Contraceptive practices and awareness: a survey among nursing staff at a tertiary care hospital

Background: India is the second most populous country in the world next to China. Increasing the contraceptive awareness and practice and proper implementation of family planning services are the major tool for improving the health of the population along with stabilizing it. Knowledge and contraceptive practice in the Nursing personnel can positively or negatively influence the population coming in contact with them. Objective of this study was to investigate the knowledge and practice of contraceptive methods among the nursing staff at a tertiary care set up.Methods: Tertiary care set up, cross sectional study. This was a cross sectional study conducted over a period of three months. Fifty staff nurses under the age of 49 years were interviewed through a pre-designed questionnaire regarding knowledge and use of contraceptive methods.Results: Contraception was practiced in 88 percent of the staff nurses. Barrier method of contraception was the most commonly used form of contraception. Permanent method of contraception was opted in 14 percent of cases. Fifty-seven percent of the females were aware of emergency contraception. Twenty-eight percent of females had used emergency contraception in the past.Conclusions: A high percentage of nursing staff was practicing some form of contraception; however, the use of permanent methods and hormonal methods remains low. Only half of study population was aware of post coital methods of contraception with only 28 percent having used it in the past

True broad ligament fibroid mimicking ovarian mass in a postmenopausal woman

Fibroids are benign smooth muscle tumors. Large fibroids are known to arise from the uterus, but occasionally from the broad ligament.  Here, we report a case of true broad ligament fibroid which is rare and difficult to diagnose in a 57 year old postmenopausal women with a large mass of 24 weeks size gravid uterus. Patient presented with pain lower abdomen and mass in abdomen with no other co-morbidity. This broad ligament fibroid was mimicking as ovarian tumor on ultrasonography and MRI as left ovary was not visualised separately, thus leading to diagnostic dilemma of ovarian malignancy. Mass resection with total abdominal hysterectomy and bilateral salpingo-oopherectomy was performed. No local or distant metastasis observed, and Histopathology showed true broad ligament fibroid of left side weighing 3.57 kilograms

Evaluation of antihyperlipidemic and antioxidant activity of Rubia Cordifolia Linn.

Hyperlipidemia is major problem among population those, who have sedentary life style. The effects of ethanolic and aqueous root extract of Rubiacordifoliain experimentally induced hyperlipidemic rats were investigated. 42 wistar rats of both sexes were used for the study. The animals were completely randomized into seven groups comprising 6 animals each. The groups were treated as follows: Group I: normal diet (ND); Group II: HFD ( Vanaspati ghee + coconut oil mixture in ratio of 3:2 at 10 ml/kg/day); Group III: HFD + Atorvastatin (10 mg/kg/day); Group IV: HFD+ ethanolic extract of roots of Rubia cordifolia low dose(200 mg/kg/day); Group V: HFD + ethanolic extract of roots of Rubia cordifolia high dose (400 mg/kg/day); Group VI: HFD + aqueous extract of roots of Rubia cordifolia low dose (200 mg/kg/day); Group VII: HFD + aqueous extract of roots of Rubia cordifolia high dose (400 mg/kg/day). Hypercholesterolemia was induced by feeding the animals with high fat diet for 21 days before administration of the extract. After 21thday of feeding, administration of extract lasted for 14 days. Preliminary phytochemical screening revealed that the ethanolic and aqueous root extract of Rubia cordifolia contains glycosides, triterpenoids, saponins, alkaloids and flavonoids. Overall, findings from the present study suggest that the antihyperlipidemic activity observed with Atorvastatin (10mg/kg oral) and the ethanolic extracts of Rubia cordifolia (400mg/kg) showed better activity thanaqueous extracts of Rubia cordifolia (200mg/kg). Keywords: Rubia cordifolia, body weight, high fat diet, serum lipid, anti-hyperlipidemic activity

Comparative Study of the Oxidation Products of Dimethylglyoxime in Conventional and Microwave Heating Conditions

Abstract: Microwave has proved to be a convenient tool in the hands of chemists for organic synthetic processes in the recent past. In the present work, the products obtained by the oxidation of dimethylglyoxime (DmgH 2 ) in tetrahydrofuran (THF) by ditertiary butyl chromate (TBC) in conventional and microwave dielectric heating conditions are studied. The analysis of the compounds was done by chemical as well as instrumental methods including FTIR and DTA/TGA mass loss pattern. The results clearly indicate that the reactions are much efficient, less energy and time consuming in case of microwave dielectric heating as compared to those in conventional methods

Mode of Mechanical Ventilation in a Case of Venolymphatic Malformation: Spontaneous-Saves, Positive-Precludes

Mediastinal venolymphatic malformations (VLM) are rare tumours, with very few reported cases in the literature. Arising often from the anterior mediastinum, VLM manifests symptoms based on invaded surrounding structures. Masses from the anterior and superior mediastinum pose an anaesthetic challenge for airway and hemodynamic management. A 7-month-old male child presented with a progressively growing mass over the left anterior chest wall for one month, about 4x4 cm, with diffuse margins and now expanded to involve the root of the neck and into the axilla. The patient was free from any apparent systemic illness. The breathing difficulty worsened in the past week with noisy respiration associated with feeding difficulty and hence sought medical admission to the paediatrics emergency unit. In conclusion, such huge mediastinal masses are managed better under spontaneous ventilation with an adequate surgical depth of anaesthesia to maintain appropriate respiratory compliance and necessitate lower peak inspiratory pressure. Given rare cases reported in the literature, similar topics would help choose the modus of ventilation and their safe management

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Concurrence of glucose-6-phosphate dehydrogenase deficiency in pregnancy

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an inherited X-linked disorder affecting red cell function and presenting as haemolytic anaemia or crisis in apparently normal population. Pregnancy is a special metabolic condition which may be equally affected with G6PD deficiency. Chronic anaemia of pregnancy may be complicated by haemolysis due to G6PD deficiency by triggering factors often observed in non-pregnant. Two cases of G6PD deficiency complicating pregnancy are being described. One of the women presented with severe anaemia triggered by a sulfa drug while other presented with jaundice precipitated by acute urinary tract infection. A prompt management led to successful outcome in both the woman. To the best of our knowledge, this is the first report of acute haemolytic crisis due to G6PD deficiency triggered by sulphamethoxazole in pregnancy, from this part of the world

Prediction of early pregnancy failure by use of first trimester ultrasound screening

Background: Spontaneous miscarriage is defined as an involuntary termination of pregnancy before 20th week of gestation or spontaneous expulsion of fetus below a fetal weight of 500 gm. The introduction of ultrasound into the obstetrical practice has been extremely useful in providing better understanding of the etiology of the first trimester spontaneous abortion and a basis for its clinical classification and management. The aims and objective of this study is to assess the early pregnancy developmental changes in first trimester ultrasound screening, identify abnormal ultrasound parameters and correlate the ultrasonic findings with the clinical outcomes and also to analyze the success of conservative management on patients.Methods: The study included 150 patients attending OPD/emergency within 5-12 weeks of gestation fulfilling the exclusion and inclusion criteria.Results: The abortion rate in our study was 16%. Seventy two percent of abortion occurred at 8-12 weeks of gestation. Threatened abortion was noted in 10% of the patients. Sixteen percent of patients had abnormal USG findings in terms of large yolk sac, abnormal mean sac diameter, crown rump length, embryonic bradycardia, increased resistive index and intrauterine hematoma.Conclusions: This study emphasizes the role of ultrasound in prediction of early pregnancy failure in first trimester. It also stresses on the importance of learning obstetric ultrasound and performing obstetric practice in the community with precision and perfection

A Study to Assess the Knowledge Regarding Prevention of Hospital Acquired Infections among the Nursing Students of a Selected Nursing Institution, Kolkata

By implementing strategies like hand hygiene, maintaining a secure and hygienic healthcare environment, and epidemiological surveillance, healthcare-associated illnesses can be stopped from spreading. The goal of the current descriptive study on Peerless Institute of Nursing is to evaluate their knowledge on how to prevent hospital acquired infections. Eighty nursing students are selected using a convenient sampling method. Data was gathered by a survey using a self-created, validated questionnaire. The majority of nursing students (85%) have a mediocre understanding of how to prevent hospital acquired infections. Their degree of awareness on the prevention of hospital acquired infections was unaffected by demographic factors. To increase their level of expertise, educational interventions through information modules were offere

Risk of Developing Antimicrobial Resistant Listeria monocytogenes in India: A Short Narrative Review

Background and Objective: Rampant application of antimicrobial drugs in food sectors triggered the development of resistance within the microorganisms in the surrounding environment. Due to the reduced susceptibility towards existing drugs, these microo-rganisms have an increased survival rate when treated. The emergence of this complication in the common food-borne pathogens is worrisome. Several antimicrobial-resistant variants of known infectious bacteria have been discovered. Listeria monocytogenes is one among those 'superbugs' bringing such public health challenges to be tackled. This article aims to review India's current situation and stance regarding the progressive issue of antimicrobial resistance and listeriosis. Results and Conclusion: The issue of antimicrobial resistance has been recognized at all food industry and health care domain levels. Solutions are constantly being made to combat the obstacle, but the antibiotic resistance crisis does not seem to retard. Despite the awareness, regulations, and restraints implemented across the globe, researches hint towards rising antimicrobial usage and the ensued more threatening infections. India's step towards curbing antimicrobial resistance is at par with other global policies and intends to lower the resistance development rate among all pathogens. Till now, Indian authorities and the public have shown insouciance towards listeriosis. There are no special rules targeting Listeria monocytogenes in India, as opposed to stringent regulations in many western countries. The Indian government and all associated authorities must study and develop plans to establish standards and statutes to control listeriosis. Above all, set up a surveillance system to monitor the causes of food-related illnesses across the country. Conflict of interest: The authors declare no conflict of interest