Comparison of centchroman and PPIUCD in terms of efficacy, safety and continuation rate in immediate postpartum period

Background: Study was done to assess the efficacy, safety and continuation rate of Centchroman and IUCD administered in immediate postpartum period (within 48 hours).Methods: An interventional study was conducted in Obstetrics and Gynecology department of Safdarjung Hospital, New Delhi, at a tertiary care hospital after approval from ethical committee. 280 women were enrolled in the study and divided into 2 groups centchroman group and PPIUCD group, 140 in each group after excluding the exclusion criteria and satisfying inclusion criteria. These women were followed up at 6 week, 3 month and 6 months to study efficacy, safety and continuation rate.Results: Centchroman as contraception is safe with fewer side effects, better satisfaction rate and better continuation rate in comparison to PPIUCD.Conclusions: Centchroman is a newer contraceptive which is recently added in basket of family planning in our country to give wider choices to women. It is an indigenous product developed by central drug research institute (CDRI), Lucknow available free of cost in government hospitals. Centchroman needs more popularity and education for its widespread use

A study of incidence of congenital anomalies in newborn: a hospital based study

Background: Congenital anomalies have emerged as a main cause of perinatal mortality as well as infant morbidity and mortality. The aim of this study is to determine the incidence of congenital anomalies and to study associated factors.Methods: It is an observational study conducted in the Department of Obstetrics and Gynecology of SMGS Hospital during a period of one year from October, 2012 to September, 2013. All women with anomalies proven on Ultrasonography and those having no antenatal record but after delivery/abortion, examination of newborns revealed anomalies; were included in the study.Results: The pattern of congenital anomalies included Central nervous system (49.60%), Urinary system (13.79%), musculoskeletal system (12.99%), GIT (7.16%), CVS (5.83%) etc. The overall incidence of congenital anomalies was 1.85%. Higher incidence of anomalies was found in babies of mother between 26-30 years of age (2.13%) and parity of 4 and above (3.65%). Frequency was more common in Muslims as compared to Hindus (2.8% vs 1.68%), in non-cephalic presentation as compared to cephalic presentation (10.28% versus 1.51%).Conclusion: This study stresses upon incidence of congenital anomalies as they are an important cause of perinatal mortality. To decrease the incidence of various congenital anomalies and their prevalence in the particular region, it is important that the distribution and prevalence are identified in that region and country as a whole.

EMAT Based Ultrasonic System for Determination of Thickness Variation in Metallic Samples

Thickness measurement is an important primary measurement parameter. It itself and from the various derived para-meters, provides valuable information in testing and process industries. Although numerous techniques are avail-able for thickness measurement which provide very good results for transparent material and when both sides are accessible, but these methods have limitations in case of opaque material and when only one side is accessible. A new EMAT based non contact technique is reported in this paper which is capable of measuring thickness variation even in opaque material and if only one side is accessible. Using EMAT it was possible to measure the thickness of a material in the order of a few nanometers. This was achi-evable by the facility developed at NPL, India to measure ultrasonic Time of Flight (TOF) to an accuracy of nano-seconds with deviation of 300 picoseconds. An experiment was done using EMAT to measure the variation in thickness due to stamped notch in an aluminium block having thick-ness of 25mm. EMAT system was able to measure considerable variation in the thickness due to notch. An experiment was also done on circular metallic pipe to determine the variation in inner diameter by measuring wall thickness. Excellent result was obtained with greater precision. This better precision is achieved because of Beam Width to Reflector ratio being close to unity. In case of flat plates this ratio is much greater than unity. To reduce this ratio to unity even in case of flat plates several samples were used in conjunction with EMAT and experiments were again performed on the above mentioned aluminium block to determine the variation in thickness due to notch

Predictors of oocyte yield in controlled ovarian hyperstimulation IVF/ICSI cycles: a retrospective analysis in a tertiary care centre

Background: The most important predictor of oocyte yield in ART cycles is female age, but other biochemical and ultrasonographic markers done before controlled ovarian stimulation may predict the oocyte yield in women undergoing COS in IVF cycles.Methods: The main aim of the study was to evaluate ovarian reserve markers before COS which can help to individualise treatment protocols to achieve optimal response and minimise risk of complications. It is retrospective observational study, 1924 women undergoing COS in IVF/ICSI cycles in tertiary care centre in India, from January 2010 to June 2017 were included. Results: Univariate analysis showed that age, D2FSH, AMH, D2AFC and E2 on the day of trigger were significant predictors of oocyte yield (p7.82 IU/ml was predictor of poor response (sensitivity 78.13%, specificity 79.53%).Conclusions: A combination of predictors demonstrated superior ability of predicting oocyte yield after controlled ovarian stimulation than compared with any single endocrine marker. D2 FSH though thought to be obsolete, but we found significant predictive ability in terms of oocyte yield in the Indian population

Outcomes and Recommendations of an Indian Expert Panel for Improved Practice in Controlled Ovarian Stimulation for Assisted Reproductive Technology

. Purpose. To improve success of in vitro fertilization (IVF), assisted reproductive technology (ART) experts addressed four questions. What is optimum oocytes number leading to highest live birth rate (LBR)? Are cohort size and embryo quality correlated? Does gonadotropin type affect oocyte yield? Should "freeze-all" policy be adopted in cycles with progesterone >1.5 ng/mL on day of human chorionic gonadotropin (hCG) administration? Methods. Electronic database search included ten studies on which panel gave opinions for improving current practice in controlled ovarian stimulation for ART. Results. Strong association existed between retrieved oocytes number (RON) and LBRs. RON impacted likelihood of ovarian hyperstimulation syndrome (OHSS). Embryo euploidy decreased with age, not with cohort size. Progesterone > 1.5 ng/dL did not impair cycle outcomes in patients with high cohorts and showed disparate results on day of hCG administration. Conclusions. Ovarian stimulation should be designed to retrieve 10-15 oocytes/treatment. Accurate dosage, gonadotropin type, should be selected as per prediction markers of ovarian response. Gonadotropin-releasing hormone (GnRH) antagonist based protocols are advised to avoid OHSS. Cumulative pregnancy rate was most relevant pregnancy endpoint in ART. Cycles with serum progesterone ≥1.5 ng/dL on day of hCG administration should not adopt "freeze-all" policy. Further research is needed due to lack of data availability on progesterone threshold or index

Developing Standard Treatment Workflows—way to universal healthcare in India

Primary healthcare caters to nearly 70% of the population in India and provides treatment for approximately 80–90% of common conditions. To achieve universal health coverage (UHC), the Indian healthcare system is gearing up by initiating several schemes such as National Health Protection Scheme, Ayushman Bharat, Nutrition Supplementation Schemes, and Inderdhanush Schemes. The healthcare delivery system is facing challenges such as irrational use of medicines, over- and under-diagnosis, high out-of-pocket expenditure, lack of targeted attention to preventive and promotive health services, and poor referral mechanisms. Healthcare providers are unable to keep pace with the volume of growing new scientific evidence and rising healthcare costs as the literature is not published at the same pace. In addition, there is a lack of common standard treatment guidelines, workflows, and reference manuals from the Government of India. Indian Council of Medical Research in collaboration with the National Health Authority, Govt. of India, and the WHO India country office has developed Standard Treatment Workflows (STWs) with the objective to be utilized at various levels of healthcare starting from primary to tertiary level care. A systematic approach was adopted to formulate the STWs. An advisory committee was constituted for planning and oversight of the process. Specialty experts' group for each specialty comprised of clinicians working at government and private medical colleges and hospitals. The expert groups prioritized the topics through extensive literature searches and meeting with different stakeholders. Then, the contents of each STW were finalized in the form of single-pager infographics. These STWs were further reviewed by an editorial committee before publication. Presently, 125 STWs pertaining to 23 specialties have been developed. It needs to be ensured that STWs are implemented effectively at all levels and ensure quality healthcare at an affordable cost as part of UHC

Nations within a nation: variations in epidemiological transition across the states of India, 1990–2016 in the Global Burden of Disease Study

18% of the world's population lives in India, and many states of India have populations similar to those of large countries. Action to effectively improve population health in India requires availability of reliable and comprehensive state-level estimates of disease burden and risk factors over time. Such comprehensive estimates have not been available so far for all major diseases and risk factors. Thus, we aimed to estimate the disease burden and risk factors in every state of India as part of the Global Burden of Disease (GBD) Study 2016

SARS-CoV-2 B.1.617.2 Delta variant replication and immune evasion

Abstract: The B.1.617.2 (Delta) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in the state of Maharashtra in late 2020 and spread throughout India, outcompeting pre-existing lineages including B.1.617.1 (Kappa) and B.1.1.7 (Alpha)1. In vitro, B.1.617.2 is sixfold less sensitive to serum neutralizing antibodies from recovered individuals, and eightfold less sensitive to vaccine-elicited antibodies, compared with wild-type Wuhan-1 bearing D614G. Serum neutralizing titres against B.1.617.2 were lower in ChAdOx1 vaccinees than in BNT162b2 vaccinees. B.1.617.2 spike pseudotyped viruses exhibited compromised sensitivity to monoclonal antibodies to the receptor-binding domain and the amino-terminal domain. B.1.617.2 demonstrated higher replication efficiency than B.1.1.7 in both airway organoid and human airway epithelial systems, associated with B.1.617.2 spike being in a predominantly cleaved state compared with B.1.1.7 spike. The B.1.617.2 spike protein was able to mediate highly efficient syncytium formation that was less sensitive to inhibition by neutralizing antibody, compared with that of wild-type spike. We also observed that B.1.617.2 had higher replication and spike-mediated entry than B.1.617.1, potentially explaining the B.1.617.2 dominance. In an analysis of more than 130 SARS-CoV-2-infected health care workers across three centres in India during a period of mixed lineage circulation, we observed reduced ChAdOx1 vaccine effectiveness against B.1.617.2 relative to non-B.1.617.2, with the caveat of possible residual confounding. Compromised vaccine efficacy against the highly fit and immune-evasive B.1.617.2 Delta variant warrants continued infection control measures in the post-vaccination era