Application of Taguchi and RSM Parameters on Surface Roughness and Material Removal Rate of AA6082T6

Taguchi and Response Surface Methodologies (RSM) for Surface Roughness (SR), and Material Removal Rate (MRR) in end processing of AA6082T6 with tungsten carbide Insert. The Experiments have been driven using the Taguchi plan. The cutting boundaries are feed, speed, and profundity of cut. The impact of machining boundaries and to assessed the ideal cuttings condition to surface unpleasantness and material expulsion rate. A second-request model has been work between the cutting limits and the machining limits to recognize out the SR and MRR by using reaction surface strategy. The test outcomes have shown the most basic factor in the surface unpleasantness is speed (31.068%) and in the material evacuation rate is profundity of cut (51.9404%). The anticipated qualities are affirmed by utilizing affirmation tests.

Prevalence of Complications after Interval Postpartum Intrauterine Device Insertion

Background and Aim: Postpartum intrauterine device (PPIUD) is a reversible, long-term and effective technique of contraception. The intrauterine device (IUD) is inserted within 48 hours of delivery. The immediate insertion of an intrauterine device causes certain complications. The present study aimed to assess the prevalence of complications after Interval Postpartum Intrauterine Device Insertion. Materials and Methods: This cross-sectional study was carried out on 147 women who underwent postpartum IUD (PPIUD) insertions during from January 2021 to June 2021 at Gynecology department, Mufti Mehmood Memorial Teaching Hospital (MMMTH), Dera Ismail Khan and Muhammad Teaching Hospital Peshawar. All the women who delivered and showed willingness for PPIUCD insertion were enrolled and continuously follow-up for 4 to 6 weeks after delivery. Demographic, obstetric, and clinical parameters were recorded on pre-designed medical proforma. PPIUCD insertion after 6 weeks of delivery were followed-up for the evaluation of complications. Uterine infection, medical removal of IUD, IUD expulsion, perforation, and method discontinuation were the outcome variables. SPSS version 20 was used for data analysis. Results: Of the total deliveries, 147 women inserted the postpartum intrauterine contraceptive device (PPIUCD). Of the total, about 122 (83%) women returned for follow-up after 6 weeks. All the women underwent transvaginal insertion of intrauterine contraceptive devices. The PPIUCD insertion related complications with prevalence were uterine infection 26 (21.3%), overall method suspension 17 (13.9%), perforation 20 (16.4%), interceptive uterine device expulsions 25 (20.5%), and intrauterine device removal 32 (26.2%). The severe uterine infection was in 2 (1.7%) cases who were hospitalized. Conclusion: The postpartum intrauterine device cumulative expulsion rate was higher among women compared to the expulsion rate of insertions. The longer duration of bloody lochia flow and delivery intrauterine device insertions were the key risk factors for expulsion of PPIUCD. Women can safely utilize intrauterine contraceptive devices with low complications beyond four week. Keywords: Postpartum intrauterine device; Complications; Intrauterine device expulsion

Correlates of Post-Partum Intra-Uterine Copper-T Devices (PPIUCD) Acceptability and Retention: An Observational Study from North India.

Background: Immediate postpartum period is the most appropriate time for introducing contraception as women are more pliable and highly motivated to adopt family planning methods. We assessed the safety and efficacy of post placental IUCD insertion (Cu- T 380A) immediately after delivery of placenta in women undergoing expected vaginal delivery or caesarean section and its compliance.Material and method: This prospective observational study was conducted for a period of (exact period of study) at a tertiary care institute in North India. Patients delivering at our hospital were recruited in the study as per inclusion and exclusion criteria after taking informed consent.Results: A total of 300 women were counselled over one year. Of these, 60% of women accepted PPIUCD. The majority of the PPIUCD acceptors were primigravida (61.7%), educated (86.1%), belonging to urban areas (61.7%), between 25 to 30 years (40.6%). The Follow-up rate was 93%, 90% and 81% at six weeks, three months, and six months, while the continuation rate at six months was 80%. The most common complication during follow-up were abnormal uterine bleeding, infection and missing threads. There was no case of perforation or failure of PPIUCD. The expulsion rate was 5%, and 14% of women had removal of PPIUCD.Conclusion: PPIUCD is a safe, highly effective, low cost, long-acting and feasible method of contraception. Skill enhancement of healthcare personnel for insertion techniques, adequate antenatal counselling, and advocacy of PPIUCD can help increase the acceptability of PPIUCD.

THE DIFFERENCESS OF DISCONTINUITAS IUD IN POST PLACENTAL AND INTRA-CESAREAN IN MADIUN

Background: Intra Uterine Device (IUD) which is placed after delivery of the placenta is an attempt to reduce the rate of population growth. However, the achievement is still very low, especially in the post-placental IUD insertion. It is this high expulsion rate that continues to be a concern for service providers, so this method is acceptable. The purpose of this study is to compare the sustainability of IUD acceptors in post-placental and intra-cesareann placement. Methods: The design of this study was cross sectional with an observational analytic method. Location of this research in the family planning clinic of Dr. Soedono Madiun Hospital, Banjarejo Health Center, Tawangrejo Health Center, and PMB Ny. “P” Madiun City in 2019.The sample used consecutive sampling as many as 114 acceptors. The independent variable was the time of IUD insertion. The dependent variable is the discontinuity of the IUD acceptor. The instrument used was the 2019 IUD acceptor medical record. The Fisher Exact Test on SPSS was used to perform data analysis. Results: From 114 acceptors, there was no difference in the discontinuity of IUD acceptors in post-placental and intra-cesarean placement (p=0.1). The incidence of expulsion was found in post-placental insertion (p=0.02). In intra-cesarean IUD acceptors more confirmed using ultrasound examination (p = 0.03). There was no perforation in both. Conclusion: There is no difference in IUD acceptor discontinuity in post-placental and intra-cesarean placement.

Efficacy of Tamsulosin and Alfuzosin in Management of Distal Ureteral Stones

Introduction: Urinary tract calculi are the most frequent condition in urology clinics worldwide. The overall prevalence is about 5 % and lower urinary tract stones account for 70% among them. Medical expulsive therapy has been used to treat distal ureteric stone as it reduces symptoms and facilitates stone expulsion. The aim of this study is to evaluate and compare the efficacy of tamsulosin and alfuzosin as medical therapy in ureteric stones. Materials and Methods: A total of 87 patients with distal ureteral stones of size ≤10 mm were randomly divided into 3 groups. Group A patients (n-30) received 0.4 mg of tamsulosin daily, group B patients (n-29) received 10 mg of alfuzosin daily and group C patients (n-28) received 75 mg of diclofenac sodium. Patients in all groups received diclofenac sodium for one week and then as required. Follow-up was done on a weekly basis for 4 weeks. The stone expulsion rate, time for stone expulsion, and side-effects were recorded in each group. Results: The mean stone size (5.66, 5.79, 5.67) mm and age (29.1, 30.31, 29.4) were comparable in each group. The stone expulsion rate was 83.3%, 79.3%, and 50% in groups A, B, and C respectively. It showed that both the study groups (Group A and Group B) were effective than the control group (p-value 0.006 and 0.02 respectively) but there was no difference between tamsulosin and alfuzosin (p-value 0.69). The duration of stone expulsion was 11.5 days, 11.8 days, and 17.3 days for Group A, B, and C respectively. The drugs related side effects reported by patients were mild and transient. Conclusion: The use of tamsulosin and alfuzosin for the medical treatment of ureteric stones proved to be safe and effective and neither did have any significant benefits over the other.

Systematic Review of Efficacy and Safety of Silodosin in Medical Expulsive Therapy for the Management of Ureteral Stones – Based on Indian Evidences

Introduction: Urolithiasis is quite a common disorder affecting around two million people in India every year. Minimally invasive therapies are effective treatment measures in most of the cases. However, a watchful waiting approach with pharmacotherapy promotes the expulsion of stones in a shorter time. We hereby review the efficacy and safety of silodosin, a selective α-1A adrenoceptor antagonist, in medical expulsive therapy for the management of urolithiasis based on the evidences in Indian population. Methods: Medical Subject Headings (MeSH) keywords which were used to systematically search electronic databases: PubMed/Medline, Cochrane Library and Google Scholar from their inception to February 2020 were “Silodosin”, “Ureteral calculi”, “Medical expulsive therapy”, “India”, “randomised controlled trials” and “prospective observational studies”. A total of 29 relevant studies could be found and were included in our analysis. Results: The primary outcomes considered were the stone expulsion rate (SER) and stone expulsion time (SET) along with pain episodes and safety outcomes like orthostatic hypotension and retrograde ejaculation. Eight studies with a total of 1064 patients were identified as evidences considering Indian population which compared silodosin with controls like tamsulosin or tadalafil. Conclusions: Silodosin is highly effective in Indian population for increasing stone expulsion for those with ureteral stones (distal ureteral stones with diameter ≥5 mm and ≤10 mm) with shorter expulsion times along with fewer episodes of pain. It is also effective in post-lithotripsy for accentuating clearance rate and curtailing time to passage of the stones.

Infection and Expulsion Rate of Intrauterine Contraceptive Device After Post Caesarean Vs Interval Insertion

Aim: To compare the frequency of infection and expulsion following insertion of IUCD immediate post casarean to that of interval insertion in parturient undergoing elective caesarean section Method: This Randomized controlled trial was conducted from 21 February to 20th August 2010. Results: It was observed that in immediate post cesarean group(Group A) expulsion rate was 8.1% and infection rate 7.2% where as in interval insertion group(Group B) expulsion rate was 10.9%and infection rate was 9.0%. The difference of expulsion rate was statistically significant in two groups (p value 0.491) i.e expulsion rate was proven to be significantly higher in interval insertion group than immediate trans cesarean insertion group. The difference of infection rate was not statistically significant between two groups (p value 0.623) although infection rate was found to be higher in interval insertion group but not clinically significant difference was found. Conclusion: Null hypothesis was rejected for expulsion rate of IUCD and a statistically significant increased expulsion rate was found in interval insertion group as compared to immediate post cesarean insertion group. Null hypothesis was accepted for infection rate after IUCD placement in two groups as no statistically significant increased infection rate was found between immediate post cesarean and interval insertion groups Keywords: Expulsion rate, infection rate,immediate post cesarean insertion,interval insertion.

Clinical Outcomes of Trans-caesarean and Vaginal Post-placental CuT380A IUCD Insertions: A Comparative Study

Background: Immediate postpartum CuT380A intrauterine contraceptive device (PPIUCD) insertion provides a novel approach in reducing the unmet contraceptive needs of family planning. The insertion can be trans-caesarean or vaginal following delivery of the placenta. The clinical outcomes of the different routes of insertion have not been adequately studied. Aim: The study aimed at comparing the clinical outcomes following trans-caesarean and vaginal post-placental insertions of CuT380A IUCD. Methodology: The study was a prospective cohort study of 81 pregnant mothers managed at a tertiary health institution in southern Nigeria. They were recruited into two groups using a convenient sampling technique; 27 and 54 mothers in the caesarean and vaginal delivery groups respectively. The pregnant mothers were followed up till delivery and at the six weeks postnatal visit. Information on their socio-demographic characteristics, Obstetrics and Gynecology history were obtained with the aid of a proforma. The proforma was updated with the clinical outcomes of immediate PPIUCD insertions in the two groups, at the six weeks visit. Data obtained were analyzed using statistical package of social sciences version 21. Continuous variables were expressed as means and standard deviations. The Chi square test was used for dichotomous or categorical variables. A p-value of less than 0.05 was considered statistically significant. Results: The study showed that PPIUCD is a safe practice in both vaginal and caesarean deliveries with no significant differences in clinical outcomes. However, incidence of missing string was higher in the caesarean group compared to vaginal group (81.5% vs 51.9%; p value-0.01); and expulsion rate was also high in the vaginal group but not significant. (13.0% vs 7.4%; p value 0.45). Conclusion: Immediate postpartum CuT380A contraception, irrespective of route of insertion, is convenient, effective, and safe. Although there is a relatively higher incidence of missing strings, including expulsions after vaginal PPIUCD insertions, immediate post-partum contraception should be encouraged. This will help to reduce high unmet contraceptive needs in our environment and loss to follow up irrespective of route of delivery. Recommendation: Immediate PPIUCD, irrespective of the route, should be encouraged and integrated into the existing Maternal and Child Health Programme. Awareness should be created to promote acceptance in our environment.

ACCEPTANCE, COMPLICATION, EXPULSION AND FAILURE RATE OF POSTPARTUM IUCD IN A TERTIARY CARE HOSPITAL

Introduction: 1 India's population has crossed one billion in the year 2000. In recent censes of 2011 it has reached 121 crores and it is estimated to 2 reach a gure of1.53 billion by 2050, making it the most populous country in the world . India is the rst country in the world to adopt an ofcial population policy and launch ofcial family planning programme way back in 1952, which remains the mainstay of family planning efforts. Aims and objectives: 1. To nd out the proportion of accepting the Post-Partum Intrauterine Contraceptive Device (PPIUCD) insertion among eligible women delivering at SSKM hospital. 2. To assess the complications of post placental &intra caesarean PPIUCD if any among these acceptors. 3. To determine the spontaneous expulsion rate of this contraceptive device. Materials and methods: All Adult ANC women attending SSKM hospital at Gynae OPD and as well as admitted in hospital wards or Labour Room who will full the inclusion criteria during data collection period. Conclusion: The study results, it can be concluded that PPIUCD in the eld of PPFP is a promising approach. Whatever may be the mode of delivery, PPIUCD is safe and efcacious in terms of safety and efcacy.

‘STUDY OF LONG ACTING REVERSIBLE CONTRACEPTION(LARC) AFTER ABORTION'

Background: The study was conducted to evaluate clinical outcome of post abortion intrauterine contraceptive device (PAIUCD) insertion in terms of acceptability, complications, expulsion and continuation rate. Methods: A prospective observational study was conducted in GMCH, Aurangabad from 2018 to 2020 after Institution Ethics committee approval. Results:Total 250 women were recruited in study. Acceptance rate of PAIUCD was 13.13%. Their age ranges from 20-36years.Majority of women who underwent PAIUCD insertion (77.3%) were from lower middle socioeconomic class of Modied Kuppuswami scale. Around 54.8% were primiparas. Complication rates of immediate PAIUCD insertion were low. Not a single case of uterine perforation was noted. The complications associated with PAIUCD were heavy menstrual bleeding (7.94%), irregular bleeding (4.2%), dysmenorrhea (6.5%) and pelvic infection (1.4%). Expulsion rate was 7.47%. It was found to be higher (5.53%) in cases of mid trimester abortion than in cases of rst trimester abortion (1.87%). Continuation rate was78.97% at the end of 6 months. Conclusion: Higher rate of continuation with lower rate of expulsion, pelvic inammatory disease and minimal risk of perforation were noted after PAIUCD insertion. PAIUCD was safe and well tolerated by women.