A retrospective analysis on acceptability and complications of PPIUCD insertion

Background: In India, 65% of women in the first year postpartum have an unmet need for family planning but only 26% of women are using any method of family planning during the first year postpartum. This leaves a huge gap which needs to be addressed if maternal health is to be optimized. This calls for a method which is both effective and acceptable immediately post-partum. This is where the role of PPIUCD needs to be studied.Methods: This study was a retrospective observational study conducted in a tertiary care hospital. All deliveries during the time period from September 2016 to August 2017 were included in the study and the women accepting PPIUCD were studied for analysed for their age, parity, booking status and complaints during the follow up visit.Results: A total of 13,039 deliveries took place in one year between Sept 2016 to Aug 2017 out of which, 1118 (8.6%) accepted PPIUCD as a method of contraception. 44.3% PPIUCD users were in the age group of 21-25 years. 57% of PPIUCD users were primigravidas. 84% of PPIUCD users were booked cases. Missing threads was the most common complication, with 8.4% patients reporting it at follow up. There were no major complications noted in the study.Conclusions: PPIUCD is a safe and effective long acting reversible contraception method. Is particularly beneficial in a setting where women do not return for contraceptive advice. With low expulsion rates and high continuation rate, authors can conclude that PPIUCD can be the solution to a country like India currently facing population crisis and high unmet need

Effect of barley malt, chickpea and peanut on quality of Barley based beverage

The present investigation had been done to optimize the effect of barley malt on production of barley based beverage. Malting of barley was carried out by steeping the cleaned and bold grains in tap water at 16°C for 2-3 days. The steeped grains were also germinated at 16°C for 2-3 days and the grains showing optimum growth were sorted out and kilning was done at 60°C for 1 day. Different levels of malted grain (i.e. 0, 1, 2, and 4 %) in barley extract were optimized. It was found that addition of 4 g malt to the extract was found to be effective in decreasing the viscosity and avoiding the formation of gruel like structure. There was non significant sensory change found on addition of roasted malt grain. Amylase activity of malt significantly increased on increasing time and no reducing sugars resulted at 90°C. Nutritive value of malted beverage was improved over control. Total soluble solids (TSS), viscosity, protein, fat, reducing sugar and total sugar of malted beverage was significantly increased as compared to control. Malted beverage was more organoleptically acceptable than control. Final beverage was made with 4 g malt, 25 g bengal gram and 15 g peanut per extract from 100 g barley with addition of sugar to 17°brix and homogenizing for proper mixing was autoclaved. Thus, malting could be an appropriate food-based strategy

To study the rate of HIV Sero-positivity in paediatric patients with high risk clinical profile

Background: Understanding the magnitude and clinical profile of pediatric HIV is essential for the clinicians and policy makers. The study was aimed to determine the rate of HIV seropositivity in pediatric patients with high risk clinical profile, study the clinical presentations and the mode of transmission of HIV in children.Methods: This prospective hospital-based study to screen 244 children aged 18 months to 12 years with high risk clinical profile for HIV seropositivity was carried out for a period of 1 year.Results: Of the 244 children screened, the commonest clinical features associated with high risk profile were failure to thrive in 200 (81.97%), persistent fever in 151 (61.89%), chronic diarrhoea in 76 (31.15%), cough >1month 112 (45.90%) patients. HIV seropositivity was reported in 11/244 (4.51%) patients; with failure to thrive in 10/11 (90.90%), chronic diarrhoea in 09/11 (81.81%), seborrheic dermatitis in 2/11 (18.18%) patients followed by persistent cough, severe malnutrition, oral thrush, generalized lymphadenopathy and recurrent bacterial skin infections in 1 patient each out of 11(9.09%). Chronic diarrhoea was a significant independent clinical risk factor for predicting HIV seropositivity (Chi2 = 13.81, p<0.001, Odds ratio=11.15). The probability of HIV seropositivity increased significantly with the number of risk factors concomitantly present, with 30% seropositivity in those with four clinical risk factors (Chi2 =32.89, D. F=1, P<0.001). The parents of all seropositive children were seropositive.Conclusions: The probability of HIV infection in a child depends upon the nature and number of clinical manifestations present. All HIV positive children h HIV positive parents in this study indicating vertical transmission

The study of maternal and perinatal outcome in prolonged pregnancy

Background: Prolonged pregnancy or post-dated pregnancy is that pregnancy which has exceeded duration considered to be upper limit of normal pregnancy that is above 40 completed weeks or 280 days from the first day of last menstrual period. The objective was to evaluate the maternal and perinatal outcome of post-dated pregnancy.Methods: A prospective case control study was conducted on antenatal women for 18 months period from May 2014- October 2015 admitted to the Obstetrics and Gynecology Department, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India. The study group was comprised of antenatal women having pregnancy beyond 40 weeks, and the control group was represented with antenatal women between 37-40 weeks admitted for delivery during this period.Results: The prevalence of post-dated pregnancy was found to be 17.6% and of post-term was 5.69%. Among post-dated subjects LSCS rate was 56.50% and in term (37-40 weeks) patient it was 34.18%. The NICU admission for birth asphyxia was 6.09% among term (37-40 weeks) patients and 17.6% in post-dated pregnancies.Conclusions: Any pregnancy that crosses expected date of delivery, Foetal well-being must be assessed and induction of labour should be considered to decrease the risk of perinatal morbidity and mortality

Behavioral Impacts of the Fear of AIDS: A Sociological Model

The paper demonstrates the conceptual meaning and utility of a sociological model for identifying correlates of the fear of AIDS and its consequent changes on peoples\u27 behaviors. A sociological notion of levels of analysis is employed for classifying correlates of AIDS\u27 fears under structural and individual categories. A tentative list of these correlates and their projected relationship with peoples\u27 fears is suggested to illustrate the model

Colposcopic evaluation with modified IFCPC 2011 nomenclature and Swede score for diagnosing premalignant lesions of cervix: a comparative study

Background: Cervical cancer has a long precancerous stage. The early diagnosis in preinvasive stage provides a golden opportunity for prompt intervention to prevent its catastrophic consequences. Through this study we intended to compare the diagnostic accuracy of modified IFCPC 2011 nomenclature and Swede score with respect to gold standard histopathology in colposcopic evaluation of premalignant cervical lesions. Methods: A comparative study was conducted at tertiary care hospital in Delhi, India between January 2021 to June 2022 on 50 women with abnormal Papanicolaou smear (ASCUS, LSIL, ASC-H, HSIL). Scoring of colposcopic lesions was done according to IFCPC nomenclature and Swede’s scoring system. The two colposcopic scores were compared and their statistical association with histological findings were analysed. The collected data was analysed using SPSS version 25. The association of the qualitative variables were analysed using Fischer’s exact test. Agreement was measured by Cohen kappa statistics. Results: Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of modified IFCPC 2011 nomenclature for predicting LSIL and HSIL were 87.50%, 58.82%, 50%, 90.91%, 68% and 100%, 100%, 100%, 100%, 100% respectively. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of swede score for predicting LSIL and HSIL were 87.50%, 41.18%, 41.18%, 87.50%, 56% and 100%, 77.27%, 37.50%, 100%, 80% respectively. Conclusions: Modified IFCPC 2011 nomenclature had better predictive value than swede score in diagnosing both low grade and high grade premalignant lesions of cervix

Sheehan’s syndrome: a case report

Sheehans syndrome or necrosis of pituitary gland is a rare complication of postpartum haemorrhage, initially described in 1937. Sheehans syndrome though rare is still one of the commonest causes of hypopituitarism in developing countries like ours. We present a case of young lady with this syndrome who presented with classical symptoms of hypopituitarism within 1 year of her delivery which was complicated by postpartum haemorrhage

Study of microalbuminuria as early risk marker of nephropathy in type 2 diabetic subjects

 Background: Diabetic nephropathy (DN) is a common complication of diabetes mellitus that lead to end-stage of kidney disease (ESKD). Detection of early-stage can slow loss of kidney function and improve patient outcomes with use of diagnostic biomarker detection of DN. Aims and objectives of this study is to evaluate the possible association between glycated hemoglobin and urinary microalbumin as a predictor of diabetic nephropathy in type 2 diabetic patients.Methods: Total 162 subjects were included in this study comprises uncontrolled diabetes 54 cases, controlled diabetes 54 cases and healthy controlled 54 controls. Micro albumin was measured by urinary microalbumin (turbidimetric immunoassay), glycated hemoglobin (HbA1c) measured by ion exchange resin method and fasting blood glucose estimated by GOD-POD method. The inclusion of age group was between 35 to 74 years. Statistical analysis was done by using SPSS, version 16.0. p values were calculated by ANOVA unpaired t-test. The p<0.05 was considered a statistically significant.Results: Urinary microalbumin levels were statistically significant increase in type 2 diabetes mellitus with nephropathy in comparison to uncontrolled diabetes mellitus and controlled diabetes mellitus (138.9±13.7 mg/l vs 67.7±14.1 mg/l and p<0.005**).  HbA1c, which acts as a biomarker of diabetes was significant higher diabetic nephropathy, in comparison to uncontrolled diabetes mellitus, controlled diabetes mellitus and healthy control (8.0±1.1% vs 7.1±0.9% and 5.7±0.4%).Conclusions: The present study was demonstrated impaired glycaemic control is associated with elevations in urinary micro albumin levels and it may be considered as risk marker of diabetic nephropathy

A rare case of unruptured rudimentary horn pregnancy

Mullerian anomalies are a rare disorder and pregnancy in a rudimentary horn is one of the rarest forms of an ectopic pregnancy. This&nbsp;rarity proves to be an obstacle in the timely diagnosis and management of such cases. Thereby, it often culminates in catastrophic&nbsp;events such as rupture of the rudimentary horn which can claim the life of the mother. In this case report, we study the presentation of&nbsp;a 27-year-old primigravida who was presented at 16 weeks gestation, with an intrauterine fetal demise and failed induction of labor.&nbsp;This case report highlights how the diagnosis of a rudimentary horn pregnancy is often missed and the pregnancy was prolonged.&nbsp;We also aim to emphasize the importance of keeping the possibility of a rudimentary horn pregnancy in mind while dealing with the&nbsp;failure of second-trimester pregnancy termination

An intervention to improve the knowledge of anganwadi workers pertaining to growth monitoring in rural areas of Varanasi district, India

Background: Growth monitoring is one of the important functions of anganwadi workers (AWWs), for which they should have sufficient knowledge and training. With this background it was hypothesized that educational intervention can make a difference in the level of knowledge of AWWs in regard to growth monitoring. The main objective of the study was to evaluate the changes in knowledge of Anganwadi workers regarding growth monitoring through knowledge up-gradation training.Methodology: It was a field based interventional study, which was conducted on 66 AWWs each from Chiraigaon (intervention) and Cholapur (control) blocks of Varanasi district. The primary tool in this study was a pre-designed and pretested interview schedule for collecting information’s pertaining to study objective.Results: The mean score of knowledge was around 19.7 (max. Score was 30) in both the blocks during baseline survey and almost all the AWWs were having either average or good knowledge of growth monitoring. Post intervention a significant (p<0.01) difference has been observed between the mean knowledge scores of AWWs in intervention (25.32±2.44) and control (20.35±2.70) blocks and as much as 48.5% of AWWs were having excellent knowledge about growth monitoring in Chiraigaon block (p<0.01), while the situation was unchanged in Cholapur block.Conclusion: The knowledge up-gradation was found effective in improving the knowledge status of AWWs with regard to growth monitoring.