Aim:To evaluate the outcome of definitive repair of anogenital injuries (AGI) in child victims of acute sexual assault.Settings and Design:It is a prospective study of emergency care provided to child victims of acute sexual assault at a tertiary care Pediatric Surgical Unit in Maharashtra, India.Material and Methods:Out of 25 children, who presented during January 2009-December 2010 with suspected sexual assault, five children (one male and four female, between 4-9 years of age), had incurred major AGI. These children underwent definitive repair and a diverting colostomy. Perineal pull-through was performed in the male child with major avulsion of rectum. One 4-year-old girl with intraperitoneal vaginal injury required exploratory laparotomy in addition.Results:The postoperative period and follow-up was uneventful in all our patients. Four out of five patients have excellent cosmetic and functional outcome with a follow-up of 2-4 years. Our continence results are 100%.Conclusion:Children with acute sexual assault need emergency care. To optimally restore the distorted anatomy, all major AGI in such children should be primarily repaired by an expert, conversant with a child’s local genital and perineal anatomy. Along with provision of comprehensive and compassionate medical care, prevention of secondary injuries should be the ultimate goal.

Background: Every doctor should strive to contribute to the generation of evidence by conducting research. A review of literature showed that the data regarding knowledge, attitude, practice towards medical research among resident doctors pursuing post graduate studies in India is lacking. The objective of the study was to assess medical research related knowledge, attitude and practice of resident doctors in BJ Medical college, Pune, Maharashtra.Methods: With written informed consent of the participant, a cross-sectional survey was conducted at BJ Medical College, Pune, Maharashtra using structured and pre-validated questionnaire. We enrolled all 102 resident doctors pursuing their second and third year residency in various subjects. Two residents have not given written consent and excluded from the study (N=100). All participants were provided with sufficient time of 7 days to fill the KAP questionnaire. In case of more than 5 unanswered questions, the participant was excluded from the study. The data was expressed in percentage and analyzed by Microsoft Office Excel 2007.Results: The concept of research hypothesis was known to 48% of the residents. 85% of the residents were aware of the procedure to obtain informed consent. 82% of the residents agreed that patient outcome improves with continued medical research. Although 56% of the residents were interested in conducting research in future, 60% had made paper/poster presentations and only 15% had publications. 'Lack of time' (60%), 'lack of research curriculum' (26%) and 'inadequate facilities' (30%) were stated as major obstacles for pursuing research.Conclusions: Our study finds that residents have a fair knowledge about research. They also showed a positive attitude toward research, but they fail to transform their knowledge and attitude into actual practices.

Background: GDM is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. Women with gestational diabetes are characterized by a relatively diminished insulin secretion and pregnancy induced insulin resistance primarily present in the skeletal muscle tissue. Normal pregnancy is a diabetogenic state characterized by exaggerated rate and amount of insulin release, associated with decreased sensitivity to insulin at cellular levels. The objective of the study was to study the maternal, the fetal and the neonatal outcomes of treated patients of GDM in present study.Methods: It was a hospital based clinical study. 1000 patients were enrolled between 24-28 weeks of gestation and DIPSI test was performed. Diagnosis of GDM was done using DIPSI criteria. 80 patients were diagnosed with GDM and followed till delivery to study the maternal, fetal and neonatal outcome.Results: Elderly patients, patients with previous history of GDM, patients with family history of diabetes, patients with high BMI and patients with polyhydramnios are at high risk for GDM.Conclusions: Hypertensive disorders and preterm birth are known to be higher with GDM are similar to the non-GDM group suggesting that early diagnosis and prompt treatment and maintaining strict glycemic control by patient may be beneficial. GDM can be managed well on MNT and lifestyle modifications, only few patients required insulin therapy. In spite of appropriate glycemic control, the incidence of macrosomia found to be high in GDM group. Sudden unexplained stillbirth can occur in spite of strict glycemic control. Neonatal complications have occurred despite well glycemic control.

Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. The importance of GDM is that two generations are at risk of developing diabetes in the future. Aim was to study the merits and demerits of capillary blood glucose estimation by glucometer over venous plasma glucose estimation while performing DIPSI test.Methods: It was a hospital based clinical study. 1000 patients were enrolled between 24-28 weeks of gestation and DIPSI test was performed. Patient was instructed to come irrespective of fasting. 75 g glucose dissolved in 200-400 ml of water and patient was asked to drink in 5 minutes. Venous blood was drawn after 2 hours, capillary blood sugar also was measured at the same time by glucometer.Results: Sensitivity of capillary blood sugar (CBS) method in detecting GDM is 100% as compared to venous plasma glucose (VPG) and specificity is 99.46% as compared to VPG. Considering the agreement between two methods for diagnosis of GDM, equal sensitivity of both methods and small number of false positive cases detected by CBS method, due to almost equal specificity (99.46%), CBS method by glucometer can be recommended as an alternative to VPG method as a screening and diagnostic test for GDM.Conclusions: It is appropriate and feasible to offer capillary blood sugar sampling by DIPSI test for screening and diagnosis of GDM. The prevalence of GDM in our study is 8% by capillary blood sugar sampling and 7.5% by venous plasma glucose sampling according to DIPSI test.

Background: Although India was the first country in the world to have national family planning policy, the acceptance of contraceptive methods has been unsatisfactory. Many women in their peak reproductive years, who wish to control their fertility, are not aware about the different methods of contraceptives available. Unregulated fertility results in unplanned pregnancies. Emergency contraceptive pills can avoid many such unplanned pregnancies. The study was to assess the knowledge and attitude about emergency contraception (EC) among the undergraduate, interns and postgraduate medical science university students.Methods: A cross sectional study was carried out among 180 medical students which include undergraduate, interns, and postgraduate students (60 from each group) studying at BJ Medical College, Pune, Maharashtra by a convenient sample method over a period of August 2016 to November 2016. Data were collected by pre-designed, pre-tested, self-administered questionnaire. Data was analyzed in the form of percentage and proportions and Chi square test was applied.Results: In this study, a total of 180 respondents, of which 110 (61.2%) were male and 70 (38.8%) were female. The knowledge about EC was highest (47.6%) among postgraduates in comparison to interns (43.3%) and undergraduate students (41.6%). Overall positive attitude toward EC was observed among 73.8% of the respondents.Conclusions: Considering the role of a medical graduate as counselor and health care provider, the technical knowledge about different aspects of EC among the study population was inadequate.