Migrated intrauterine contraceptive device: erosion in to sigmoid colon

Intrauterine contraceptive devices (IUCDs) are one of the most widely chosen contraceptive methods with high efficacy, less side effects, and low cost especially in a developing country like India. Although they have low side effect profile but they are also associated with serious complications like device migration into adjacent organs, uterine perforation and sepsis. Any patient presenting with loss of thread should be assessed for localization of the IUCD. Authors are thereby reporting a case of a 30-year-old lady who presented with 2 month amenorrhea with loss of IUCD thread. She was diagnosed with intrauterine pregnancy with migrated IUCD into distal sigmoid colon. The patient was explored, IUCD was removed, dilatation and evacuation were done. Authors concluded that IUCDs are safe only in experienced hands and an institutional training is must for family planning workers. Patient education regarding regular checkup for threads is also emphasized

Rupture uterus: a one year review to find out the causative factors

Background: Rupture uterus is a life-threatening obstetric emergency associated with high perinatal mortality. This study aims to find out the common factors associated with this catastrophic condition so as to help in decreasing the incidence of this condition in this study set-up. The objective of this study was to determine incidence, socio-demographic factors, etiology, types of presentation, patterns of management and maternal and fetal outcome in cases of rupture uterus presenting in this study hospital in one year.Methods: In this retrospective study 40 cases of ruptured uterus admitted in the hospital between January to December 2016 were analyzed. Detailed history of relevant socio-demographic factors, prior obstetric and surgical history, clinical findings, nature of management done, fetal and maternal outcome were thoroughly analyzed from the record.Results: A total 40 cases of ruptured uterus during this one-year period out of total 1220 deliveries constituted an incidence of 3%. The commonest age group is 25-30 years (47%). Majority of patients of rupture uterus were those with previous scarred uterus trying for vaginal delivery in hands of dais, untrained birth attendants and midwives. Repair was possible in the majority of cases. There were no maternal deaths but fetal mortality was 92.5%.Conclusions: Proper antenatal care, transportation facilities, good counseling of patients with history of previous uterine surgery for institutional delivery can help in reducing the incidence of rupture uterus in developing countries like India. Prompt surgical intervention can help in reducing the maternal morbidity and mortality associated with rupture uterus

Numerical Simulation of the Phase Space of Jupiter-Europa System Including the Effect of Oblateness

We have numerically investigated the phase space of the Jupiter-Europa system in the framework of a Circular Restricted Three-Body Problem. In our model, Jupiter is taken as oblate primary. We have considered time-frequency analysis (TFA) based on wavelets and the Poincare Surface of Section (PSS) for the characterization of orbits in the Jupiter-Europa model. We have exploited both cases: a system with and without considering the effect of oblateness. Graphs (ridge-plots) explaining the phenomenon of resonance trapping, a difference between chaotic sticky orbit and the non-sticky orbit, and periodic and quasi-periodic orbit are presented. Our results of Poincare surfaces of the section of the Jupiter-Europa system (with and without the effect of oblateness) reveal the impact of oblateness of Jupiter as reducing parameter for regular and chaotic regions. Time-frequency analysis based on wavelets is comparatively fast and is suitable for the identification and characterization of the different type of trajectories in the nonlinear dynamical system

Impact of simulation-based-teaching in obstetrics and gynecology in under-graduate medical education

Background: Simulation based teaching (SBT) is an evolving teaching-learning method (TLM) that can enhance skill acquisition among students while providing multiple practice sessions, before on-patient implementation helping to improve confidence and competency among medical students. Methods: The study was conducted among 150 students of Phase II MBBS students of Adesh medical college and hospital, KKR, Haryana, from April 2022 to October 2022 on batches of 30 students each during their clinical postings of 4 weeks in the OBG department. They were further divided into batches of 10, and given didactic lecture on the selected topic. Following which, the facilitators demonstrated the skill. The students were allowed to practice individually. There doubts were cleared. An OSCE evaluation of the skill was made, followed by a debriefing session. A feedback form was then filled by both students and facilitators to assess impact of SBT. Results: Among the 150 students of phase II MBBS students, 146 responses were received. Both the medical students and the facilitators showed high levels of satisfaction with SBT. About 60.27% (88) students had a good overall experience with this new TLM. Conclusions: SBT improves retention as well as understanding of the concept. The teachers witnessed improved confidence and enhanced overall performance. The current study concludes that SBT is a highly effective tool and should be firmly inculcated in medical education

A Rare Presentation of Imperforate Hymen: A Case Report

Introduction. Acute urinary retention in a child is rare. Haematocolpos can cause a mechanical obstruction, resulting in acute urinary retention. Case Report. A 12-year-old girl presented to the surgical department with a one-day history of acute urinary retention and suprapubic tenderness. She had not started menses but had described period-like pains every month for the past six months. On examination, she had a palpable bladder with over 500 mls of residual urine and a bluish-grey bulge posterior to her urethral meatus. An US scan showed a large mass posterior to her bladder resembling a haematocolpos, and this was confirmed with an MRI scan. She was catheterised and eventually underwent a hymenectomy using a cruciate incision. She made a good recovery postoperatively. Conclusion. In the case of a peripubertal female presenting with acute urinary retention, haematocolpos should be considered as a diagnosis

A randomised clinical study to compare the haemodynamic effects of etomidate with propofol during induction of general anaesthesia

Background: Induction agents are frequently associated with changes in heart rate and blood pressure and various adverse effects. Since the introduction of general anaesthesia, no ideal induction agent has yet been discovered in term of providing a stable hemodynamic with fewer adverse effects. This prospective randomized clinical study was conducted to compare propofol and etomidate for their effect on hemodynamic and various adverse effects on patients scheduled for elective surgeries during the induction of general anesthesia.Methods: 50 patients of ASA I and II of age group 18-60 years scheduled for elective surgeries under general anaesthesia were randomly assigned in two groups (n=25) receiving etomidate (0.3 mg/kg) in group E and propofol (2.5 mg/kg) in group P as an induction agent. Hemodynamic parameters were recorded at various time intervals. Any adverse effect pain on injection and myoclonus was carefully watched. VAS score was recorded for pain on injection. Statistical analysis was done using software (SPSS IBM version 20). P value was considered significant if (p0.05). Patients in propofol group showed significant fall of  systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP) and compared to etomidate (P<0.05).) Pain on injection was more in propofol group (P=0.021), While incidence of myoclonus activity was higher in etomidate group (P=0.0027).Conclusions: Etomidate is a better induction agent over propofol as it provides more hemodynamic stability and less pain on injection as compared to propofol

Knowledge, attitudes, and practices towards COVID-19 among blood donors during the COVID-19 outbreak

Background: Assessments of the blood donors’ knowledge, attitudes, practices, and perceptions of this infection are essential for controlling the spread of COVID-19. Aim and objectives: This study aimed to evaluate the KAP among blood donors towards COVID 19 pandemic and how to increase the number of blood donations during pandemic. Materials and Methods: This study was conducted among 630 blood donors at the Department of Transfusion Medicine, at a tertiary care center in North India. It was an observational study. Statistical analysis: The data were analyzed using Kruskal-Wallis and Mann-Whitney test. To correlate variables Chi-square test was used. Results: The knowledge score of demographic variables marital status, education &amp; occupation showed a significant association, while its association with age, gender, and religion was insignificant. The entire demographic variables under study showed a significant association with Attitude questionnaire 1. According to univariate analysis, the variables Intercept, Unemployed and Physical Labour showed significant impact on knowledge level with the corresponding effect size 0.10 and 0.022. Conclusions: This study reveals that blood donors have good knowledge with positive attitudes and practices. By improving the knowledge with the help of health education platforms, the number of blood donations will also increase

DEVELOPMENT OF BINARY AND TERNARY COMPLEX OF CEFUROXIME AXETIL WITH CYCLODEXTRIN FOR IMPROVING PHARMACEUTICAL CHARACTERISTICS

Objective: The current research objective is systematic development and characterization of binary and ternary inclusion complexes of cefuroxime axetil with β-cyclodextrin to improve its pharmaceutical characteristics by using the kneading method. Methods: Phase solubility study was carried out using Higuchi and Connors method. Based on its result, binary complexes of cefuroxime axetil with different ratio of β-cyclodextrin were developed and characterized using differential scanning calorimeter (DSC), fourier transform infrared spectroscopy (FT-IR) and X-ray powder diffractometry (XRD). Then, binary complexes were analyzed for in vitro dissolution testing. The ternary complexes were developed using different ratio of PVP K-30 as a ternary component and evaluated for in vitro dissolution testing and in vitro taste masking. Results: Binary complex of cefuroxime axetil with β-cyclodextrin (1:1) showed better drug release than pure drug. During the development of the ternary complex, β-cyclodextrin (1:1) and 1% w/v PVP K-30 as a ternary agent resulted in an optimized ternary complex. The DSC, FT-IR and XRD studies clearly revealed the formation of binary and ternary complexes. The ternary complex showed better drug release of&gt;85% within 30 min. in comparison to binary complex. The in vitro taste-masking study revealed the taste masking efficiency of the ternary complex of cefuroxime with β-cyclodextrin. Conclusion: The developed binary and ternary complex of cefuroxime axetil based on β-cyclodextrin with PVP K-30 showed improved in vitro dissolution rate and taste masking in comparison to pure drug. The drug release was better in ternary complexes. The present research work successfully shows the utility of binary and ternary complexes for improving pharmaceutical characteristics of cefuroxime axetil

Disparity in Relation to Covid-19 Preventive Behaviour and Associated Myths among Rural and Urban Residents of Lucknow: A Community Based Study

Introduction: For curbing Covid-19 disease, adequate knowledge, attitude, and practices of both rural and urban population for Covid-19 disease prevention is required along with busting of the associated myths. Objectives: To assess the Knowledge, Attitude and Practices of urban and rural residents of Lucknow district regarding covid-19 preventive behaviour and associated myths. Methodology: A community-based study was conducted among 420 rural and 421 urban residents of Lucknow. Multistage random sampling was done to select the study subjects. A pre-designed pretested semi-structured questionnaire was used to collect the information regarding the Knowledge, Attitude and Practices of the residents for covid-19 disease causes, prevention, and treatment. Further, KAP scoring was done to compare the two groups. Results: The mean age of the rural and urban residents was 31.48 ± 12.05 and 30.93 ± 11.96 years respectively. Only 40.4 % urban and 25.5 % rural people had correct knowledge about social distancing (p&lt;0.0001). Knowledge regarding quarantine for covid-19 disease prevention was less among the urban residents (64.6%) as compared to rural (70.5%) (p=0.035). More than one-third (37.6%) of the rural resident believed in the myth that alcohol can prevent the covid-19 disease (p=0.003). 68.8 and 70.5 percent rural and urban residents had positive attitude towards the Indian government’ efforts in curbing the disease. Majority of the urban (90%) and rural (87.6%) residents wore mask when they went out. Only one-fourth of the urban (24.7%) and rural (22.9%) had correct practices for the duration of hand washing. Conclusion: The knowledge was more among the urban people, attitude and practices were almost similar among both the rural and urban residents while myths were more observed among the rural residents