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Background: Cervical cancer is one of the most common cancers among women worldwide. The incidence rate in Indian women between 25 to 44 years is about 3.5%, and age standardised incidence rate is 22 per 1,00,000 women. In rural areas, it is a major health problem, where the disease is diagnosed usually at a late stage. Cervical cancer has a long window for diagnosis, during which the precancerous lesions can be diagnosed by various screening methods. Pap smear is one such method. It is cost effective and can be done easily in an outpatient set-up. For satisfactory implementation of the screening programme for early diagnosis of pre-cancerous lesions, the services of the nursing staff can be utilised to educate and motivate all eligible women of the community to take Pap smear. The present study was conducted to assess the knowledge about cervical cancer and Pap smear practice among the nursing staff of the rural hospital in Maharashtra, India. Materials and Method: This is a cross-sectional descriptive study performed during 1st December, 2020 and 28th February, 2021. A total of 320 staff nurses participated in the study. A structured questionnaire was given to each of them after obtaining verbal consent. The answered questionnaires were collected for further analysis. Results: Majority of the participants were between 21 and 35 years of age. 91.56% of the participants were married, 97.19% (N=311) were aware about cervical cancer, while 88.75% (N=284) were aware about Pap smear. Among the 311 respondents, 35.05% knew that Human papillomavirus is a causative agent of cervical cancer, and 33.75% are aware about HPV vaccination. Even though 47.19% of the 284 participants were trained to take Pap smear, 48.51% of those trained had not taken any Pap smear. Among the married group, 37.06% (N= 293) had undergone Pap smear screening themselves. Conclusion: Though the knowledge about cervical cancer and Pap smear is adequate among the participants, the practice is not satisfactory. The nursing staff need to be encouraged, educated and trained to practice the screening method for themselves and for other women of the community so that the morbidity and mortality from cervical cancer is controlled. [ABSTRACT FROM AUTHOR]

Background: Family planning is one of the most crucial interventions to address maternal morbidity and mortality. It also refers to the use of contraceptives for spacing child birth and achieving the desired family size, which is in turn beneficial for the family and society, from a financial and practical perspective. Usage of contraceptives is also pivotal in maintaining an optimal balance of the national and global population. Objective: This study aims to identify the knowledge, acceptability and practice among antenatal patients attending the antenatal care unit at the Rural Hospital of Pravara. Materials and methods: A descriptive cross-sectional study has been conducted using a structured questionnaire which was given to the respondents attending the antenatal clinic. Results: The respondents belong to the age group of 18 and 32 years. A high level of awareness was noted among the respondents, but the usage was low. The main reason for not using contraceptives was willingness to conceive (as majority of them had not yet reached their desired family size). Other factors associated with non-usage were apprehensions like fear of side-effects and harmful effects on health (which indicate that intense and in-depth counselling is required to allay the apprehensions). Husband's consent also plays an important role in family planning. Conclusion: Incorporation of family planning and contraception into a greater proportion of households will require trained healthcare professionals to provide detailed counselling to patients. There is also a strong need for media to promote the usage of contraceptives. Additionally, education of women is integral to facilitate the society reaching a more conscientious and enlightened state without any gender bias. [ABSTRACT FROM AUTHOR]

Background and Objectives: The residents of gynaecology should have sound knowledge on pelvic anatomy and have to be adequately trained on common surgical procedures. The training programme was conducted in the dissection hall of Anatomy department of Rural Medical college Loni. During residency, they may not receive adequate training on common surgical procedures for various reasons like shortage of cases, infrequent performance of certain procedures, inability of the faculty to give time, attention for training in OT and fear of possible complications and medico legal litigations. Material and methods: Twelve residents in Gynaecology and two senior faculty members each from the department of Gynaecology and Anatomy participated in training programme. Five training sessions of dissection of a single human female cadaver, each lasting for two and half hour duration, were conducted. Pretest and post test were performed with prevalidated and pre tested questionnaire and results compared to assess the impact of training. Level of satisfaction of residents about this innovative method of teaching and training was assessed through 7 point Likert scale. Results: Training programme resulted in significant improvement in the residents knowledge on pelvic surgical anatomy and common surgical gynaecological Procedures. Faculty members identified new insights into the interdisciplinary process of teaching. Conclusion: Surgical training using human cadaver was effective and feasible. It made the teaching process interactive and interesting. Residents expressed happiness about the innovative method of teaching. [ABSTRACT FROM AUTHOR]

Background: The rate of primary cesarean section (CS) is on the rise. More and more women report with a history of a previous CS. A trial of vaginal delivery can save these women from the risk of repeat CS. Aims: The study was conducted to assess the safety and success rate of vaginal birth after CS (VBAC) in selected cases of one previous lower segment CS (LSCS). Materials and Methods: The prospective observational study was carried out in a tertiary care teaching hospital over a period of two years. One hundred pregnant women with a history of one previous LSCS were enrolled in the study. Results: In the present study, 85% cases had a successful VBAC and 15% underwent a repeat emergency LSCS for failed trial of vaginal delivery. Cervical dilatation of more than 3 cm at the time of admission was a significant factor in favor of a successful VBAC. Birth weight of more than 3,000 g was associated with a lower success rate of VBAC. The incidence of scar dehiscence was 2% in the present study. There was no maternal or neonatal mortality. Conclusion: Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas. [ABSTRACT FROM AUTHOR]

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. Aim: The study was to assess the knowledge and attitude about emergency contraception (EC) among the undergraduate, interns and postgraduate medical science university students. Materials and Methods: A cross-sectional study was carried out among 180 medical students which include undergraduate (final year MBBS), interns, and postgraduate students (60 from each group) studying at Rural Medical College and Pravara Rural Hospital of Pravara Institute of Medical Sciences University of central India by a convenient sample method over a period of February 2009 to May 2009. 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. [ABSTRACT FROM AUTHOR]

Umbilical cord accidents (UCA) refer to a group of conditions, where the umbilical cord vessels undergo sudden compression, compromising the blood flow to the fetus. UCA are associated with still birth and are often considered to be an etiology of sudden antenatal death syndrome. Herein, we report three cases of UCA, which reported late to us, resulting in fetal demise. [ABSTRACT FROM AUTHOR]

Introduction: ShishuPoshan is a free Android application for mothers that provides scientific guidance on breastfeeding and baby care issues in the local language. We aimed to assess its effect and acceptability in primi mothers in a rural area of Maharashtra, India. Material and Methods: A before and after study was conducted in 50 primi mothers to study the acceptability and effect of ShishuPoshan mHealth application on knowledge, attitude and practice about breastfeeding in primi mothers in a rural tertiary care hospital. Results: Most participants (84%) downloaded the application, and 60% used it regularly. Major reason for not using the app was discomfort with mobile phone (7%) and not having anyone to read the content in the house (7%). The application was easy to use by 48%, and 10% did not find time to use it. Enablers were regional language, easy-to-understand content, simple interface, and frequently asked question (FAQ) format to give information. Barriers to adoption were that women preferred tips from family members, were uncomfortable with mobile phones, and did not have anyone to help them use them. Conclusion: It successfully delivered key messages like exclusive breastfeeding, colostrum use, proper maternal nutrition, and demand to feed, but it needs to further emphasise early initiation of feeding. Incorporation of feedback like adding videos, myth busters, and making app more interactive may further improve its effectiveness. mHealth interventions like ShishuPoshan are promising modalities for the dissemination of appropriate information. [ABSTRACT FROM AUTHOR]

A response from the authors of the article about the scoring scale of attitude component of paramedical staff towards emergency contraception (EC) in a previous issue is presented.

The article offers tips for young researchers to get their work published. It points out that a researcher must use simple English and decide on a deadline for writing work. It cites IMRAD, which stand for Introduction, Methodology, Results and Discussions as the universally accepted protocol for the basic structure of research publication. It emphasizes that the all authors must give their written consent and take joint responsibility for the contents and opinions expressed in the paper.

Introduction: Placenta accreta spectrum (PAS) is a serious condition with a mortality as high as 7%. However, the factors associated with this type of death have not been adequately described, with an almost complete lack of publications analyzing the determining factors of death in this disease. The aim of our work is to describe the causes of death related to PAS and to analyze the associated diagnosis and treatment problems. Material and methods: This is an inter‐continental, multicenter, descriptive, retrospective study in low‐ and middle‐income countries. Maternal deaths related to PAS between January 2015 and December 2020 were included. Crucial points in the management of PAS, including prenatal diagnosis and details of the surgical treatment and postoperative management, were evaluated. Results: Eighty‐two maternal deaths in 16 low‐ and middle‐income countries, on three continents, were included. Almost all maternal deaths (81 cases, 98.8%) were preventable, with inexperience among surgeons being identified as the most relevant problem in the process that led to death among 87% (67 women) of the cases who had contact with health services. The main cause of death associated with PAS was hemorrhage (69 cases, 84.1%), and failures in the process leading to the diagnosis were detected among 64.6% of cases. Although the majority of cases received medical attention and 50 (60.9%) were treated at referral centers for severe obstetric disease, problems were identified during treatment in all cases. Conclusions: Lack of experience and inadequate surgical technique are the most frequent problems associated with maternal deaths in PAS. Continuous training of interdisciplinary teams is critical to modify this tendency. [ABSTRACT FROM AUTHOR]

Splenic hemangioma, a vascular malformation represents the most common benign primary neoplasm of the spleen with fewer than 100 cases reported in literature. Rupture of hemangioma is a life threatening complication occurring mostly in third trimester or puerperium with maternal mortality of 70% and fetal mortality of 90-95%. We herein report the first case of rupture of capillary hemangioma of spleen occurring in mid trimester pregnancy. [ABSTRACT FROM AUTHOR]