Evaluation of Acceptability, Safety, and Efficacy of Intrauterine Device Insertion during the Postpartum Period: A Prospective Analysis

Background: Intrauterine contraceptive devices (IUCD) are a rapidly reversible method of contraception. It is necessary toassess the acceptability and uptake of IUCD in parturients elaborating its safety and success.Aims and Objectives: The aim of the study was to evaluate the acceptability, safety, and follow-up of postpartum insertion ofIUCD both in vaginal and cesarean section deliveries among parturients with the ultimate goal is to avoid unplanned pregnanciesand to expand the usage of IUCD.Materials and Methods: The study was a prospective one conducted during the period of January 2014–January 2015. All theantenatal patients at their visits after 30 weeks of gestation were taken in the study and parturients accepted for postpartumIUCD (PPIUCD) insertion constitute the study population.Results: A total of 202 patients were included in the study population. Majority of cases accepted for PPIUCD had at leasta primary level of education, were primiparous, and had their last childbirth >2 years age consisting of 90.10%, 46.53%, and44.55%, respectively. About 27.72% of the parturients were aware of the PPIUCD and 58.91% of parturients accepted PPIUCDdue to its long-term effect. PPIUCD insertion done for the study was three types such as: Within 10 min, immediate (within 24 h),and trans-cesarean consisting of 23.76%, 15.35%, and 60.89%, respectively. About 96.04%, 79.70%, and 60.90% cases wereattaining for follow-up at 6 weeks, 3 months, and 6 months, respectively. At 6 week follow-up, pelvic inflammatory disease,irregular cycles, and pain were the chief concerns consisting of 34.16%, 23.27%, and 16.83%, respectively, whereas bleedingper vagina, lost string, and expulsion were less seen. PPIUCD expulsion was seen in 14.85% of the parturients.Conclusions: Awareness of the PPIUCD among women was poor despite high acceptance and needs strategies to increaseawareness. The PPIUCD was demonstrably safe, having no reported incidence of perforation with low rates of expulsion, pelvicinfection, and few lost strings.

Prevalence Rate Of Depression Among Elderly Population In Central India

The adult population is booming at an alarming rate leading to the most difficult challenges faced by both developing and developed nations. The rapid changes in social and cultural values have marked influence on the psychological well being of the elderly. Depression among the elderly remains unrecognized or inadequately treated condition. The goal of this study was to determine the magnitude of depression in elderly people living in central India. MATERIALS AND METHOD- 200 elderly individuals of 60 years of age or more reporting to the institute who gave consent for the study were screened. While those individuals who refused to provide consent were excluded. Demographic details were recorded, and level of depression was assessed using Geriatric depression scale (Sheikh & Yesavage, 1986.) RESULT: The data was analysed and the results were recorded. The Chi-square test was used for categorical variables. In this study, severe depression was found in 30% elderly while 50% were mildly depressed. Also, Women were more depressed as compared to men. CONCLUSION- The high prevalence of depression among elderly especially females emphasize increased need of family and community support and availability of better health care services. The small sample size of this study is limitation, so large-scale studies are needed for a better picture of mental health in rural older adults in India.

Study of Placenta in HELLP Syndrome Patient: A Case Report.

HELLP syndrome is a multi systemic disorder that complicates pregnancy and has a poor prognosis. HELLP syndrome is frequently associated with severe pre-eclampsia or eclampsia but can also be diagnosed in the absence of these disorders .We report a case of 20 year old married pregnant female who was diagnosed as a patient of HELLP syndrome.

Evaluation of serum transferrin receptor and sTfR ferritin indices in diagnosing and differentiating iron deficiency anemia from anemia of chronic disease.

Objective. The present study was conducted to assess the utility of serum transferrin receptor (sTfR) and sTfR ferritin indices to differentiate ACD from IDA and also to diagnose coexisting IDA and ACD. Methods. The study group comprised of 30 IDA patients, 30 cases of ACD and 30 age and sex matched controls. Complete hemogram with peripheral smear examination, markers of ACD, iron profile including serum ferritin and serum transferrin receptor levels were done in all patients and controls. Serum TfR and ferritin indices were calculated. Results. sTfR levels were significantly higher in the IDA group compared to ACD group (p<0.001). ACD group was further subdivided into two groups on the basis of sTfR levels (B1<3 μg/ml and B2 ≥ μg/ml), suggesting coexisting IDA in group B2. sTfR/log ferritin index was > 1.5 in all cases of IDA and ACD with coexisting IDA while all pure ACD cases and control subjects had sTfR/log ferritin index < 1.5. All case in IDA group had log sTfR/serum ferritin index > 2.55 and all patients with ACD with or without associated iron deficiency had log sTfR/serum ferritin ratio < 2.55. Conclusion. The sTfR levels along with the above mentioned indices can be very useful in differentiating pure IDA, ACD and ACD with coexisting iron deficiency, thus providing a noninvasive alternative to bone marrow iron.

Parental awareness regarding childhood injuries.

OBJECTIVE: To assess parental awareness regarding common childhood injuries and to focus on preventive issues. METHODS: Two hundred parents of children each grouped into 2 attending OPD of government hospital and private clinic respectively were enrolled, interviewed and responses analyzed. RESULTS: The commonest potential mode of injuries identified in both groups was falls (53% vs 84%). None of the households in group 1 and less than 2/3rd in group 2 had provision of restraints at stairs. Awareness was found to be greater in the group with higher educational background and socioeconomic status. CONCLUSION: Awareness regarding common childhood injuries and their prevention was lacking. There was a felt need that the pediatricians must counsel the parents on this aspect during visits. Since the sample size is small, a larger community based study is needed.

Comparison of tympanic and rectal temperature in febrile patients.

OBJECTIVE: To compare tympanic membrane temperature and rectal temperature in febrile pediatric patients. METHODS: Sixty febrile children were enrolled as continuous enrollment at initial triage. Two readings of ear temperature were taken in each child with Thermoscan infrared thermometer. Rectal temperature was recorded by a digital electronic thermometer. Comparison of both the techniques was done and co-relation co-efficients calculated. Parental preference for both techniques was assessed. RESULTS: It was observed that mean ear temperature was 38.9+/-0.90 C and that for rectal temperature was 38.8+/-0.80 degrees C. The correlation coefficient between the two was 0.994 (p < 0.01). Coefficients for both sites were comparable over a wide age range. The difference between readings taken from two ears was not significant. Temperature ranges over which readings were recorded were quite wide for both techniques. Parental preference for tympanic thermometry over rectal thermometry was noticed. Tympanic thermometry utilizes pyro-electric sensors, to detect infra-red rays emitted from the surface of tympanic membrane. Ear temperatures correlates well with rectal temperatures which have long been considered as "core" temperatures. Parents prefer the technique of ear thermometry which is quick (2 sec), safe and non-invasive and patient resistance for this is also less. CONCLUSION: A non-invasive, non-mucous device which is accurate over a wide range of temperature could be very useful.