Menstrual hygiene is far from satisfactory among a large proportion of Indian women. To overcome the barriers for using sanitary napkins among rural women in Haryana, a social marketing scheme was launched. As the program is in nascent stage of implementation the factors influencing it need to be evaluated. Therefore, this study aimed to analyze the stakeholder's perspectives and factors influencing this scheme.

We carried out a qualitative study during April’ 2011 in Lalpur, Naraingarh, Ambala, Northern India. The experience and opinion of rural girls, women, ANM, ASHA and Sakshar Mahila Samooh (SMS) members were elicited during 10 in-depth interviews and four FGDs.

Majority of women were motivated to use sanitary napkins. They perceived that use of sanitary napkin was beneficial for them. The grass root workers involved in production work of sanitary napkins were disappointed with irregular flow of funds. The other stakeholders in the community were not actively involved in the implementation of this scheme.

To conclude, there is a huge marketing potential of low cost sanitary napkins in this rural area of Haryana. The program needs to actively involve various stakeholders and to ensure regular flow of fund.

Sinha S, Singh A. Adolescent Health-Tackling Menstrual Hygiene Issue through Social Marketing of Sanitary Napkins Scheme: An Evaluation study from Haryana J Postgrad Med Edu Res 2013;47(3):127-130.

Patients undergoing surgery for intracranial tumors are at significant risk of developing deep venous thrombosis (DVT) due to postoperative immobilization. The role of heparin prophylaxis in preventing this complication and the risk of intracranial hemorrhagic complications due to anticoagulation is not well established. The present study was designed to address this issue.

A prospective randomized study was conducted to include 100 patients who were undergoing surgery for intracranial tumors. Patients who were immobilized in bed for more than 48 hours after surgery were included. The patients were categorized into two groups depending upon whether they received heparin prophylaxis or not. Further each group was subdivided into two based upon the duration of surgery: Less than or more than 3 hours. The incidence of DVT and of postoperative hemorrhagic complications was studied in all the groups. Various demographic as well as risk factors were analyzed to assess their impact on the incidence of DVT.

Overall incidence of DVT was 17%. Incidence of DVT was 12% in patients who received heparin as compared to 22% who did not. However, this difference did not reach statistical significance. The incidence was almost double when the duration of surgery was more than 3 hours. Patients with 2 or more risk factors had an increased frequency of DVT. One patient in the heparin positive group died as a result of postoperative hemorrhagic complication.

The incidence of DVT was found to be numerically lower in patients who received postoperative heparin as well as in patients in whom the duration of surgery was less than 3 hours.

Singla N, Bendapudi DP, Chhabra R, Malhotra P, Prakash M, Gupta SK. A Prospective Randomized Controlled Study of the Role of Heparin in Preventing Deep Venous Thrombosis in Postoperative Craniotomy Patients. J Postgrad Med Edu Res 2013;47(3):131-137.

Bedsores are quite frequent in bedridden cases. Caregivers have an important role in the management of such cases.

To assess the knowledge, beliefs and practices of caregivers regarding bedsore care practices and management.

A cross-sectional study was conducted in Chandigarh from September to November 2011. Caregivers were interviewed about the knowledge, attitude and practice regarding care of bedridden patients and their problems like bedsores.

Data was collected from 42 bedridden cases (22 males and 20 females). Age was 18 to 90 years. Bedsores were found in 10 bedridden cases. Most common underlying diagnosis was neurological disease in 24 cases. Twenty-nine patients consulted government hospitals. Earlier episode of bedsore was experienced in about 14 cases. In 24 cases bed sheet was changed daily. In 11 cases, for more than two times patient had to wait for more than half an hour if urine/stools were passed in bed. In six cases unqualified practitioners were also consulted. Thirty-seven of them complied with the physician's advice. Seventeen of the caregivers were aware of the warning signs of development of bedsores. Exercises were not performed in 26 cases. Different dressing regimes were reported viz til oil, desi ghee, platelet ointment, paraffin wax, etc.

Quality of care of bedridden was not good. There is a need for formal training for the caregivers as most of them were untrained. Evaluation of various dressing regimes for bedsores is needed.

Sharma U, Kaur S, Singh A. Knowledge, Beliefs and Practices of Caregivers Regarding Home Based Bedsore Care in Chandigarh, North India. J Postgrad Med Edu Res 2013;47(3):138-143.

Dudeja P, Singh A, Jindal A, Bhatnagar N. Preference for Male Child in Two Semiurban Communities of Pune. J Postgrad Med Edu Res 2013;47(3):144-147.

Jeyashree K, Kathirvel S, Singh A. Divergent Approaches to Health-related Behavior Change: Pampering under NACP vs Persecution under RCH II J Postgrad Med Edu Res 2013;47(3):148-149.

Reversal of Hartmann's procedure is a difficult surgical exercise with significant morbidity and mortality. One of the difficulties encountered during surgery is the presence of a very short rectal stump.

We present two cases where the patients underwent a Hartmann's procedure for abortion induced colonic injury and a subsequent failed attempt at reversal. The distal stump was mobilized from the sacrum (virgin field). An end to side anastomosis was performed between the distal end of colon and the posterior surface of the rectal stump using an end to end circular stapler.

The patients had a complete recovery with good functional results.

This is a novel technique which when applied in such situations will prove technically easy and functionally adequate.

Singh G, Gupta V. Reversal of Hartmann's Procedure in Patients with Very Short Rectal Stump: A New Technique. J Postgrad Med Edu Res 2013;47(3):150-152.

Kohli R, Singh S, Gupta AK, Matreja PS. A Case Report of Signet-Ring Cell Carcinoma Colon. J Postgrad Med Edu Res 2013;47(3):153-155.

Bhagwat K, Bachhal V, Bali K, Dhillon MS. Ipsilateral Type IV Closed Talus and Calcaneal Fractures: A Case Report and Review of Literature. J Postgrad Med Edu Res 2013;47(3):156-158.

Mahajan D, Kang M, Gupta R, Khandelwal N. Hydatid Cyst of Liver: A Rare Cause of Secondary Budd-Chiari Syndrome. J Postgrad Med Edu Res 2013;47(3): 159-161.

Carcinoma expleomorphic adenoma (CXPA) is a rare neoplasm of the salivary gland which arises in the epithelial component of a pleomorphic adenoma. It is not automatically a high-grade tumor as is traditionally suggested and should be further qualified as to type, grade of carcinoma and extent, since intracapsular and minimally invasive tumors behave favorably.

Department of Head and Neck oncosurgery, Kidwai Memorial Institute of Oncology, Bengaluru.

A 38-year-old female was referred to our outpatient clinic with history of a painless swelling in the left side of the neck since 8 years. Fine needle aspiration revealed carcinoma of the submandibular gland. Contrast enhanced CT revealed a large heterogeneously enhancing mass lesion in the submandibular fossa with the gland not seen separately. Lymph nodes in level Ib and II were enlarged. Excision of the tumor revealed CXPA with foci of high grade mucoepidermoid carcinoma.

CXPA should no longer be considered a specific diagnosis but a category in which the carcinoma should be typed, graded and quantitated to impart more prognostically and therapeutically relevant data for efficient management.

Naik SM, Shenoy AM, Chavan P, Halkud R, Biswas S, Kalloli M, Gupta S, kudpaje A. Carcinoma Expleomorphic Adenoma of the Submandibular Gland. J Postgrad Med Edu Res 2013;47(3):162-166.

Sodhi KS, Dutta M, Saxena AK, Singhal M, Khandelwal N. Tulip Bulb Sign. J Postgrad Med Edu Res 2013;47(3):167-168.