Contraceptive practices among reproductive age group of women in Justice K. S. Hegde Medical College Hospital, Mangalore

Background: India’s population as per 2011 census was 1.21 billion second only to china in the world, and is estimated to overtake china by 2050. India was the first country to launch National Family Planning Program in 1952. Even though various measures have been taken to encourage the usage of contraception but, the achievement in this field was not to the extent expected due to various social and cultural factors.Methods: It was a cross sectional study conducted in out patients and inpatients of department of obstetrics and gynecology, Justice K. S. Hegde medical college hospital, Mangalore. The study constituted 705 subjects. It was an interview based study. The study was aimed to know the awareness, acceptance and prevalence of temporary and permanent contraceptive methods among the study group and various factors affecting the contraceptive usage.Results: A total of 705 women in the age group between 18-45 years were studied.  671 (95.2%) were aware of one or multiple methods of contraception, 615 (87.2 %) accepted the contraceptive practices, and 495 (71.2%) followed or are following contraception at the time of study. Of 705 women, 366 (51.9%) followed or used temporary methods, 227 (32.2%) followed permanent methods of contraception.Conclusions: Awareness about the contraception is not sufficient enough to use contraception in the community, also shows that more programs are required to combat the influence of various factors on contraception usage, and emphasizing on the positive effects of the use of contraception

A case of ovarian Sertoli-Leydig cell tumor with multiple endocrine gland involvement

Sertoli-Leydig Cell Tumors (SLCT) comprises an uncommon and heterogeneous group of ovarian neoplasms within sex-cord stromal category. Retiform type accounts to about 10-15% of all SLCTs and they are less androgenic than other variants. We present to you a 20 year old lady who came to us with features of virilisation and abdominal mass. Intra-operatively, mass arose from left ovary. Left salpingo-oophorectomy was done. Histopathological diagnosis was SLCT with retiform pattern and with a foci of heterologous elements. Interestingly, patient had undergone hemithyroidectomy at the age of 9 for thyroid adenoma. As a part of pre-operative work up, computed tomography revealed an incidental finding of adrenal adenoma but overnight dexamethasone suppression test was negative. There have been reports of association of thyroid conditions with SLCT but here we are reporting association of two endocrine glands (thyroid and adrenal) in the same patient

Laparoscopic evaluation of tubal factor in cases of infertility

Background: Tubal factor infertility accounts for approximately 25-35% of cases of female infertility. The evaluation of the fallopian tube is necessary to determine the management plan for infertility. Tubal patency can be diagnosed by hysterosalpingography (HSG) or laparoscopy with chromopertubation. The aim of this study was to determine the role of laparoscopy in the evaluation of tubal factor in infertile women.Methods: Fifty women presenting with complaints of primary and secondary infertility were investigated for tubal disease by laparoscopy at K. S. Hegde Charitable Hospital, Mangalore, from January 2007 to July 2008. Tubal patency was tested by chromopertubation using Methylene blue dye. Results: Thirty four (68%) patients were in primary infertility group while 16 (32%) patients were in secondary infertility group. 88% women were in the age group of 21 to 35 years. In 64% of women, the duration of infertility was between 1 to 5 years whereas 32% cases had been infertile for 6 to 10 years. Tubal pathology was detected in 64.7% cases of primary infertility and 68.7% cases of secondary infertility. Bilateral tubal occlusion was found in 8% and unilateral occlusion in 28% cases.Conclusion: Laparoscopy is an effective diagnostic tool for evaluation of tubal pathology. Laparoscopy and chromopertubation test should be recommended as a first step in the investigation of infertile women with tubal factor

Primary tubal choriocarcinoma

Choriocarcinoma is extremely aggressive form of gestational trophoblastic disease. It occurs due to neoplastic changes in the chorionic villi. The most common site of origin is uterus but rarely can occur in tube, cervix or ovary. Tubal choriocarcinoma may develop either by malignant transformation of a tubal pregnancy or can arise denovo without an ectopic pregnancy. The reported incidence of tubal choriocarcinoma is approximately 1.5/1,000,000 births. Here, we report a case in which salphingectomy was done thinking it was an acute ectopic pregnancy, but histopathological examination showed tubal choriocarcinoma. This tubal choriocarcinoma occurred denovo and was not secondary to an ectopic pregnancy. Patient did not need adjuvant chemotherapy as it was detected early and is being followed up by β-hcg monitoring

Study of clinical characteristics of women with polycystic ovarian syndrome

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrinal disorders of the reproductive age group causing anovulation, infertility incidence being 8.7-17.8%. It is associated with obesity, insulin resistance, dyslipidaemia and metabolic syndrome. This study was aimed to study the different clinical characteristics of women diagnosed with PCOS, attending a tertiary care hospital outpatient department.Methods: This was a hospital-based cross-sectional observational study of 200 patients with PCOS meeting the revised Rotterdam criteria from January 2018-June 2019 excluding pregnant and women with other systemic disorders. A detailed history and examination done, data collected regarding menstrual complaints, features of hyperandrogenism, hirsutism, acne, oily skin and Acanthosis Nigricans (AN) was documented. All data were statistically analyzed and compared using the chi-square or fissures’ exact test. p-value <0.05 considered significant.Results: A total of 200 patients with PCOS were included in the study, of which 41% were obese, 18% lean. The mean age was 24.44±5.62 years. Menstrual complaints were present in 88% -oligomenorrhea (49%) being the most common. 59% had hirsutism,38% of severe grade. Acanthosis nigricans was present in 33% of the patients. Correlation between hirsutism and alopecia, waist to hip ratio (WHR); acanthosis and WHR were statistically significant.Conclusions: PCOS is an ill-defined symptom complex where ethnicity plays a vital role, hence creating a greater need to know the characteristics of the syndrome in different populations and ethnicity. All women presenting with oligomenorrhea or other menstrual complaint should be investigated for PCOS and treated accordingly. The syndrome usually occurs with multiple characters. Though obesity is common in PCOS, non-obese are also at risk. The prevalence of AN and Hirsutism in PCOS were comparable. This mandates a need to increase awareness regarding the syndrome in the general population

Discoid lupus erythematosus with epithelial dysplasia: a case report

Lupus erythematosus is a classic example of an immunologically mediated condition and is one of the most common of the so called “collagen vascular” or connective tissue diseases. Lupus erythematosus was first described by Biett in 1828 and Kaposi in 1872. Development of squamous cell carcinoma (SCC) can occur in DLE, with about 20 cases reported in the world literature to-date, which led the World Health Organization (WHO) to classify DLE as one of the precancerous conditions. Thus malignant changes in such a condition must be given utmost importance. This article focuses on a rare case of DLE with epithelial dysplasia

Awareness of consequences of obesity on reproductive health problems among women in an urban area in South India

Background: Obesity is a well-known risk factor for number of non-communicable diseases. There is paucity of data however with regard to awareness of its consequences on reproductive health hazards.Methods: Data was collected from 208 women aged ≥18 years from households chosen by systematic random sampling in an urban area.Results: The mean age of participants was 41.4±14.2 years. Majority of them completed their graduation [109(52.4%)] and were housewives [80(38.5%)]. Most of them were married [167(80.3%)]. Out of 208 study participants, 166(79.8%) knew that obesity adversely affects reproductive health causing problems like PIH [156(75.0%)], GDM [150(72.1%)], menstrual irregularities [130(62.5%)], infertility [117(56.2%)], decreased efficacy of hormonal contraception [84(40.4%)], premature delivery [67(32.2%)], miscarriages [66(31.7%)] and fetal malformations [55(26.4%)] during pregnancy. Difficulties during delivery [137(65.9%)], higher chances of caesarean section [130(62.4%)], infections [36(17.3%)] and PPH [33(15.9%)] in the intra and post natal period were also known to participants. Majority of women [158(76%)] had average awareness level regarding consequences of obesity on their reproductive health. Only 21(10.1%) had good awareness. Source of information among majority of participants was media [116(55.8%)]. Good awareness level was significantly more among those aged ≤ 25 years (p=0.03), with higher level of education (p=0.038), nulligravida (p=0.037) and professionals (p=0.02).Conclusions: Awareness generation on consequences of obesity on reproductive health is required to bring about behavioral change regarding obesity prevention among women in the setting.

Appearance of L90I and N205S Mutations in Effector Domain of NS1 Gene of pdm (09) H1N1 Virus from India during 2009–2013

In the present study, full length sequencing of NS gene was done in 91 samples which were obtained from patients over the time period of five years from 2009 to 2013. The sequencing of NS gene was undertaken in order to determine the changes/mutations taking place in the NS gene of A H1N1 pdm (09) since its emergence in 2009. Analysis has shown that the majority of samples belong to New York (G1 type) strain with valine at position 123. Effector domain of NS1 protein displays the appearance of three mutations L90I, I123V, and N205S in almost all the samples from 2010 onwards. Phylogenetic analysis of available NS1 sequences from India has grouped all the sequences into four clusters with mean genetic distance ranging from 12% to 24% between the clusters. Variability in length of NS1 protein was seen in sequences from these clusters, 230-amino-acid-residue NS1 for all strains from year 2007 to 2008 and for 21 strains from year 2009 and 219-residue products for 37 strains from year 2009 and all strains from year 2010 to 2013. Mutations like K62R, K131Q, L147R, and A202P were observed for the first time in NS1 protein and their function remains to be determined

The integration of palliative care with oncology: the path ahead.

The delivery of comprehensive cancer care within a progressively intricate healthcare environment requires oncology providers to become well-versed in the integration of palliative care (PC). Moreover, as healthcare professionals are urged to prioritize the individual preferences of patients and their families who confront life-limiting illnesses, it has become evident that oncology patients and their families have identified their psychosocial care needs as multifaceted and distinct, calling for specialized attention from care providers. Nevertheless, this is a skill that can be acquired through learning and practice. The landscape of PC is rapidly changing, with paradigm shifting studies highlighting the importance of early concurrent palliative and oncology inpatient and outpatient care for those with new advanced cancer diagnosis. Early concurrent care can notably improve quality of life (QoL), symptom control, patient and caregiver satisfaction, reduce costs and even improve survival. There is no longer a question of if PC should be offered, but instead when referral should be completed, what is the optimal model for service delivery and what barriers are present to achieve concurrent care. Conceptual models have been identified for optimal integrated palliative and oncology care delivery. In order to provide the best integrated care however, multiple obstacles need to be overcome. This narrative review discusses the importance of early integrated oncology and PC for patients with advanced cancer diagnosis, as well as the barriers to the integration of these specialties and potential models for delivery

Conventional and Molecular Breeding Approaches for Biofortification of Pearl Millet

Pearl millet [Pennisetum glaucum (L.) R. Br.] is an essential diet of more than 90 million people in the semi-arid tropics of the world where droughts and low fertility of soils cause frequent failures of other crops. It is an important nutri-rich grain cereal in the drier regions of the world grown on 26 mha by millions of farmers (IFAD 1999; Yadav and Rai 2013). This makes pearl millet the sixth most important crop in the world and fourth most important food crop of the India, next to rice, wheat, and maize with annual cultivation over an area of ~8 mha. Pearl millet is also primary food crop in sub-Saharan Africa and is grown on 15 mha (Yadav and Rai 2013). The significant increase in productivity of pearl millet in India is attributed to development and adoption of hybrids of early to medium duration maturity. More than 120 diverse hybrids/varieties have been released till date for various production environments. The heterosis breeding and improved crop management technologies increased productivity substantially achieving higher increased production of 9.80 mt in 2016–2017 from 2.60 mt in 1950–1951 in spite of declined of area under the crop by 20–30% over last two decades (Yadav et al. 2012)