scholarly journals Comparative study of post-partum intra uterine contraceptive device insertion and interval intra uterine contraceptive device insertion in a tertiary care hospital

2017 ◽  
Vol 6 (7) ◽  
pp. 2760
Author(s):  
Manimegalai R. ◽  
Suganthi R.
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Family Health ◽  
Common Reason ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Medical College

Background: NFHS (National Family Health Survey) 2005-2006 in India revealed that the contraceptive prevalence rate is 53.5%. 10% of all pregnancies are mistimed and 11% of all pregnancies are unwanted in India. Objective of present study was to compare the benefits and complications of postpartum IUCD insertion (PPIUCD) over interval IUCD insertion in a tertiary care hospital.Methods: It is a retrospective study conducted in the Department of Obstetrics and Gynecology, Govt. Mohan Kumaramangalam Medical College, Salem from 2009-2014. The cases of interval IUCD for the year 2009-2014 and PPIUCD cases for the year 2012-2014 both vaginal insertion and intracaesarean insertion were taken for study. Complications, benefits and reasons for removal were compared between the two groups.Results: The total number of cases of IUCD insertion significantly increased after the introduction of PPIUCD programme in 2012. The acceptance of IUCD insertion was steadily increasing after the introduction of PPIUCD even though the follow up of PPIUCD cases was less (32%). The rate of removal in patients who came for follow up was less in PPIUCD group (18%) compared to interval IUCD cases (57%) when the reason was menorrhagia. The most common reason for removal was menorrhagia in interval IUCD patients. Abdominal pain was the most common reason for removal in PPIUCD patients. The rate of expulsion was higher in PPIUCD (6%) compared to interval IUCD patients (<1%). No cases of perforation and no cases of pregnancy in situ were reported in PPIUCD cases during the study period. Even though the rate of infection and missing strings were higher in PPIUCD patients when compared to interval IUCD patients who came for follow up the number of women with infection in PPIUCD patients is less and easily managed with appropriate antibiotics.Conclusions: In India PPIUCD insertion soon after delivery is a safe, effective, reversible and reliable method of long term contraception. Both vaginal and intracaesarean insertions are safe, efficacious and convenient even though there are few complications which are easily manageable. There are no incidences of perforations, pregnancy in situ, ectopic pregnancy and low rates of infection. Hence PPIUCD is a promising approach to decrease the fertility rate in the field of family planning.

scholarly journals Determinants of uptake of post-partum intra-uterine contraceptive device among women delivering in a tertiary hospital, Odisha, India

2017 ◽  
Vol 6 (5) ◽  
pp. 2017 ◽  
Author(s):  
Srabani Pradhan ◽  
Jaya Singh Kshatri ◽  
Rishika Sen ◽  
Arpika Aparajita Behera ◽  
Radha Madhab Tripathy
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Male Child ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Nuclear Families ◽  
Antenatal Period ◽  
Medical College ◽  
Control Study

Background: IUCDs are used by only two percent of the contraceptive users in India. There is a need for identifying the factors which influence the uptake of PPIUCD, so as to plan ways for increasing its usage. To determine the uptake and factors influencing the uptake of PPIUCD among the women delivering in a tertiary care hospital of OdishaMethods: This was a case control study conducted at the Obstetrics Department of M.K.C.G Medical College, Berhampur. All those who had agreed for and had undergone PPIUCD insertion were included in cases and those who did not undergo PPIUCD insertion were pooled into controls.Results: 94 cases and 188 controls were recruited. Significantly higher proportions of cases belonged to nuclear families, had one or more male child, did not want any future pregnancies, had heard about it prior to pregnancy and also had received counselling for the same during the antenatal period. The adjusted odds of uptake of PPIUCD in women having at least one male child is 10 (4.3-22.6) times that of mothers with no male children. The most common reasons told by controls for not taking up PPIUCD was disapproval from family members (42.6%), followed by fear of complication (33%) and preference for other methods of contraception (20.2%).Conclusions: In present study, we found that counselling in the antenatal period was a key point in increasing acceptance of post-partum IUCD. Desire for male child also influenced uptake of postpartum IUCD.

scholarly journals Acceptance, safety and complications of postpartum intra uterine contraceptive device: a prospective study in tertiary care hospital

2019 ◽  
Vol 8 (5) ◽  
pp. 1916
Author(s):  
Rekha Jain ◽  
Manisha Sharma ◽  
Shruti Gupta
Keyword(s):  
Side Effects ◽  
Retention Rate ◽  
Post Partum ◽  
Tertiary Care ◽  
Intrauterine Contraceptive Device ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Intrauterine Contraceptive ◽  
Reversible Method

Background: Intrauterine contraceptive device is a long acting, effective and reversible method of contraception. It can be inserted post placental during vaginal or LSCS delivery and within 48 hours of delivery.  This study evaluates the acceptance, safety, side effects and complications associated with immediate post-partum intrauterine contraceptive device (PPIUCD) insertion.Methods: The study was conducted at Hindu Rao Hospital and NDMC Medical College, Delhi for a period of 18 months. Patients admitted and delivered at Hindu Rao Hospital were counseled for PPIUCD, CuT 380 A / CuT 375 insertions and it was inserted within 10 minutes of delivery of placenta during vaginal delivery or LSCS or within 48 hours of delivery. Patients were followed at 6 weeks and then between 6 to 12 months of delivery for continuation, side effects or any complications.Results: After counseling 1253 (9.8%) patients agreed for PPIUCD insertion out of which 650 patients came for follow up. 46% women came for routine follow up while 54.06% came with one or the other complications. Missed thread was most common complications, followed by bleeding P/V and pain abdomen. Expulsion in 5.5% and CuT failure was seen in 0.92% women only. Removal of IUCD was done in 94 patients for one or other reasons. There was retention of PPIUCD in 84.5% while removal was done in 14.5% during period of 6 months to one year follow up. Missed thread was main cause of anxiety among acceptors.Conclusions: Immediate PPIUCD is safe and effective method of contraception with a high retention rate. Though acceptance in initial months was less but it gradually increased over time with increasing awareness, counseling of patients and training of health personnel.

scholarly journals A novel approach to meet the unmet need for family planning

2018 ◽  
Vol 8 (1) ◽  
pp. 169
Author(s):  
Subrata Samanta ◽  
Sujoy Dutta ◽  
Sudipta Samanta ◽  
Agrima Mullick
Keyword(s):  
Family Planning ◽  
Post Partum ◽  
Tertiary Care ◽  
Unmet Need ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Expulsion Rate ◽  
Satisfaction Rate ◽  
Novel Approach

Background: Post-partum intra-uterine contraceptive device is one of the important methods of spacing to meet up the unmet need of family planning. The low complication rate, ease and certainty of insertion and one-time adoption advantages made it an option of family planning by Government of India. In the background of recent trends in family planning, the study aims to establish the efficacy and draw-backs of PP-IUCD among the clients in a tertiary care hospital of West Bengal.Methods: Prospective observational study on 1680 women during January 2016 to December 2016, where the PP-IUCD was given to the patients after vaginal delivery or Cesarean section and were followed up to 3 months.Results: During the study 1.37% patients did not turnup in either follow-up. The most common complication encountered was missing thread (4.64% at 6th week follow-up and 6.67% at 3rd month follow-up). Expulsion rate was much lower (2.02% at 6th week and 2.5% at 3rd month). Heavy bleeding per-vagina was in 1.55% at 6th week and 2.08% at 3rd month. Pain abdomen was .83% at 6th week and 1.67% at 3rd month. Incidence of perforation and failure was both nil at either follow-up. Dysmenorrhea was complained 2.44% at 6th week and 3.33% at 3rd month. Overall satisfaction rate at 6th week (86.05%) was higher than non-satisfaction (13.95%). This was also true for 3rd month where satisfaction rate (77.85%) was higher than non-satisfaction rate (22.15%).Conclusions: PP-IUCD appears to be a safe, efficacious, acceptable and accessible method of contraception.

scholarly journals Outcome Of Immediate PPIUCD At Follow Up Visit In Women At A Tertiary Care Hospital In Karachi, Pakistan

2018 ◽  
Vol 09 (01) ◽  
pp. 43-47
Author(s):  
Sadia Suboohi ◽  
Sughra Abbasi ◽  
Saba Pario
Keyword(s):  
General Hospital ◽  
Vaginal Bleeding ◽  
Vaginal Discharge ◽  
Post Partum ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Abnormal Vaginal Discharge

Objective: To evaluate the outcome of Immediate Post Partum Intrauterine Contraceptive device (PPIUCD) insertion among married women of reproductive age at a tertiary care Creek General Hospital, Karachi, Pakistan. Study Design: Prospective Interventional study. Methodology: The clinical study was conducted in department of Obstetrics & Gynaecology, Creek General hospital Karachi from August 2015 to July 2016. One hundred and twenty five women were selected for immediate PPIUCD insertion, however the result was analysed for hundred women as twenty five were lost to follow-up. PPIUCD was inserted within 10 minutes of delivery of placenta. Follow up was done at 6 weeks, the primary outcome measures were the clinical outcomes in terms of safety (irregular vaginal bleeding, abnormal vaginal discharge, infection and perforation) and efficacy (un-descended IUCD strings, expulsion, discontinuation and pregnancy). The results were analyzed by SPSS data analysis software (IOBM). Results: Among hundred women in whom PPIUCD was inserted and returned for follow-up, majority (44%) were in age group 26-30 years; around 52% had primary or less education, and considerably high (84%) belonged to the low socio economic status. Moreover, majority (46 %) had 3 or more alive children. Importantly, 73% women had IUCD inserted after vaginal delivery. As safety was evaluated, irregular vaginal bleeding was observed in 15%, abnormal vaginal discharge (20%), infection (11%), abdominal pain (4%) and perforation in only 1% of cases. Finally, in terms of efficacy the undescended IUCD strings were observed in 7%, expulsion incidence (6%), discontinuation requested by (5%) and none of the case ended up in pregnancy. Conclusion: Post partum IUCD insertion immediately following delivery is an effective, safe, and acceptable long-term reversible method available for postpartum contraception.

scholarly journals Pattern of compliance to anti- hypertensive medications in hypertensive patients in a tertiary care hospital in Bangladesh

2016 ◽  
Vol 24 (1) ◽  
pp. 62-66
Author(s):  
Syed Zakir Hossain ◽  
Mohammad Rofiqul Islam ◽  
Sarmistha Biswas ◽  
Prodip Kumar Biswas ◽  
Mohammad Zaid Hossain ◽  
...  
Keyword(s):  
Negative Impact ◽  
Care Delivery ◽  
Tertiary Care ◽  
Health Care Delivery System ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Hypertensive Patients ◽  
Medical College ◽  
Physician Patient

Background: Non-adherence to anti-hypertensive medications can have a negative impact on long term cardiovascular outcome. Various studies have been conducted on this issue but factors are not yet explored properly, particularly in Bangladesh. This study was conducted to find out the prevalence and factors associated with pattern of compliance to anti-hypertensive medications in a tertiary level hospital.Methods: This descriptive study was done on 146 indoor hypertensive patients, included by purposive sampling in july’2015 who were taking anti-hypertensive for last 6 months. Data were collected through a questionnaire after obtaining informed consent.Results: This study revealed that 55.47% patients were compliant and 44.53% were noncompliant. Age >60 yrs. are more non-compliant (56.6%). Female (65.11%), house wife and urban population are more compliant. Population, with longer duration of hypertension are more non-compliant. Among the co-morbidities diabetic patients are more non-compliant. Population taking two anti-hypertensive are more compliant (76.47%).Conclusion: In our study most of the populations are compliant but yet significant number of populations are non-compliant. Collective participation of physician, patient and health care delivery system can improve the situation more. As consequence of non-compliance to antihypertensive is grave, community based studies should be conducted to explore the extent of non-compliance.J Dhaka Medical College, Vol. 24, No.1, April, 2015, Page 62-66

scholarly journals A retrospective study on management of bell\'s palsy in a tertiary care hospital

2021 ◽  
Vol 11 (2) ◽  
pp. 173-176
Author(s):  
P.K Purushothaman ◽  
Dhanyan Harshidan ◽  
Priyangha Elangovan
Keyword(s):  
Clinical Symptoms ◽  
Tertiary Care ◽  
Bell’S Palsy ◽  
Care Hospital ◽  
Bell's Palsy ◽  
College Hospital ◽  
Medical College ◽  
Therapeutic Measures

Bell's palsy is the most common facial nerve disorder. The clinical symptoms of Bell's palsy include facial muscle paralysis, difficulty in eating, drinking and talking. Bell's palsy management is still controversial. Many patients recover spontaneously; some require medicines like corticosteroids, antiviral drugs and other managements.To study the effectiveness of Bell's palsy management that has been followed in our institution.This analysis had carried out from June 2016 to June 2019at SRM Medical College Hospital and Research Institute, Chennai. Total of 30 patients with Bell's palsy who had admitted in the Department of Otorhinolaryngology had enrolled in this study. All the patients underwent thorough clinical examination and laboratory investigation, and the results were statistically analyzed and discussed.Out of 30 patients, 16(53%) patients were males, and 14(47%) patients were females. 53.3% of patients had onset of symptoms after 48 hours. There was a statistical significant improvement in House-Brackman scale on 6 months follow-up.The therapeutic measures for Bell's palsy if initiated within 72 hours of onset aids in bringing better outcome and improves the quality of life in patients.

scholarly journals Awareness of contraception in post-partum women in a tertiary care centre

2017 ◽  
Vol 6 (9) ◽  
pp. 3850
Author(s):  
Rupali Atmaram Gaikwad ◽  
Shrinivas N. Gadappa ◽  
Sonali S. Deshpande
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Contraceptive Device ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Oral Contraceptive Pills ◽  
Medical College ◽  
Contraceptive Pills ◽  
Intrauterine Contraceptive

Background: In this modern or scientific era even though women are working equally or one step ahead of men, in family planning decision they are still lagging behind. Postpartum period is very crucial for a woman especially for many of those belonging to the villages as this may be the only time she comes in contact with a health personnel and in a mood to listen health advice. Keeping this in mind, this crucial period was considered as opportunity to test the issue of awareness regarding contraception.Methods: We conducted a cross-sectional study in the department of obstetrics and gynecology of Govt medical college and hospital, Aurangabad between August 2016 to December 2016. A total 720 post-partum women were interrogated and counselled regarding various methods of contraception.Results: Only 55.69% were aware about various methods of contraception. Awareness was maximum for Sterilisation (91%) followed by Intrauterine contraceptive device (81%) and Oral contraceptive pills (41%). Women knew about contraception from health care system (45%) and mass media (36%). After counselling 97% patients ready to use.Conclusions: There is lack of awareness regarding contraception. Contraceptive services are to be strengthened by intergrating with antenatal sevices.

Clinical profile and outcome of acute nephritic syndrome in children from a tertiary care centre in south India: a descriptive study

2017 ◽  
Vol 4 (3) ◽  
pp. 769
Author(s):  
Shemeena Valiyat ◽  
Harsha T. Valoor
Keyword(s):  
South India ◽  
Tertiary Care ◽  
Descriptive Study ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Nephritic Syndrome ◽  
Long Term Follow Up ◽  
Acute Nephritic Syndrome

Background: Acute nephritic syndrome (ANS) is major cause of morbidity in developing countries. This study is an attempt to evaluate the clinical characteristics, complications and outcome of acute nephritic syndrome.Methods:This hospital based descriptive study was conducted at a tertiary care hospital in Kerala, South India. 103 children with ANS were analysed. Detailed clinical examination and relevant laboratory investigations were done. These children were followed up for 1 year.Results: Out of 103 patients studied 64% were male and 36% were female. The peak age group was 6 to 8 years. Skin infection was the most common predisposing condition (68.9%). Hypertension was present in 60.1% of patients. 26.2% of patients developed complications. Of these Acute renal failures was the most commonly encountered complication (18.4%). Proteinuria (87.4%) and microscopic hematuria (80.6%) were the most consistent features.  82.5 % patients had low C3 at the time of diagnosis. Majority of patients with low C3 level had positive ASO titre. (p = 0.014). At 3month follow up C3 became normal in 95.2% of patients. At 3 months’ majority of patients with normal C3 had incomplete recovery. (p = 0.010). At the end of 12m, microscopic heamaturia was present in 4 patients, persistent hypertension in 2 patients, 11 patients had proteinuria. These patients are kept under long term follow up.Conclusions:Complications and morbidity is significantly high during the acute phase in ANS. This study highlights the need for long term follow up of these patients. 

Intravenous paracetamol for neonates: long-term diseases not escalated during 5 years of follow-up

2020 ◽  
pp. fetalneonatal-2020-319069
Author(s):  
Sanna Juujärvi ◽  
Timo Saarela ◽  
Tytti Pokka ◽  
Mikko Hallman ◽  
Outi Aikio
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Tertiary Care ◽  
Epidemiological Studies ◽  
Speech Disorders ◽  
University Hospital ◽  
Care Hospital ◽  
Intravenous Paracetamol

ObjectiveTo evaluate the long-term adverse reactions of paracetamol in children who required intensive care shortly after birth. Paracetamol is a widely used analgesic in neonates, but the long-term studies are lacking. Previous epidemiological studies have reported associations between early paracetamol intake and diseases in childhood.DesignFive-year follow-up cohort of children who required intensive care shortly after birth.SettingSingle tertiary care hospital; neonatal and paediatric intensive care units.InterventionsIntravenous paracetamol was administered for pain and discomfort to the neonates during their intensive care, while for the control infants, it was not available.Main outcome measuresThe primary outcome was the incidence of asthma; secondary outcomes were neonatal diseases and long-term morbidities (atopic dermatitis, inflammatory bowel disease, autism, speech disorders, cerebral palsy). Long-term morbidities were adjusted based on antenatal and neonatal risk factors.ResultsWe screened all neonates admitted to the intensive care units soon after birth in Oulu University Hospital, Oulu, Finland, during 1 October 2007 to 31 December 2013. Altogether, 1552 infants needed intensive care. Of them, 735 (47%) were treated with intravenous paracetamol. We obtained their long-term data from the Finnish National Institute for Health and Welfare, including all physician-made diagnoses from all primary healthcare units and hospitals in Finland. We found no difference in the asthma incidence or in other long-term morbidities between paracetamol-treated and non-exposed infants.ConclusionsIntravenous paracetamol given to neonates did not associate with childhood disorders compared with the non-exposed infants during the 5-year follow-up. The previous hypothesis that early paracetamol use causes childhood morbidities was not confirmed.

scholarly journals TO STUDY THE RISK FACTOR OF POST-PARTUM HEMORRHAGE IN TERTIARY CARE HOSPITAL IN NORTH WEST RAJASTHAN

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Santosh Khajotia ◽  
Kavita Choudhary ◽  
Moolchand Khichar ◽  
Manoj Gupta ◽  
Madhuri Sharma ◽  
...  
Keyword(s):  
Risk Factor ◽  
Placenta Previa ◽  
Post Partum ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
North West ◽  
Medical College ◽  
Prolonged Labor

Introduction: Present study was conducted to evaluate the risk factor of PPH.  Methodology: Study group comprises of 100 females attending obstetrics and gynecology department in S.P. Medical College, Bikaner. Delivered women ? 28 weeks seen during the first hour of PPH with visual blood loss >500 ml in normal vaginal delivery and > 1000 ml during LSCS were included in the study.  Results: Out of 100 cases, 17(17%) had multiparity followed by 7(7%) each had previous LSCS and prolonged labor, 5(5%) each had multiple pregnancy and macrosomia, 3(3%) each had placenta previa and previous 2 LSCS, 2(2%) each had postdatism and precipitate labor and 1(1%) had breech. Conclusion: Multiparty was most common risk factor. Keywords: Hemorrhage, Post-partum, Risk factor

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