Urogenital myiasis – An atypical presentation

The infestation of the human body by maggots has been reported worldwide and occurs most commonly in people of lower socioeconomic status and poor personal hygiene. Urogenital is the rarest site of myiasis presentations. Here we report the case of a 20-year-old, sexually inactive female student who presented with a necrotic growth in the paraurethral region infested with numerous maggots. The lesion involved the urethra and the bladder base. She was treated with debridement and bladder irrigation. The cystoscopy and local examination performed 2 weeks after admission, confirmed the complete healing of the urogenital lesion. Managing this patient’s unique challenge was to assess the extent of the involvement and removal of all maggots from the deepest wound portion. The female internal and external urogenital myiasis is a very occasional and under-reported health hazard. Reporting such cases increases the public and physician awareness about the mode of presentation, right diagnosis, and available treatment options

Comparison of intrauterine insemination and timed intercourse following controlled ovarian hyperstimulation in unexplained infertility: a randomized controlled trial

Background: Being a diagnosis of exclusion the treatment options of unexplained infertility are often empiric. There is significant dilemma regarding the superiority of one over another. Despite increasing use of intrauterine insemination (IUI) in adjunct to controlled ovarian hyperstimulation (COH) there is scarcity of randomized controlled trials (RCT) from developing countries. Objective was to compare IUI and timed intercourse (TI) in super ovulated cycles among couples with unexplained infertility over one year.Methods: In this prospective randomized controlled trial total 85 patients were randomly assigned into group 1 (COH with IUI, N= 44) and group 2 (COH with TI, N=41). Patients underwent COH using sequential Clomiphene Citrate and injection human menopausal gonadotrophin followed by IUI in group 1 and timed intercourse in group 2. Either protocol was repeated for three consecutive cycles. Finally, both groups were compared for clinical pregnancy rate, adverse effects and acceptability of the treatment process and outcome. Comparison was done by Student’s unpaired t test for continuous and 2-tailed chi square test for categorical variables.Results: Clinical pregnancy rates following COH/IUI and COH/TI were 13.64% and 19.51% respectively. There was observable difference in the acceptability of the outcome (38.64% in IUI and 56.09% in TI group). All the results including complications and side effect rates were statistically insignificant.Conclusions: Present study failed to show any improvement of pregnancy rates following addition of IUI over TI and it raised the probability that the outcome of the procedure may not be well accepted

Primary pelvic hydatid cyst in a postmenopausal female: a surgical challenge

Primary pelvic hydatid cysts are a rare entity and are often overlooked as a differential diagnosis of a pelvic-space-occupying lesion particularly in non-endemic regions. Unpreparedness and a hasty decision on the surgical approach may end in life-threatening complications and systemic dissemination of the disease. We report the case of a 55-year-old postmenopausal woman with a history of two previous unsuccessful surgeries to remove pelvic cystic lesions due to dense adhesions between the surrounding gut wall, bladder, and the cyst wall. Clinical and imaging findings failed to diagnose the nature of the cysts, and a laparotomy was contemplated. On the third surgical attempt, the clinical suspicion was considered and by meticulous dissection the cysts were removed thoroughly without undue complications. In the postoperative follow-up period there was no sign of disease recurrence or disseminatio

Projected climate change impacts on Indiana’s Energy demand and supply

This paper estimates changes in future energy demand and supply for Indiana due to projected climate change impacts. We first estimate demand changes under both the business-as-usual emissions scenario (RCP 8.5) and a scenario based on reduced emissions consistent with a 2-degree increase in global mean temperature (RCP 4.5), on both a statewide basis and for major urban areas. We then use our adjusted statewide energy demand projections as an input to a comprehensive model of Indiana’s energy system, to project expected changes in the state’s energy supply under both scenarios. Finally, we consider the potential impacts of two policy scenarios—a carbon pricing scheme and a renewable energy investment tax credit—on emissions and future energy supply choices. Our results suggest that climate change will have a relatively modest effect on energy demand and supply in Indiana, slightly increasing commercial demand and decreasing residential demand but having little effect on energy supply choices. In addition, our results suggest the potential for policy proposals currently being adopted in other states, such as a relatively small carbon price or investment credits for renewable energy sources, to have a larger impact on the state’s future energy mix, increasing production from low or zero carbon energy sources and reducing emissions

Climate Change and Indiana’s Energy Sector: A Report from the Indiana Climate Change Impacts Assessment

Indiana’s climate and its manufacturing-heavy economy make it a prime user of energy. In fact, Indiana is the ninth-most energy intensive state per capita in the country. Nearly three-quarters of Indiana’s electricity comes from coal, and 5 percent is generated by renewable sources, though the wind energy sector is growing and coal use is declining. This energy mix makes the Hoosier State the eighth-largest emitter of climate-changing gases, at 183 million metric tons of carbon dioxide (CO2) emitted per year. As global and local climates continue to shift, it is important to know how Indiana’s future energy profile will be affected and what those changes mean for Hoosier families and businesses. This report from the Indiana Climate Change Impacts Assessment (IN CCIA) looks at projected changes to Indiana’s residential and commercial energy demands as the state warms, and to Indiana’s energy supply over the coming century

Primary pelvic hydatid cyst in a postmenopausal female: a surgical challenge

Primary pelvic hydatid cysts are a rare entity and are often overlooked as a differential diagnosis of a pelvic-space-occupying lesion particularly in non-endemic regions. Unpreparedness and a hasty decision on the surgical approach may end in life-threatening complications and systemic dissemination of the disease. We report the case of a 55-year-old postmenopausal woman with a history of two previous unsuccessful surgeries to remove pelvic cystic lesions due to dense adhesions between the surrounding gut wall, bladder, and the cyst wall. Clinical and imaging findings failed to diagnose the nature of the cysts, and a laparotomy was contemplated. On the third surgical attempt, the clinical suspicion was considered and by meticulous dissection the cysts were removed thoroughly without undue complications. In the postoperative follow-up period there was no sign of disease recurrence or disseminatio

A study to assess the level of knowledge regarding prevention and management of acute respiratory infection among mothers of children 0-5 years in selected hospital in Siliguri

Background: In developing countries like India acute respiratory infection (ARI) contributes in child mortality upto 75% and out of 10, 7 deaths are due to ARI. The knowledge of the mothers towards the disease is a significant determinant of child’s health.Methods: A descriptive cross-sectional study included 100 mothers of children 0-5 years admitted in pediatric ward and postnatal ward in selected hospital Siliguri during the year 2022 in the month of March. Data was collected using structured interview method.Results: 20% of mothers have good knowledge in prevention and 33% had good knowledge in management of ARI.Conclusions: As the leading cause of death among children, knowledge assessment about ARI among the mothers is very important, which helps for better understanding of the intensity of the problem

Testing a global standard for quantifying species recovery and assessing conservation impact.

Recognizing the imperative to evaluate species recovery and conservation impact, in 2012 the International Union for Conservation of Nature (IUCN) called for development of a "Green List of Species" (now the IUCN Green Status of Species). A draft Green Status framework for assessing species' progress toward recovery, published in 2018, proposed 2 separate but interlinked components: a standardized method (i.e., measurement against benchmarks of species' viability, functionality, and preimpact distribution) to determine current species recovery status (herein species recovery score) and application of that method to estimate past and potential future impacts of conservation based on 4 metrics (conservation legacy, conservation dependence, conservation gain, and recovery potential). We tested the framework with 181 species representing diverse taxa, life histories, biomes, and IUCN Red List categories (extinction risk). Based on the observed distribution of species' recovery scores, we propose the following species recovery categories: fully recovered, slightly depleted, moderately depleted, largely depleted, critically depleted, extinct in the wild, and indeterminate. Fifty-nine percent of tested species were considered largely or critically depleted. Although there was a negative relationship between extinction risk and species recovery score, variation was considerable. Some species in lower risk categories were assessed as farther from recovery than those at higher risk. This emphasizes that species recovery is conceptually different from extinction risk and reinforces the utility of the IUCN Green Status of Species to more fully understand species conservation status. Although extinction risk did not predict conservation legacy, conservation dependence, or conservation gain, it was positively correlated with recovery potential. Only 1.7% of tested species were categorized as zero across all 4 of these conservation impact metrics, indicating that conservation has, or will, play a role in improving or maintaining species status for the vast majority of these species. Based on our results, we devised an updated assessment framework that introduces the option of using a dynamic baseline to assess future impacts of conservation over the short term to avoid misleading results which were generated in a small number of cases, and redefines short term as 10 years to better align with conservation planning. These changes are reflected in the IUCN Green Status of Species Standard

Evaluation of the effectiveness of yoga in management of premenstrual syndrome: a systematic review and meta-analysis

Aim: The management of Premenstrual Syndrome (PMS) is still evolving due to the modest effect sizes of the available treatment modalities. Yoga as therapeutic intervention in PMS has been gathering interest amongst researchers. The current manuscript reviews the evidence surrounding yoga in PMS. Methods: This manuscript was a systematic review and meta-analysis evaluating the effectiveness of yoga on the total scores and sub-domains of PMS after studies were identified using a pre-defined selection criterion after a search in PubMed, Google Scholar, Scopus and Web of Science. Both quantitative and qualitative analysis of the accumulated data was performed. Overall, 14 studies were identified for the review, 11 of which were used for the purpose of quantitative analysis. Results: The studies were heterogenous in terms of the design, yoga regimes, nature of interventions and tools used for outcome measures. It was found that yoga was beneficial in the management of PMS. This benefit was also seen when all the sub-domains of PMS were individually examined except physical sub-domain. Conclusion: Though there were certain limitations in our review like heterogeneity in studies, possibility of publication bias and restrictive selection criterion; it supported that yoga can be beneficial in patients with PMS

Burnout among Indian Maternity Care Providers during COVID-19 Pandemic

Background: Occupational burnout among healthcare providers has been a matter of focus since many years. Burnout can involve emotional and physical exhaustion and cause reduced acknow-led¬gement of personal accomplishment. Burnout can be accentuated in times of increased stress on healthcare system, like during the current episode of COVID-19 pandemic. Maternity care providers (MCP) face unique challenge in the given context owing to longer duty hours, high exposure to emergency situations and high expectation of deliverance.Subjects and Method: An online, nationwide, invited survey was conducted involving 198 MCP (28 interns, 52 residents, 82 consultant/faculty, 36 staff nurses) who were assessed for burnout and professional fulfillment using Professional fulfillment index (PFI), for self-preparedness regarding COVID-19 using Knowledge attitude and practice (KAP) ques¬tio¬nnai¬re and for family support using another questionnaire.Results: The prevalence of burnout in MCP was 36.36%. It was significantly high among interns posted in maternity services (64.28%) and least amongst obstetrics residents (26.92%). MCP with burnout tended to have higher number of night-shifts and employ¬ment in government set-ups. Subjects with burnout also scored lower on KAP questionnaire and, professional fulfillment and worse family support.Conclusion: The prevalence of burnout in MCP was quite high, but our study could not find any significant rise during the COVID-19 pandemic. Cross-sectional design and possible selection bias were the major limitations of our study. Our study provides important clues required in the micro-planning that can help lessen the burden of burnout in MCP.Keywords: burnout, maternity care provider, obstetrics, professional fulfillment, COVID-19.Correspondence: Arghya Pal. Department of Psychiatry. All India Institute of Medical Sciences, Raebareli Email- [email protected]. Mobile: 9674417987.Journal of Maternal and Child Health (2022), 07(02): 125-137https://doi.org/10.26911/thejmch.2022.07.02.02