Profile of unmet needs of family planning in an urban slum of Ganjam district, Odisha, India: a cross-sectional study

Background: Unmet need for family planning refers to the percentage of fecund women of reproductive age either married or in union, women who either wish to postpone the next birth (spacers) or who wish to stop child bearing (limiters) but are not using a contraceptive method. This clearly indicates a gap between a woman’s reproductive intention and current contraceptive behaviour. The objectives of the present study was to determine the prevalence of unmet need for family planning, to assess the association between socio-demographic characteristics and unmet need of family planning, to identify the reasons for unmet need.Methods: It was a cross-sectional study conducted from June to August 2018 in Ankuli (UHTC). A total of 188 ever married women in the reproductive age group were selected by simple random sampling.Results: Out of 188 women, 41 (21.8%) had no need for contraception and needs for family planning of 78 (41.5%) women had been met. The prevalence of unmet need for family planning was 36.7% consists of 24 (12.8%)  spacing need and 45 (23.9%)  limiting need. It was found that age, education of women, age at marriage, number of living children, contraceptive knowledge and inter-spousal communication were significantly associated with unmet need for family planning. The most common reason for not using any contraceptive method was fear of side effects (40.6%).Conclusions: The unmet need for family planning was high and in order to reduce the gap, the program should address the above reasons

Efficacy of botulinum toxin in masseter muscle hypertrophy for lower face contouring

Background Masseter muscle hypertrophy (MMH) usually presents with cosmetic concerns as it may lead to widening of the lower face. Apart from the traditional surgical approaches, botulinum toxin type A (BTA) injection is a non-invasive treatment option available. There are no standard guidelines for this procedure. Objectives To study the efficacy of botulinumtoxin A in MMH for lower face contouring. Methodology The Cochrane Library, PubMed/MEDLINE, Google-scholar, Science-Direct database, and ResearchGate from inception until September 2021 were searched using the keywords “botulinumtoxin type A,” “masseter muscle hypertrophy,” “lower face contouring,” and “masseter botox.” All available retrospective and prospective studies, case-series, case-reports, and expert reviews were included with an emphasis on efficacy of BTA in MMH and units injected into the muscle, points of placement, adverse events, and the duration of its effect. Reference lists of the resultant articles, as well as relevant reviews, were also searched. Result 40 articles were shortlisted for the review, of which 14 studies with sample-size ≥10 in accordance with the study requirements were summarized in a tabular form for analysis and easy comparison and reference. Conclusion BTA injection is a non-invasive, safe, and effective treatment for MMH. The optimum number of BTA units could not be ascertained due to wide variability in the studies as well as ethnicity of patients and extent or some measurement of MMH. The points of placement of injection should be well within the boundaries of the masseter muscle. The maximum effect of BTA after a single injection session is usually seen in ~3 months, and the duration may last for 6–12 months. Multiple injection sessions may be required to maintain a long-term effect. Injection technique and total number of injection units of neuromodulator must be individualized for each patient

A rare case of acne fulminans

Acne fulminans (AF) is a rare yet the most severe inflammatory form of acne. It predominantly affects prepubertal boys in the form of multiple exuberant pustular and ulcerative lesions over the face and trunk associated with systemic symptoms in the form of fever, polyarthralgia, and osteolytic bone lesions. In spite of multiple mentioned triggering agents, till date, no direct cause has been ascertained. Drugs like isotretinoin for acne and anabolic steroids are known to precipitate this condition. Due to systemic symptoms, the patient may sometimes require an aggressive inpatient treatment to prevent any systemic complications and grossly morbid scarring as a result of the disease. Herein, we report a rare case of AF in a 16-year-old female with predominantly facial involvement who was managed with oral corticosteroids and isotretinoin with excellent response

Beneficiary satisfaction with mental health care services: A cross sectional study at district mental health programme OPD of Ganjam District

contact drop outs. Active participation of people with mental illness (PWMI) & their caregivers is of utmost important to achieve the objectives of DMHP and reduce the longstanding mental & neurological disorder (MND) cases. Aim: To describe the beneficiary satisfaction with mental health care services under DMHP Ganjam. Materials & Methods: Descriptive theoretical framework & cross-sectional study design. Beneficiaries were selected by probability sampling. Beneficiary satisfaction was measured by using questionnaire in a Likert scale. Results: Communication skills of doctor, waiting time for consultation, availability of drugs at drug distribution centre were in the 4th quartile, cleanliness of OPD and Drug distribution centre functioning were in 3rd quartile. Adequacy of information available at hospital and waiting time at registration were in 2nd quartile. The functioning of NIDAN diagnostic centre and behaviour of hospital staff other than doctor got lowest score and were in 1st quartile. Conclusion: The distribution score in quartiles gave a preliminary evidence on components of beneficiary satisfaction on mental health care services at DMHP OPD. Recommendation: Counselling on service availability at NIDAN, training on communication skill for hospital staff, steps to reduce waiting time & need assessment of beneficiaries. Participatory research to explore the beneficiary perception needs to be carried out. Keywords: Mental Health, PWMI, MN