ABSTRACT
In India, 14.6% of adolescents are currently using tobacco in any form and tobacco control is a major public health challenge. The objective of this systematic review is to analyze all the existing literature and evaluate the effectiveness of school-based tobacco use prevention programs for adolescents in India. The review protocol was registered in PROSPERO (CRD42020159535). Studies were selected using database search, manual search, gray literature, reference chasing, and contacting the authors. All randomized controlled trials, cluster-randomized trials, quasi-experimental, and non-randomized studies reporting school-based tobacco use preventive interventions for adolescents in India; articles published in English (other languages where it can be translated to English) published between January 2000 till May 2020 were included. Data was independently extracted by two reviewers. The Risk of bias (RoB) and quality of the study were assessed using appropriate tools. Among 7972 identified articles, only 13 studies met the inclusion criteria. Each study implemented a unique intervention and measured distinct outcomes. Postintervention, all the studies reported improvements in the study group with respect to the reduction of tobacco use and change in the knowledge, attitude, practices, and/or behavior outcome parameters. Twelve study results were based on short-term assessment. Overall, a 5.17–17.0% tobacco use reduction rate was noted. RoB was high for six studies. Key methodological problems related to study design, duration, outcome parameter, follow-up time, type of intervention, and attrition were identified. School-based tobacco use prevention programs for adolescents in India might have shown positive outcomes but are associated with significant limitations.
ABSTRACT
Intrauterine retention of foetal bone is a rare complication of abortion. These patients may present with irregular bleeding per vaginum, dysmenorrheal, pelvic pain and secondary infertility. A 27 year old female (G2, P1, L1, A1) referred by a general practitioner to our OPD as a case of secondary infertility. Patient was asymptomatic and had a second trimester abortion three years back. USG showed a foreign body in the uterine cavity. There was no history of IUCD insertion. On the advice of general practitioner, CT scan was done, which showed similar finding. Then this case was referred to us for further clinical evaluation. On hysteroscopy, we found foetal bones impacted between two Ostia which were removed with difficulty in the same setting. Dye test for patency of tubes was negative, probably due to edema. After that, patient conceived naturally within four months and delivered a healthy baby. Retained foetal bone in the uterine cavity was causing secondary infertility by its IUCD effect. Hysteroscopy is the gold standard method for diagnosis and treatment of foreign body in the uterine cavity.