Hysteroscopic evaluation in infertility and abnormal uterine bleeding

Background: Hysteroscopy an endoscopic procedure for visualization of uterine cavity may be extensively used in both primary and secondary infertility and abnormal uterine bleeding for evaluating intrauterine pathology. The objectives of this study were to visualize and identity intrauterine pathology in both primary and secondary infertility and abnormal uterine bleeding (AUB) by hysteroscopic evaluation and to perform hysteroscopic guided therapeutic procedures like endometrial currettage, polypectomy, adhesiolysis.Methods: Hysteroscopic evaluation of uterine cavity for any intrauterine pathology in AUB and Infertility. Adhesiolysis, polypectomy, endometrial biopsy misplaced copper T removal were carried out under hysteroscopic vision.Results: Intrauterine synechia in 20.51%, Submucous fibroid in 5.13%, bicornuate uterus, endometrial hyperplasia and endometrial polyp were seen in 2.56% patient each were detected in infertility group while 81.95% cases with AUB had abnormal intrauterine pathology commonest being endometrial hyperplasia in 33.33% followed by endometrial polyps in 23.81% cases, submucous fibroid and misplaced copper T in 9.52% each and intrauterine synechia in 4.76% patient. Endometrial biopsy and polypectomy was done in 23.80% each with AUB, misplaced copper T removal in 9.52% and adhesiolysis in 4.76% patient with AUB.Conclusions: Hysteroscopy remains gold standard for evaluating intrauterine lesions in abnormal uterine bleeding and infertility. A safe, simple minimally invasive procedure not only diagnostic but therapeutic modality for adhesiolysis, endometrial biopsy/curettage, polypectomy, misplaced copper T removal under direct vision with minimal complication within reach of every Gynaecologist thereby reducing burden of major surgical intervention

Sociodemographic and seroprevalence profile of sexually transmitted infections (HIV, Hepatitis B, Hepatitis C and Syphilis) in asymptomatic pregnant females

Background: Globally 499 million new episodes of curable STIs occur in the age group of 15-49 years, 80% in developing countries and 79 million in India alone. There is an increasing trend for viral STIs while bacterial STIs are on decline. Number of pregnant women with STIs is increasing by about 250 million a year in developed world and double that number in developing countries. The objective of the study was to estimate seroprevalence of STIs (Hepatitis C, Hepatitis B, HIV and Syphilis) and to evaluate impact of sociodemographic profile and sexual behaviour on STIsMethods: This observational study was carried out on 1000 asymptomatic pregnant females attending antenatal clinics, Department of Obstetrics and Gynecology, Government Medical College Patiala, Punjab.Results: Seroprevalence for STIs in asymptomatic pregnant females was 22.5%. Hepatitis C-9%, Hepatitis B-6.3%, HIV-5.5%, and Syphilis 1.7%. Illiteracy, low socio economic status, homemakers, rural background with multiple sex partners in the 21-30 years age group is associated with increasing trends of STIs in pregnancy.Conclusions: Screening asymptomatic pregnant women for STIs remains a key programme strategy for quadruple (Hepatitis C, Hepatitis B, HIV and Syphilis) prevention. Mandatory screening for STIs to reduce perinatal transmission is need of the millennium– a step toward ending STI epidemics as a global priority.

PRESCRIPTION PATTERN OF ANTIBIOTICS AND THEIR APPROPRIATENESS IN PATIENTS WITH CHRONIC KIDNEY DISEASE-AN OBSERVATIONAL STUDY IN A TERTIARY CARE TEACHING HOSPITAL IN SOUTH INDIA

Objective: The primary objective of the study was to assess the prescribing pattern of antimicrobial agents in patients with chronic kidney disease. The secondary objectives of this study are to assess antibiotic appropriateness and dose optimization in patients with chronic kidney disease in relation to their comorbidities. Methods: A retrospective study was conducted, and medical records of all patients with CKD who were admitted in the nephrology department of Sri Venkateswara Institute of Medical Sciences, Tirupati, during Jan 2018-Dec 2018 were reviewed for antibiotic prescriptions. A total of 200 medical records were selected and assessed for antimicrobial prescriptions. A p-value <0.05 was considered significant throughout the statistical analysis. Results: Analysis showed that overall 163 drugs were prescribed to CKD patients, of which nearly 96 (58.9%) required dosage adjustment. Of those 163 drugs, the majority N= 25 (26%), were unadjusted, and the remaining N = 71 (74%) were properly adjusted. The length of hospitalization of CKD patients was below 7 was 13.5%, above 7 was 86.5%. Mean and SD was 10.27±7.18 d, (Range: 1–35 d). The Chi-square analysis confirmed that out of the seven studied variables, two i.e. Length of stay days; p<0.001. Conclusion: It is concluded that the occurrence of medication dosing errors was moderate in hospitalized chronic kidney disease patients in our study. Nearly 20% of patients who had prolonged stays were prescribed antibiotics for a prolonged period. The predictors of medication dosing errors in CKD patients were the severe-to-end stages of chronic kidney disease, the number of prescribed antibiotics, and the length of hospitalization

Mid-Career academic women and the prestige economy

Drawing on 30 semi-structured interviews with women academics based in London higher education institutions in the UK, this paper investigates the gendered nature of the prestige economy in academia. We explore how mid-career academic women strategise their career development and the opportunities and barriers they perceive, particularly in relation to the accrual of academic esteem. Concept maps were used to facilitate dialogue about career plans and provided an artefact from the interviewee’s own perspective. The analysis draws on the concept of prestige, or the indicators of esteem that help advance academic careers, against the backdrop of a higher education context which increasingly relies on quantitative data to make judgements about academic excellence. The interviews indicated that women generally feel that men access status and indicators of esteem more easily than they do. Many women also had ambivalent feelings about gaining recognition through prestige: they understood the importance of status and knew the ‘rules of the game’, but were critical of these rules and sometimes reluctant to overtly pursue prestige. The findings are valuable for understanding how women’s slow access to the highest levels of higher education institutions is shaped by the value that organisations place on individual status

Low levels of cardiovascular risk factors and coronary heart disease in a UK Chinese population.

OBJECTIVE: To compare the prevalence of cardiovascular risk factors and coronary heart disease in Chinese and Europid adults. DESIGN: Population based, cross sectional survey. SETTING: Newcastle upon Tyne, UK, 1991-93. SUBJECTS: Altogether 380 Chinese and 625 Europid adults, aged 25-64 years. MAIN OUTCOME MEASURES: Fasting lipid levels, blood pressure, body mass index (BMI), the proportions who smoked, and the prevalence of coronary heart disease based on the Rose angina questionnaire and major electrocardiographic abnormalities on resting 12 lead electrocardiogram (Minnesota codes 1.1-1.2). All figures were age adjusted to the 1991 England and Wales population. RESULTS: Altogether 183 and 197 Chinese, and 310 and 315 Europid men and women respectively were seen. Compared with Europid men, Chinese men had a lower mean total cholesterol concentration (5.1 versus 5.6 mmol/l, p 0.05) and diastolic (75 versus 68 mmHg, p < 0.001) blood pressures. The prevalence of coronary heart disease was significantly lower in Chinese than Europid men (4.9% versus 16.6%, p < 0.001) but not significantly different in women (7.3% versus 11.1%, p = 0.16). CONCLUSION: Strategies for UK Chinese are needed to maintain this favourable risk factor profile and prevent any potential increase in the risk of coronary heart disease associated with increasing acculturation

Reduction of low- and high-grade cervical abnormalities associated with high uptake of the HPV bivalent vaccine in Scotland

In Scotland, a national HPV immunisation programme began in 2008 for 12-13 year olds, with a catch-up campaign from 2008-2011 for those under the age of 18. To monitor the impact of HPV immunisation on cervical disease at the population level, a programme of national surveillance was established.  We analysed colposcopy data from a cohort of women born between 1988-1992 who entered the Scottish Cervical Screening Programme (SCSP) and were aged 20-21 in 2008-2012.  By linking datasets from the SCSP and colposcopy services, we observed a significant reduction in diagnoses of cervical intraepithelial neoplasia 1 (CIN 1) (RR 0.71, 95% CI 0.58 to 0.87, p=0.0008), CIN 2 (RR 0.5, 95% CI 0.4, 0.63, p<0.0001) and CIN 3 (RR 0.45, 95% CI 0.35 to 0.58, p< 0.0001) for women who received 3 doses of vaccine compared with unvaccinated women.  To our knowledge, this is one of the first studies to show a reduction of low and high grade cervical intraepithelial neoplasia associated with high uptake of the HPV bivalent vaccine at the population level. These data are very encouraging for countries that have achieved high HPV vaccine uptake

The time of the Roma in times of crisis: Where has European neoliberal capitalism failed?

This paper argues that the economic and financial crisis that has ensnared Europe from the late 2000s has been instrumental in reshaping employment and social relations in a detrimental way for the majority of the European people. It argues that the crisis has exacerbated the socio-economic position of most Roma people, immigrants as well as of other vulnerable groups. This development is approached here as an outcome of the widening structural inequalities that underpin the crisis within an increasingly neoliberalised Europe. Through recent policy developments and public discourses from a number of European countries I show how rising inequalities nurture racialised social tensions. My account draws on classic and contemporary theoretical propositions that have been propounded about the nature of capitalism, its contemporary re-articulation as well as its ramification for the future of Europe

Resistance and Resignation:Responses to Typecasting in British Acting

This article draws on 38 in-depth interviews with British actors to explore the operation of typecasting. First, we argue that typecasting acts as the key mechanism through which the ‘somatic norm’ is established in British acting. It delivers an oversupply of leading roles for white, male, middle-class actors while ensuring that those who deviate somatically are restricted to largely socially caricatured roles. Second, we focus on the career trajectories of ‘othered’ actors. While they frequently experience acting roles as offensive and discriminatory, we demonstrate how most nonetheless reluctantly accept the terms of their ‘type’ in order to survive and succeed. Third, we focus on the minority who have attempted to challenge their type. Here we find that successful resistance is accomplished by carefully choosing work that subverts the somatic norm. However, the ability to exercise such choice is highly contingent on resources associated with an actor’s class origin