A clinical review of obstetric hysterectomies done in medical college, Kottayam for a period of six years

Background: Obstetric/peripartum hysterectomy is a hysterectomy performed for any indication during pregnancy, labour or puerperium. It is important to know the general incidence, changing trends and indications of this surgery. The objective of the study is to find out the incidence of obstetric hysterectomy, type of obstetric hysterectomy done, indications of the procedure, maternal clinical profile, postoperative complications and the maternal and fetal outcome.Methods: A retrospective, descriptive case series study of all pregnant women who underwent hysterectomy in a six year period has been done.Results: 57 women underwent hysterectomy. The incidence of obstetric hysterectomy in this study is 0.17%. Mean age of the women was 30.3 years. Mean parity was two. 1.75% of cases were unbooked. 24.56% of cases underwent obstetric hysterectomy following vaginal delivery and 74.44% of cases had the procedure following abdominal route of delivery. 56.14% of cases underwent obstetric hysterectomy for postpartum hemorrhage, 36.84% underwent it for morbidly adherent placenta. 90.47% of morbidly adherent placenta had previous caesarean section as a major risk factor. 12.3% of mothers died postoperatively.Conclusions: By good obstetric practices, proper diagnosis of morbidly adherent placenta, bringing down the number of unnecessary caesarean section the incidence of this procedure can be brought down

Prevalence of menopausal symptoms and perceptions about menopause among postmenopausal women attending Gynaecology OPD at GMC Idukki, India

Background: Idukki is a hilly tract area in the state of Kerala. No studies regarding menopause has been reported from Idukki. This study is done among postmenopausal women in an attempt to shed light on the prevalence of menopausal symptoms and perceptions of postmenopausal women in a panchayat in Idukki district which is typically a rural area. Primary objectives of the study were to find the prevalence of menopausal symptoms in post-menopausal women attending the outpatient department of Government Medical College, Idukki, India and to find the perceptions about menopause among these post-menopausal women. Secondary objectives were to find the mean age and pattern of attainment of menopause among postmenopausal women and to find the treatment seeking behavior of the post-menopausal women residing in this area.Methods: A cross-sectional observational study is done among 100 postmenopausal women attending the outpatient department of Obstetrics and Gynaecology. Questions are asked based on interview schedule. The results are then analyzed.Results: The mean age of menopause was 45.69± 4.35. 78% of population had one or more symptoms in the menopausal period. Only 19.5% of the symptomatic women took treatment. 77% had positive perceptions.Conclusions: The awareness of these women in this area is poor thus limiting the treatment seeking behavior. Improvement of awareness is a must to improve the quality of life of post-menopausal women

Maternal and neonatal outcome in primigravida with mobile head at ≥39 weeks of gestation

Background: Primigravida with mobile head at ≥39 weeks of gestation are prone to the probability of caesarean section. With this study we aimed to identify the maternal and neonatal outcome of primigravida with mobile head at ≥39 weeks of gestation under the watchful expectancy and good conduct of labour.Methods: A cross sectional study was conducted among primigravida with mobile head at ≥39 weeks admitted for delivery in the department of obstetrics and gynaecology, govt. medical college, Kottayam, Kerala, from February 2021 to September 2021. A sample size of 247 was identified considering 28% proportion of presentation with deflexed head, 95% confidence interval and 2% margin of error. A detailed history, physical examination and ultrasonography was performed.Results: Of the 250 participants, the mean age of the study subjects was 24.97±3.93 and mean body mass index (BMI) was 23.72±4.78 kg/m2. The most common cause for mobile head was a deflexed head (35.2%). A lower segment caesarean section (LSCS) was conducted in 28.8% participants while vacuum assistance ad forceps assistance was required for 9.6% and 4.4% participants respectively. The most common indication for LSCSC being moderate to thick meconium-stained amniotic fluid (MSAF) 23% followed by 1st degree CPD failed trial in 17% cases. A significant association with maternal morbidity was observed in undiagnosed placenta previa (p=0.039) and vacuum-assisted deliveries (p=0.001). We observed that 3.6% of babies have meconium aspiration syndrome, and 8% of new born were admitted in intensive care for foetal distress.Conclusions: Primigravida with mobile head at term during labour requires intense monitoring. Although the duration of labour appeared to be prolonged in a small proportion of patients with watchful expectancy and good conduct of labour and timely intervention, vaginal delivery is possible with minimal maternal and neonatal morbidity.

Inventaire Et Identification Des Dégâts Des Insectes Infestant Les Plants De Manioc (Manihot Esculenta Crantz) À Deux Et Huit Mois Après Plantation Et Essai De Lutte Biologique Dans La Localité De Daloa (Côte d’Ivoire)

Le manioc est devenu un aliment de base des populations de Côte d’Ivoire. La présente étude qui lui est consacrée a été réalisée dans la période d'avril à octobre 2020 et avait pour objectif d'établir l'inventaire de l'entomofaune qui lui est associée, trouver leurs dégâts afin de mettre en place une stratégie de lutte pouvant réduire ces pathogènes. Cette étude a été réalisée sur deux variétés de manioc : Bocou 1 et Yavo. Plusieurs méthodes ont été utilisées pour la collecte des insectes à savoir : le piégeage, la capture à la main et au filet fauchoir. Les résultats ont montré une entomofaune très diversifiée avec 12 ordres d’insectes parmi lesquels il peut être cité : les Hétéroptères (les plus nombreux), suivis des Diptères, des Thysanoptères, des Coléoptères, des Hyménoptères et des Orthoptères. Ces insectes ravageurs sont vecteurs de plusieurs maladies dont la virose avec une incidence de 38,88% chez la variété Bocou 1, la bactériose avec une incidence de 85,55% chez la variété Yavo et 67,77% chez la variété Bocou 1. La solution aqueuse à base de neem a été également utilisée afin de lutter contre ces ravageurs. Cette solution s’est montrée efficace contre les insectes ravageurs des cultures de manioc. Cette étude a donc permis de faire l'inventaire de quelques insectes associés au manioc dans cette localité et d’établir une méthode de lutte biologique. Cassava has become a staple food for people in Côte d'Ivoire. The present study devoted to it was carried out in the period from April to October  and aims to establish an inventory of the entomofauna associated with it, to find their damage in order to set up a control strategy that can reduce these pathogens. This study was carried out on two varieties of cassava: Bocou 1 and Yavo. Several methods were used for the collection of insects namely: trapping, capture by hand and with a hay net. The results showed a very diverse entomofauna with 12 orders of insects among which we can cite: Heteroptera, the most numerous, followed by Diptera, Thysanoptera, Coleoptera, Hymenoptera, Orthoptera. These insect pests are vectors of several diseases including virosis with an incidence of 38.88% in variety Bocou 1, bacteriosis with an incidence of 85.55% in variety Yavo and 67.77% in variety Bocou 1. The aqueous solution based on neem has also been used to control these pests. This solution has been shown to be effective against insect pests of cassava crops. This study therefore made it possible to make an inventory of some insects associated with cassava in this locality and to establish a method of biological control

Asymptotic stability of impulsive high-order Hopfield typeneural networks

AbstractIn this paper, we discuss impulsive high-order Hopfield type neural networks. Investigating their global asymptotic stability, by using Lyapunov function method, sufficient conditions that guarantee global asymptotic stability of networks are given. These criteria can be used to analyse the dynamics of biological neural systems or to design globally stable artificial neural networks. Two numerical examples are given to illustrate the effectiveness of the proposed method

Global exponential stability of impulsive high-order Hopfield typeneural networks with delays

AbstractIn this paper, we investigate the global exponential stability of impulsive high-order Hopfield type neural networks with delays. By establishing the impulsive delay differential inequalities and using the Lyapunov method, two sufficient conditions that guarantee global exponential stability of these networks are given, and the exponential convergence rate is also obtained. A numerical example is given to demonstrate the validity of the results

Prevalence of Schistosoma mono- and co-infections with multiple common parasites and associated risk factors and morbidity profile among adults in the Taabo health and demographic surveillance system, South-Central Côte d'Ivoire

BACKGROUND: Schistosomiasis remains an important public health problem, also among adults, and infected individuals not treated serve as a reservoir for continued transmission. Despite this fact, evidence on the epidemiology of schistosomiasis in adults in Cote d'Ivoire is scanty. This study aimed to determine the prevalence and risk factors of Schistosoma infection and co-infection with other helminth species and Plasmodium among adults in the Taabo region in the south-central part of Cote d'Ivoire. METHODS: A cross-sectional survey was carried out in April and May 2017 in the frame of the "Cote d'Ivoire Dual Burden of Disease Study" (CoDuBu). A total of 901 randomly selected individuals, aged 18-90 years, provided blood, stool and urine samples for the diagnosis of malaria and helminth infections. Stool samples were subjected to the Kato-Katz technique for detection of Schistosoma mansoni and soil-transmitted helminth eggs, while urine samples were examined for eggs of Schistosoma haematobium and circulating cathodic antigen of S. mansoni. Risk factors and morbidity profiles were assessed using health examination and questionnaires. Multinomial logistic regressions were employed to identify risk factors and morbidity patterns associated with S. mansoni mono- and co-infections. RESULTS: The prevalence of S. mansoni and S. haematobium was 23.2% and 1.0%, respectively. Most S. mansoni were mono-infections (81.3%). Independent determinants of S. mansoni infection were young age, low socioeconomic status (mono- and co-infection) and poor hygiene practices (co-infection) (P < 0.05). S. mansoni infection was independently associated with higher pain and symptom scores (mono-infection), poor self-rated health and low healthcare use (co-infection) (P < 0.05). CONCLUSIONS: This study showed that adults represent a substantial reservoir of S. mansoni. To sustain schistosomiasis control and improve people's wellbeing, it is important to expand preventive chemotherapy from school-aged children to adults, coupled with hygiene and health education

Parasitic Worms: Knowledge, Attitudes, and Practices in Western Côte d’Ivoire with Implications for Integrated Control

There is a need to better understand communities' knowledge, attitudes, and practices (KAP) of neglected tropical diseases to improve prevention and control efforts. We studied the socio-cultural aspects of parasitic worm infections in two villages (Mélapleu and Zouatta II) of western Côte d'Ivoire, where research and control activities have been implemented. Zouatta II was exposed to a community-based approach, while school-based interventions were implemented in Mélapleu. KAP surveys were carried out using qualitative and quantitative methods. Although there was some knowledge of parasitic worm infections in both villages, we found important differences between the two villages regarding intestinal schistosomiasis: there was a better understanding of this disease in Zouatta II. However, even the community-based research and control efforts implemented in Zouatta II were ineffective in transforming the information conveyed into preventive behavior related to water contact. Our results suggest that KAP of parasitic worm infections conveyed by research and control activities targeting only school-aged children have shortcomings as older population groups are left out. Hence, for effective control of parasitic worms, children and adults must be educated and interventions should include access to deworming drugs, clean water and sanitation

Effect of an integrated intervention package of preventive chemotherapy, community-led total sanitation and health education on the prevalence of helminth and intestinal protozoa infections in Côte d'Ivoire

Preventive chemotherapy with donated anthelminthic drugs is the cornerstone for the control of helminthiases. However, reinfection can occur rapidly in the absence of clean water and sanitation coupled with unhygienic behaviour. The purpose of this study was to assess the effect of an integrated package of interventions, consisting of preventive chemotherapy, community-led total sanitation (CLTS) and health education, on the prevalence of helminth and intestinal protozoa infections and on participants' knowledge, attitude, practice and beliefs (KAPB) towards these diseases including water, sanitation and hygiene (WASH).; A cross-sectional survey was carried out in nine communities of south-central Côte d'Ivoire to assess people's infection with helminths and intestinal protozoa and KAPB. Subsequently, interventions were targeted to five communities, while the remaining communities served as control. The intervention encouraged latrine construction and an evaluation was done 6-7 months later to determine open defecation status of the respective communities. Anthelminthic treatment was provided to all community members. A follow-up cross-sectional survey was conducted approximately one year later, using the same procedures.; Overall, 810 people had complete baseline and follow-up data and were given anthelminthic treatment. The baseline prevalence of hookworm, Schistosoma haematobium, Trichuris trichiura, Schistosoma mansoni and Ascaris lumbricoides was 31.1%, 7.0%, 2.0%, 1.0% and 0.3%, respectively. Four of the five intervention communities were classified open-defecation free. For hookworm infection, we observed higher negative changes in terms of proportion of decrease (-0.10; 95% confidence interval (CI): - 0.16, -0.04) and higher egg reduction rate (64.9 vs 15.2%) when comparing intervention with control communities. For intestinal protozoa, prevalence reduction was higher in intervention compared to control communities (8.2 vs 2.6%) and WASH indicators and intervention outcomes associated with lower odds for infection at follow-up. The intervention significantly impacted on reported latrine use (before: 15.5%, after: 94.6%), open defecation in the community surroundings (before: 75.0%, after: 16.7%) and awareness for environmental contamination through open defecation (before: 20.4%, after: 52.2%).; An integrated package of interventions consisting of preventive chemotherapy, health education and CLTS reduces the prevalence of helminth and intestinal protozoa infection. Additional studies in other social-ecological settings are warranted to confirm our findings