Demographic and clinical analysis of post sterilization failure cases in a tertiary care hospital, Chennai, Tamil Nadu, India

Background: The most common permanent method of family planning accepted in India is female tubal sterilization as it has a very low failure rate of 0.1- 0.8% in the first year and over all pregnancy chances of 1 in 200. It can be done by open method but laparoscopic method has now gained wide popularity.Methods: Ours was a retrospective study of post female sterilization failure cases admitted to the Department of Obstetrics and Gynecology, Government Kilpauk Medical College Hospital within a 10 year time period between April 2007 and March 2017.Results: Over a decade we had 134 post sterilization failures. 71 patients presented with intrauterine pregnancy whereas 63 presented as ectopic pregnancy following sterilization. Majority of patients belonged to 26-30 year age group and the median age was 28 years. 40.3% ectopic presented at 5-6 weeks gestational age. Over 90% of sterilization failures were done by open method and around 35.8% were done during caesarean section. Around 65.0 % sterilization failures were seen within 5 years of sterilization but 2 patients presented as late as 17 years post sterilization. In four cases (3%) failure was due to improper surgical procedure.Conclusions: Female sterilization may result in failure even after years of sterilization. In the present study, pregnancy after sterilization is higher in the youngest age group (15-30) years than for the age group (31-35) years and stabilized in the oldest age group (36-49) years. Open sterilization had a higher failure rate than laparoscopic sterilization. The most common mode of sterilization failure was intrauterine pregnancy than the ectopic pregnancy and it was almost equal to each other. Therefore, patients undergoing sterilization must be counselled about chances of failure; even though it is a permanent method, and to consult immediately if missed period else at a later stage they may go in for rupture ectopic leading to high maternal morbidity and mortality

A cross sectional study on willingness and acceptance of postpartum sterilization by mothers at a tertiary hospital

Background: India was the first country in the world to launch the Family Planning Programme in 1951. Despite this fact, India still lags behind in practicing contraception and limiting family size. Even though various measures for encouraging the usage of contraception have been taken up, the achievement in this field is not up to the expectation due to various social and cultural factors. The aim of our study is to estimate the prevalence of awareness, willingness and acceptance of postpartum sterilization among mothers who delivered with two and more children before discharge at a tertiary hospital.Methods: It is a cross sectional study using the survey data on uncovered mothers who are discharged without accepting sterilization and mothers who underwent sterilization in a tertiary hospital.Results: Total number of mothers with 2 and more living children was 231. All the mothers were aware of female sterilization method. Only 38.5% mothers underwent sterilization. 66.9% of mothers stated willingness for sterilization but not done among the uncovered mothers with 2 and more children. This disparity was due to various medical reasons (pediatric opinion 57.7%, anesthetist opinion 0.7%, not treated within 7 days of delivery 8.5%).Conclusions: In our study, the awareness of female sterilization in women was 100%. 79.6% of them were willing for sterilization. Women willing for sterilization were more in caesarean section (45.4%) than in women who delivered vaginally (34.2%)

A comparative study of PPIUCD acceptance between primiparaous and multiparaous women in a tertiary care hospital in Tamil Nadu

Background: Postpartum intrauterine contraceptive device (PPIUCD) is a postpartum family planning method which provides spacing to the next pregnancy and also it helps to avoid unwanted / unintended pregnancy during postpartum period. Our aim is to study the willingness and PPIUCD acceptance between primiparaous and multiparaous women and compare them as a factor of route of insertion (vaginal versus caesarean).Methods: 1060 vaginal and caesarean deliveries conducted over a period of three months and 676 PPUCD insertions was done among the deliveries in a tertiary care hospital. A comparative cross-sectional study was done on the acceptance of PPIUCD by postpartum mothers between primiparous and multipararous women among the deliveries for the study period.Results: The proportion of willingness for PPIUCD was 68.8% among the postpartum mothers. The percentage of acceptance of PPIUCD was 73.8% and 51.4% in respect of primiparous and multiparous postpartum mothers. The route of PPIUCD insertion was more in caesarean deliveries (34.1%) than in vaginal deliveries (29.7%) in the total deliveries. The PPIUCD insertion in primiparous women was effective and statistically significant at p-value is <0.05.Conclusions: PPIUCD is a strong weapon in the family planning and should be encouraged in both vaginal and caesarean deliveries. The acceptability of PPIUCD by postpartum mothers was more in primiparous than in multiparous women

A cross sectional study on willingness and acceptabily: PPIUCD by primipara mothers at a tertiary care hospital, Tamil Nadu

Background: Postpartum intrauterine contraceptive device is a postpartum family planning method which provides spacing to the next pregnancy and also it helps to avoid unwanted / unintended pregnancy during postpartum period. Our aim was to study the willingness and acceptability of Postpartum intrauterine contraceptive device among primi paraous women and compare them as a factor of route of insertion (vaginal versus caesarean).Methods: A cross sectional analytical study was done in a tertiary care teaching institution to know the willingness and acceptance among primi paraous delivery (either vaginal and caesarean deliveries) for the period of three months using the hospital records that a total number of 587 primi paraous deliveries and among them 433 mothers had Postpartum intrauterine contraceptive device over the three months period, were taken as a secondary data and studied for their willingness and acceptance for Postpartum intrauterine contraceptive device.Results: 82.8 % of primi paraous women were showing willingness for Postpartum intrauterine contraceptive device and 73.8 % of them had Postpartum intrauterine contraceptive device insertion. Postpartum intrauterine contraceptive device insertions were more in caesarean deliveries than in vaginal deliveries of mothers with one child.Conclusions: Postpartum intrauterine contraceptive device is a strong weapon in the family planning and should be encouraged in both vaginal and caesarean deliveries. The acceptability of Postpartum intrauterine contraceptive device in women with one child was effective and statistically significant at p value is < 0.05

NANOROBOTICS IN CANCER TREATMENT

Disease and ill health are caused largely by damage at the molecular and Cellular level. Today\u27s surgical tools are, at this scale, large and crude. From the Viewpoint of a cell, even a fine scalpel is a blunt instrument more suited to tear and injure than heal and cure, where in real-time the organ most affected is heart. The present method of treatment-bypass surgery or angioplasty is outdated in this Nan world. Our work shows any viral respiratory infection could be diagnosed with the help of quantum dot system in an efficient manner. Finally, this paper clearly pictures the solutions for human illness using the “Nanotechnology” which will be driver for the future technologies of today’s “shrinking world

Assessment and management of venous thrombo­embolism risk during pregnancy and the puerperium SAVE: The South African cohort

Background. Venous thromboembolism (VTE) is associated with significant morbidity and mortality. Pregnancy and the puerperium are hypercoagulable states and increase the risk of VTE. There is a paucity of South African (SA) data related to use of thromboprophylaxis during pregnancy and the puerperium.Objectives. To evaluate local practice of VTE risk stratification among SA pregnant women and senior doctors’ attitudes to VTE prophylaxis.Methods. This was a cross-sectional descriptive study of conveniently sampled sites in the private and public health sectors. Patients with confirmed pregnancy and an underlying medical condition were enrolled after giving informed consent. Assessments were made based on the participating doctors’ questionnaires and case report forms. In essence, this was a local evaluation of a specific group of patients by a specific group of doctors.Results. Two hundred and twenty patients were enrolled at six sites. In the participating doctors’ opinion, 126/220 women assessed (57.2%) were at risk of VTE during pregnancy and the postpartum period (information was missing for 1 woman during the postpartum period). Of the women at risk of VTE, 23/126 (18.3%) were at high risk, 59/126 (46.8%) at moderate risk and 44/126 (34.9%) at low risk. Of the women identified as at risk of VTE, 104/127 (81.9%) received some form of VTE prophylaxis; 94/127 (74.0%) were at risk during pregnancy and 32/126 (25.4%) during the postpartum period. Of those who received pharmacological treatment, 15/15 received low-molecular-weight heparin during pregnancy and before delivery and 87/100 during the puerperium. Thirty-four patients received thromboprophylaxis for only 5 - 10 days after caesarean delivery, and 2 received mechanical thromboprophylaxis during pregnancy.Conclusions. Doctors participating in the study were generally aware of VTE risk during pregnancy and the puerperium. Pharmacological thromboprophylaxis was the most commonly used intervention to reduce VTE risk. Mechanical thromboprophylaxis was underutilised. Adherence to VTE guidelines, specifically in terms of duration of thromboprophylaxis and its utilisation during pregnancy, was suboptimal.Â

Assessment and management of venous thrombo­embolism risk during pregnancy and the puerperium (SAVE): The South African cohort

Background. Venous thromboembolism (VTE) is associated with significant morbidity and mortality. Pregnancy and the puerperium are hypercoagulable states and increase the risk of VTE. There is a paucity of South African (SA) data related to use of thromboprophylaxis during pregnancy and the puerperium.Objectives. To evaluate local practice of VTE risk stratification among SA pregnant women and senior doctors’ attitudes to VTE prophylaxis.Methods. This was a cross-sectional descriptive study of conveniently sampled sites in the private and public health sectors. Patients with confirmed pregnancy and an underlying medical condition were enrolled after giving informed consent. Assessments were made based on the participating doctors’ questionnaires and case report forms. In essence, this was a local evaluation of a specific group of patients by a specific group of doctors.Results. Two hundred and twenty patients were enrolled at six sites. In the participating doctors’ opinion, 126/220 women assessed (57.2%) were at risk of VTE during pregnancy and the postpartum period (information was missing for 1 woman during the postpartum period). Of the women at risk of VTE, 23/126 (18.3%) were at high risk, 59/126 (46.8%) at moderate risk and 44/126 (34.9%) at low risk. Of the women identified as at risk of VTE, 104/127 (81.9%) received some form of VTE prophylaxis; 94/127 (74.0%) were at risk during pregnancy and 32/126 (25.4%) during the postpartum period. Of those who received pharmacological treatment, 15/15 received low-molecular-weight heparin during pregnancy and before delivery and 87/100 during the puerperium. Thirty-four patients received thromboprophylaxis for only 5 - 10 days after caesarean delivery, and 2 received mechanical thromboprophylaxis during pregnancy.Conclusions. Doctors participating in the study were generally aware of VTE risk during pregnancy and the puerperium. Pharmacological thromboprophylaxis was the most commonly used intervention to reduce VTE risk. Mechanical thromboprophylaxis was underutilised. Adherence to VTE guidelines, specifically in terms of duration of thromboprophylaxis and its utilisation during pregnancy, was suboptimal.

Effect of drought on gas exchange and chlorophyll fluorescence of groundnut genotypes

Drought is one of the major threats to groundnut productivity, causing a greater loss than any other abiotic factor. Water stress conditions alter plant photosynthetic activity, impacting future growth and assimilating mobilization towards sink tissues. The purpose of this study was to investigate how drought impacts the photosynthesis of plants and its links to drought tolerance. The influence of reproductive stage drought on photosynthetic activity and chlorophyll fluorescence of groundnut is well studied. The experiment was conducted in Kharif 2019 (Jul-Sep), where recent series in groundnut genotypes (60 nos) sown under rainfed conditions and water stress was created by withholding irrigation for 20 days between 35-55 days after sowing in the field to simulate drought conditions. Imposition of water deficit stress reduced PS II efficiency, which significantly altered the photosynthetic rate in the leaf. Observation of gas exchange parameters viz., photosynthetic rate, stomatal conductance and transpiration rate after 20 days of stress imposition revealed that of all 60 genotypes, 20 genotypes (VG 17008, VG 17046VG 18005, VG 18102, VG 18077, VG 19572, VG 19709, VG 18111, VG19561, VG19576, VG 19620, VG 19681, VG 19688, etc.,) had better Photosynthetic rate, Stomatal conductance. Similarly, PS II efficiency analyzed through fluorescence meter revealed that among the 60 and all the genotypes given above recorded higher value in Fv/Fm. Results obtained from Cluster analysis and PCA confirmed that photosynthetic rate and Fv/Fm is useful parameter in screening adapted cultivars under drought stress. These findings lay the groundwork for a future study to decipher the molecular pathways underpinning groundnut drought resistance

Magnitude and direction of association for yield and yield attributes in groundnut (Arachis hypogaea L.)

Correlation analysis among kernel yield and its component characters was carried out to identify the selection indices in BC1F1 populations of two crosses viz., CO 7 × GPBD 4 and CO 7 × COG 0437. Kernel yield per plant and pod yield per plant expressed significant and positive correlation with plant height, number of primary branches, number of pods per plant, 100-pod weight and shell weight, in both crosses. Hence these characters may be considered as selection indices. These characters may be given due emphasis in breeding for high kernel yield in groundnut. The association of kernel yield per plant with 100-kernel weight, sound mature kernel, late leaf spot score and rust score varies with the crosses. Hence these characters may also be considered as selection indices with caution