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Biomedical subjects

Monica Agarwal

Publications and source records attributed to Monica Agarwal.

4 recordsLinked to original sources

Experiences from the front-line routine consenting of surplus surgically removed tissue: without investment by the National Health Service fully informed consent for all is not available.

The study investigated the routine introduction of a new surgical consent form containing a tissue consent section to investigate patient attitudes to the use of surplus tissue for research (after the Alder Hey inquiry) and also the differing approaches by consent takers. All surgical consent forms received in histopathology for the same 2-month period in 2 consecutive years were analysed, recording available information about the specimen, the tissue consent section and, for the second year, the consent taker. The findings showed that <5% of patients whose views were recorded disagreed with the use of their tissue for research. They also showed that the number of completed forms sent to histopathology had increased but the pattern of completion had changed very little. A wide variation between departments and also between clinicians was apparent in the levels of completion of the tissue consent section, suggesting wide variability in the quality of the consenting process. When asked, patients rarely object (<5%) but if the highest standards of consent for surgical tissue are to be achieved and the wishes of patients to donate tissue are to be effectively recorded then new resources or approaches will be needed for this process.

Attitude to Health↗

Danger signs of neonatal illnesses: perceptions of caregivers and health workers in northern India.

OBJECTIVE: To assess household practices that can affect neonatal health, from the perspective of caregivers and health workers; to identify signs in neonates leading either to recognition of illness or health-care seeking; and to ascertain the proportion of caregivers who recognize the individual items of the integrated management of neonatal and childhood illnesses (IMNCI) programme. METHODS: The study was carried out in a rural community in Sarojininagar Block, Uttar Pradesh, India, using qualitative and quantitative research designs. Study participants were mothers, grandmothers, grandfathers, fathers or "nannies" (other female relatives) caring for infants younger than 6 months of age and recognized health-care providers serving the area. Focus group discussions (n = 7), key informant interviews (n = 35) and structured interviews (n = 210) were conducted with these participants. FINDINGS: Many household practices were observed which could adversely affect maternal and neonatal health. Among 200 caregivers, 70.5% reported home deliveries conducted by local untrained nurses or relatives, and most mothers initiated breastfeeding only on day 3. More than half of the caregivers recognized fever, irritability, weakness, abdominal distension/vomiting, slow breathing and diarrhoea as danger signs in neonates. Seventy-nine (39.5%) of the caregivers had seen a sick neonate in the family in the past 2 years, with 30.38% in whom illness manifested as continuous crying. Health care was sought for 46 (23%) neonates. Traditional medicines were used for treatment of bulging fontanelle, chest in-drawing and rapid breathing. CONCLUSION: Because there is no universal recognition of danger signs in neonates, and potentially harmful antenatal and birthing practices are followed, there is a need to give priority to implementing IMNCI, and possible incorporation of continuous crying as an additional danger sign.

Acute Disease↗

Male adnexal tumour of probable Wolffian duct origin.

Male adnexal tumours of Wolffian duct origin are very rare. They have variable malignant potential and surgical excision is recommended. We report the case of a 56-year-old male who presented with a swelling in the perineum thought to be a haematoma as the result of a complication of a laparoscopic inguinal hernia repair. It recurred after incision and two attempts at drainage and was then completely excised. Histology revealed the lesion to be an adnexal tumour of probable Wolffian duct origin. To our knowledge there have only been two previous cases of male adnexal tumour of Wolffian duct origin reported in the literature.

Diagnosis, Differential↗

Bone densitometry. Interpretation and pitfalls.

Dual-energy x-ray absorptiometry (DXA) is the method of choice to measure bone mineral density in elderly patients and others at risk for osteoporosis. Early detection is important because fractures represent an enormous health burden. In this article, the authors discuss the application and interpretation of DXA scans as well as limitations and conditions that can affect results.

Absorptiometry, Photon↗