Manorama Verma

Congenital malformations--a retrospective study of 10,000 cases.

The frequency of congenital malformations in a retrospective study done on 10,000 consecutive births from January 1983 to March 1989 was 3.6%. The predominant system involved was CNS. Major malformations constituted 79.7% of the total. Malformations were seen 4 times more often among still births. The common malformations in still births were also of CNS. The frequency of malformations was similar in both the sexes, though genitourinary anomalies were commoner among male, while anencephaly in female babies. A statistically significant increase in the frequency of congenital malformations was observed with decreasing gestation and birth weight. There was a significant correlation between maternal factors, like previous abortions, drug intake and fever during 1st trimester, diabetes mellitus, pre-eclamptic toxemia, antepartum hemorrhage and congenital malformations in the baby.

G6PD Deficiency in Neonates : A Prospective Study

One thousand consecutively born babies were screened for G6PD deficiency and observed for seven days for development of jaundice. Frequency of the deficiency was 3.9%, being 5% in males and 2.8% in females. Religion did not have any bearing on the frequency. Parental screening in cases of babies deficient in G6PD enzyme revealed deficiency of the enzyme in majority of the mothers. Hyperbilirubinemia developed in 48.7% of babies having G6PD deficiency : It is recommended that any neonate presenting with jaundice must be screened for G6PD deficiency not only to define the etiology of hyperbilirubinemia but also to prevent future hemolytic episodes.

Reliability of Essay Type Questions — effect of structuring

ABSTRACT The present study was designed to test the reliability of traditional essay type questions and to see the effect of ‘structuring’ on the reliability of those questions. Sixty‐two final MBBS students were divided into two groups of 31 each. Group A was administered a 2‐hour test containing five traditional essay questions picked up from previous university papers, while Group B was administered the same questions in a structured format. The answer sheets were xeroxed and evaluated independently by seven examiners. The dispersion of marks was significantly greater in Group A, as was the variance between marks awarded by the seven examiners to each student. Correlation of individual marks awarded was also poor for Group A scripts. The internal consistency for Group A was 0.31 (p > 0.05) while that for Group B was 0.69 (p < 0.05). Inter‐examiner agreement on ranks awarded was better for Group B. These findings suggest that reliability of traditional essay questions can be improved by structuring them.

Prevalence of Behavioral Problems in School Going Children

The study was conducted on 957 school children using Rutter B scale which was to be completed by the class teachers in Ludhiana, India. One hundred and forty-one children (14.6%) scored more than 9 points and were included in the second part of the study. An equal number of sex matched children scoring less than 9 points served as controls. Both these groups were called for an interview with a child psychiatrist along with their parents. Only 117 and 124 children turned up and were included in the analysis. Based on the screening instrument results and parental interview, 45.6% of the children were estimated to have behavioural problems, of which 36.5% had significant problems. It was noticed that neither the screening instrument nor the interview was able to detect all the problems. Scholastic under-achievement was found to be associated with maximum problems. Scholastic under-achievement can be a useful starting point of identifying children with behavioural problems. Close cooperation between school teachers, parents, and health care providers is essential to ensure healthy development of children.

Perinatal mortality at a tertiary care hospital in punjab

The present report is a comparative analysis of perinatal mortality rate (PNMR) over two different periods of seven years each viz. 1982–1983 and 1989–1995. Data of at) the perinatal deaths in babies born at Christian Medical College and Hospital, Ludhiana from January 1989 to December 1995 was collected. The cause of death was ascertained by a detailed history, clinical examination and whenever possible, by autopsy and analysed by modified Wigglesworth’s classification. The PNMR during both the study periods was exactly the same i.e. 74/1000. There was a significant decline in the early neonatal mortality rate from 32/1000 to 25/1000. This was mainly due to improved survival of preterms as there were better life support measures available in the latter part of study period. In contrast, the still birth rate increased significantly from 42/1000 to 49/1000, thus neutralizing the fall of neonatal mortality. There was no change in the pattern of causes of death. Macerated still births occurring mainly in growth retarded babies and asphyxia remained the major causes of death. Mere provision of health services is not going to decrease PNMR. There is a need to educate ‘the ultimate’ consumers i.e. the women, for better utilization of these services. There is also an urgent need to sensitize and involve the medical practitioners imparting obstetrical services for solving these issues.

Perinatal mortality in Ludhiana, Punjab : a seven year hospital study

Perinatal deaths occurring over a seven year period were studied in a teaching hospital in Punjab. Causes of death were analysed as per Wigglesworths classification. We have further modified this by correlating different gestations and weight groups with causes of death. The perinatal mortality rate (PNMR) in the present study was 74/1000 and showed a downward trend secondary to a statistically significant fall of early neonatal mortality. There was a decline in PNMR among babies of 1500–2000 g. birth weight and 33–36 weeks gestation. Asphyxia and macerated still births were found to be the two main causes of death. Macerated still births were seen more commonly among babies of lower weight at all gestations. the PNMR of babies born to booked mothers was 22/1000 as compared to 152/1000 among unbooked mothers. It was concluded that to bring down the PNMR, economic development alone is not enough. Provision of adequate antenatal care to all mothers, health education and timely referral of high risk mothers is very essential.