Study of knowledge and contraception practices in low socio-economic women of Delhi

Background: Objective of current study was to assess the knowledge and practice of contraception among the low socio-economic women of reproductive age group in Delhi.Methods: A cross-sectional study was done on 272 low socio-economic women attending a family planning clinic at a Delhi municipal corporation hospital, of which 106 came for Medical Termination of Pregnancy (MTP) and 166 came for family planning advice. They were interrogated through a pre-designed structured questionnaire, to evaluate their knowledge and practices towards regular contraceptive methods, Emergency Contraception (EC) and medical abortion. They were counselled about the available contraceptive methods and allowed to make choices according to their suitability.Results: All women belonged to low socio-economic group according to the modified Kuppuswamy scale. 22.1% were illiterate. 47.8% were ignorant of contraception. 38.3% women were aware of EC. Only 24.2% knew about medical abortion. The main reasons cited for not using contraception was desire for male child (24.6%), fear of side effects (20%), desire for another child (20%), opposition from family members (15.4%), inaccessibility (4.6%) and inconvenience and lack of privacy (5.4%).  Conclusions: This study highlights that lack of education, knowledge and awareness led to inadequate usage of regular methods of contraception in reproductive age group women belonging to low socio-economic status. Thus only availability is not sufficient to reach optimum female health. Accessibility need to be increased by educating females and motivating couples to make adequate use of existing family planning methods and resources. In contrast the awareness for emergency contraception is more than regular methods. It mandates need to educate women that emergency contraception should not replace regular methods.

Bone mineral changes during pregnancy: a cross-sectional study

Background: Changes in bone mineral density during pregnancy are not widely studied because of the risk of radiation hazard to the fetus. But newer technology like DEXA has made it possible to measure bone density accurately with low dose radiations which are safe even during pregnancy. The aim of this study was to evaluate the changes in maternal bone turnover markers and bone mineral content at forearm during pregnancy.Methods: A total of 32 pregnant women with singleton pregnancy of more than thirty five weeks gestational age and thirty non-pregnant, non-lactating women as controls were recruited. Baseline blood investigations, serum calcium, serum alkaline phosphatase and DEXA of the forearm at ultra-distal, mid radius and proximal 1/3rd of radius were done at the time of recruitment into the study.Results: Bone mineral density of forearm of pregnancy group was compared with non-pregnant, non-lactating control group to see the effect of pregnancy. Bone turnover markers like serum calcium and serum ALP were also compared among pregnancy group and controls. The mean bone mineral density of controls at ultra-distal radius was 0.437±0.058g/cm2, while in pregnant women it was 0.431±0.58g/cm2 that was not statistically significant. Bone mineral density at mid radius in control was 0.599±0.051g/cm2 and in pregnant women it was 0.597±0.048 g/cm2 with no significant difference. BMD at proximal 1/3rd radius in controls was 0.670±0.36 g/cm2 as compared to pregnant women where it was 0.660±0.036 g/cm2 without any statistical significance. Total BMD at forearm in control and pregnant women was 0.586±0.035 and 0.582±0.036 respectively and again there was no statistically significant difference.Conclusions: There is no significant impact of pregnancy on bone mineral density of forearm. Although more bone areas need to be investigated for the further confirmation

A large posterior vaginal wall cyst simulating rectocele: an account of an unusual perplexing case

Benign cystic lesions of the vagina are uncommon, often being an asymptomatic incidental finding revelled during routine gynaecological examination. Large vaginal wall cysts > 5cm size are a rare gynaecological entity. Most of the work available in literature accounts their mullerian genesis. Large epidermal inclusion cysts are further rarer. Thus, here is described a case illustrating an exceptional case of large epidermal inclusion vaginal wall cyst mimicking rectocele. Also, clinical considerations and relevant literature review on the same has been addressed. A 40 year old lady P2L2 presented in gynecology OPD with complaints of feeling of fullness in the vagina associated with some mass protruding out of the vagina for last few years. Careful evaluation indicated it to be a large posterior vaginal wall cyst 7x6 cm, aping enterocele, lying separate from rectum. The cyst was then surgically excised without any intraoperative or postoperative complications. Giant vaginal cysts are an uncommon occurrence. Meticulous clinical evaluation, bolstered with pertinent investigations can help in clinching the diagnosis early

Knowledge, attitude and practices regarding smoking amongst young females

Background: Smoking amongst women is increasing in the developing countries like India. There is paucity of data on the knowledge, attitude and practices of smoking amongst females in India. Hence a study was planned to assess the same.Methods: It was a qualitative research using descriptive questionnaire, prepared using the basic protocols available as per WHO Global Adult Tobacco Survey, conducted by self-reporting, from February to March, 2018 in the University Institute of Applied Management Sciences, Panjab University, Chandigarh. It was administered to 111 females aged 18 to 35 years, residing in Chandigarh.Results: Total22.5% of the female respondents were current smokers. Majority of them belonged to the age group of 26-35years; were either employed or were studying and felt that females resorted to smoking for gaining pleasure and relieving stress. Most of them were aware of passive smoking. Majority felt that people who smoke should quit for their own health and for their families and street plays, public awareness camps, television and cinema halls are important mediums for helping to quit. Will power be found to be most important to help smokers quit. Some quoted the role of nicotine replacement therapy, exercise, individual counseling etc also. Majority of the females started smoking early, at an age of 16-25years, consuming 1-10cigarettes per day and had been smoking since more than a year when interviewed. Smoking was primarily introduced by peers. All the smokers were aware of different types of smoking hazards, most commonly reported as cancer and asthma. 16/25 smokers wanted to quit and 14/16 had tried in the past but were unsuccessful.Conclusions: This study gives an indication of rising smoking trend in females. Smoking cessation measures need to be made more gender-sensitive, targeting females in their early ages

Incidental gonadoblastoma in swyer syndrome: a case report with brief review of literature

Swyer syndrome is a disorder of sexual differentiation with an incidence of 1 in 80,000 population. Dysgenetic gonads have a propensity for malignant transformation particularly in the presence of Y chromosome and hence need prophylactic removal. We report a case of an adolescent girl who presented with primary amenorrhea who was identified as a case of 46 XY dysgenesis after karyotype studies. Extirpation of gonads were done laparoscopically and on histopathological assessment gonadoblastoma was detected. This case report aims to reiterate the importance of gonadectomy in patients with swyer syndrome as tumors could arise even in the absence of frank adnexal masses

Vaginal Rhabdomyosarcoma in a patient with advanced cervical cancer; a case report and review of literature

Rhabdomyosarcoma is very rare in adults accounting for less than 5% of all soft tissue tumours and less than 1% of all malignancies. Vagina is one of the least common sites for occurrence of Rhabdomyosarcoma in the genital tract. We present a case of a 53-year-old woman who is a follow up case of cervical cancer stage IIIB, managed by radiotherapy and chemotherapy. She was doing well till 5 years of her treatment for cervical cancer when she presented with complaints of pain lower abdomen and discharge per vaginum for 10 days. On examination she was found to have an abdominal mass of 18 weeks size and on local examination there was 4X4 cm fixed mass on lower third of vagina arising from left side. MRI abdomen and pelvis was done. Biopsy from the vaginal mass showed features of Rhabdomyosarcoma. Further follow up of the patient was not possible due to lockdown in view of the pandemic. She was last contacted telephonically on 25th March 2020; she said she was waiting for the lockdown to be lifted so that her further management can take place. This is just one patient; there are many more with other medical conditions all over the world who are losing their lives because of not being able to access medical care due to the present pandemic. New growth in the region of local recurrence in a known malignancy cannot necessarily be the recurrence of the primary tumour. It is important to keep our mind open to other differentials apart from the recurrence of primary malignancy, sometimes it can turn out to be a very rare tumour as we encountered in our case

Logic Locking - Connecting Theory and Practice

Due to the complexity and the cost of producing integrated circuits, most hardware circuit designers outsource the manufacturing of their circuits to a third-party foundry. However, a dishonest foundry may abuse its access to the circuit\u27s design in a variety of ways that undermine the designer\u27s investment or potentially introduce vulnerabilities. To combat these issues, the hardware community has developed the notion of logic locking, which allows the designer to send the foundry a ``locked\u27\u27 version of the original circuit. After the locked circuit has been manufactured, authorized users can unlock the original functionality with a secret key. Unfortunately, most logic locking schemes are analyzed using informal security notions, leading to a cycle of attacks and ad hoc defenses that impedes the adoption of logic locking. In this work, we propose a formal simulation-based security definition for logic locking. We then show that a construction based on universal circuits provably satisfies the definition. More importantly, we explore ways to efficiently realize our construction in actual hardware. This entails the design of alternate approaches and optimizations, and our evaluation (based on standard hardware metrics like power, area, and performance) illuminates tradeoffs between these designs

A tool for hemodynamic data analysis

Thesis (M. Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2004.Includes bibliographical references (leaves 83-85).Nearly 2% of all live births are very premature (gestational age less than 32 weeks), and 50% of all new cases of cerebral palsy occur in survivors of premature birth (gestational age less than 37 weeks). Because of their underdeveloped vascular structure, premature infants are especially vulnerable to brain injury caused by unregulated and erratic changes in blood pressure. A challenge in the prevention of serious brain injury in premature infants is the inability to identify impending or recent hemodynamic events that might lead to injury of the newborn's brain. If events that indicate a propensity to experience brain injury can be identified, then such events can be monitored clinically, and steps can be taken to prevent them from occurring. We designed and implemented a software tool, HemDAT, that can be used to test hemodynamics related hypotheses and to facilitate the discovery of interesting relationships among hemodynamic signals. HemDAT uses signal processing and statistical knowledge to provide clinical researchers a tool that can help develop a better understanding of how brain injury occurs in premature newborns. HemDAT is capable of processing and navigating large data sets of blood pressure and cerebral blood flow. Large data sets are important because the events that cause brain injury are believed to be short-lived, possibly infrequent, and unpredictable. Additionally, since this is a relatively unexplored area in human infants, HemDAT provides flexibility in performing repeated analyses with different parameters modifiable by the user. HemDAT also provides convenient visualizations of results and does not demand signal processing or statistical expertise from the user.by Deepali Garg.M.Eng