Risks of venous thromboembolic complications in related to combined oral contraceptives

Hormonal contraception is the most popular and effective reversible method for preventing unwanted pregnancy exerting multiple prophylactic and therapeutic effect along with contraceptive activity. The main adverse coupled to combined oral contraceptives (COCs) is its impact on the hemostasis and increased risk of venous thromboembolic complications. A great evolutionary path has been travelled after beginning application of hormonal contraception to reduce dose of its estrogen component and improving quality of gestagen component. Nevertheless, thrombotic complications related to COCs use still remain a pressing issue not only due to disease severity and high mortality rate from pulmonary embolism (PE), but also due to the difficulties in its timely diagnostics. Here we describe a clinical case of a 19-year-old patient suffering from vena cava inferior thrombosis complicated by PE after using COCs.

Genetic Diversity of Non-Tuberculous Mycobacteria among Symptomatic TB negative Patients in Kenya

Non-Tuberculous Mycobacteria (NTM) transmission to humans occurs through inhalation of dust particles or vaporized water containing NTM leading to pulmonary manifestations. NTM infections are often misdiagnosed for tuberculosis (TB) due to their similar clinical and radiological manifestations. We, therefore, performed a species-level identification of NTM in symptomatic TB negative patients through sequencing of the hsp65 gene. We conducted a cross-sectional study at the National Tuberculosis Reference Laboratory in the period between January to November 2020. One hundred and sixty-six mycobacterial culture-positive samples that tested negative for TB using capilia underwent Polymerase Chain Reaction targeting the hsp65 gene. Isolates showing a band with gel electrophoresis at 441 bp position were sequenced using Sanger technology. Geneious software was used to analyze the obtained sequences, and the National Center for Biotechnology Information gene database identified NTM species for each isolate. A phylogenetic tree was constructed from the DNA sequences and evolutionary distances computed using the general time-reversible method. Pearson chi-square was used to determine the association between NTM infection and participants characteristics. Our study identified 43 different NTM species. The dominant NTM belonged to Mycobacterium avium complex 37 (31%). Slow-growing NTM were the majority at 86 (71%) while rapid-growing NTM were 36 (29%). A significant association (p<0.05) was observed for regions and age, while patient type had a week likelihood of NTM infection. Our study characterized the diversity of NTM in Kenya for the first time and showed a high diversity of NTM species.

Direct Targeting of the Anterior Nucleus of the Thalamus via 3 T Quantitative Susceptibility Mapping

Objective: Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is a potentially effective, minimally invasive, and reversible method for treating epilepsy. The goal of this study was to explore whether 3 T quantitative susceptibility mapping (QSM) could delineate the ANT from surrounding structures, which is important for the direct targeting of DBS surgery.Methods: We obtained 3 T QSM, T1-weighted (T1w), and T2-weighted (T2w) images from 11 patients with Parkinson’s disease or dystonia who received subthalamic nucleus (STN) or globus pallidus interna (GPi) DBS surgery in our center. The ANT and its surrounding white matter structures on QSM were compared with available atlases. The contrast-to-noise ratios (CNRs) of ANT relative to the external medullary lamina (eml) were compared across the three imaging modalities. Additionally, the morphology and location of the ANT were depicted in the anterior commissure (AC)-posterior commissure (PC)-based system.Results: ANT can be clearly distinguished from the surrounding white matter laminas and appeared hyperintense on QSM. The CNRs of the ANT-eml on QSM, T1w, and T2w images were 10.20 ± 4.23, 1.71 ± 1.03, and 1.35 ± 0.70, respectively. One-way analysis of variance (ANOVA) indicated significant differences in CNRs among QSM, T1w, and T2w imaging modalities [F(2) = 85.28, p &lt; 0.0001]. In addition, both the morphology and location of the ANT were highly variable between patients in the AC–PC-based system.Conclusion: The potential utility of QSM for the visualization of ANTs in clinical imaging is promising and may be suitable for targeting the ANT for DBS to treat epilepsy.

A study of different contraceptive methods: need of the hour during COVID 19 pandemic

Background: COVID-19 disease is the pandemic caused by a single-stranded RNA virus that belongs to the coronavirus family known as 2019-nCoV (SARS-Co V). The disease is highly contagious and transmitted mainly by droplets or close contact. In this time of pandemic it is need of the hour to prevent more and more unwanted pregnancies. This study was to evaluate the contraceptive methods of choice which are easily available, cost effective and suitable to most of the patients during this terrible period of pandemic.Methods: This was a prospective observational study done from April 2020 to December 2020. Women coming to the OPD for contraceptive advice after medical termination of pregnancy and patients desiring postpartum contraception were included in the study. All data were collected from the OPD and IPD of our hospital. Different contraceptive methods available, their costs, hospital visits, complications, failure rate and reason for its discontinuation was analysed.Results: In this study 76.5% patients (n-459) accepted Inj. DMPA as compared to 10 % used Cu T and 13% used OC pills as a method of contraception. Inj DMPA is easily available, cost effective, has lesser side effects and need less hospital visits.Conclusions: DMPA should be made available as a first line method to all those who wishes to opt for reversible method of contraception. This study concludes, during the period of pandemic Inj DMPA was most preferred method of contraception.

KNOWLEDGE ,ACCEPTIBLITY AND COMPLIANCE OF DMPA IN TERTIARY CENTER OF BIHA

In India , a large proportion of women with an unmet need for contraception are within their rst year after childbirth. It is major obstacles for nation social and economic development. The present study concentrates to educate postpartum women for contraception and to study the acceptance and compliance of medroxyprogesterone acetate (DMPA) in Bihar women. METHODS: This is retrospective study with cross sectional data collection from 210 patients for a period of 14 month , from JANUARY 2019 TO FEBRUARY 2020. RESULTS: The study concluded that DMPA is highly effective contraceptive in the immeadiate post partum period with low failure rate .CONCLUSION: It should be available as a rst line method to all who wish to opt reversible method of contraception.

Fe(iii)-complex mediated bacterial cell surface immobilization of eGFP and enzymes

A facile and reversible method to immobilize His6-tagged proteins on the E. coli cell surface through the formation of an Fe(iii)-complex.

Study the acceptance, compliance and efficacy of injection depot medroxy progesterone acetate as contraception: a prospective observational study

Background: India was the first country in the world to launch a family planning programme, as early as 1952, with the main aim of controlling its population. Depot medroxy progesterone acetate, or DMPA is a progestin-only method of contraception. It is a 3-monthly intramuscular injectable that delivers 150 mg of medroxyprogesterone acetate in microcrystalline suspension form that delays absorption of the hormone after the injection. It provides long acting, effective and reversible contraception. In this study, we evaluated patients in reproductive age group 18-35 years who were willing to use injectable DMPA as a method of contraception to study the acceptance, compliance and efficacy of injection depot medroxyprogesterone acetate as contraception.Methods: It is a prospective observational study carried out at Government medical college Miraj on 150 patients who fulfil the inclusion criteria. The postpartum, interval and postabortal categorisation of patients done and they are councelled about the benefits and side effects and drawbacks of DMPA. Injection is given deep intramuscularly after written informed consent and a DMPA card is given to beneficiary. Follow up date explained and patients are observed for follow up and any evidence of bleeding weight gain or any other side effects of DMPA are noted.Results: The mean age of subjects was 24.48±3.494 years. 2) 3.3% of the patients were nullipara, primi para 46.7%, 36% were second para, 11.3% were third para and 2.7% were fourth par. 3) After 1st injection, 47.3% patients were lost to follow-up i.e., they did not turn up for their second dose of injection. 4) Out of 150 patients who accepted the injection as contraception, only 79 patients turned up for their 2nd injection after 3months, out of which only 37 patients turned up for their 3rd dose of injection after 6 months and only 5 patients turned up for their 3rd injection. Thus showing that the compliance is poor among this study population. 5) At 2nd injection, 39.2% discontinued due to amenorrhea, 10.7% discontinued due to irregular bleeding, 18.5% due to weight gain and 31.6% due undergoing permanent method. 6) No patients who came for follow up reported any pregnancies during the course of injection, therefore the efficacy of injection depot medroxy-progesterone acetate, as a method of contraception is 100% in this study.Conclusions: The DMPA is a good method of long acting reversible method of contraception with good acceptance and efficacy with less compliance.

Management of Intrauterine Device Migrated into the Bladder: A Case Report and Literature Review

Intrauterine device represents the most reversible method of contraceptive worldwide. Its insertion is a medical procedure not free from complication. We report a rare case of intravesical migration of a copper intrauterine device inserted 18 months earlier in a 28-year-old multiparous woman. The patient presented with irritative lower urinary tract symptoms, and she was managed endoscopically. This case underscores the role of cystoscopy in irritative lower urinary tract symptoms post IUD insertion.

Controlling the symmetry of inorganic ionic nanofilms with optical chirality

Manipulating symmetry environments of metal ions to control functional properties is a fundamental concept of chemistry. For example, lattice strain enables control of symmetry in solids through a change in the nuclear positions surrounding a metal centre. Light–matter interactions can also induce strain but providing dynamic symmetry control is restricted to specific materials under intense laser illumination. Here, we show how effective chemical symmetry can be tuned by creating a symmetry-breaking rotational bulk polarisation in the electronic charge distribution surrounding a metal centre, which we term a meta-crystal field. The effect arises from an interface-mediated transfer of optical spin from a chiral light beam to produce an electronic torque that replicates the effect of strain created by high pressures. Since the phenomenon does not rely on a physical rearrangement of nuclear positions, material constraints are lifted, thus providing a generic and fully reversible method of manipulating effective symmetry in solids.

OCCLUSAL SPLINTS: TYPES, MATERIALS AND PROPERTIES - A LITERATURE REVIEW

ABSTRACT Temporomandibular Disorder (TMD) is considered the major cause of non-dental pain in the orofacial region and the most crucial symptom for which patients seek medical attention, negatively affecting quality of life. The plates have gained prominence as a treatment for TMD but the success or failure of the occlusal plates will depend on their correct selection and indication, materials for making and adjusting, in addition to the cooperation of the patient. The purpose of this study is to highlight the most used types of occlusal plaques, their advantages, disadvantages, indications and contraindications, in addition to identifying and analyzing the materials currently used in their manufacture. A literature review was conducted with searches on articles from the electronic databases PubMed, Virtual Health Library (BVS) and Google Scholar with the descriptors: disfunção, placa occlusal, tratamento, dysfunction, plate, occlusal and treatment. We also use bibliographic information from Okeson (2013). From the data collected in this literature review, it can be concluded that the occlusal plaque is considered a conservative and reversible method and has stood out for its low cost and high success rate. This study demonstrated that the most advantageous material for the manufacture of the plates was the photopolymerizable resin. However, the dentist must be attentive to a correct diagnosis, selection and indication, preparation and adjustment materials, in addition to the patient's cooperation in order to provide the appropriate treatment.