Knowledge and awareness of the cause, prevention and control of cervical cancer amongst female undergraduates and faculty of health sciences: a cross sectional survey

Background: Carcinoma cervix is the second most common cancer in women worldwide, and the most common in India. In this study, the current knowledge of female undergraduates and faculty of health sciences regarding the various parameters like risk factors, symptoms, screening tests and vaccinations pertaining to cervical cancer was assessed.Methods: A cross-sectional, self-administered anonymous questionnaire-based survey was carried out, in a medical college in Mangalore, which included 260 staff and students. Non random sampling was done and the study was carried out only after gaining institutional Ethical community approval and written informed consent from the subjects.Results: Majority of the participants 185 (71.4%) were aware that cervical cancer is one of the most wide- spread gynecological cancers in Asia. The awareness of causative agents of cervical cancer was known to 53.9% of the undergraduates and 50% of the faculty members. 73% of the total study groups have heard of HPV and around 68% agreed that it was detectable. 71% of the study sample had heard about the Pap smear test and 42% have undergone the test. The questions pertaining to the preventive measures of cervical cancer had good faculty preponderance with 91.8% giving a positive response. 84.1% of the students and 79.5% of the faculty members knew that abnormal vaginal bleeding was a symptom.Conclusions: In this study an attempt has been made to study the correlates of knowledge of cervical cancer in a cohort which consisted of health care undergraduate and faculty. Majority of our study group was well aware of the various risk factors of cervical cancer and its preventable nature however awareness regarding the association between diets, multiple pregnancies and use of tobacco was poor.

Quality of medical education: Is our health in safe hands?

The medical profession, once considered a “noble profession” has been under the scanner for deterioration in services. This decline is generally attributed to commercialisation of services, waning human values, and a lack of empathy and communication skills. At a time when discussions are focused on devising approaches to test medical students for attributes such as empathy, communication skills and concern for the less privileged, developing nations like India are suffering from the “problem of too many”. On the one hand, a skewed doctor-patient ratio in India (less than 1 doctor per 1000 people that is lower than that prescribed by the World Health Organisation) has left medical practitioners so overburdened, they have little time to empathise with their patients. Students inadvertently follow their teachers and the vicious cycle continues. On the other hand, there has been a mushrooming of commercially–run medical institutions to overcome this shortage of doctors. Medical education has become unaffordable to many and, very obviously, merit has taken a back seat.

The Medical Termination of Pregnancy (Amendment) Bill, 2014 – progressive or regressive.

The Medical Termination of Pregnancy (MTP) Act, 1971, lays down the existing guidelines and criteria for the “who, when, where, how and why” of the medical termination of pregnancy in India. Recently, the Draft MTP (Amendment) Bill was tabled for deliberations. The highlight of the bill is its proposal that the words “registered medical practitioners” be replaced with “registered healthcare providers”. This implies that pregnancy can be terminated not only by medical practitioners with medical qualifications, but also practitioners qualified in homeopathy, ayurveda, unani or siddha, nurses or auxiliary nurse midwives. The draft bill also proposes an increase in the time limit for the termination of pregnancy, from the existing 20 weeks to 24 weeks. In addition, it seeks to do away with any time limit if foetal abnormality is detected.

Medical diploma factories in India.

Recently, I was surprised at the number of pages in a reputed medical journal dedicated to advertisements endorsing unrecognised post-graduate diplomas, fellowship and certificate courses conducted by private institutions and hospitals for MBBS doctors. Obviously, the journal had also put in a disclaimer advising individual discretion.

Victim profile and pattern of thoraco-abdominal injuries sustained in fatal road traffic accidents.

The present research aims to highlight the pattern of thoraco-abdominal injuries sustained by the victims of fatal road traffic accidents (RTA) in Manipal, South India. The study is an autopsy based observation of thoraco-abdominal injuries in victims of fatal road traffic accidents during 1999 – 2003. Road traffic accidents accounted for most of the injury related deaths (77%) during the study period. A male preponderance (86%) was observed with a male-female ratio of 6:1. Individuals in the age group of 21 to 50 years formed the most vulnerable (83%) group. External thoracic injuries were more common than internal thoracic injuries in the thoracic region. In the abdominal region, internal injuries were more common than external injuries. Lungs (61%) and kidneys (23%) were the most commonly involved organs in the thoracic and abdominal regions respectively. Majority of the victims were two wheeler occupants (35%) followed by pedestrians (23%). The study indicates the pattern of thoraco-abdominal injuries sustained along with the trend of road traffic accidents in the region.

Krait bite poisoning in manipal region of Southern India.

Krait commonly inhabits the South Asian countries and is regarded as the most dangerous species of venomous snake in the Indian subcontinent. This prospective research included the consecutive cases of Krait bite cases admitted to Kasturba Hospital, Manipal during August 2003 and November 2005. All the victims of Krait bite were females aged between 17 and 35 years. Victims were from a rural background and most of them were bitten indoors and during the night time. Most of the bites involved the lower limbs. Signs of envenomation (neurological symptoms) were observed in 50% of the cases. In the only case of fatal outcome in our study, there was a delay in diagnosis of Krait bite owing to the absence of bite marks. The case emphasizes on the fact that the possibility of snake bite should be considered in an otherwise healthy person who presents with sudden onset of neuroparalytic features.

Epidemiology of cobra bite in Manipal, Southern India.

Envenomation by poisonous snakes is considered as an occupational hazard. Cobra bite is commonly encountered in the South Asian countries. The prospective research was conducted in the Department of Forensic Medicine, Kasturba Medical College, Manipal to study the epidemiology, manifestations and treatment of cobra snakebite cases admitted to Kasturba Hospital, Manipal during August 2003 and November 2005. Twenty cases of cobra bite were reported during the study period. The victims of cobra bite predominantly were females. Mean age of victims was 41.9 years. Maximum cases occurred during the summer and pre-monsoon months, during daytime and involved the upper limbs. Ptosis was the chief neurotoxic feature followed by dysarthria. Cellulitis as a complication was observed in most of the cases. Polyvalent Anti Snake Venom (ASV) vials were used as specific treatment. No mortality was reported during the study period.

Human organ trade: Is enough being done.

In recent times, instances of illegal organ transplants are on a rise. Despite of strict regulations doctors, donors, middlemen and hospitals are indulging frequently in organ trade. Any organ transplant, if not done in accordance with transplantation of human organ act, 1994 is considered illegal in Indian law. The act permits any registered medical practitioner to transplant human organs for therapeutic purpose without any motive of financial gains, neither to the doctor not to the donor. Such procedures can be done by permission of appropriate authorization committee in any hospital, authorized by law for the purpose. Any adult healthy person can volunteer to donate tissues from his body to any needy patient; such donations can be made during ones life time if they don’t pose danger to ones life, after taking his consent or after his death (cadaveric donation) by permission of next of kin. If no consent (living will) is present, then also the legal possessors of body can allow removal, if they don’t have any reason to believe deceased’s refusal for the same. In hospital deaths, if bodies are unclaimed for 48 hrs after death then hospital can dispose the body and use the organs as directed by the deceased. Before certification of death proper diagnosis of brain stem death is to be made as per Harvard’s criteria. Live donations are exclusively made, to save the life of a patient, preferably by a near relative as defined in the act. Unrelated donations are made in inevitable circumstances, on approval by appropriate authorization authority [1]. Any transplantation which is not in accordance with transplantation of human organ act is illegal and doctor, donor as well as recipient can be punished. Punishment can be imprisonment upto 5 years and fine upto Rs. 10000/- or both. Whosoever, engages in commercial dealings in human organs is punished with imprisonment of 2-7 years and a fine of Rs. 10000 to Rs. 20000. When a doctor is convicted under the act, action is also taken by medical council. It can lead to temporary erasure of name from medical register for the 1st offence and penal erasure for subsequent one [1]. Unfortunately, even strict legislation has not deterred the offenders. Recent investigations made a shocking revelation of a village, Magadi in Bangalore rural area where people have been selling kidneys to pay their debts. This racket was traced extending to several nearby villages. Huge amount of money was being made by middle men depriving the donor of the sum assured [2]. Ignorance of law among donors, considerable monetary gains and feeling among offenders that they can easily get away from the law may be responsible for this growing menace. General awareness about the act among the masses is proposed along with a review of penal portion of the act and strict implementation of the provisions provided in the act to control illegal trade of human organs.

Profile of near drowning victims in a coastal region of Karnataka.

BACKGROUND: Drowning and near drowning are serious public health problems and an important cause of morbidity and mortality worldwide. Present study is done to understand the pattern of near drowning cases in this coastal region of Karnataka. METHODS: This hospital based retrospective research was conducted at Kasturba Hospital, Manipal in Southern India from January 1993 to December 2003. A detailed victimologic profile was made. RESULTS: Study included a total of 58 cases of near drowning. Males were predominantly affected (84.5%). Majority of the victims were aged below 10 years (39.7%). Manner was accidental in maximum (82.3%) reported cases. Incidence of fresh water drowning was more than sea water drowning. Fatal outcome was reported in 12.1% cases with maximum fatalities occurring within one to three days of hospitalization. Most of the victims witnessed respiratory complications (55.2%). CONCLUSION: Males in the first decade are at increased risk of accidental drowning. Swimming under adult supervision, immediate resuscitative measures and early medical aid is proposed.

Biotechnology in forensic science: the revolution continues.

Molecular biology has become one of the most fascinating fields of biology in recent years. Molecular methods have been applied in various fields of biology including Medical/Health Science. In this paper, light has been shed on the application of different molecular methods (DNA analysis) in the field of Forensic Medicine.

Handedness in skeletal remains.

Identification of a highly decomposed body and skeletal remains is of paramount importance in the investigation of a crime. While general characteristics of the skeletal remains like age, sex, stature, race etc. place the subject in a specific group, determination of any special characteristic can help identify the remains further. Handedness can be an important individual skeletal characteristic and an important criterion of identification in highly decomposed bodies and skeletal remains when used in corroboration with other findings. A case report of skeletal remains examination that was suggestive of handedness presented with review of relevant literature.