A prospective study of safety, efficacy and acceptability of postpartum insertion of intrauterine contraceptive device in a tertiary care hospital in Maharashtra, India

Background: IUCD (intrauterine contraceptive device) to prevent pregnancy are among the oldest method of contraception. The modern IUCD are highly effective, safe private, long acting and rapidly reversible contraceptive method. Aims and objective of this study was to study the acceptability and safety of postpartum intrauterine contraceptive device (PPIUCD) in postpartum period and to assess the feasibility, safety, efficacy and expulsion rate of IUCD.Methods: A prospective observational study was conducted at tertiary care teaching hospital in Maharashtra from January 2018 to October 2018 and patients were followed up to a period of one-year post IUCD insertion.Results: Majority of patients in this study were in age group 21 to 26 years of age (58.7%) and the least number were in the age group more than 30 years (3.3%). This study showed that majority of patients were primigravida (44%) and the lowest number belonged to gravida 6 (0.3%). Regarding timing of IUCD insertion 73% were done intra caesarean, 22.3% were done post placental and 4.7% were done within 48 hours of delivery. In this study authors found that 4% of patients had per vaginal discharge, 5% had missing IUCD thread and 2% of patients had IUCD expulsion. It was found in this study that 98% of patients continued to use IUCD and only 2% discontinued the usage.Conclusions: From the study authors came to conclusion that PPIUCD insertion is a safe, feasible, effective and reversible method of contraception

Teaching surgical skills in obstetrics and gynaecology using cadaver simulation: an innovative teaching learning method

Background: Transfer of knowledge from teachers to students traditionally occurs in one direction using blackboards, overhead projectors, power-point presentations and lectures. It has many disadvantages. The main challenge in medical education is to teach surgical skills. For the learning of critical interventions, simulation-based training is structured so that the acquisition of new skills does not harm patients. Thus, the objective of this study was to enhance and improve procedural skills of resident doctors of Obstetrics and Gynaecology department of Government Medical College, Miraj using cadaver simulation in doing abdominal hysterectomy.Methods: Second year resident doctors from Obstetrics and Gynaecology department of GMC, Miraj who had completed their first year successfully in terms of basic orientation regarding surgical procedures were taken for study purpose. They were divided in two groups randomly. The first group underwent conventional method of teaching to learn the abdominal hysterectomy procedure and underwent feedback from them regarding the conventional teaching learning method. Then they were allowed to perform the procedure on a live patient and their performance of procedural skill was assessed by DOPS. (Direct observation of procedural skills). The second group underwent innovative method of use of cadaver simulation for the abdominal hysterectomy procedure and feedback on the same. They were allowed to perform the procedure on a live patient and their performance of procedural skill was assessed by DOPS. (Direct observation of procedural skills). All data was collected, analysed and processed to study the outcome of research project.Results: In group B, all resident were fully satisfied with newer method of teaching and learning for abdominal hysterectomy as surgical procedure. As far as, the advantages and disadvantages of teaching and learning are concerned, all residents pointed out large number of disadvantages in the conventional method. Evaluation of the surgical procedural skill was done by DOPS by senior faculty members of the department as per the questionnaire which showed good performance from group B.Conclusions: The benefit of simulation based medical education (SBME) is that it offers both learners and patients a safe environment for practice and error. In addition, SBME can provide a learning cycle of debriefing and feedback for learners as well as assessment and certification for procedures and competency

Level of awareness and knowledge of emergency contraception in patients undergoing induced abortions in a rural part of India

Background: Emergency Contraceptive Pills (ECP) was introduced in National Family Welfare programme of India since 2003 and is easily available. Aim of this study was to assess the awareness and knowledge of ECP in the women undergoing induced abortion, which represent huge number of unintended pregnancies in India which have negative impact on health resources.Methods: This questionnaire based cross-sectional study was conducted for 10 months in Government Medical College in Miraj and included 110 women.Results: 57.2 %, women belonged to 20 to 30 years of age. 89% attended some years of school. 33.6% of patients were not using any contraception while 47.27 % had irregularly used some contraception; only 19.09 % were using contraception regularly. Only 7.2 % patients had ever heard of emergency contraception pills while none had ever used or knew how to use ECPs. None of the patients knew if ECP were available in any government hospitals.Conclusions: The huge number of patients undergoing MTP in represent increased surgical load on the government medical facilities. Majority of literate patients signifies the potential target area for contraception counselling and will be much ready to accept some form of contraception including ECPs as a backup. Only 7.2 % had ever heard of emergency contraception points to the glaring deficits in knowledge and practice of ECP despite government efforts. Government centres should promote ECP aggressively as was done in case of barriers/ CuT methods along with proper counselling

Level of awareness and knowledge of emergency contraception in patients undergoing induced abortions in a rural part of India

Background: Emergency Contraceptive Pills (ECP) was introduced in National Family Welfare programme of India since 2003 and is easily available. Aim of this study was to assess the awareness and knowledge of ECP in the women undergoing induced abortion, which represent huge number of unintended pregnancies in India which have negative impact on health resources.Methods: This questionnaire based cross-sectional study was conducted for 10 months in Government Medical College in Miraj and included 110 women.Results: 57.2 %, women belonged to 20 to 30 years of age. 89% attended some years of school. 33.6% of patients were not using any contraception while 47.27 % had irregularly used some contraception; only 19.09 % were using contraception regularly. Only 7.2 % patients had ever heard of emergency contraception pills while none had ever used or knew how to use ECPs. None of the patients knew if ECP were available in any government hospitals.Conclusions: The huge number of patients undergoing MTP in represent increased surgical load on the government medical facilities. Majority of literate patients signifies the potential target area for contraception counselling and will be much ready to accept some form of contraception including ECPs as a backup. Only 7.2 % had ever heard of emergency contraception points to the glaring deficits in knowledge and practice of ECP despite government efforts. Government centres should promote ECP aggressively as was done in case of barriers/ CuT methods along with proper counselling