Journal of Nurse Midwifery and Maternal Health

  Objective: The purpose of this report is to present the case of a 30 years old female patient with a confirmed diagnosis of Galactocele right breast. Clinical features: The patient presented with swelling/ lump in upper quadrant associated with pain on palpation. Patient was also suffering with hypothyroidism from last two years. Intervention and outcome: Sonomammography and aspiration cytology were performed on the patient which confirmed the presence of galactocele of right breast. The patient then underwent the excision of galactocele. Conclusion: Galactocele is a milk cyst which occurs in females during lactation or after cessation of lactation. It feels like a smooth movable lump in the breast which causes discomfort. The aspiration can act as diagnostic as well as curative in this case. Sometimes excision may also be required. 

Keywords: Galactocele; Cyst; Aspiration cytology; Lump; Excision.

 The practices of early marriages continue to be prevalent in the rural India, where teenaged or under aged girl (usually within the ages of 13-19) becoming pregnant. Nearly 40-50% girls in south Asia are married and become pregnant before they are 20. Main factors which forced to have the scenario are numerous; as social, economical, ignorance, illiteracy, familial so on. There are numerous ill effects on mother, baby, family and society as well. It is at most important to prevent early marriages and teenage pregnancies. 

Keywords: Teenage Pregnancy; Adolescence; Under Aged; Sexually Transmitted Diseases; Counseling, Youth Friendly.

 Despite considerable debate and research over many years the concept of “normality” in labour and delivery is not standardized or universal. Recent decades have seen a rapid expansion in the development and use of a range of practices designed to start, augment, accelerate, regulate or monitor the physiological process of labour, with the aim of improving outcomes for mothers and babies, and sometimes of rationalizing work patterns in institutional birth. In developed countries where such activity has become generalized questions are increasingly raised as to the value or desirability of such high levels of intervention. In the mean time, developing countries are seeking to make safe, affordable delivery care accessible to all women. The uncritical adoption of a range of unhelpful, inappropriate and/or unnecessary interventions, all too frequently poorly evaluated, is a risk run by many who try to improve the maternity services.

 Keywords: Labour; Normal Birth; Care Giver.

  Shoulder dystocia refers to difficulty in delivery of the fetal shoulders. It occurs in 0.2 to 2 % of births and can be a distressingemergencyin obstetrics. The goal of management is to prevent fetal asphyxia, while avoiding physical injury (eg, Erb’s palsy, bone fractures). The overall incidence of shoulder dystocia varies based on fetal weight. The incidence of shoulder dystocia is generally reported to be between 0.5 % and 1.5% with scattered reports listing values both higher and lower. Management of shoulder dystocia commonly includes Recognition of shoulder dystocia, Call for help, McRobert’s maneuver, Suprapubicpressure, Evaluate the need for an episiotomy, Internal maneuvers, Gaining internal vaginal access, Delivery of the posterior arm, Internal rotational maneuvers, All fours position, Documentation. It is important to remember to avoid traction and fundal pressure while attempting to deliver the shoulder dystocia.

Keywords: Shoulder dystocia; Suprapubicpressure; Episiotomy; Internal maneuvers.

 Healthy living is about knowing your mind and your body and practicing a routine that is sustainable and energizing. We believe in balance. But in order to maintain any degree of work/life balance, you need to maintain your health. Nonetheless, a number of postmenopausal women suffer from unpleasant symptoms every day. Menopause is an important stage in a woman’s life, and to better understand this transition, hence an attempt has been made in this article to create certain guidelines to the overcome the symptoms of menopause.

Keywords: Menopause; Hot flashes; Phytoestrogens and Isoflavones.

 Natural birthing gives extra comfort and calm and reduce labor pain has been reported by many studies. In a natural birthing option woman moves in response to what she feels. Whether she gives birth in a hospital, birthing center, or at home. She is able to use a wide variety of comfort measures; for example, moving freely, listening to music, taking a shower or bath, and having her feet and hands massaged. The three important natural birthing options for less pain and feel joy during birth practiced in some countries not much popular in many counties like India is Water birth, Hypnobirthing and Bradley method. Water birth is a method of giving birth to a child in a bath tub or pool full of warm water mostly practiced in birthing center. Hypnosis is a state of deep mental and physical relaxation that enables the hypnotized person to focus intensely on a thought or feeling, blocking outside distractions. In this state, proponents say, the mind is more open to suggestions that change our beliefs and behavior. The Bradley Method of natural childbirth also known as “husband-coached childbirth” is a method of natural childbirth which emphasizes on mother’s body, diet and exercise throughout pregnancy; and it teaches couples to manage labor through deep breathing and the support of a partner or labor coach. 

Keywords: Natural Birth; Water Birth; Hypnobirth; Birthing Center; Bradley Method.

 Background: Cervical cancer is a significant public health burden in most developing countries, where it is a major cause of mortality and morbidity among women. Despite the availability of free Papanicolaou (Pap) smear screening, cervical cancer is the second leading cause of cancer related deaths among women. Cancer of the cervix uteri is the 4th most common cancer among women worldwide, with an estimated 527,624 new cases and 265,672 deaths in 2012. According to World Health Organization (WHO), the highest burden of cervical cancer occurs in developing nations, where there is a lack of effective screening programs and low uptake of Pap smear or pelvic examination. Objectives: To assess the barriers to cervical cancer screening among women.To associate the barriers to cervical cancer screening with selected socio-demographic variables. Methods: A descriptive study involving 100 women was carried out with interview schedule. Data were collected by using a structured questionnaire. Data regarding socio-demographic characteristics and checklist related to barriers to cervical cancer screening. Data were analysed with Cronbach’s Alpha, ANOVA, Correlation Coefficient. Hypothesis H01 states there is a significant association between barriers to cervical cancer screening with selected demographic variables was accepted. Results: Out of 100 study participants, (55%) having medium barriers, and 32 women having high barriers and few participants, 13 reported low barriers. Conclusion: There should be improve awareness regarding importance of cervical cancer screening by providing information regarding cervical cancer screening uses, screening intervals and also various services are available to screening in order to improve the women health. 

Keywords: Cervical Cancer; HPV; Screening; Barriers; PAP.

 Backgroud : Urinary tract infections are caused by the pesence and growth of microorganisms in the urinary tract and are perhaps the single commonest bacterial infections of mankind. Urinary tract infection (UTI) is a common clinical diseases established in health settings world wide. Urinary tract infection represents one of the most infectious pathologies, affecting pregnant women as it has been reported among 20% of pregnant women. Pregnant women are at increased risk of urinary tract infection beginning in the 6th week and peaking during the 22 to 24 weeks. The preventive measures it includes drinking plenty of water , wash hands before using the toilet. Objectives : 1) To assess the knowledge regarding urinary tract infections among antenatal mothers. 2)To find the association between knowledge regarding urinary tract infections among antenatal mothers with their selected socio demographic variables. 3)To develop information booklet regarding urinary tract infections. Methods: A descriptive study involving 100 antenatal mothers was carried out with interview schedule. Data were collected by using a structured questionnaire. Data regarding socio-demographic characteristics and checklist related to knowledge regarding urinary tract infections. Data were analysed with Cronbach’sAlpha, Correlation Coefficient. Hypothesis H01 states that there was no significant association between the levels of knowledge among antenatal mothers with their socio demographic variables. Results: Out of 100 study participants, 27% had inadequate knowledge 49% had moderate knowledge and 24% had adequate knowledge. Conclusion : There should be improve knowledge regarding urinary tract infections among antenataal mothers in order to improve the health of the maternal and child health. 

Keywords: Urinary Tract Infections; E.Coli; Antenatal Mothers.

 A study was conducted to evaluate the effectiveness of Planned Teaching Programme (PTP) on knowledge regarding Reproductive Health Care among Ist year B.Sc (N) students at K.L.E’s Institute Of Nursing Sciences, Hubballi. Thirty (30) students were selected by non probability; purposive sampling technique. The knowledge was assessed by using structured knowledge questionnaire. The study results revealed that most of the respondents 20(66.66%) of them had poor knowledge, 7(23.33%) of them had average knowledge and 3(10%) of them had good knowledge during pretest. After administration of planned teaching programme, 19(66.33%) of them had good knowledge, 10(33.33%) of the respondents had average knowledge and 1(3.33%) of them had poor knowledge. The calculated paired ‘t’ test value of 21.8* is greater than the table value at 0.05 level of significance, which indicates that there is a significance difference between in mean pre-test and post-test knowledge scores of respondents. It is concluded that PTP was effective in increasing knowledge of Ist year B. Sc students regarding Reproductive Health Care. 

Keywords: Effectiveness; Knowledge; Planned Teaching Programme; Reproductive Health Care.

 Preparing the women for childbirth and to help her go through a successful birth experience is an important role of a nurse midwife. The purpose of the present study is to assess the effectiveness of childbirth education on childbirth experiences of pregnant women in a tertiary hospital, Kerala, South India. A Quasi experimental appraoach with pretest-posttest control group design was used for the study. The sample consisted of forty primigravid women attending the Obstetric Outpatient department, in the age group of 18-35 years, gestational age of 35 weeks or above and without any complications. The first twenty women were assigned consecutively to the control group and next twenty to control group. Childbirth expectancy was measured using Wijma Delivery Expectancy Questionnaire (Version A) before the intervention in both groups. Women in the experimental group received childbirth education. Childbirth experience was measured using Wijma Delivery Experience Questionnaire (Version B) following childbirth. The finding of the study shows that childbirth expectancy score of the experimental (57.10±15.88) and the control group (58.80±14) was not significantly different before childbirth. Whereas childbirth experience score of experimental group (38.00 ± 11.85) was lower than the control group (65.25 ± 18.85) which was statistically significant at 0.001 level. Results of the present study suggest that childbirth experience of the women can be improved with childbirth education. 

Keywords: Child Birth Education; Childbirth Experience; Pregnant Women; Effectiveness.

 Background: Today, diarrhea remains a major public health problem. In developing countries, diarrhea is among the leading causes of childhood morbidity and mortality. An estimated one billion episodes and 2.5 million deaths occur each year among children under five years of age. About 80% of deaths due to diarrhea occur in the first two years of life [1,2]. The oral rehydration therapy is the keystone of National Diarrhoeal Disease Control Programme.The packets of oral rehydration salts (ORS) are available at the Primary health centres as well as in chemist shops. There are depot holders of ORS packets in the community too. Most of the times the health care workers do not emphasise the role, benefits and method of preparation of ORS. As a result of this mothers do not know the right method of preparation of ORS and do not understand the need to give ORS to the child [3]. Objectives: To assess the knowledge regarding ORT for acute diarrhea among mothers of under five children .To assess the practice regarding ORT for acute diarrhea among mothers of under five children. To associate the relationship between knowledge and practices of mothers of under five children regarding ORS for acute diarrhea with selected socio demographic variables. Methods: A descriptive study involving 100 mothers of under five children was carried out with interview schedule. Data were collected using a structured questionnaire. It included data regarding socio-demographic characteristics and questions pertaining to knowledge and practices of mothers of under five children about ORS. Results: Out of 100 study participants, 71(71%) mothers were homemakers and 42(42%) were primary education and the most common source of information regarding ORS was health personnel. It was seen that 56 (56%) mothers had moderate knowledge about ORS, 36(36%) mothers had moderate knowledge on practice regarding ORS for acute diarrhea. 100(100%) participants knew about zinc supplementation. The higher education level of mother was associated with better knowledge regarding various aspects of oral rehydration therapy. conclusion: The knowledge and practices regarding the use of ORS for acute diarrhea is moderate . So, there is need to educate mothers regarding the use of ORS as well as homemade ORS substitutes during diarrhea, in order to reduce children mortality and morbidity rates. 

Keywords: Diarrhea; Oral Rehydration Salts (ORS); Acute diarrhea; ORT.

 Infertility has been relatively neglected as both a health problem and a subject social science research in south Asia, as in developing world more generally. Infertility affects a large numbers of couples globally between 50 and 80 million couples. To explore the lived in experience of infertile women in Korlagunta community, Tirupati, a qualitative phenomenological approach was used. 15 Samples were selected using convenient sampling technique. Samples were interviewed with Semi structured Interview guide and focus group discussions were also used to explore their lived in experiences. The data were transcribed, coded, arranged and analyzed for categories and themes such as physical, psychological, social, economical, spiritual involvement in women with infertility. Under each dimension sub-themes were formulated based on women’s lived-in experiences. Results showed that infertile women were stigmatized in their living community, had personal abuse from their relatives including their husbands, and in-laws. They had a sense of shame and guilt feelings towards their lives. Most of them had economical constraints due to their treatment expenses. High spiritual belief was found to be their hopes for living. Study concludes that , infertile women suffer the social effects of being childless. Coping strategies need to be strengthened among them and with this view, a pamphlet on coping strategies of infertility was given to the women for their empowerment.

Keywords: Infertility; Women; Dimensions; Experiences; Themes.

 The purpose of the study was to assess the knowledge and attitude among post menopausal women of medical profession regarding hormonal replacement therapy. The Research Approach used was Survey Approach, with a Descriptive Design. The Setting of the Study was at areas of Panavoor Primary Health Centre, Trivandrum, among Post menopausal women under medical profession. There were 100 Samples selected by means of Purposive sampling. The tool used for Data Collection was structured questionnaire and 5 point Likert scale by Self Administration Method. The data were analysed using descriptive and inferential statistics. The overall mean and standard deviation of knowledge scores were 22.37 and 1.119 respectively whereas the overall mean and the standard deviation of attitude scores were 84.47 and 3.228 respectively.

Keywords: Assess; Knowledge; Attitude; Menopause; Post-Menopausal Women Hormonal Replacement Therapy.

 Background: Every newborn when placed on her mother’s chest, soon after birth has the ability to find her mother’s breast all on her own and to decide when to take the first breast feed. This is called “Breast crawl”. Aim: This study aimed to assess the effectiveness of video assisted teaching regarding breast crawl on knowledge among staff nurses. Methods: The present study was conducted in selected hospitals at Kerala namely Josgiri, Christuraja, Cherukunne & Amala. Out of which, Josgiri hospital and Christuraja hospital were selected for the study group and Cherukunne hospital and Amala hospital were chosen for control group. Quasi experimental, pre test and post test design was adopted for the study. 60 staff nurses were selected by convenient sampling technique. Out of which, 30 of them were allotted to study group and 30 to control group. Inclusion criteria for sample selection includes a) Staff nurses who were working in the maternity wards of selected hospitals, b) Staff nurses who were willing to participate in the study and c) Staff nurses who had diploma or graduate degree in nursing. Staff nurses who underwent Inservice education or any awareness programme on breast crawl were excluded from the study. Structured questionnaire was used to assess the knowledge regarding breast crawl among staff nurses which was devised by the investigator. The scores were interpreted as adequate knowledge, moderately adequate knowledge and inadequate knowledge. Result: The present study findings revealed that, there was statistically significant difference found in the post test level of knowledge on breast crawl among staff nurses between study and control group at p=0.001 level. The overall gain score of knowledge of staff nurses in study group after video assisted teaching was 12.63 and the percentage difference with 95% confidence interval was 36.1%. Conclusion: The current study results conclude that , video assisted teaching on breast crawl was effective in improving the knowledge of staff nurses in the study group. An understanding of the techniques of breast crawl by the staff nurses holds the possibility that more women will experience this natural way of initiation of breast feeding immediately after birth, which in turn helps to reduce the morbidity and mortality rate of the Newborn. 

Keywords: Video Assisted Teaching; Breast Crawl and Knowledge.

 Stem cells have the remarkable potential to develop into many different cell types in the body during early life and growth. In addition, in many tissues they serve as a sort of internal repair system, dividing essentially without limit to replenish other cells as long as the person or animal is still alive. The main objective of this study was to assess the effectiveness of IEC Package on knowledge regarding stem cells among antenatal mothers at Chrompet General Hospital. Quantitative approach Quasi experimental one group pre-test and post-test design was adopted. A total of 50 samples were selected using simple random sampling technique. The tool used for the study comprises of two sections. Section A comprises of demographic data which includes age, gravida, education, availability of mass media, occupation of the head of family, occupation of self, family size, type of family. Section B comprises of structured questionnaire to assess the knowledge regarding stem cells among antenatal mothers developed by the investigator which includes 18 questions. The data was collected and analysed by using descriptive and inferential statistics. The results of the study revealed that there was a significant difference between pre- est and post-test knowledge on stem cell among antenatal mothers at p=0.001 level. 

Keywords: Stem Cells; Antenatal Mothers; Information; Education; Communication Package.