A retrospective study of post-partum intrauterine contraceptive devices in a government maternity home of Delhi

Background: Post-partum period is defined to be an ideal time for family planning counselling. Being a second largest populated country, India has a high rate of unintended pregnancy especially in post- partum women. There is a need for accessible, reliable contraception like post-partum intra uterine contraceptive device (PPIUCD) in our country. The present study is an attempt to evaluate the safety and efficacy of intra- uterine devices in post-partum women.Methods: The study population included all the women who delivered vaginally who were counselled for PPIUCD insertion in prenatal period, early labour and within 48 hours of delivery and were willing to participate in the study. Participants were interviewed prior to discharge after receiving a PPIUCD and then six, ten, fourteen weeks and 6 months or earlier when necessary. Institutional ethical approval and informed consent were taken.Results: A total of 1625 deliveries took place out of which only 888 were inserted PPIUCD. So, the total acceptance rate was 54.6%. Majority of cases were between the age group of 21-25 (46.4%) and most of them were primipara (39.8%). 34.8% came for routine follow up in OPD at 6 weeks, 14% at 6 months and 6.1% at 1 year.Conclusions: The IUCD insertion has been proved to be a safe and effective method of contraceptive with very few side effects and no major complications. To increase the knowledge and skills among health care providers, it is necessary to arrange training on PPIUCD

Acute hemorrhagic edema in a nursing infant - An unusual diagnosis

Acute hemorrhagic edema of infancy is a rare, small vessel vasculitis of young children with characteristic skin findings. We have described an 8-month-old male infant who presented with upper respiratory infection followed by acute onset of generalized swelling of both lower limbs and appearance of erythematous, purpuric, and ecchymotic lesions on the lower limbs, face, and ear lobules. There were no systemic complications and the lesions resolved completely

Retrospective study of clinical profile and management of patients with swine flu at tertiary care hospital

Background: The first isolation of a swine influenza virus from a human occurred in 1974. There are no unique clinical features that distinguish swine influenza in humans from typical influenza. Thus, clinical course and management were recorded as per a planned pro forma and analysed. This type of study has not been done previously in Himalayan region.Methods: Retrospective observational study done in a group of patients diagnosed with swine flu admitted in department of pulmonary medicine at the tertiary care hospital from November 2016 to July 2017.Results: Out of 30 patients, 53.3% were male, mean age was 48.8±17.7, history of travel or contact to infected person was only 13.3%. Most common symptom recorded was fever (83.3%), followed by dyspnoea, cough, throat pain. Most common co-morbidity was diabetes and presence were significantly associated with admission in an ICU (P<0.05). Bilateral lung infiltrate seen in 53.3% on chest X-ray. Organ involved other than respiratory were renal followed by liver involvement. 40% of patients received corticosteroid for an average of 6days, mostly given in patients with sepsis, septic shock, multi organ involvement. Out of 40%, 16.6% patient expired, 6.6% left against medical advice and 16.6% were discharged, corticosteroid doesn’t help in reducing mortality.Conclusions: A multivariate model to identify independent predictors associated with mortality in swine flu were the use of vasopressor, respiratory failure, requirement of mechanical ventilation and number of organ failure. Use of corticosteroid is controversial

Socio-demographic and Clinico-pathological Profile of Cervical Cancer Patients at a Tertiary Care Centre in New Delhi: A Five-Year Retrospective analysis

Background: Cervical cancer remains a major public health challenge in low and middle-income countries including India. However, if detected early, it is preventable and curable. Objective: The present study aimed to ascertain the sociodemographic and clinical profile of cervical cancer patients visiting a tertiary cancer center. Methodology: A retrospective study was carried out at the Delhi State Cancer Institute, New Delhi. The study population included 136 women who were diagnosed with cervical cancer. A pretested data extraction sheet was used as the study tool for collecting information from the inpatient records. Descriptive analysis and chi-square test were performed and the level of significance was set at p&lt;0.05. Results: A total of 136 cervical cancer patients with mean age of 46 ± 9.85 and mean BMI of 23.78 ± 5.03, were studied retrospectively. About 36.8% of patients were aged between 40-49 years and 57.4% were illiterate. While 40.4% of the patients belonged to FIGO stage II, 27.2% had FIGO stage III cancer. Majority (63.2%) of patients were diagnosed with squamous cell carcinoma (SCC), while the rest were adenocarcinoma (25%) and adenosquamous (11.8%). Clinical stage of cancer was found to be significantly associated with educational status (p=0.03) and dietary practices (p=.007). Conclusion: Our study found higher percentage of women with stage II and III cervical lesions and reaffirms the importance of education and healthy diet in early detection and prevention of cervical cancer. Therefore, it is suggested that accelerated population awareness and screening, incorporating digital innovations including vaccination programs are mandatory

Participation In Online Health Communities: Decoding the antecedents and outcomes

A significant number (49 %) of Indian users tend to rely on digital media to either access health-related information or use the internet as a precursor to visit a doctor [20]. According to a report by Raheja [48], "The Internet of Things” (IoT) connection has the potential to change the malfunctioning medical system into a comprehensive, effective, and individualised system. This will allow for a more proactive approach to wellness and overall health, reducing medical expenses through these inclusive practices. Online health communities in India demonstrate significant clout to transform the healthcare industry by empowering patients. They offer a platform to all key stakeholders, that are, the healthcare professionals, patients and even the caregivers alike, to come forth, share their experiences and develop remedies for various issues faced by the healthcare industry. This paper examines the antecedents involved in the empowerment of patients in Online Health Communities (OHCs) and the outcomes of this in the form of participant compliance. The research additionally examines the moderating impact of certain factors such as the patients’ e-health literacy and health locus of control (HLOC) and the physicians’ paternalism, in examining the relationship between patient empowerment and compliance. The findings of the research propose a construct or a theoretical model for the numerous factors and moderators associated with the patient’s participation in online health communities. The social support available to patients leads to more empowered patients, ultimately resulting in higher Patient compliance. Further, this patient empowerment, which comprises of sense of autonomy, competence and self-efficacy makes people more compliant. The theoretical construct between patient empowerment and patient compliance, is further moderated by the patients’ e-health literacy and health locus of control (HLOC) and the physicians’ paternalism

Leveraging the energy transition for gender-equitable growth in rural livelihoods

Agriculture in India contributes close to 20% of GDP and employs 44% of the workforce. Of these agricultural workers, 55% are women, and this percentage is likely to increase as women have fewer opportunities than men to find non-farm jobs. On top of that, women face significantly more barriers and constraints in accessing natural resources such as water and land because – despite significant legal and social efforts – the land rights of women are not widely acknowledged

Systematic Evaluation of Published Research Studies Conducted Among Medical Undergraduate Students on Learning Environment in Medical Colleges of India Using the DREEM Inventory Tool

Objective: To evaluate original studies conducted among medical undergraduate students to assess education and learning environment in India using DREEM (Dundee Ready Educational Environment Measure) tool. Material &amp; Methods: The online search engine PUBMED and Google scholar were utilized to short list original published research studies on learning environment. The eligibility criteria included: study conducted in India upon medical students using DREEM tool; information on sample size, total, and sub-domain DREEM score available. Fourteen original research publications with a total sample size of 4215 medical students were considered. Results: Total DREEM score (range, 0-200) was 119.5 that indicated that there was more positive education environment in selected medical colleges of country. The average score of different sub domains of DREEM also supported the positive environment. Sub-domain DREEM mean scores derived through this analysis was SPL-28.7 (range, 0-48); SPA-28.4 (range, 0-48); SPT-25.8 (range, 0-44); SASP-20.2 (range, 0-32); and SSSP-16.4 (range, 0-28). The scores of all the studies were in the similar range except two. Mean score of most (80%) of the items (40/50) lied between 2 and 3 (range, 0-4) indicating that these areas were ‘neither strong nor weak’ but could be ‘enhanced’. Some aspect of the learning and education environment with average score of less than 2 include inherent challenges of the extensive medical course; the teaching over-emphasizes factual learning (item-25); students are able to memorize all the matter (item-27); and rarely feel bored (item-14) require attention. However, issues like teaching is too teacher centered (item-48); the teachers are authoritarian (item-9); and the teachers get angry in class (item-39) requires sensitization and introspection by the esteem faculty members. Conclusion: Overall students perceived progressive and positive developmental milieu in the learning environment in the selected medical colleges of India

Pradhan Mantri Jan Arogya Yojana – Ayushman Bharat

Introduction: “Ayushman Bharat Initiative” also known as Pradhan Mantri Jan Arogya Yojana (PMJAY) was launched in 2018, by Government of India. The core principle of Ayushman Bharat - National health protection mission is co-operative federalism and flexibility to states. PMJAY encapsulates a progression towards promotive, preventive, palliative and rehabilitative aspects of Universal Health coverage through access of Health and Wellness Centre (HWCs) at the primary level and provisioning of financial protection for accessing curative care at the secondary and tertiary levels through engagement with both public and private sector. PMJAY covers 1350 medical packages including surgery and day care treatments, cost of medicines and diagnostics. It involved participation of centre and states, use of technology for administration of the scheme and involved participation of private sector hospitals and insurers to provide accessible and affordable healthcare by a large section of society. Aims and objectives: The objective of this review is to explore the PMJAY program and to assess how far it could achieve the goal of universal health coverage. Conclusion: It is a major step by Government of India to fulfil the goal of universal health coverage hence if implemented properly it could be a game changer

Fe(III)-Mediated Two-Fold Oxidative Coupling of Furan with Indole provides Modular Access to Bis(Indolyl)Furans - A New Class of Tetra-(hetero)arylated Furan with up to four different Substituents

Highly arylated heteroarenes constitute an intriguing class of molecular scaffolds for material science applications. Among these, tetraarylated furans have demonstrated differentiated properties as compared to other similar heterocyclic cores. Among tetraarylated furans, the synthetic complexity increases drastically with increasing number of different peripheral aryl groups. There are only a very limited number of methodologies developed to access furans with four different (hetero)aryl substituents, none of which involve oxidative coupling on furan core. Herein, we report the first methodology based on a sequential two-fold oxidative C-C coupling of furans with indoles to access bis(indolyl)furans - a new class of tetra-(hetero)arylated furans with up to four different substituents. Moreover, the reaction is mediated by inexpensive, earth-abundant FeCl3.6H2O and displays wide substrate scope and aqueous compatibility. Through the characterization of the photophysical and electrochemical properties of this novel class of furans, we present the first validation of the extensively studied aggregation-caused quenching (ACQ) property of tetraarylated furans beyond phenyls as peripheral groups