Knowledge, attitude and practices regarding reproductive health among rural and urban adolescent girls

Background: Menstruation is a biological event imbued with social, cultural and personal significance. Due to impact of social media and internet the incidence of indulging in unprotected sexual intercourse and unplanned pregnancies are rapidly increasing among teenagers. Objectives were to assess the knowledge regarding safe sex and contraceptive methods and compare the menstrual and sexual awareness among adolescent girls in rural and urban settings.Methods: The health questionnaire was prepared from WHO adolescent health manual as reference base. The adolescent survey was done.Results: In present study maximum number of girls had attained menarche between 12-15 years in both groups. The study showed lack of menstrual hygiene among rural girls in compare to urban girls where 79% girls use either sanitary pads or cotton and in comparison to urban girls, rural girls had more restrictions in going out.Conclusions: Education regarding proper physiology of menses and there should be open discussion regarding restrictions and taboos related to menses at the school level to minimise the false beliefs

Effect of Mineral Supplementation on Rumen Metabolites and Enzymes in Sheep Fed Sorghum Stover Based Diets

Supplementation of area specific mineral mixture (ASMM) containing Ca, P, Na, Cu, and Zn to producing animals showed noticeable improvement in growth, milk production and reproductive performances. However, there was paucity of information on rumen metabolites and enzymes in animals supplemented with ASMM. Therefore, the present investigation was conducted to study the effect of mineral supplementation (ASMM) on rumen metabolites and enzymes in sheep fed sorghum stover based diets

Obstetric outcome in twin pregnancies complicated with single intrauterine fetal demise

Background: It has been reported that single intrauterine fetal death in twin pregnancy occurs in 3.7-6.8% all twin pregnancies. The objective of this study was to evaluate the maternal and fetal demographic features and feto-maternal outcomes in twin pregnancies complicated with single intrauterine fetal demise and evaluation of available management guidelines.Methods: This retrospective study was conducted at obstetrics and gynecology department of SGRRIM and HS, Dehradun, Uttarakhand between January 2015 and December 2019. There was a total of 182 twin deliveries at study hospital during this period and 35 of these cases were complicated with single intrauterine fetal demise. Maternal age, parity, chorionicity of twin gestation, gestational age at single intrauterine fetal demise, gestational age at delivery, mode of delivery, birth weight, Apgar Score at birth, neonatal intensive care unit stay of newborn,  maternal fibrinogen levels during pregnancy and delivery time and associated obstetric complications were analyzed in these cases of single intrauterine fetal demise with twin gestation. All monochorionic twin pregnancies were included in the study Group A and dichorionic twin in Group B.Results: The mean age of 32 patients included in study was 29.7±4.6 years. Twenty (62.5%) of these patients were dichorionic and 12 (37.5%) of these were monochorionic twin gestation. Single intrauterine fetal demise occurred in first trimester in 8 (25%) patients, during the second trimester 20 (62.5%) and 4 (12.5%) patients had third trimester single intrauterine fetal demise. Preterm deliveries occurred in 18 (56.3%) of patients and 8 (44.4%) of patients were of monochorionic and 10 (55.6%) of dichorionic twin patients. Among thirty-two patients, 11 (34.4%) patients had caesarean delivery and 21 (65.6%) patient had vaginal birth. No maternal or fetal mortality noted and none of the patients had maternal coagulation disorder.Conclusions: This study indicates that in cases of twin pregnancies with single fetal intrauterine demise with individualized management plan at higher centre and close maternal and fetal surveillance live fetus can be saved without any maternal risk

Non-surgical management of ectopic pregnancy

Background: Ectopic pregnancy is a condition when a fertilized ovum is implanted outside the uterine cavity. It is one of the important causes of maternal mortality and morbidity in India. Treatment includes expectant management, medical management and surgical management. Expectant and medical management are the treatment of choice for hemodynamically stable patients who do not want surgical treatment and are desirous of future fertility. The aim of study was to analyse the clinical profile, regimen of medical method used and outcome of non-surgical management in patients with ectopic pregnancy.Methods: It was a retrospective observational distributive study conducted at Shri Guru Ram Rai Institute of Medical and Health Sciences from January 2015 to December 2019. There were total 182 diagnosed cases of ectopic pregnancy during this duration. Out of them, 87 patients were given non-surgical management. Data was obtained from their medical records to analyse the clinical profile, outcome of expectant and medical management and efficacy of regimen used.Results: Total 87 patient out of 182 diagnosed cases of ectopic pregnancy were studied. Out of these, 57 (65.5%) patients were in the age group of 20 to 30 years, 44 (50.6%) patients were third gravidas and 32 (36.8%) patients did not have any live issue. Thirty three (37.93%) patients had haemoglobin less than 10 gm%, 41 (47.13%) patients had one or more previous caesarean sections and 73 (83.91%) patients had tubal ectopic pregnancy. Overall success rate with non-surgical management was 94.25%.Conclusions: Our study emphasised the role of expectant and medical management in stable patients of ectopic pregnancy and recommends to use methotrexate as therapy even when initial serum β HCG levels are more than 5000 IU and haemoglobin level less than 10 gm% under close monitoring

Factors associated with induced second trimester abortion at a tertiary level hospital of Uttarakhand region: a 6-year retrospective study

Background: Despite the liberalization of the abortion services since the early 1970s in India, access to safe abortion services remains limited for the vast majority of Indian women particularly from rural areas. Second trimester abortions have different indications and associated with increased maternal morbidity and mortality as compared to the first trimester abortions.Methods: This study was a retrospective study conducted from the January 2014 to December 2019 at obstetrics and genecology department of Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India. All patients of 12 weeks to 20 weeks of confirmed gestational age were given medical method of second trimester abortion. Data was collected and analyzed regarding demographic features, gestational age, indications, and induction-abortion interval and post abortion contraceptive methods accepted by patient.Results: During this study period a total of 180 patients had second trimester abortion at study institute. Maximum number of patients 69 (38.3%) were of 25-30 years of age group and 161 (85%) patients were of Hindu religion. Major indication was failure of contraception (42.8%) and congenital anomalies in the fetus (45.6%). There was one case of failed medical abortion in which emergency hysterectomy was done for undiagnosed adherent placenta. All patients were compliant of using contraceptive methods after the abortion because of recent medical and mental stress and majority 82 (45.6%) of the patients preferred oral combined contraceptive pills.Conclusions: Apart from congenital anomalies rest all indications can be reduced if women in our country are empowered to control their fertility, get education to become more aware and provided with social security

Knowledge, attitude, and practices of nursing mothers toward breastfeeding in a tertiary care center in Navi Mumbai

Objective: Breastfeeding (BF) has been accepted as the most vital intervention for reducing infant mortality and ensuring optimal growth and development of a child. A major barrier to successful BF is inconsistency in information and improper cultural practices. To assess the knowledge, attitude, and practices toward BF among nursing mothers following up in a tertiary care center in Navi Mumbai, Maharashtra. Methods: A community-based cross-sectional study was conducted among 512 mothers in Navi Mumbai in the state of Maharashtra, India, between January 2016 and June 2016 using a pre-set questionnaire. The mothers with children under the age of 2 years were interviewed following which descriptive statistics were obtained. Results: Our study highlights the growing awareness of the advantages of BF. Of the 512 mothers enrolled in our study, 78.9% believed in exclusive BF (EBF) till 6 months while 51% actually practiced EBF. Nearly 78% mothers felt shy to feed in public places. BF was initiated <1 h of delivery in 35.9% mothers while insufficient milk was the predominant reason (41.4%) in mothers to stop BF before 2 years. Conclusion: The majority of our participants had adequate knowledge and a positive attitude toward EBF, with right posture practiced while feeding