阴道镜检查在阴道上皮内瘤变中的应用

目的:探讨电子阴道镜检查在阴道病变中的临床应用价值。方法:对2007年8月～2010年8月在吉林市妇产医院妇科门诊就诊的宫颈上皮内瘤变、阴道上皮内瘤变或宫颈癌术后31例患者行阴道细胞学涂片检查,结果异常者15例行电子阴道镜检查,在可疑病变区取活检送病理检查。16例细胞学检查为正常或鳞状上皮非典型增生者给予阴道用药治疗1～3个疗程,3个月后复查宫颈阴道涂片,2例细胞学仍异常,行阴道镜下活检送病理检查,余14例细胞学阴性者定期复查细胞学。结果:15例涂片异常者中检出阴道上皮内瘤变9例,原位癌2例,余4例避免活检。阴道镜检查准确率达73.33%,与病理学诊断符合率达81.82%。结论:阴道镜对阴道上皮内瘤变的诊断至关重要,活检定位准确,避免不必要的活检。     

Factors Influencing Utilization of ASHA Services under NRHM in Relation to Maternal Health in Rural Lucknow

Background:

Under National Rural Health Mission (NRHM), ASHA (accredited social health activist) has been identified as an effective link to address the poor utilization of maternal and child health (MCH) services by rural pregnant women.

Objective:

To study the factors influencing utilization of ASHA services in relation to maternal health.

Study Design:

Cross-sectional.

Setting

Primary Health Centre (PHC), Sarojininagar, Lucknow and its rural field area.

Study Period:

September 2007 to August 2008.

Study Unit:

RDW (recently delivered women) were considered as those who delivered a live newborn at PHC Sarojininagar, within a week of interview and belonged to villages within the confines of the PHC being served by ASHA.

Materials and Methods:

350 RDW were interviewed at their bedside, by a preformed and pretested schedule and then were followed-up after six weeks.

Results:

Utilization of ASHA services for early registration was significantly associated with age and religion of RDW. Young, educated and socio-economic class III RDW utilized ASHA services the maximum for early registration. Utilization of ASHA services for adequate ANC or antenatal care (100 iron and folic acid tablets, 2 tetanus toxoid injection and ≥3 antenatal visits) was also inversely associated with age of RDW. Young, Hindu, scheduled caste, middle school pass, Class III RDW and those with birth order one had high odds for utilization of ASHA services for adequate ANC. With regard to postnatal check-up, again young RDW with birth order one, Hindu RDW in reference to Muslim and RDW in socio-economic class III had higher likelihood for utilization of ASHA services. Caste-wise scheduled caste (SC) and other backward caste (OBC) RDW had higher odds for utilization of ASHA services. Educated RDW and those with educated husband had higher odds for utilization of ASHA services for postnatal check-up.

Conclusion:

Young, educated RDW with low parity, educated husband and belonging to higher socio-economic class had higher odds of utilization of ASHA services.     

Oral squamous cell carcinoma: overview of current understanding of aetiopathogenesis and clinical implications

MEDLINE contains well over 14 000 papers revealed by a search using keywords 'oral squamous cell cancer' or 'oral squamous cell carcinoma', over 27 000 using 'oral carcinoma' and over 48 000 using the keywords 'oral cancer'. It is difficult to see how clinicians could keep abreast of such a subject. This paper attempts to help by providing an overview of the aetiopathogenesis of oral squamous cell carcinoma (OSCC), discussing changes in epidemiology and increasing awareness of the wide range of risk factors, emphasising the genetic background to cancer susceptibility and the genetic changes associated with progression to OSCC and highlighting clinical implications.     

“红丝带关爱中心”在艾滋病患者护理服务中的作用

目的探讨"红丝带关爱中心"在艾滋病患者护理服务中的作用。方法为患者建立健康电子档案,实施网络和电话健康咨询、心理咨询、行为干预、健康教育及法律援助等服务。结果提高了患者的满意度(P0.01),减少了艾滋病的传播(P0.01)。结论 "红丝带关爱中心"在艾滋病护理服务中深化了优质护理服务,减少了艾滋病的传播。     

Temperature, heart rate, and blood pressure changes associated with clinical MR imaging at 1.5 T

Temperature, heart rate, and blood pressure responses to high-field-strength magnetic resonance (MR) imaging were studied in 50 patients who underwent procedures at exposures to radiofrequency radiation above the present recommended whole-body average specific absorption rate (SAR) of 0.4 W/kg. Body temperature significantly increased an average of 0.2 degrees C. The highest body temperature recorded after MR imaging was 37.5 degrees C. There was no significant correlation between the change (before and after imaging) in body temperature and whole-body average SARs. Changes in skin temperatures were variable, depending on anatomic site. The largest change was 3.5 degrees C, and the highest skin temperature recorded after imaging was 35.1 degrees C. There was a modest correlation between the change in skin temperatures and whole-body average SARs. Average heart rate and average mean blood pressure measured immediately before imaging were not significantly different afterward. High-field-strength MR imaging at the whole-body average SARs of 0.42-1.2 W/kg studied was not associated with any temperature- or hemodynamic-related deleterious effects.