Frequency, Indications and Maternal Outcome in Obstetric Hysterectomy in a Tertiary Care Centre in India.

The aim of present study is to review the frequency, indications, associated risk factors, maternal morbidity, maternal and fetal mortality associated with emergency obstetric hysterectomy in a tertiary care academic referral centre. A retrospective descriptive analysis from Jul 2005 to Jun 2010 was carried out in a tertiary care academic referral centre. Main outcome measures were frequency, indications, associated risk factors, maternal morbidity, maternal and fetal mortality associated with emergency obstetric hysterectomy. There were 41 cases of obstetric hysterectomy over the study period and the frequency of obstetric hysterectomy was 22.9/10,000 births. The incidence of hysterectomy for vaginal delivery was 0.017% and for caesarean section was 0.318%. Maximum number of patients (36.5%) were in the age group 26-30 years. 60.9% patients were antenatally unbooked emergency cases. It was most common in para two (46.3%) followed by para four or more (26.8). Main indications for obstetric hysterectomy were rupture uterus and postpartum haemorrhage (31.7% each) followed by morbidly adherent placenta (21.9%). All women required blood transfusion, 26 (63.42%) were anaemic, 5 (12.19%) required ICU stay. There was one maternal mortality and varied morbidity pattern. 12 fetal mortalities were noted, including 9 for uterine rupture, 2 for placenta previa in scarred uterus and one in obstructed labor case. Emergency obstetric hysterectomy still remains a life saving procedure and complications can be minimized by timely and thoughtful decision. Unnecessary delay or undue haste increase maternal morbidity.

Awareness of emergency contraception among female college students in Chandigarh, India.

SUMMARY: Adolescents and young women are at the greatest risk of unintended pregnancy because they are unlikely to see a family planning provider before or immediately after the sexual activity. Therefore, preventing unintended pregnancy among them is the important concern. Sexually active young women are clients with special needs for contraception. They are eligible to use a variety of the available contraceptives. Introduction of emergency contraception (EC) in the recent past can help them avoid such unintended pregnancies. OBJECTIVE: To investigate the awareness of emergency contraception in female college students. STUDY DESIGN: Cross-sectional, questionnaire-based study. MATERIALS AND METHODS: This study was conducted among college-going undergraduate and graduate female students of Punjab University, Chandigarh. Systematic random sampling was used to select the respondents. RESULTS: Of the 1,017 college students included in the study, 507 (49.9%) knew about different contraceptive methods. Maximum awareness was regarding oral contraceptive pills (239, 47.1%). Only 74 (7.3%) had knowledge about emergency contraceptive pills (ECP). Of them, 10 (14.7%) students knew the correct time for use of ECP and the side effects of ECP were known to 48 (88.9%) respondents. CONCLUSIONS: Awareness about ECP was very low among female college students of Chandigarh, especially regarding correct timing of its use and its side effects. Appropriate awareness programs on EC are needed for them.

Private sector involvement in tuberculosis control in Chandigarh.

Background: Private practitioners in India treat a substantial proportion of the TB cases. The present study is an attempt to find out the extent of private sector involvement in the control of tuberculosis in the Union Territory of Chandigarh. Methodology: The study was conducted in Union Territory of Chandigarh, during 2003-04. This study was a cross-sectional study involving 20 per cent of private practitioners practising allopathic system of medicine in Chandigarh. A questionnaire was used for collection of data after pre-testing. Results: Out of 114 doctors interviewed, 71 per cent dealt with TB patients. In response to a question as to how many sputum samples were required for routine microscopy, 72 per cent stated 3 samples but only 6 per cent knew the correct timing of sputum collection. 8.6 per cent of the practitioners followed the recommended guidelines of RNTCP treatment. As to reasons for not following the standard guidelines, 46.6 per cent said that they were not aware of these guidelines. About 82 oer cent were willing to be partners for implementation of RNTCP. A case history was given to practitioners to assess their knowledge regarding DOTS. It was observed that only 7.8 per cent knew the correct dosage and 21per cent knew the correct duration of treatment. Conclusion: Knowledge of private practitioners regarding RNTCP and DOTS strategy was poor and they were not following recommended guidelines for control of tuberculosis, but they were willing to participate in the programme.