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Background: Centchroman a non-steroidal selective estrogen receptor modifier (SERM). It is highly effective contraceptive which is devoid of side effects of COCs and there is prompt return of fertility upon discontinuation. Data in terms of its acceptability and continuation rates is limited when compared to combined oral contraceptive (COC). Therefore, the study was planned to study the acceptability, efficacy and continuation rates of centchroman and compare it with the combined oral contraceptives.Methods: The study was a prospective interventional comparative randomized study carried out in the department of obstetrics and gynecology VMMC and SJH, New Delhi, for a period of 18 months from November 2018 to April 2019.Results: A total of 945 women were screened and finally 240 women who met the criteria were recruited in 2 study groups of 120 women each. Majority were in the age group 18-28 years in either groups. Patients were followed up at 2nd week and then at 1st, 3rd, 6th and 12th months after initiation of the OCP with no loss to follow up. The pearl index in this study was 0.83 for ormeloxifene. The study showed statistically significant differences with higher level of satisfaction reported with 77.5% in the ormeloxifene compared to 65% of COCs. The continuation rates for ormeloxifene and COC users were in decreasing trend with increase in duration. No untoward events were reported with either formulation.Conclusions: Both the hormonal, combined hormonal contraceptive [combined oral contraceptive (COC), MALA-N] and the non-hormonal, centchroman (ormeloxifene) oral contraceptive pills are safe, effective, well tolerated and not associated with adverse outcomes when used immediately after abortion. Continuation rates of the pills in both the groups decrease in trend with time.
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Introduction: Hernia is defined as the gap in the continuity of the fascia. The most common types of hernia are inguinal (innergroin), incisional (resulting from an incision), femoral (outer groin), umbilical (belly button), and hiatal (upper stomach).Aim: The aim of the study was to study the various risk factors and complications of different types of hernias, clinicalpresentations, and their management.Materials and Methods: All cases of abdominal wall hernias presenting above 12 years of age were included in the study.Patients were assigned to undergo suture repair or mesh repair at the operating surgeon’s discretion. All patient-related datawere collected for analysis.Results: Among the 185 cases studied, 86 were incisional hernia (46.4%), 75 were umbilical hernia (40.5%), and 21 wereepigastric (11.3%), one Spigelian, and two lumbar hernia. Female preponderance was seen in incisional hernias with male tofemale ratio of 1:6.7. The swelling was the most common complaint in 55% followed by pain 31.6. Previous surgery or traumawas the single most important cause for ventral (Incisional) hernias. Simple suture repair and or Mayo’s repair was the choiceof repair in emergencies in all age groups.Conclusion: Size of the defect and presence of complications are the guiding factors for choosing the type of repair. Laparoscopicapproach for ventral hernia repair is definitely a method of choice with the advantages of good operative field visibility, lessenedduration of hospital stay, and minimal post-operative scar.
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Background: Dysfunctional uterine bleeding is one of the most often encountered gynecologic problems causing anemia, reduced quality of life and unnecessary hysterectomies. A prospective study was conducted on women with DUB to study the effect of ormeloxifene versus combined oral contraceptive pills in controlling blood loss in them.Methods: 100 Women with DUB were enrolled randomly in three groups. After baseline assessment each patient in group A was treated with iron tablets, containing 100 mg elemental iron and folic acid 1.5 mg, for three months and were termed as control group. Group B patients were treated with ormeloxifene in dose of 60 mg twice a week for twelve weeks. Group C patients were treated with combined oral contraceptive pills for twenty- one days starting from third day of their LMP. The treatment was continued for three consecutive cycles. The efficacy of the studied drugs was analyzed by comparing the baseline and post treatment PBAC score, haemoglobin level and endometrial thickness, using appropriate statistical tests.Results: Ormeloxifene was more effective than only iron or combined oral contraceptive therapy in controlling menstrual blood loss (79.11% versus 58.57%). There was a reduction in endometrial thickness in group receiving ormeloxifene as well as in the group receiving combined oral contraceptive pills (p=0.486), however this was statistically not significant.Conclusions: Ormeloxifene was significantly better than combined OCP in reduction of menstrual blood flow in cases of DUB. It has better compliance and marked improvement in subjective symptoms as compared to OCP.
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Background: Centchroman (INN: Ormeloxifene), was developed at CDRI, Lucknow in 1967. This drug was finally approved and licensed in 1991 and launched as Saheli and Choice-7 for marketing in 1992. The Ministry of Health and Family Welfare, India has now introduced centchroman in national family planning programme under the trade name “Chhaya” from April 2016. Centchroman is a novel nonsteroidal contraceptive that inhibits the fertilised ovum from implantation and thus prevents pregnancy. The aim of this study was to assess the effectiveness, side effects, discontinuation rates and failure rate among the users of Centchroman (Chhaya).Methods: The retrospective study was conducted by reviewing the records of Centchroman (Chhaya) contraceptives acceptor over the period of one year from September 2017 to August 2018 in family welfare clinic of Department of Obstetrics and Gynecology at Tomo Riba Institute of Health and Medical Science, a tertiary level center in Naharlagun, Arunachal Pradesh, India.Results: A total of 146 women were evaluated for the study. Majority of the women were in the age group of 20-30 years (76.02%) with mean age of 26 years. Most of the centchroman acceptors were multipara (74.65%) and women in post-abortion (38.35%) and postpartum group (36.3%). Duration of use ranged from 3 months in 146 women to 12 months in 98 women. The discontinuation rate was 31.5%. The major menstrual complaint was delayed menstrual cycle in 15.06% women and irregular cycle in 10.95%. Of the 146 women in the study group, pregnancy occurred in 3 women. Pearl index calculated for centchroman was 2.05/HWY.Conclusions: Centchroman is a non-steroidal, non-hormonal oral contraceptive drug with good therapeutic efficacy and a favourable side effect profile. Centchroman has an important place in postpartum contraception due to its safety profile in breastfeeding women.
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Introduction: Centchroman is an effective oral contraceptive has a good patient acceptability and compliance due to its minimal side effects, low cost and simple dosage schedule. This study was undertaken to study the adverse drug reactions of centchroman used for contraceptive purpose. Material and Methods: The cases were selected from the patients attending post partum programme centre and outdoor department of Obstetrics and Gynaecology, at LLRM Medical college and associated hospital, Meerut, UP, who were taking non-hormonal oral contraceptives (centchroman) preparations for a period of twelve months. Women of reproductive age groups were included and asked not to use any other method of contraception during the study. Every Woman was asked to report immediately if she develops any problem after taking pills and asked for regular follow up at every month. Results: During the study period, a total of 25 women receiving centchroman for contraception were evaluated. The most common adverse drug reaction reported was menstrual irregularity. After 6 months of therapy, 40% women presented with this complain. 12% cases presented with other complaints in form of abdominal pain and giddiness. Conclusion: Non-hormonal oral contraceptives (centchroman) are quite safe regarding adverse effect but menstrual irregularities are the major limiting factor for its use as contraceptive.
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The biosynthesis of nucleic acids and proteins was studied in rat uterus by following the incorporation of [3H]-thymidine, [3H]-uridineand[14C]-leucinein control and pregnant rats in the presence and absence of two anti-implantation drugs. One of the drugs, 78/224 caused a significant increase in incorporation whereas the other drug, Centchroman, caused an inhibition in incorporation of all the three precursors. The implications of these changes in the light of estrogenicity, agonist and antagonist actions of anti-estrogens have been analysed. The importance of homeostatic mechanisms involved in nucleic acids and proteins for the maintenance of constant internal milieu for blastocyst attachment has been discussed.