Morbidity pattern of out-patient attendance

Summary The incidence of various diseases seen in children attending the O.P.D. has been analyzed, by month. Gastroenteritis and respiratory infections were common. Prevention of these and of malnutrition and infectious diseases is suggested through health education and immunization. From the Department of Medicine, Medical College, Bankura.     

Torsion of the greater omentum: treatment by laparoscopy

Four new cases of necrosis of the omentum secondary to torsion are reported. We review the associated signs and symptoms, which are usually those of an acute inflammatory condition in the right lower quadrant (RLQ), very similar to acute appendicitis. Because of acute abdominal pain in the RLQ, along with an uncertain diagnosis, laparoscopic surgery was performed in these cases. Laparoscopy demonstrated the existence of the omental infarction and allowed for complete treatment of the condition without the need for laparotomy.     

Gyneco-obstetrical morbidity in the population of Santiago

1607 women were interviewed about their gyneco-obstetrical health in a survey of 469 randomly selected households in the province of Santiago, Chile. The dependent variables correspond to the frequency of gynecologic or obstetrical morbidity and demand for medical attention in 2 weeks of April, 1987. Independent variables were age, educational status, and health insurance coverage. 125 of the households were headed by uninsured persons. The average woman was 34.4 years old. 43.1% had 8 years or less of education, 42.6% had 9.12 years, and 14.2% had 13 or more years. 21 new cases of acute obstetrical or gynecological disorders were reported, including 15 of vulvovaginitis, 3 abortions, 1 bartholinitis, 1 intrahepatic cholestasis of pregnancy, and 1 urinary tract infection. There were 55 cases of chronic disorders, including 12 benign ovarian lesions, 8 dysmenorrheas, 8 uterine dystropias, 10 cases of menstrual disturbances, 1 of infertility, 4 benign cervical lesions, 5 benign uterine lesions, 2 pelvic inflammations, 2 cervical cancers, 2 breast cancers, and 1 ovarian cancer. Among the 1607 women, 11 had consulted for family planning in the 2 weeks, 25 for pregnancy, 22 for gynecological conditions, and 9 for postpartum care. 58.3% of the women aged 15-49 used a contraceptive method. The proportions of users of oral contraceptives and IUDs respectively were 62.5% and 37.5% for women under 20, 60% and 40% for women 20-29, 27% and 61% for women 30-39, and 15.1% and 60.6% for women 40-49. 28.2% of women over 15 had had a Pap test in the past year. The proportions of different age groups having Pap tests ranged from 2.0% for women under 20 to 46.7% for women aged 30-39. 3 women in the sample households had died in the past year of gyneco-obstetric causes, 1 of complications of childbirth and 2 of cervical cancer.     

Validity of hand-held systems for otoacoustic emissions in hearing screening

Hearing screening objective is the development of an universal screening. With that purpose, new hand-held system of Otoaccoustic Emissions have been designed, which are easier to perform and to interpret the results, to detect hearing loss disordersas soon as possible. To validate the hand-held systems of Otoaccoustic Emissions in the hearing screening, we have compared the results of the tests with Otoaccoustic Emissions clinic systems and tonal audiometry in two groups of population: new-borns and hearing-loss adults aged between 16 and 56. Our study showed that the hearing screening results in children with hand-held system were similar to classic Otoaccoustic Emissions system, but there were more than 40% of adult hearing losses not detected with this system. These results can invalidate the test.     

Processes of care for community-acquired pneumonia

Clinical and economic outcomes in hospitalized patients with CAP directly are related to the way that certain processes of care are executed at the local-hospital level. For each process of care, a clear and evidence-based recommended course of action should be stated. Having an unambiguous action plan helps to develop process-of-care indicators and to educate healthcare workers. Improving processes of care is a secure way to improve outcomes in hospitalized patients with CAP.     

Epidemiologic study of Helicobacter pylori infection in Perú

We present the results of our investigations in the epidemiology of H. pylori infection in Peru during the last two decades. The prevalence of Helicobacter pylori infection in Lima is decreasing in people of middle and high socioeconomic status and continues stationary in people of low socioeconomic status. This decrease is similar in Peruvian and Japanese population in this city, and is associated to the decrease of the gastrointestinal diseases related to this bacterium: peptic ulcer and stomach adenocarcinoma. The infection is slightly greater in males and is acquired in early ages of life. Via oro-fecal and water contamination are probably the most important transmission ways. In our country, so far, there is no evidence to assure that some races have higher pre-disposition to acquire the infection. There are no differences in the infection by H. pylori among coast, mountain or jungle populations; and people who live in high altitudes have more atrophic chronic gastritis secondary to H. pylori infection than people who live at sea level.