KAP study of contraception in clients undergoing MTP and sterilization in Gujarat, India

Background: Lack of awareness, knowledge and education, religious beliefs and fear of side effects are the main causes why women do not use family planning methods. To study the knowledge, attitude and practice of contraception among clients undergoing to Medical termination of pregnancy (MTP) and sterilization.Methods: This prospective study was done among 400 indoor cases at Department of Obstetrics and Gynecology in B.J. Medical college, Ahmedabad during July 2002 to October 2003. All the clients undergoing MTP and sterilization were explained and counseled about contraception with GATHER approach of family planning. After taking detail history, a thorough clinical examination of the clients was carried out with preliminary investigations.Results: Almost 58% clients were willing to accept TL method as contraceptive option, 39.5% IUCD, 1.75% OC pill method of contraception. Regarding history of side effect of contraceptive use, 17.3% condom users, 68.5% OC pill users, 63% CuT users have felt side effect. Almost 42.5% clients were operated by MTP + Lap TL, 39.5% by MTP + CuT and 14.5% by plain Lap TL.Conclusions: Efforts should be made to promote information, education and communication regarding emergency contraception targeted to all women of reproductive age group. It is important that unwanted pregnancy be prevented through effective contraceptive practice rather than abortion

Study of association of thyroid disorders with abnormal uterine bleeding

Background: Abnormal uterine bleeding from the vagina that is usually occurred when ovary do not release egg and if it occurred during fertile period leads to various complication like anemia, Infertility etc. and among all causes one of the most common cause of abnormal uterine bleeding is disturbance in level of Thyroid hormones.Methods: 100 female Patients of age group between 20-45 having complain of Abnormal uterine bleeding visited at Gynec OPD of our institute were included in this study. fasting blood samples was taken from all participants and samples were analyzed for Thyroid function test (TSH, T3, T4) at central laboratory of our hospital. Obtained data was analyzed statistically by using prizam software.Results: The bleeding abnormality that is found most of the women is polymenorrhaggia and menorrhaggia. 32% of patients who were studied had thyroid dysfunction, of which 18% of patients had subclinical hypothyroidism, 11% of patients had hypothyroidism and only 3% of patients had hyperthyroidism.Conclusions: Present study concludes that thyroid dysfunction should be considered as an important etiological factor for menstrual abnormality especially during fertile period

Adverse effects of temperature on perinatal and pregnancy outcomes: methodological challenges and knowledge gaps

Evidence linking temperature with adverse perinatal and pregnancy outcomes is emerging. We searched for literature published until 30 January 2023 in PubMed, Web of Science, and reference lists of articles focusing on the outcomes that were most studied like preterm birth, low birth weight, stillbirth, and hypertensive disorders of pregnancy. A review of the literature reveals important gaps in knowledge and several methodological challenges. One important gap is the lack of knowledge of how core body temperature modulates under extreme ambient temperature exposure during pregnancy. We do not know the magnitude of non-modulation of body temperature during pregnancy that is clinically significant, i.e., when the body starts triggering physiologic counterbalances. Furthermore, few studies are conducted in places where extreme temperature conditions are more frequently encountered, such as in South Asia and sub-Saharan Africa. Little is also known about specific cost-effective interventions that can be implemented in vulnerable communities to reduce adverse outcomes. As the threat of global warming looms large, effective interventions are critically necessary to mitigate its effects

Modelling of Cascade Fin Aerodynamics Near Stall using Kirchhoff's Steady-state Stall Model

Nonlinear longitudinal aerodynamics associated with cascade fins at high angles of attack near stall has been modelled using Kirchhoff's formulation. Grid fins are a relatively recent development in guided missile technology. In this paper, a new category of grid fins, nomenclatured as cascade fins, has been proposed. In cascade fin design, an appropriate selection of gap-to-chord ratio and the number of planar members lead to desired stall angle and acceptable overall lift coefficient, respectively. Kirchhoff's steady-state stall model has been validated on wind tunnel data generated for Cascade fins having rectangular airfoil cross-section. National Wind Tunnel Facility (NWTF) of IIT, Kanpur, was used to generate the wind tunnel data consisting of the variation of lift coefficient with angle of attack. The cascade fins were tested to generate the data by varying gap-to-chord ratio and number of planar fins. The cascade fins with rectangular cross-section were tested with and without end plates. Kirchhoff's steady-state stall model was applied to wind tunnel data of cascade fins for modelling flow separation point and maximum likelihood method was used to estimate the parameters characterising stall characteristics. The effects of end plates, variation of number of fins and gap-to-chord ratio on parameter estimation were also studied. It has been observed that Kirchhoff's steady-state stall model could advantageously be applied to model nonlinear aerodynamics associated with cascade fins at high angle of attack.Defence Science Journal, 2011, 61(2), pp.157-164, DOI:http://dx.doi.org/10.14429/dsj.61.48

Leveraging Multiple Teachers for Test-Time Adaptation of Language-Guided Classifiers

Recent approaches have explored language-guided classifiers capable of classifying examples from novel tasks when provided with task-specific natural language explanations, instructions or prompts (Sanh et al., 2022; R. Menon et al., 2022). While these classifiers can generalize in zero-shot settings, their task performance often varies substantially between different language explanations in unpredictable ways (Lu et al., 2022; Gonen et al., 2022). Also, current approaches fail to leverage unlabeled examples that may be available in many scenarios. Here, we introduce TALC, a framework that uses data programming to adapt a language-guided classifier for a new task during inference when provided with explanations from multiple teachers and unlabeled test examples. Our results show that TALC consistently outperforms a competitive baseline from prior work by an impressive 9.3% (relative improvement). Further, we demonstrate the robustness of TALC to variations in the quality and quantity of provided explanations, highlighting its potential in scenarios where learning from multiple teachers or a crowd is involved. Our code is available at: https://github.com/WeiKangda/TALC.git

Monetary policy and informal finance: Is there a pecking order?

The paper utilizes state-level data on household dependence on informal finance for an extended time span to examine whether it is impacted by a monetary contraction. The analysis suggests a substitution effect such that borrowing from moneylenders declines, whereas landlords and relatives turn out to be the preferred financing choices. In addition, the evidence also supports a hierarchy among these preferred financing choices. This suggests that monetary policy needs to take on board its impact on the hitherto neglected informal sector

Diagnosis and management of postpartum hemorrhage and intrapartum asphyxia in a quality improvement initiative using nurse-mentoring and simulation in Bihar, India.

BackgroundIn the state of Bihar, India a multi-faceted quality improvement nurse-mentoring program was implemented to improve provider skills in normal and complicated deliveries. The objective of this analysis was to examine changes in diagnosis and management of postpartum hemorrhage (PPH) of the mother and intrapartum asphyxia of the infant in primary care facilities in Bihar, during the program.MethodsDuring the program, mentor pairs visited each facility for one week, covering four facilities over a four-week period and returned for subsequent week-long visits once every month for seven to nine consecutive months. Between- and within-facility comparisons were made using a quasi-experimental and a longitudinal design over time, respectively, to measure change due to the intervention. The proportions of PPH and intrapartum asphyxia among all births as well as the proportions of PPH and intrapartum asphyxia cases that were effectively managed were examined. Zero-inflated negative binomial models and marginal structural methodology were used to assess change in diagnosis and management of complications after accounting for clustering of deliveries within facilities as well as time varying confounding.ResultsThis analysis included 55,938 deliveries from 320 facilities. About 2% of all deliveries, were complicated with PPH and 3% with intrapartum asphyxia. Between-facility comparisons across phases demonstrated diagnosis was always higher in the final week of intervention (PPH: 2.5-5.4%, intrapartum asphyxia: 4.2-5.6%) relative to the first week (PPH: 1.2-2.1%, intrapartum asphyxia: 0.7-3.3%). Within-facility comparisons showed PPH diagnosis increased from week 1 through 5 (from 1.6% to 4.4%), after which it decreased through week 7 (3.1%). A similar trend was observed for intrapartum asphyxia. For both outcomes, the proportion of diagnosed cases where selected evidence-based practices were used for management either remained stable or increased over time.ConclusionsThe nurse-mentoring program appears to have built providers' capacity to identify PPH and intrapartum asphyxia cases but diagnosis levels are still not on par with levels observed in Southeast Asia and globally

Monetary policy and informal finance: Is there a pecking order?

The paper utilizes state-level data on household dependence on informal finance for an extended time span to examine whether it is impacted by a monetary contraction. The analysis suggests a substitution effect such that borrowing from moneylenders declines, whereas landlords and relatives turn out to be the preferred financing choices. In addition, the evidence also supports a hierarchy among these preferred financing choices. This suggests that monetary policy needs to take on board its impact on the hitherto neglected informal sector

Batch Splitting in an Assembly Scheduling Environment

This paper presents mathematical models and algorithms for a production scheduling problem with batch splitting of assembly operations. The operation precedence is represented in an operations network, and the operations at any particular workcenter are split into suitable batch sizes on the available identical parallel processors for faster completion. The solution methodology comprises of a batch splitting algorithm followed by a batch scheduling algorithm. The batch splitting algorithm is developed based on a preemptive scheduling algorithm after incorporating non-zero setup times. The batch scheduling algorithm is based on a Critical Path algorithm for an operations network. The mathematical model also considers movesizes for batches which determine the threshold for the batch size that needs to be built up before it can be transferred for the successor operation. The computational results for different problem sizes show that the proposed solution scheme can satisfactorily solve this complex scheduling problem for cases where the standard solvers fail to generate solutions within practical time limits. Moreover, there is a significant reduction in makespan due to batch splitting