- Email: [email protected]
Women's police station — A women-in-distress cell
146
MONDAY,
P1.19.27 STUDY OF THE PHYSIOLOGY OF MICTURITION AFTER ABDOMINAL HYSTERECTOMY BY TRANSPERINEAL AND URODYNAMIC ULTRASONOGRAPHY H.GuimarCes, M. Freitas, .I. Machado, A. Berezowski, S. Pinheiro, P. Magnani, F. Costa, University Hospital, Faculty of Medicine of RibeirPo Preto, 3900 Bandeirantes Ave., RibeirPo Preto, SP, Brazil, 14049-900. Objective: The objective of the present study was to compare clinically and by ultrasound the effect of total hysterectomy by the abdominal route on the physiology of micturition in continent women at menachme. Study methods: The study was conducted on 22 continent patients with no history of surgery of the lower urinary tract and taking no medications affecting the urinary tract. The patients were divided into three groups: group 1 five patients with a body mass index (BMI) of < 25 kgim2; group 2 seven patients with BMI of 25 to 30 kgim2, and group (3) ten patients with BMI higher than 30 kgim2. Initial urogynecological evaluation was performed by urodynamics and ultrasound of the bladder neck before and 90 days after the surgical procedure. An ATL instrument model HDI 3000 coupled to an intracavity 9 to 5 MHz transducer was used for transperineal ultrasonographic evaluation of the bladder neck, and a Urobyte 5000 instrument was used for urodynamic evaluation. Conclusions: In group 1, all 5 patients were clinically continent and ultrasonographically normal before and after surgery. In group 2, four patients were continent, with normal pre- and postoperative ultrasonographic (USG) evaluation, one was continent and had preoperative USG showing increased mobility, and postoperative USG showing normal mobility; one patient had borderline preoperative mobility and increased psotoperative mobility; one patient was incontinent after surgery, with increased pre- and postoperative mobility. In group 3, four continent patients had normal pre- and postoperative USG evaluation, one continent patient had normal preoperative USG evaluation and increased postoperative USG evaluation; three continent patients had increased preoperative USG evaluation and normal postoperative evaluation; two continent patients had increased pre- and postoperative USG evaluation. Development of postoperative urinary incontinence occurred in only one case, which was predicted by the increased mobility of the bladder neck detected by preoperative USG. However, five patients who had shown increased mobility of the bladder neck by preoperative USG did not develop postoperative incontinence. An increased number of patients and a longer time of observation are needed for a better elucidation of this condition.
P1.20 VIOLENCE
AGAINST
WOMEN
P1.20.01 WOMEN FRIENDLY HOSPITAL INlTIATIVE: A STRATEGY FOR ADDRESSING VIOLENCE AGAINST WOMEN Rawshan Ara Khanam, Dept.OB/GYN, Dhaka Medical Hospital, Dhaka, Bangladesh. Jennyfer Merry Clerck, UNICEF, Bangladesh. Objectives: 1. To improve quality of care. 2. Mother baby package 3. Addressing violence against women. 4. Gender equity. Materials And Methods: In 1998 Women Friendly Hospital Initiative begun to working. In first phase 15 hospital of different facility like, Medical College Hospital, District Hospital and Health Complexes declared women friendly. In 1999another 15 hospital including some specialized hospital declared women friendly. Observations and results: Three delays model is responsible for most of the maternal deaths. Quality of care influence each phase of delays. For assessing cause of delay in receiving services in hospital on May 1998 first stakeholders committee was formed in each facility with participation of all level of hospital staff and members from community. All sitting together propose an action plan to improve the present situation. Quality of care which includes- attitudes, privacy, team spirit within hospital and between hospital & community Mother baby package includes standard Obstetric & antenatal care. There is a general agreement in the society that violence should not be used against pregnant women. This gives an entry point for addressing this sensitive issue. So, a training was devised that is appropriate for management of violence against women. In July 99 training for doctors, nurses and
SEPTEMBER
ancillary staff of hospital was arranged first which is still continued batch wise. Emphasis given upon psychosocial counseling. Conclusion: * VAW is a public health issue. * It may present obviously or may be hidden. * It needs multisectorial approach. * Available psychosocial support is limited in all facilities. * Change is always difficult and slow. * The response has been variable. * The best can be said, is that, the ideas and the ideals have been presented and change has started.
P1.20.02 WOMEN’S POLICE STATION- A WOMEN-IN-DISTRESS CELL A.R. B. Bala and R.K. Sarin, Aastha Medical Center and Women’s Police Station, Punjab, India Domestic violence against women is common worldwide. Broadly there are two methods to tackle this problem-legal and informal counseling. At Patiala, a district headquarter, a quasi-legal approach has been adopted by having an exclusive women’s police station. We report our experiences in this regard. This Cell has been operating since April ‘89, providing an exclusive facility for women tortured by their husbands/relatives to an extent which drives them to attempt suicide or causes grave injure or danger to their life and health-both mental and physical. The Cell is run by police officials and public persons with a female police officer as director. She is equipped with a Flying Squad around the clock. On receipt of a compliant, help is dispatched urgently to rescue the victim and to bring her to the Cell. Usually parties to the dispute are brought together and all efforts are made for an amicable compromise by counseling only. Most of the cases are settled out of court. During 1999,843 complaints were received and a compromise was possible in 613 (72.7%) cases. 195 (23.1%) cases were referred to the civil courts and only 27 (3.27)D cases were registered for criminal offences. We concluded that a quasi-legal approach to tackle domestic violence against women is effective and can save much time, psychological trauma and litigation.
P1.20.03 ABORTED ADOLESCENTS IN KUMANOVO, REPUBLIC OF MACEDONIA IN PERIOD FROM 1989 TO 1998 P.Bozichkovich; M.Denkovski; O.Bozichkovich; Medical center and Institute for health protection in Kumanovo, Street “11 Noemvri “ 27-2 / 4,913OO Kumanovo, Republic of Macedonia. Objectives: The aim of the title was to turn to the number of aborted adolescents in Kumanovo from 1989 to 1998. Intensive social, economical and geopolitical changes in this region have changed the live style. This changes brought bigger sexual abuse of children and adolescents. Study Methods: We have gather dates for the aborted adolescents younger than 19 registered at Medical center of Kumanovo .The number of aborted adolescents was compared with the number of labored adolescents in Kumanovo and in Republic of Macedonia. Results: 22 adolescents aborted in 1990 and 12 in 1995.In the relation of the total number of women, who aborted, 1,06% in 1989 and 2,12% in 1998 were adolescents. The percentage of delivered adolescents in this period was about 8%. The number of aborted adolescents was reduced for 50%. 5.10% of labored women in Kumanovo was adolescents and 9,9-11.4% in Republic of Macedonia. Conclusions: in Republic of Macedonia the number of sexual abused adolescents is growing. The results have shown that there is relative growth of the number of aborted adolescents and reduction of the number of deliveries at adolescents. The reasons for these trends according by us are: * the fall of standard. * More information about consequences of early maternity. * Education for protection of unwanted pregnancy.
4
MONDAY,
P1.19.27 STUDY OF THE PHYSIOLOGY OF MICTURITION AFTER ABDOMINAL HYSTERECTOMY BY TRANSPERINEAL AND URODYNAMIC ULTRASONOGRAPHY H.GuimarCes, M. Freitas, .I. Machado, A. Berezowski, S. Pinheiro, P. Magnani, F. Costa, University Hospital, Faculty of Medicine of RibeirPo Preto, 3900 Bandeirantes Ave., RibeirPo Preto, SP, Brazil, 14049-900. Objective: The objective of the present study was to compare clinically and by ultrasound the effect of total hysterectomy by the abdominal route on the physiology of micturition in continent women at menachme. Study methods: The study was conducted on 22 continent patients with no history of surgery of the lower urinary tract and taking no medications affecting the urinary tract. The patients were divided into three groups: group 1 five patients with a body mass index (BMI) of < 25 kgim2; group 2 seven patients with BMI of 25 to 30 kgim2, and group (3) ten patients with BMI higher than 30 kgim2. Initial urogynecological evaluation was performed by urodynamics and ultrasound of the bladder neck before and 90 days after the surgical procedure. An ATL instrument model HDI 3000 coupled to an intracavity 9 to 5 MHz transducer was used for transperineal ultrasonographic evaluation of the bladder neck, and a Urobyte 5000 instrument was used for urodynamic evaluation. Conclusions: In group 1, all 5 patients were clinically continent and ultrasonographically normal before and after surgery. In group 2, four patients were continent, with normal pre- and postoperative ultrasonographic (USG) evaluation, one was continent and had preoperative USG showing increased mobility, and postoperative USG showing normal mobility; one patient had borderline preoperative mobility and increased psotoperative mobility; one patient was incontinent after surgery, with increased pre- and postoperative mobility. In group 3, four continent patients had normal pre- and postoperative USG evaluation, one continent patient had normal preoperative USG evaluation and increased postoperative USG evaluation; three continent patients had increased preoperative USG evaluation and normal postoperative evaluation; two continent patients had increased pre- and postoperative USG evaluation. Development of postoperative urinary incontinence occurred in only one case, which was predicted by the increased mobility of the bladder neck detected by preoperative USG. However, five patients who had shown increased mobility of the bladder neck by preoperative USG did not develop postoperative incontinence. An increased number of patients and a longer time of observation are needed for a better elucidation of this condition.
P1.20 VIOLENCE
AGAINST
WOMEN
P1.20.01 WOMEN FRIENDLY HOSPITAL INlTIATIVE: A STRATEGY FOR ADDRESSING VIOLENCE AGAINST WOMEN Rawshan Ara Khanam, Dept.OB/GYN, Dhaka Medical Hospital, Dhaka, Bangladesh. Jennyfer Merry Clerck, UNICEF, Bangladesh. Objectives: 1. To improve quality of care. 2. Mother baby package 3. Addressing violence against women. 4. Gender equity. Materials And Methods: In 1998 Women Friendly Hospital Initiative begun to working. In first phase 15 hospital of different facility like, Medical College Hospital, District Hospital and Health Complexes declared women friendly. In 1999another 15 hospital including some specialized hospital declared women friendly. Observations and results: Three delays model is responsible for most of the maternal deaths. Quality of care influence each phase of delays. For assessing cause of delay in receiving services in hospital on May 1998 first stakeholders committee was formed in each facility with participation of all level of hospital staff and members from community. All sitting together propose an action plan to improve the present situation. Quality of care which includes- attitudes, privacy, team spirit within hospital and between hospital & community Mother baby package includes standard Obstetric & antenatal care. There is a general agreement in the society that violence should not be used against pregnant women. This gives an entry point for addressing this sensitive issue. So, a training was devised that is appropriate for management of violence against women. In July 99 training for doctors, nurses and
SEPTEMBER
ancillary staff of hospital was arranged first which is still continued batch wise. Emphasis given upon psychosocial counseling. Conclusion: * VAW is a public health issue. * It may present obviously or may be hidden. * It needs multisectorial approach. * Available psychosocial support is limited in all facilities. * Change is always difficult and slow. * The response has been variable. * The best can be said, is that, the ideas and the ideals have been presented and change has started.
P1.20.02 WOMEN’S POLICE STATION- A WOMEN-IN-DISTRESS CELL A.R. B. Bala and R.K. Sarin, Aastha Medical Center and Women’s Police Station, Punjab, India Domestic violence against women is common worldwide. Broadly there are two methods to tackle this problem-legal and informal counseling. At Patiala, a district headquarter, a quasi-legal approach has been adopted by having an exclusive women’s police station. We report our experiences in this regard. This Cell has been operating since April ‘89, providing an exclusive facility for women tortured by their husbands/relatives to an extent which drives them to attempt suicide or causes grave injure or danger to their life and health-both mental and physical. The Cell is run by police officials and public persons with a female police officer as director. She is equipped with a Flying Squad around the clock. On receipt of a compliant, help is dispatched urgently to rescue the victim and to bring her to the Cell. Usually parties to the dispute are brought together and all efforts are made for an amicable compromise by counseling only. Most of the cases are settled out of court. During 1999,843 complaints were received and a compromise was possible in 613 (72.7%) cases. 195 (23.1%) cases were referred to the civil courts and only 27 (3.27)D cases were registered for criminal offences. We concluded that a quasi-legal approach to tackle domestic violence against women is effective and can save much time, psychological trauma and litigation.
P1.20.03 ABORTED ADOLESCENTS IN KUMANOVO, REPUBLIC OF MACEDONIA IN PERIOD FROM 1989 TO 1998 P.Bozichkovich; M.Denkovski; O.Bozichkovich; Medical center and Institute for health protection in Kumanovo, Street “11 Noemvri “ 27-2 / 4,913OO Kumanovo, Republic of Macedonia. Objectives: The aim of the title was to turn to the number of aborted adolescents in Kumanovo from 1989 to 1998. Intensive social, economical and geopolitical changes in this region have changed the live style. This changes brought bigger sexual abuse of children and adolescents. Study Methods: We have gather dates for the aborted adolescents younger than 19 registered at Medical center of Kumanovo .The number of aborted adolescents was compared with the number of labored adolescents in Kumanovo and in Republic of Macedonia. Results: 22 adolescents aborted in 1990 and 12 in 1995.In the relation of the total number of women, who aborted, 1,06% in 1989 and 2,12% in 1998 were adolescents. The percentage of delivered adolescents in this period was about 8%. The number of aborted adolescents was reduced for 50%. 5.10% of labored women in Kumanovo was adolescents and 9,9-11.4% in Republic of Macedonia. Conclusions: in Republic of Macedonia the number of sexual abused adolescents is growing. The results have shown that there is relative growth of the number of aborted adolescents and reduction of the number of deliveries at adolescents. The reasons for these trends according by us are: * the fall of standard. * More information about consequences of early maternity. * Education for protection of unwanted pregnancy.
4