RESUMEN
Background: Intrauterine contraceptive device (IUCD) is an effective form of long-acting reversible contraceptive (LARC). Postpartum IUCD insertion is labelled when IUCD is inserted within 10 minutes to 48 hours of expulsion of placenta. assess the acceptability and short-term complications of postpartum intrauterine contraception device insertion in tertiary care hospital of Bangladesh. The aim of the study was to assess the evaluation of factors associated with acceptability of post-partum intrauterine contraceptive device (PPIUCD).Methods: This was a prospective observational study was conducted at department of obstetrics and gynecology, Dhaka Medical College Hospital (DMCH).Results: Out of 360 eligible counselled postpartum patients, 48 (13.3%) women underwent PPIUCD insertion. Acceptance of PPIUCD was higher in the age group of 25-30 years (43.75%), having former health counselling about PPIUCD (70.8%), multipara (68.75%). The commonest complications were missing thread (8.3%) followed by lower abdominal pain (6.25%), irregular per vaginal bleeding (4.2%).Conclusions: PPIUCD is not very acceptable in our set up but it is a safe, highly effective method of contraception with very few side effects and no major complications and contraindications. The acceptability of PPIUCD can be increased with antenatal counselling and institutional delivery.
RESUMEN
Background: Those who recovered from the COVID-19, suffers various health-related as well as mental problems. To measure a person's disease impact, disability, and mental condition, health-related quality of life (HRQoL) is used. The aim of this study was to assess the state of health-related quality of life of women of reproductive age after recovery from COVID-19.Methods: This cross-sectional study was conducted in Department of Reproductive and Child Health, National Institutes of Public Health and Social Medicine in Mohakhali, Dhaka, Bangladesh, during the period from January to December 2020. Total 202 women of reproductive age who were recovered from COVID-19 were included in this study.Results: In this study, majority of the women (46%) were within 36-50 years and majority (20.8%) had bronchial asthma. Most of the respondents suffering from COVID-19 from 15 days to 3 months (43.6%). In a study, the average HRQOL score among respondents was 66.01 (±11.81), with physical well-being scoring highest (19.89±4.41) and functional well-being lowest (14.44 ±4.19). Age-wise, respondents aged 15-25 scored highest in various health domains. Statistical analysis revealed significant differences in Fact-G scores across age groups, with 15-25-year-olds scoring highest, indicating a notable age-related variation in health quality.Conclusions: Findings of the study shows that fifteen to twenty-five years’ age of women’s HRQOL was higher than other groups. Educated women have better HRQOL score. Physical wellbeing was higher than other domains and functional wellbeing was lower than other domains. Elderly women who had comorbidities had lower HRQOL score.
RESUMEN
Objective: To study the clinico-hematological profile, complications, and management of children with non-transfusion dependent thalassemia (NTDT) in northern India. Method: We retrieved and analyzed the data of 69 children with NTDT diagnosed between January, 2006 to December, 2018, aged under 18 years from our unit’s records. Result: The participants mean (SD) age was 4.4 (3.1) years, and they presented with anemia (29%), jaundice (13%), hemolytic facies (13%), splenomegaly (87%), thromboembolism (2.9%) and pathological short stature (28.5%). The most common cause of NTDT was ?-thalassemia (45%), followed by either compound-heterozygous or homozygous for E?-thalassemia mutation. The most frequent single genotype observed was compound heterozygous for IVS1-5 (G>C) and codon 26 (G>A). The mean (SD) follow-up duration was 3.5 (2.4) years. On follow-up, 27 children (%) remained transfusion free, and 30 (%) needed occasional transfusions. 63% of patients initially presenting with pathological short stature showed improvement in growth. Amongst children older than 10 years (n=20), subclinical hypothyroidism was detected in 6 children and impaired glucose tolerance test in 1 child. Conclusion: Eß-thalassemia was the commonest cause of NTDT in this population.
RESUMEN
Background: Vaginal bleeding during the first trimester of pregnancy may or may not be associated with subchorionic hemorrhage (SCH). The volume of SCH may affect foetal growth or development. The aim of the study was to determine the impact of first trimester pregnancy SCH on pregnancy outcome.Methods: 151 women each in two groups (with and without SCH), all with first trimester bleeding were enrolled, monitored throughout pregnancy and outcome noted.Results: 72.8% women with SCH and 78.1% women without SCH gave birth to a live neonate. The relative risk of pregnancy wastage (spontaneous abortion, antepartum or intrapartum stillbirth) for the women with SCH was 1.22 (95% CI 0.81-1.82; p value =0.33) as compared to those with no SCH. 97% of women with SCH>10 ml had pregnancy wastage (mostly aborted before 20 weeks), 40% of women with SCH>5-10 ml had pregnancy wastage (p<0.001).Conclusions: The mere presence of SCH did not increase the risk of adverse pregnancy outcomes. However, a large volume of SCH significantly increased the risk of pregnancy wastage in comparison to a smaller SCH.
RESUMEN
Background: Hypertensive disorders of pregnancy (HDP) are a common cause of morbidity and mortality. Inflammation is considered as one of the etiologic factors along with a complex interplay of multiple genetic, nutritional and other environmental agents. This study was undertaken to find association of biochemical markers with severity and time of onset of HDP.Methods: Institutional review board and ethics committee approval was taken prior to the study. History and examination was done. Blood pressure was recorded at each antenatal visit. Blood samples were taken for the study of biochemical markers-hsCRP and interleukin 6 levels. Data was analyzed. P value <0.05 was taken as significant.Results: Of the 80 women, 27.5% had early onset HDP. 72.5% had severe HDP. Inflammatory indices were altered as compared to the range of normal pregnant women. Mean IL-6 and hsCRP levels were found to be raised but no statistically significant association was observed between IL-6 levels or hs-CRP levels and time of onset of HDP (p value = 1 and 0.5859 respectively and severity of onset of HDP (p value = 0.197 and 0.453 respectively).Conclusions: Biochemical indices, IL-6 and hs-CRP levels were elevated in women with HDP, indicative of increased inflammation.
RESUMEN
Background: Vaginal bleeding during the first trimester of pregnancy may or may not be associated with subchorionic hemorrhage (SCH). The volume of SCH may affect foetal growth or development. The aim of the study was to determine the impact of first trimester pregnancy SCH on pregnancy outcome.Methods: 151 women each in two groups (with and without SCH), all with first trimester bleeding were enrolled, monitored throughout pregnancy and outcome noted.Results: 72.8% women with SCH and 78.1% women without SCH gave birth to a live neonate. The relative risk of pregnancy wastage (spontaneous abortion, antepartum or intrapartum stillbirth) for the women with SCH was 1.22 (95% CI 0.81-1.82; p value =0.33) as compared to those with no SCH. 97% of women with SCH>10 ml had pregnancy wastage (mostly aborted before 20 weeks), 40% of women with SCH>5-10 ml had pregnancy wastage (p<0.001).Conclusions: The mere presence of SCH did not increase the risk of adverse pregnancy outcomes. However, a large volume of SCH significantly increased the risk of pregnancy wastage in comparison to a smaller SCH.
RESUMEN
Background: Hypertensive disorders of pregnancy (HDP) are a common cause of morbidity and mortality. Inflammation is considered as one of the etiologic factors along with a complex interplay of multiple genetic, nutritional and other environmental agents. This study was undertaken to find association of biochemical markers with severity and time of onset of HDP.Methods: Institutional review board and ethics committee approval was taken prior to the study. History and examination was done. Blood pressure was recorded at each antenatal visit. Blood samples were taken for the study of biochemical markers-hsCRP and interleukin 6 levels. Data was analyzed. P value <0.05 was taken as significant.Results: Of the 80 women, 27.5% had early onset HDP. 72.5% had severe HDP. Inflammatory indices were altered as compared to the range of normal pregnant women. Mean IL-6 and hsCRP levels were found to be raised but no statistically significant association was observed between IL-6 levels or hs-CRP levels and time of onset of HDP (p value = 1 and 0.5859 respectively and severity of onset of HDP (p value = 0.197 and 0.453 respectively).Conclusions: Biochemical indices, IL-6 and hs-CRP levels were elevated in women with HDP, indicative of increased inflammation.
RESUMEN
Objective: We examined the ‘nutrients of concern’ in pre-packaged food products that are commonly advertised, as per WHO standards and Nova Classification. Methods: This was a qualitative study, using a convenience sampling method, to identify advertisements of prepackaged food products. We also analyzed their content from information on the packets, and their compliance with applicable Indian laws. Results: We found that all the advertisements of the food products in this study did not provide important information about the amount of nutrients of concern i.e., total fat, sodium, and total sugars. These advertisements mostly targeted children, made health claims, and used endorsements of celebrities. All the food products were also found to be ultra-processed in nature and high in one or more nutrients of concern. Conclusion: Most of the advertisements are misleading, needing effective monitoring. Health warnings on the front-of- pack label and restrictions on marketing of such food products may go a long way in reducing non-communicable diseases.
RESUMEN
Purpose: To study the safety and efficacy of optic nerve sheath fenestration surgery in patients with optic disc edema due to different etiologies. Methods: Records of 18 eyes of 15 patients who underwent optic nerve sheath fenestration for vision threatening optic disc edema were reviewed retrospectively, and results were analyzed. Improvement of visual acuity was the main measure of outcome. Improved visual fields, resolution of optic disc edema, diplopia, and headache were other benefits that were observed. Results: Fifteen patients between 13 and 54 years of age were included in the study. Three patients underwent successive bilateral surgery. Idiopathic intracranial hypertension was the most common cause for optic disc edema and was found in 80% of the patients. Mean preoperative logMAR acuity was ?1.9789 ± 1.46270, which improved to ?0.9022 ± 1.23181 (p < 0.005) in the operated eye, and mean logMAR acuity of contralateral eye improved from ?1.3378 ± 1.50107 to ?1.0667 ± 1.33813 (p < 0.05). Conclusion: Early optic nerve sheath fenestration is an effective modality for treating optic disc edema due to a wide myriad of causes and helps resolve the associated symptoms.
RESUMEN
Background: Subarachnoid block has been used for intracavitary radiotherapy (ICRT) for carcinoma cervix, but the literature on the appropriate dose of local anesthetic required to achieve the desired effect is lacking. We compared two different intrathecal doses of 0.5% hyperbaric bupivacaine (1.2 and 1.5 mL) for providing optimal surgical conditions and readiness to discharge in patients undergoing ICRT for carcinoma cervix. Materials and Methods: This prospective double?blind study was done in 80 patients undergoing ICRT. The patients were randomized into two groups (Groups I and II) to receive 1.2 and 1.5 mL of intrathecal hyperbaric bupivacaine, respectively, for ICRT. The level of sensory achieved, the patient satisfaction score, radiation oncologist score, time to L5 regression, and time to motor recovery (walking unaided) were assessed. Statistical Analysis Used: The data were analyzed using SPSS 20 for Windows (IBM, Chicago, IL, USA). Results: The time taken for the block to regress to L5 (Group I: 134.6 � 32.4 minutes vs. Group II: 143.2 � 43.0 minutes, P = 0.31) were comparable. However, the mean time for walking unaided (Group I: 220.87 � 47.12 minutes versus Group II: 247.00 � 49.83 minutes, P = 0.032) after the subarachnoid block was significantly less in Group I. The patient satisfaction with the procedure and overall satisfaction of the radiation oncologists regarding the operating condition were comparable in both the groups. Conclusions: Hence, a 1.2 mL dose of intrathecal hyperbaric bupivacaine for ICRT provides optimal surgical conditions with hemodynamic stability and ensures the early discharge of the patient.
RESUMEN
The environment is seriously threatened as a result of the world’s rising volume of solid waste generation. Biodegradable pollutants will impart an unpleasant smell and create an unsanitary situation if suitable precautions are not implemented. Vermicomposting can be suitable option for handling solid waste in an eco-friendly manner. The review aims to assess the viability of using vermitechnology to extract nutrients from organic sludge and return them to the environment. This review is focused on earthworms and their mechanisms in vermicomposting process, various affecting factors and physical-microbial properties of vermicast
RESUMEN
Context: In India nearly 71% of adolescent girls have no knowledge about menstruation until menarche. Menstrual practices still face several social, cultural, and religious restrictions and discouragement of open discussion on the topic acts like a major deterrent in the path of menstrual hygiene management. Moreover, lack of knowledge and incorrect practices during menstruation can sometimes have serious health outcomes. Hence, it becomes imperative to ascertain the knowledge of adolescent girls about menstruation and reproductive health and the practices adopted by them during menstruation so that health education programs can to tailored to address the gaps. The study Aims: aims to assess the knowledge of adolescent girls and their current practices with regard to menstrual hygiene and reproductive health and study the association of these with socio-demographic variables. This cross-sectional community based Methods: descriptive study was conducted among 181 adolescent girls selected from two urbanized villages of Meerut district of India using a semi-structured questionnaire. For assessment of level of knowledge a scoring system was developed. Both descriptive and inferential statistics were used for analysis. Based on the scoring, 77.3% of our study participants had overall poor Results: knowledge about menstruation and reproductive health, nearly 20% had satisfactory knowledge and only 2.2% had good knowledge. Most participants reported using sanitary napkins during menses (80.7%) and the remaining were using clean cloth (19.3%). 100% of the participants whose mothers were illiterate had poor knowledge about menstrual hygiene and reproductive health. Participants whose mothers were engaged in semi-skilled or skilled work were more likely to have satisfactory (39.4%) or good (4.3%) knowledge scores. Overall knowledge of our study participants regarding Conclusion: menstrual hygiene and reproductive health was poor; however the practices adopted by them during menstruation were good. The two main impediments in the path of menstrual hygiene management were lack of knowledge and non availability of services at affordable cost
RESUMEN
A field experiment was conducted at Krishi Vigyan kendra, Sawaimadhopur, Rajasthan, India in two consecutive years during 2018-19 and 2019-20 on Zone III –B of Rajasthan, India. In this experiment was performed in randomized block design which includes four treatments of weed control i.e. weedy check (T1), Hand weeding at 25 DAS (T2), Hand weeding at 25 & 45 DAS (T3), Pre emergence application of Pendimethaline @ 1.0 kg a.i. ha-1 (T4) and replicated five times. Results revealed that Weed Density (no m-2) 60 days after sowing, Dry weight (kg ha-1) 60 days after sowing, weed control efficiency (%) and weed index found lowest in two hand weeding at 25 and 45 days after sowing fb Pre emergence application of Pendimethaline @ 1.0 kg a.i. ha-1 (T4) during both the years during 2018-19 and 2019-20, respectively. Highest seed yield (2341 kg ha-1) and (2431 kg ha-1) was found under two hand weeding (25 & 45 days after sowing) during 2018-19 and 2019-20 respectively.
RESUMEN
Background: A large surge of intensive care unit (ICU) admissions leading to mortal outcome was observed in wave-2 of coronavirus disease 2019 (COVID-19) due to the higher virulence of the Delta variant of the COVID-19 virus, which led to the scarcity of resources in hospitals. This study was done to observe the clinical characteristics of COVID-19 patients with fatal outcome. Materials and methods: We conducted a retrospective cross-sectional study in adults with COVID-19 pneumonia having fatal outcome during wave-2 of COVID-19, and their clinical characteristics were studied. Results: Out of 136 patients included in the study, the most common risk factors leading to adverse outcome were in the male gender, age (middle and elderly), with hypertension and diabetes mellitus (DM) as predominant comorbidities, early onset dyspnea, high C-reactive protein (CRP), high neutrophil to lymphocyte ratio (NLR), high D-dimer, bilateral lower zone involvement of lungs in chest X-ray (CXR), and development of acute kidney injury (AKI). Conclusion: The characteristics of the severely ill COVID-19 patients highlighted in the study could help clinicians in the early identification and management of high-risk patients. This study would help with resource planning and preparation for further COVID-19 waves and future pandemics.
RESUMEN
The present study was carried out to investigate the effect of irrigation and nitrogen levels on growth and yield of Chandrasur (Lepidium sativum Linn.) in two consecutive years Rabi 2018-19 and Rabi 2019-20 at Krishi Vigyan Kendra, Sawaimadhopur, Rajasthan. Results revealed that higher yield attributes No of branches plant-1, Fresh weight at harvest (g plant-1), 1000 seed weight (g), plant height (cm) were found significantly higher under three irrigation (25, 50 and 75 Days After Sowing) which was at par with two irrigations (25 & 50 Days After Sowing (DAS) and with 80 kg of N ha-1 which was at par with 60 kg N ha-1. Under different level of irrigations application of three irrigation (25, 50 & 75 Days After Sowing (DAS) found higher seed yield (1593.34 kg ha-1) which remained at par with two irrigation (25 & 50 DAS) compared to (one irrigation at 25 Days After Sowing), respectively. In sub plot treatments of different nitrogen levels Application of 80 kg of N ha-1 resulted in highest yield (1586 kg ha-1) which was statistically at par with 60 kg of N ha-1 as compared to 40 & 20 kg N ha-1 respectively.
RESUMEN
Objectives: We investigated the correlation of transient elastography (TE) with MRI R2* values and serum ferritin in patients with transfusion-dependent thalassemia (TDT) Methods: We reviewed hospital records of 59 patients with TDT aged ?8 years without any evidence of chronic liver disease and who had fibroscan within 3 months of MRI T2*, who seen at our center between January, 2014 and December, 2019. Spearman correlation and linear regression analysis were used to evaluate the correlation between TE liver stiffness measurements and R2* MRI values and with serum ferritin. Results: Mean (SD) age of the subjects was 13.0 (3.1) years and body mass index was 16.6 (2.3) kg/m2. Mean liver stiffness measurement, MRI T2*(3T), corresponding MRI R2*(3T), and ferritin values were 6.55 (3.10) kPa, 3.4 (4.6) milliseconds, 616.20 (383.9) Hz, and 2874.69 (1570.7) ng/ mL, respectively. TE measurements correlated with MRI R2* values (r=0.61; P=0.001) and with serum ferritin level (r=0.59, P=0.001). Conclusion: TE is a reliable tool to estimate hepatic iron overload in patients with TDT.
RESUMEN
Background & objectives: Majority of the studies of hospital-acquired diarrhoea conducted in Western countries have focused on the detection of Clostridium difficile in stool samples. Limited Asian and Indian literature is available on hospital-acquired diarrhoea. This study was aimed to describe the aetiological profile for hospital-acquired diarrhoea in children aged below five years. Methods: One hundred children aged one month to five years who developed diarrhoea (?3 loose stools for >12 h) after hospitalization for at least 72 h were enrolled. Children who were prescribed purgatives or undergoing procedures such as enema and endoscopy or those with underlying chronic gastrointestinal disorders such as celiac disease and inflammatory bowel disease were excluded from the study. Stool samples from the enrolled children were subjected to routine microscopic examination, modified Ziel- Nielson (ZN) staining for Cryptosporidium and culture for various enteropathogens. Multiplex PCR was used to identify the strains of diarrhoeagenic Escherichia coli. Rotavirus detection was done using rapid antigen kit. Toxins (A and B) of C. difficile were detected using enzyme immunoassay. Results: Of the 100 samples of hospital-acquired diarrhoea analysed, diarrhoeagenic E. coli (DEC) was found to be the most common organism, detected in 37 per cent of cases (enteropathogenic E. coli-18%, enterotoxigenic E. coli-8%, enteroaggregative E. coli-4% and mixed infections-7%). Cryptosporidium was detected in 10 per cent of cases. Rotavirus was detected in six per cent and C. difficile in four per cent of cases. Interpretation & conclusions: The findings of this study suggest that the aetiological profile of hospital- acquired diarrhoea appears to be similar to that of community-acquired diarrhoea, with DEC and Cryptosporidium being the most common causes. The efforts for the prevention and management of hospital-acquired diarrhoea should, thus, be directed towards these organisms.
RESUMEN
Lymphatic filariasis (LF) is a vector-borne neglected tropical disease, causing permanent disability. The disease is debilitating and widespread, leading to tremendous productivity and economic loss. The Government of India (GOI) prioritized the elimination of LF through the annual mass drug administration (MDA) programme in 2004 and continued with a single dose of diethylcarbamazine citrate (DEC), 6 mg/kg of body weight, plus albendazole annually over a period of 5-6 years. The GOI had set the target to achieve LF elimination by 2015 and now by 2030. The progress so far has been suboptimal. Much remains to be done as about 84 per cent of the total 328 endemic districts are still under MDA. The major challenge in implementing MDA is poor compliance. It is necessary to have a feasible alternative strategy addressing the above challenge to achieve the desired goal of LF elimination. At this juncture, a well-researched approach, i.e. the use of DEC-fortified salt, also advocated by the World Health Organization, as a unique form of MDA, is proposed. As per this strategy, a low dose of DEC (0.2% w/w) is added to the cooking salt at the manufacturing facility of iodized salt and consumed by the LF-endemic communities for about two years. Many examples of successful use of this strategy for LF elimination in small- and large-scale trials have been documented in India and several other endemic countries in the world. Implementing DEC–iodine-fortified salt is a safe, less expensive, more efficient and prompt approach for achieving the elimination of LF in India. Adverse effects are none or minor and self-limiting. The DEC-fortified salt strategy can easily piggyback on the existing countrywide deployment of iodized salt under the National Iodine Deficiency Disorders Control Programme (NIDDCP), which has achieved a great success in reducing iodine-deficiency disorders such as hypothyroidism. This existing robust programme can be leveraged to launch DEC-fortified salt for the community. If implemented appropriately, this strategy will ensure the complete cessation of LF transmission within two years from its introduction. If the said strategy is implemented in 2022, it is expected that India will be able to achieve the LF elimination by 2024, much before the global target of 2030.
RESUMEN
A nondescript sow with the history of delivering eight piglets and one remain in uterus since three days but unable to deliver was reported. The case was diagnosed as dystocia due to uterine inertia and laparohysterotomy was performed under general anesthesia, one male dead piglet was recovered successfully. The animal showed uneventful recovery.
RESUMEN
Background & objectives: COVID-19 pandemic has triggered social stigma towards individuals affected and their families. This study describes the process undertaken for the development and validation of scales to assess stigmatizing attitudes and experiences among COVID-19 and non-COVID-19 participants from the community. Methods: COVID-19 Stigma Scale and Community COVID-19 Stigma Scale constituting 13 and six items, respectively, were developed based on review of literature and news reports, expert committee evaluation and participants’ interviews through telephone for a multicentric study in India. For content validity, 61 (30 COVID-19-recovered and 31 non-COVID-19 participants from the community) were recruited. Test–retest reliability of the scales was assessed among 99 participants (41 COVID-19 recovered and 58 non-COVID-19). Participants were administered the scale at two-time points after a gap of 7-12 days. Cronbach’s alpha, overall percentage agreement and kappa statistics were used to assess internal consistency and test–retest reliability. Results: Items in the scales were relevant and comprehensible. Both the scales had Cronbach’s ? above 0.6 indicating moderate-to-good internal consistency. Test–retest reliability assessed using kappa statistics indicated that for the COVID-19 Stigma Scale, seven items had a moderate agreement (0.4-0.6). For the Community COVID-19 Stigma Scale, four items had a moderate agreement. Interpretation & conclusions: Validity and reliability of the two stigma scales indicated that the scales were comprehensible and had moderate internal consistency. These scales could be used to assess COVID-19 stigma and help in the development of appropriate stigma reduction interventions for COVID-19 infected, and mitigation of stigmatizing attitudes in the community.