Minimally invasive surgical approach to retrieve migrated intrauterine contraceptive device

Background: To present experience with clinical presentation, diagnosis and minimally invasive removal of migrated intrauterine contraceptive device (IUD).Methods: A total of 6 patients were included in retrospective study. Diagnosis was based on clinical presentation, TVS and Abdominopelvic X- ray. Minimally invasive approach was utilized to remove migrated IUD.Results: The mean (range) age of the patient was 36.6 (26-55) years. The mean (range) of parity was 3.5 (2-6). The mean (range) duration of IUD use was 8.1 (3-25) years. Five patients had TCu380A IUD. One patient had Lippes loop type of IUD. Three patients underwent laparoscopy, two had hysteroscopy and one had cystoscopy, for removal of IUD. The mean (range) operative time was 40.8 (18-76) mins. No anesthesia or surgery related complications were observed intraoperatively. The mean (range) duration of hospital stay was 34 (24-48) hours. The postoperative course was uneventful and all the patients were followed for 3-6 months period of time with no complaints.Conclusion: Removal of migrated IUDs is recommended in symptomatic and asymptomatic patients using minimally invasive approach.

Continuous Density Hidden Markov Model for Hindi Speech Recognition

State of the art automatic speech recognitionsystem uses Mel frequency cepstral coefficients as featureextractor along with Gaussian mixture model for acousticmodeling but there is no standard value to assign number ofmixture component in speech recognition process.Currentchoice of mixture component is arbitrary with littlejustification. Also the standard set for European languagescan not be used in Hindi speech recognition due to mismatchin database size of the languages.Parameter estimation withtoo many or few component may inappropriately estimatethe mixture model. Therefore, number of mixture isimportant for initial estimation of expectation maximizationprocess. In this research work, the authors estimate numberof Gaussian mixture component for Hindi database basedupon the size of vocabulary.Mel frequency cepstral featureand perceptual linear predictive feature along with itsextended variations with delta-delta-delta feature have beenused to evaluate this number based on optimal recognitionscore of the system . Comparitive analysis of recognitionperformance for both the feature extraction methods onmedium size Hindi database is also presented in thispaper.HLDA has been used as feature reduction techniqueand also its impact on the recognition score has beenhighlighted

Glyceryl trinitrate patch versus intravenous ritodrine for tocolysis in pre-term labour

Background: Preterm birth is the single most important determinant of adverse infant outcome. Tocolytic therapy has shown beneficial effect in certain selected patients. The present study was conducted to evaluate the efficacy, maternal and fetal outcome with the use of Transdermal Glyceryl nitrate patches versus Intravenous Ritodrine tocolytic agents.Methods: Study included 50 patients of gestation 24-34 weeks in preterm labor. Group I: Glyceryl trinitrate patch releasing 10mg/24 hours (0.4mg/ hour) was applied transdermally and repeated after 2 hours if no reduction in contractions was seen. Group II: Intravenous Ritodrine infusion prepared by adding 50mg to a bottle of 5% dextrose or ringer lactate solution and infusion started at an initial rate of 0.05mg/min which was increased by 50 micrograms per minute every 15 min until contractions ceased.Results: 22 patients in group I treated with GTN and 19 patients in group II treated with Ritodrine achieved successful tocolysis. The difference was statistically insignificant (P value - 0.23). Mean Gestational age at delivery was 34.97 in GTN Group as compared to 33.24 weeks in Ritodrine Group ; difference which is statistically significant (P = 0.0004). Very few adverse effects were observed in the GTN Group. Comparatively, the Ritodrine Group had severe adverse effects requiring discontinuation of therapy. Fetal outcome was satisfactory in both groups.Conclusions: The effects of Glyceryl trinitrate and Ritodrine in the treatment of preterm labor were essentially similar. Glyceryl trinitrate is associated with lesser maternal and fetal adverse effects and appears to be a very viable, inexpensive and safer alternative to Ritodrine

A rare case of subacute uterine inversion managed by Haultain’s repair

Uterine inversion is a rare but serious obstetrical emergency which usually occurs due to mismanagement of third stage of labour. If the condition is promptly recognized before incarceration, manual repositioning of the uterus may be successful. However in neglected uterine inversion, incarceration may occur due to constriction ring formation, necessitating surgical intervention. We present a case of neglected uterine inversion managed by Haultain`s repair

Standard Splenic Volume Estimation in North Indian Adult Population: Using 3D Reconstruction of Abdominal CT Scan Images

A prospective study was carried out to establish normative data for splenic dimensions in North Indian population and their correlation with physical standard on abdominal CT of 21 patients aged between 20 and 70 years having no splenic disorders. Splenic volume was measured by two methods—volume and surface rendering technique of Able 3D doctor software and prolate ellipsoid formula. Volumes measured by both the techniques were correlated with their physical standards. Mean splenic volume was 161.57 ± 90.2 cm3 and range 45.7–271.46 cm3. The volume of spleen had linear correlation with body height (r = 0.512, P < .05). Splenic volume (cm3) = 7 × height (cm) − 961 can be used to generate normal standard volume of spleen as a function of body height in North Indian population (with 95% confidence interval). This formula can be used to objectively measure the size of the spleen in adults who have clinically suspected splenomegaly

Marriage and motherhood: An exploratory study of the social and reproductive health status of married young women in Gujarat and West Bengal

In India, sexual activity and childbearing among young women take place overwhelmingly within the context of marriage. Despite the high prevalence of early marriage, little is known about the lives of married young women, and few interventions have focused on supporting this group. In response, the Population Council, in partnership with Child In Need Institute in Kolkata (West Bengal) and Deepak Charitable Trust in Vadodara (Gujarat), initiated the First-Time Parents project aimed at developing and testing an integrated package of health and social interventions that would improve married young women’s reproductive and sexual health knowledge and practices, and expand their ability to act in their own interests. As part of a quasi-experimental study to test the effects of the project, the Institute for Population Sciences and the Council conducted a baseline survey in selected rural sites from late 2002 to early 2003. All women meeting the selection criteria—i.e., newly married, first-time pregnant or first-time mothers, regardless of age—in the intervention and control villages were invited to be interviewed. This report presents findings from the baseline survey

Identification of risk factors for malaria control by focused interventions in Ranchi district, Jharkhand, India

Background & objectives: Ranchi, the capital of Jharkhand state is endemic for malaria, particularly the Bundu Primary Health Centre (PHC) is the worst affected. Therefore, a study was initiated during 2009 using remote sensing (RS) and geographical information system (GIS) to identify risk factors responsible for high endemicity in this PHC. Methods: Bundu and Angara in Ranchi district were identified as high and low malaria endemic PHCs based on epidemiological data of three years (2007–09). The habitation, streams, other water body, landform, PHC and village boundary thematic maps were prepared using IRS-P6/LISS III-IV imageries and macro level breeding sites were identified. Digital elevation model (DEM) of the PHCs was generated using Cartosat Stereo Pair images and from DEM, slope map was derived to calculate flat area. From slope, aspect map was derived to indicate direction of water flow. Length of perennial streams, area under rocky terrain and buffer zones of 250, 500 and 750 m were constructed around streams. High resolution remote sensing imageries were used to identify micro level breeding sites. Based on macro-micro breeding sites, six villages from each PHC were selected randomly having combination of different parameters representing all ecotypes. Entomological data were collected during 2010–11 in pre- and post-monsoon seasons following standard techniques and analyzed statistically. Differential analysis was attempted to comprehend socioeconomic and other determinants associated with malaria transmission. Results: The study identified eight risk factors responsible for higher malaria endemicity in Bundu in comparison to Angara PHC based on ecological, entomological, socioeconomic and other local parameters. Conclusion: Focused interventions in integrated vector management (IVM) mode are required to be carried out in the district for better management and control of disease

Deep phenotyping and genomic data from a nationally representative study on dementia in India

The Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD) is a nationally representative in-depth study of cognitive aging and dementia. We present a publicly available dataset of harmonized cognitive measures of 4,096 adults 60 years of age and older in India, collected across 18 states and union territories. Blood samples were obtained to carry out whole blood and serum-based assays. Results are included in a venous blood specimen datafile that can be linked to the Harmonized LASI-DAD dataset. A global screening array of 960 LASI-DAD respondents is also publicly available for download, in addition to neuroimaging data on 137 LASI-DAD participants. Altogether, these datasets provide comprehensive information on older adults in India that allow researchers to further understand risk factors associated with cognitive impairment and dementia.Peer reviewe