Introduction Tympanoplasty is the treatment of choice for patients suffering with Chronic Otitis Media (COM). Outcome of tympanoplasty depends on various factors like size and location of tympanic membrane perforation, ear ossicles, degree of otorrhea, cholesteatoma, smoking history, granulation tissue etc. Prediction of outcome of tympanoplasty procedure prior to surgery with respect to graft uptake and hearing improvement can serve as a crucial factor in decision making in resource limited nations. Hence, a study was conducted to evaluate the role of Middle Ear Risk Indices (MERI) in predicting the outcome among patients undergoing tympanoplasty procedure. Materials and Methods A prospective study at a tertiary care centre was conducted for a duration of 2 years among 60 patients with COM who underwent tympanoplasty. Results The mean age of patients was 25.32 ± 8.43 years with a male to female ratio of 3:2. Majority (78.46%) of the patients had Mild MERI score; 18.46% patients had moderate MERI score and 3.08% patients had severe MERI risk score. The difference in mean Air –Bone (AB) gap in the mild and moderate MERI groups’ pre and post operatively was found to be statistically highly significant (p<0.001). Conclusion Lower MERI scores prior to surgery showed significantly better outcomes with respect to graft uptake, degree of AB gap closure and hearing improvement.

症例は93歳男性．主訴は肛門出血．肛門周囲皮膚に15mm大の表面平滑な易出血性の無茎性隆起型ポリープを認めた．老人性疣贅の診断にて単純切除し，病理検査に提出したところ，基底細胞癌の診断で，断端陽性であった．入院の上，腰椎麻酔下に病変部全周性に3mmのmarginをおいて追加切除を行った．永久標本では治癒切除を確認できた．基底細胞癌は，多くが露出部皮膚に出現し，肛門周囲皮膚での発生は稀である．医中誌で検索したところ，当症例は国内報告例で最高齢であった．肛門周囲皮膚の疣贅を認めた際には，基底細胞癌の可能性も考慮する必要があると思われた．

CINEC Academic Journal is a peer reviewed open access multidisciplinary journal published by the CINEC Campus, Malabe, Sri Lanka. CINEC Academic journal publishes papers on all aspects of higher education streams in humanity and education, social sciences, business and management, engineering, information technology, health and medical sciences, maritime sciences and maritime engineering.

The journal is the official publication of the College of Surgeons of Sri Lanka. Its mission is to reach the highest standard of scientific surgical practice by dissemination of high quality scientific information and to foster and promote the growth of scientific surgery in Sri Lanka and in the region. The Sri Lanka Journal of Surgery publishes peer-reviewed leading articles, review articles, scientific articles, perspectives and case reports in the field of surgery and broadly related surgical sciences The journal adheres to the publication ethics as portrayed by the Committee on Publication Ethics (COPE) and is a member of this organisation. It is listed as an ICMJE journal which follow its recommendations (ICMJE recommendations) on Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals.

No abstract available

症例は52歳，男性．2013年１月下旬より下腹部痛が出現，近医にて１週間消炎剤，抗生剤の内服治療を施行していたが，改善がないため当院受診となった．来院時，WBC 12,300/µl，CRP 9.81 mg/dlと高値，CTにて虫垂腫大を認め急性虫垂炎と診断した．抗生剤の投与を行ったが，翌日の血液生化学所見はWBC 12,200/µl，CRP 12.52mg/dlと改善を認めず，腹痛も増悪したため虫垂切除術を施行した．病理組織検査にて杯細胞型カルチノイド，切除断端陽性と診断された．初回手術28日後に開腹したところ，後腹膜に播種と思われる結節を多数認めた．同結節の切除および回盲部切除術（D2郭清）を施行した．病理組織診断は杯細胞型カルチノイド，SE，N3，H0，P2，M0，Stage Ⅳであった．術後FOLFOX＋bevacizumabによる化学療法を施行中である．虫垂杯細胞カルチノイドは内分泌細胞と粘液産生性の腺がん細胞に類似した組織学的特徴を有する稀な疾患であり，進行例ではリンパ節転移，腹膜播種をきたし予後不良である．本症例は初回手術より術後８カ月が経過した現在，肺，肝転移はなく，腹膜播種の増悪所見は認めていない．

Single-incision laparoscopic appendectomy seeks to further reduce the trauma of parietal access to abdomen. The challenge of this surgery lies in the compromised ergonomics of instrument movement and triangulation. In this context, a feasibility study of an operative technique of single-incision laparoscopic appendectomy with technical modifications was conducted. This prospective study was carried out in tertiary care teaching institute of a semi-urban area in South India over a period of 1year from June 2010 to May 2011. Thirty-two patients of acute appendicitis were included in this study. Mean operative time was 56.7min (40-85min). Mean age of subjects was 41 ± 15years. M/F ratio was 2:1. There was no significant peri-operative morbidity or mortality. Mean follow-up period was 8months. We propose that this technique of single-incision laparoscopic appendectomy using conventional multiport laparoscopic instruments (SILACI) is feasible, safe, and cost-effective.

Dyslipidemia and oxidative stress were evaluated in patients with polycystic ovarian syndrome. MATERIALS AND METHODS: Total cholesterol, Triglyceride, HDL cholesterol, LDL cholesterol, Malondialdehyde (MDA) and Total antioxidant capacity were measured in serum of PCOS subjects and age matched controls. RESULTS: Study group comprised of 31 women with PCOS and control group with 31 healthy volunteers. Mean serum levels of MDA, Cholesterol, Triglycerides and LDL cholesterol were significantly increased and TAC and HDL cholesterol were significantly decreased in PCOS subjects compared to controls. CONCLUSION: Our results revealed that PCOS is associated with dyslipidemia and altered oxidative status. Women with PCOS would be predicted to be at high risk for dyslipidemia because they have elevated androgen levels and are frequently obese. Moreover, since they are also often hyperinsulinemic and insulin resistant, they would also be expected to be at increased risk for the dyslipidemia associated with insulin resistance. Insulin, rather than androgen, levels correlate best with lipid abnormalities, and suppressing androgen levels does not alter lipid profiles in PCOS. Insulin resistance and hyperinsulinemia are also associated with an atherogenic plasma lipid profile. Elevated plasma insulin concentrations enhance very low density lipoprotein (VLDL) synthesis, leading to hypertriglyceridemia. Progressive elimination of lipid and apolipoproteins from the VLDL particle leads to an increased formation of intermediate-density and low-density lipoproteins, both of which are atherogenic. Last, insulin, independent of its effects on blood pressure and plasma lipids, is known to be atherogenic. The hormone enhances cholesterol transport into arteriolar smooth muscle cells and increases