Perceptual analysis of women on tubectomy and other family planning services: a qualitative study

Background: In our country India, Population explosion has become a major concern to all. As per NHFS 3 report, in MP 44.3%, adopted the female sterilization other methods like male sterilization 1.3%, Intrauterine devices 0.7% and pills users were 1.7%, condom 4.8%. The study probed into the reasons of female sterilization as the method of choice and to know ideas of other temporary contraceptives and male sterilization.  Methods: In the study qualitative technique was adopted to understand the perception of participants. FGD’s and in-depth interviews were conducted with residents of Ratua village between Nov 2011 - April 2012 to explore the gaps. 52 women participated in the study. They were between 20-40 years, married and had children.Results: The interview transcripts were thematically analysed. All the participants knew tubectomy operation either through health care workers, friends, relatives or media. They thought it as a better and safer way to prevent unwanted pregnancy as compared to temporary ways and male sterilization. Economic incentives were looked up as insufficient motivation for undergoing the procedure. The decision was combined and women had less freedom in decision making. All felt strongly need of having at least one son for the family progression and care provider to them during the old age. They were hesitant to use temporary methods as they had misconceptions about the adverse effects. The male sterilization was unacceptable to all the participant as they thought it causes weakness and would adversely affect the physical work performance of their husband Conclusions: Participants in the study were hesitant to use temporary contraceptive methods for the fear of adverse effects. Multiple approaches to educate and transform their misconceptions of contraceptive methods and male sterilization should be adopted.

Immune Thrombocytopenia in a Challenging Case of Disseminated Tuberculosis: A Case Report and Review of the Literature

Mycobacterium tuberculosis (MTB) continues to predominate the cause of morbidity, and mortality in the developing world. The disease affects all the organ systems, and presents in various pathologic disease states. We report an uncommon manifestation of this rather common infectious disease in a 19-year-old male. Immune-mediated thrombocytopenia occurring as a consequence of the tuberculosis infection itself is an exceedingly rare occurrence, and at the time of writing of this paper, only 15 such published reports exist in the English literature so far

Off-label use of direct oral anticoagulants in patients receiving surgical mechanical and bioprosthetic heart valves

This cohort study assesses direct oral anticoagulant use in patients with surgical prosthetic heart valves in the United States and evaluates differences in preoperative and postoperative profiles in patients discharged while receiving direct oral anticoagulant vs warfarin

Similar Events but Contrasting Impact: Appraising the Global Digital Reach of World Heart Day and Atrial Fibrillation Awareness Month

Background: With over 18.6 million deaths annually, cardiovascular diseases (CVDs) are the leading cause of mortality worldwide. One such complication of CVDs that can result in stroke is atrial fibrillation (Afib). As part of global outreach and awareness, World Heart Day and Atrial Fibrillation Awareness Month are celebrated annually on 29 September and the month of September, respectively. Both of these events are important cardiovascular awareness initiatives to assist public education and develop awareness strategies, and they have received considerable support from leading international organizations. Objective: We studied the global digital impact of these campaigns via Google Trends and Twitter. Methods: We evaluated the overall number of tweets, impressions, popularity and top keywords/hashtags, and interest by region to determine the digital impact using various analytical tools. Hashtag network analysis was done using ForceAtlas2 model. Beyond social media, Google Trends web search analysis was carried out for both awareness campaigns to examine ‘interest by region’ over the past five years by analyzing relative search volume. Results: #WorldHeartDay and #UseHeart (dedicated social media hashtags for World Heart Day by the World Heart Federation) alone amassed over 1.005 billion and 41.89 million impressions as compared with the 1.62 million and 4.42 million impressions of #AfibMonth and #AfibAwarenessMonth, respectively. On Google Trends web search analysis, the impact of Afib awareness month was limited to the USA, but World Heart Day had a comparatively global reach with limited digital involvement in the African continent. Conclusions: World Heart Day and Afib awareness month present a compelling case study of vast digital impact and the effectiveness of targeted campaigning using specific themes and keywords. Though the efforts of the backing organizations are commended, planning and collaboration are needed to further widen the reach of Afib awareness month

Bicuspid Aortic Valve Disease: Classifications, Treatments, and Emerging Transcatheter Paradigms

Bicuspid aortic valve (BAV) is a common congenital valvular malformation, which may lead to early aortic valve disease and bicuspid-associated aortopathy. A novel BAV classification system was recently proposed to coincide with transcatheter aortic valve replacement being increasingly considered in younger patients with symptomatic BAV, with good clinical results, yet without randomized trial evidence. Procedural technique, along with clinical outcomes, have considerably improved in BAV patients compared with tricuspid aortic stenosis patients undergoing transcatheter aortic valve replacement. The present review summarizes the novel BAV classification systems and examines contemporary surgical and transcatheter approaches

Relative Predictive Value of Circulating Immune Markers in US Adults Without Cardiovascular Disease: Implications for Risk Reclassification

OBJECTIVE: To investigate the relative predictive value of circulating immune cell markers for cardiovascular mortality in ambulatory adults without cardiovascular disease. METHODS: We analyzed data of participants enrolled in the National Health and Nutrition Examination Survey from January 1, 1999, to December 31, 2010, with the total leukocyte count within a normal range (4000-11,000 cells/μL [to convert to cells ×10 RESULTS: Among 21,599 participants eligible for this analysis, the median age was 47 years (interquartile range, 34-63 years); 10,651 (49.2%) participants were women, and 10,713 (49.5%) were self-reported non-Hispanic white. During a median follow-up of 9.6 years (interquartile range, 6.8-13.1 years), there were 627 cardiovascular deaths. MLR had the best predictive value for cardiovascular mortality. The addition of elevated MLR (≥0.3) to the 10-year ASCVD risk score improved the classification by 2.7%±1.4% (P=.04). Elevated MLR had better predictive value than C-reactive protein and several components of the 10-year ASCVD risk score. CONCLUSION: Among ambulatory US adults without preexisting cardiovascular disease, we found that MLR had the best predictive value for cardiovascular mortality among circulating immune markers. The addition of MLR to the 10-year risk score significantly improved the risk classification of participants

Transcatheter and Doppler waveform correlation in transcatheter aortic valve replacement

Transcatheter aortic valve replacement (TAVR) has become the preferred therapy for treatment of severe aortic stenosis in patients at intermediate to high risk of perioperative mortality following surgical aortic valve replacement. Haemodynamic assessment is an integral part of the procedure, and it is crucial for the operator to have an in-depth understanding of the haemodynamic alterations that occur during balloon aortic valvuloplasty and transcatheter valve deployment. Comprehension of the haemodynamic tracings is also pivotal for early recognition of periprocedural complications. With expanding indications for TAVR, it is imperative for members of the structural heart team to have an in-depth, nuanced understanding of transcatheter haemodynamic waveforms and their correlation with echocardiographic Doppler waveforms that are obtained periprocedurally during TAVR. This review provides a collection of transcatheter haemodynamic tracings and their corresponding Doppler echocardiography correlates that are demonstrative of physiological alterations and pathological lesions (complications) that occur during TAVR