IMPLEMENTASI R-SHINY UNTUK ANALISIS BIPLOT KOMPONEN UTAMA (Studi Kasus: Penggunaan Alat Kontrasepsi pada Peserta Aktif KB di Provinsi Jawa Tengah Tahun 2019)

The population problem is a fairly complex and complicated problem. Therefore, Indonesia seeks to control the birth rate with the Family Planning program. The implementation of this program can be evaluated through statistical data. The statistical analysis used is biplot principal component analysis to see the relationship between districts/cities in choosing the contraceptive device/method used, the variance of each contraceptive device/method, the correlation between contraceptive devices/methods, and the superiority value of the contraceptive device/method in the population. each district/city. The problem with performing the analysis is the limitations of easy-to-use open source software. As with R, users must understand writing code to perform data analysis. Therefore, to perform a biplot analysis of the principal components, an RShiny application has been created using RStudio. The R-Shiny that has been made has many advantages, including complete results which include data display, data transformation, SVD matrix, to graphs along with plot graph interpretation. The results of the principal component biplot analysis using R-Shiny with α =1 have the advantage of a good principal component biplot, which is 95.63%. This shows that the biplot interpretation of the main components produced can be explained well the relationship between the district/city and the contraceptive methods/devices used.

Incidental retained intrauterine Lippe’s loop in 65 years old woman: a rare case report

Intrauterine contraceptive devices are a widely used method of contraception. It is cheap, easy and an effective method. The first intrauterine device was Lippe’s loop which was double S shaped trapezoid loop introduced in 1962. Nowadays, third generation intrauterine devices are used which are effective for 5 and as well as 10 years. Here we presented a rare case of first generation of intrauterine device, that was, Lippe’s loop in a 65 year old lady which was found as an incidental finding. Intrauterine device insertion without the knowledge of women can lead to the forgotten device which can adversely affect the health of women.

Size dependent inhibition of sperm motility by copper particles as a path towards reversible male contraception

Effective inhibition of sperm motility using a spermicide can be a promising approach in developing non-invasive male contraceptive agents. Copper is known to have contraceptive properties and has been used clinically for decades as intrauterine contraceptive devices (IUDs) for contraception in females. Beyond that, the spermicidal use of copper has not been explored much further, even though its use could also subdue the harmful effects caused by the hormonal contraceptive agents on the environment. Herein, we study the size, concentration and time dependent in vitro inhibition of bovine spermatozoa by copper microparticles. The effectivity in inhibiting the sperm motility is correlated to the amount of Cu2+ ions released by the particles during incubation. The copper particles cause direct suppression of sperm cell motility upon incubation and thereby show potential as sperm inhibiting, hormone free candidate for male contraception beyond condoms.

Misplaced intrauterine contraceptive devices: a case report

Contraception is a new topic gaining attention in country like India and a new proposed area of research. Intrauterine contraceptive devices (IUCDs) are one contraceptive method requiring less efforts and having more efficacy. ‘Misplaced IUCD’ is one of the rare and the most dreadful complication of IUCD insertion. Clinically, it can present as having pain, bleeding, recurrent pregnancy loss or can be asymptomatic. This is a case report of a 40 year old P4A1L4 female who presented to us with suspicion of misplaced IUCD without clinical symptoms. Clinical examination and radiological investigations made a diagnosis of misplaced IUCD and laparoscopy confirmed it. Laparoscopically misplaced IUCD was removed.

The Role of Cultural Capital in Strengthening the Relationship between Need and Demand for Contraceptive Devices and Drugs in Several Cultural Areas in Indonesia

BACKGROUND: Acceptor’s decision to use particular contraceptive devices/drugs is influenced by cultural capital. Cultural capital has three forms: Embodied state, objectified state, and institutionalized state. AIM: This study aimed to analyze the influence of culture as a moderating variable on the relationship between need and demand for contraceptive devices/drugs in several cultural areas in Indonesia. METHODS: This observational study used a cross-sectional design. The criteria for research subjects were: (1) Women at child-bearing age who were currently using contraceptive devices/drugs of IUD, implants, pills, or injections; (2) Aged 15–49 years old; and (3) Indonesian citizens who come from Dayak and Javanese cultural areas. Sampling was performed using the multistage random sampling technique. The data were obtained through questionnaire and analyzed using the Partial Least Square (PLS) statistical test. RESULTS: The results of statistical tests showed that there was a significant relationship between the need and use of contraception (p = 0.000). The amount of influence between need and demand for contraceptive devices/drugs contraceptives reached 79.2% (R2 = 0.7 92). It was found that cultural capital (objectified state and institutionalized state) did not have a significant relationship with demand (p = 0.113) and had an insignificant moderating effect value (p = 0.722). Thus, it can be interpreted that cultural capital (objectified state and institutionalized state) is a variable that has the potential to become a moderating variable that can affect the strength of the relationship between need and demand. The original sample moderating effect value was positive at 0.017, meaning that the cultural capital moderating variable can strengthen the relationship between the need and demand for contraceptive devices/drugs. CONCLUSION: There is a significant relationship between need and demand for contraceptive devices/drugs. Culture capital (objectified state and institutionalized state) is a variable that has the potential to become a moderating variable that can strengthen the relationship between the need and demand for contraceptive devices/drugs. Therefore, a cultural approach is needed so that acceptors can use contraceptive devices/drugs that suit their needs.

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

Failed tubectomy procedures: a retrospective study

Background: It is difficult to understand the nature of factors leading to failure of sterilization from single institute. Knowing the factors, we can take preventive measures. Those data were of women who filed claims under Family Planning Indemnity Scheme, 2013 (revised 2016). The scheme was not reached at grassroots; therefore, not enough women got the benefit of this scheme. We gave the list of documents as well, which help medical fraternity working in rural area.Methods: Retrospective study of 32 women of failed tubal ligation over a period of four years (from 2016 to 2019). The variables under consideration of study were, parity and age at the time of tubectomy. Time and method of tubectomy. Interval between tubectomy and subsequent pregnancy. Outcome of subsequent pregnancy and further contraceptive acceptance. Descriptive statistics used for frequency analysis.Results: Median age of women was 26 years during tubal sterilization. Seventy two percent women were accepted sterilization on two children. Sixty nine percent of tubal sterilization were performed in puerperium; concurrent with caesarean section and medical termination of pregnancy, while 31% were during interval period. Thirty four percent of women became pregnant within 24 months(2years) of sterilization and cumulative 75% within 60 months (5 years) after sterilization. Sixty nine percent of women had intrauterine pregnancies and 31% ectopic pregnancies. Fifty six percent women accepted medical termination of pregnancy and 53% chosen repeat tubal sterilization. Four women (12%) gave live births. Two of them accepted repeat sterilization and another two intrauterine contraceptive devices. Thirty one percent women had ectopic pregnancy; nine of them came as ruptured ectopic, therefore, exploratory laparotomy with bilateral total salpingectomy were to be performed.Conclusions: Failed tubal sterilization is common when it was performed at younger age and in puerperium. Missed period after sterilization should have high index of suspicion of ectopic pregnancy, which leads to severe maternal morbidity.

Silent perforation and migration of IUCD: A diagnostic challenge in patients with pain abdomen: A case report

Secondary perforations of intrauterine contraceptive devices (IUCD) may be clinically silent. The patient may not report the missing threads due to a lack of acute symptoms or under the impression that the device could have been expelled. We present a case of a 42-year-old lady treated for renal cell carcinoma and presenting with recurrent right lower quadrant abdominal pain for 2 years. Ultrasound scans did not reveal any abnormality. A plain computed tomography (CT) revealed a migrated IUCD embedded in the omentum with adjacent inflammation. Although CT is not the modality of choice in the diagnosis of migrated IUCD, it proved helpful in diagnosing this case as history was not forthcoming. This case highlights the diagnostic dilemma faced in cases of silent IUCD migration presenting with pain abdomen. It is important to counsel the patient at the time of IUCD insertion for the early recognition of missing devices and prompt diagnosis of complications.

735Dynamics and Determinants of Birth Spacing in India

Background Birth spacing is an important determinant of the high fertility populations and has a strong bearing on maternal and infant health. The birth interval is composed of three major components namely postpartum amenorrhoea (PPA), waiting time to conception and gestation. To manage the high fertility in India, the present study is aimed to investigate the differential pattern of duration of birth interval components with respect to various socio demographic, child mortality, family planning services etc. Methods The data for this analysis was taken from National Family Health Survey 2015-16 (NFHS-4), provides information on population, health and nutrition for India and each State / Union territory. It gathered information from 601,509 households from overall India. Results Cox’ regression explores infant mortality, lactation, use of contraceptive devices, son preference and religion are found significant (P < 0.01) factors on the dynamics of birth interval components After adjustment of the effects of other explanatory variables, duration of breast feeding (P < 0.01), infant mortality (P < 0.01) and family income (P < 0.05) are found to have their significant impacts on the variation of PPA whereas death of previous child in infancy (P < 0.01), sex of previous child (P < 0.05), lactation (P < 0.01), education of mother (P < 0.05), and use of effective contraceptives have are found to be significant factors influencing the duration of waiting time to conception. Conclusions Among the determinants, infant mortality, lactation and religion have significant impacts on both duration variables in the Cox’s stepwise regression models. Key messages To control the growth of population, birth spacing must be maintained.