2.Unmet Needs for Contraception in Married Women in a Tribal Area of India
Sapna S.Patil ; Abdul Rashid K ; KA Narayan
Malaysian Journal of Public Health Medicine 2010;10(2):44-51
Background and Objectives: Unmet need for contraception is the gap between women's reproductive intentions and their contraceptive behavior. This community based interventional study was carried out to determine the unmet needs for contraception, the reasons for this and to assess the impact of interventional measures on acceptance of contraception. Subjects and Methods: This study was conducted in 52 villages in the state of Maharashtra, India, among 363 married women selected by cluster sampling. Data was collected using an interview guide. An intervention was done for the women who had an unmet need and an assessment of the change was done subsequently. Data was analyzed by using SPSS. Results The prevalence of contraceptive usage was 59.2% and the prevalence of unmet need for contraception was 44% (160). The unmet need for spacing births was 53.8%, 38.7% for limiting births and 7.5% women were dissatisfied with the current contraceptive method. The reasons ranged from side effects to contraceptives to source of obtaining contraceptives. Age of the respondents, education and number of living children showed statistically significant association with unmet needs. Post intervention, the contraceptive prevalence rate increased significantly 85.7% and there was a significant reduction in the unmet needs for spacing and limiting births, equally there was a significant reduction of dissatisfaction with using contraception. Conclusion: Improvement in the use of contraception and addressing the unmet need for contraception requires community involvement and ongoing, sustained efforts by health workers to ensure quality care to the beneficiaries.
3.Prevalence Of Exclusive Breast Feeding And Its Correlates In An Urban Slum In Western India
Patil Sapna S ; Hasamnis Ameya A ; Pathare Rooma S ; Parmar Aarti ; Rashid A K ; Narayan K A
International e-Journal of Science, Medicine and Education 2009;3(2):14-18
Background: The World Health Organization
recommends the practice of exclusive breastfeeding of
infants for the first 6 months after birth. The objective
of present study was to estimate the prevalence and
the factors influencing exclusive breastfeeding.
The perceptions of mothers about breastfeeding in an
urban slum area of Western India were also enquired.
Methods: This cross sectional study was conducted over
six months amongst 200 mothers of children in the age
group of 6 – 12 months attending the growth and
development clinic in one of the urban health centres.
Data was collected using a pre-tested, structured
questionnaire on breastfeeding practices. Factors related
to exclusive breastfeeding were analysed using bivariate
and multivariate analysis.
Results: Prevalence of exclusive breastfeeding reported
by the participants was 61.5%. Having a male child,
maternal age < 30 years, level of education of mother,
parity, receiving infant feeding advice, initiation of
breastfeeding within one hour of birth and
administration of colostrum to the baby were associated
with exclusive breastfeeding (p<0.001). Multivariate
logistic regression analysis revealed that male sex
(adjusted odd ratios: 20.03), primiparity (0.19), home
delivery (0.32), receiving infant feeding advice (5.90),
initiation of breastfeeding within one hour of birth
(0.26) and giving colostrum to the baby (2.56) were
independently associated with exclusive breastfeeding.
Prelacteal feeds were given by almost 35% of mothers.
Conclusion: Prevalence of exclusive breastfeeding was
higher than the national figures. However, practices like
discarding the colostrum, giving prelacteal feeds,
early/late weaning and use of formula feeds are still
widely prevalent and need to be addressed.
4.Eco-friendly reduced graphene oxide for the determination of mycophenolate mofetil in pharmaceutical formulations
Narayan S. PRASHANTH ; Teradal L. NAGAPPA ; Jaldappagari SEETHARAMAPPA ; Satpati K. ASHIS
Journal of Pharmaceutical Analysis 2018;8(2):131-137
Graphene oxide (GO) was synthesized and characterized by scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), atomic force microscopy (AFM), X-ray diffraction (XRD), Fourier transform-infrared spectroscopy (FT-IR) and thermogravimetric analysis (TGA). GO was then electro-chemically reduced and used for electrochemical study of mycophenolate mofetil (MMF). The electro-chemically reduced graphene oxide (ERGO) film on glassy carbon electrode (GCE) showed enhanced peak current for electrooxidation of MMF. MMF exhibited two irreversible oxidation peaks at 0.84 V (peak a1) and 1.1 V (peak a2). Effects of accumulation time, pH and scan rate were studied and various electro-chemical parameters were calculated. A differential pulse voltammetric method was developed for the determination of MMF in bulk samples and pharmaceutical formulations. Linear relationship was ob-served between the peak current and concentration of MMF in the range of 40 nM―15μM with a limit of detection of 11.3 nM. The proposed method is simple, sensitive and inexpensive and, hence, could be readily adopted in clinical and quality control laboratories.
5.Posterior dislocation of the hip with ipsilateral displaced femoral neck fracture.
Vivek TRIKHA ; Tarun GOYAL ; Ram-K JHA
Chinese Journal of Traumatology 2011;14(2):104-106
Traumatic posterior dislocation of hip associated with ipsilateral displaced femoral neck fracture is a rare injury. Moreover, the management of such patients evokes strong views regarding primary replacement or preserving the femoral head. We presented a case of young adult with such an injury. He was operated upon with reduction of the dislocation and fixation of femoral neck fracture with the help of cancellous screws. Two years later, the fracture had united and the patient was asymptomatic. We further proposed the mechanism of injury for such a fracture and discussed the management in the changing trauma scenario of the developing world.
Adult
;
Femoral Neck Fractures
;
complications
;
surgery
;
Fracture Fixation, Internal
;
Hip Dislocation
;
complications
;
surgery
;
Humans
;
Male
6.Multiple floating metatarsals: a unique injury.
Vivek TRIKHA ; Tarun GOYAL ; Amit-K AGARWAL
Chinese Journal of Traumatology 2013;16(2):110-112
Concomitant dislocation of the tarsometatarsal and metatarsophalangeal joints of foot is an extremely rare injury. Such injuries presenting in a single or adjacent dual rays have been described in few cases previously. We describe such an injury in adjacent three metatarsals of a polytrauma patient. These injuries are likely to be missed in the initial assessment of a polytrauma patient. These patients are at risk of an overlooked diagnosis but the consequences of missing this type of injury may be quite severe. This case is presented in view of its uniqueness along with possible mechanism of injury, the sequence of reduction and follow-up. Knowledge of such injury and its proper management may be useful to the trauma surgeons.
Adult
;
Female
;
Humans
;
Joint Dislocations
;
surgery
;
Metatarsal Bones
;
injuries
;
surgery
;
Metatarsophalangeal Joint
;
injuries
;
surgery
7.Imaging cardiac sarcoidosis by cardiac positron emission tomography (PET): a local experience using a high-fat, low-to-no carbohydrate protocol.
Angela S M KOH ; Tian Yue KOK ; David K L SIM ; Narayan LATH ; Ru San TAN
Annals of the Academy of Medicine, Singapore 2014;43(7):383-385
Adult
;
Cardiac Imaging Techniques
;
Cardiomyopathies
;
diagnostic imaging
;
Clinical Protocols
;
Diet, Carbohydrate-Restricted
;
Diet, High-Fat
;
Female
;
Fluorodeoxyglucose F18
;
Humans
;
Middle Aged
;
Multimodal Imaging
;
Positron-Emission Tomography
;
Radiopharmaceuticals
;
Sarcoidosis
;
diagnostic imaging
;
Tomography, X-Ray Computed
8.Latarjet operation carries three times the risk of failure in seizure versus non-seizure recurrent anterior dislocation of the shoulder joint: outcome of a systematic review with meta-analysis
Alok RAI ; Dushyant CHOUHAN ; Sandeep Kumar NEMA ; Arkesh MADEGOWDA ; Rudra NARAYAN ; Bikram K. KAR
Clinics in Shoulder and Elbow 2024;27(2):160-168
Recurrent anterior shoulder dislocation (RASD) in cases of seizure disorders (SDs) total 50%–80% of all SD-associated shoulder instabilities. Based on the extent of bone loss, treatment options include bony and soft-tissue reconstructions, arthroplasty, and arthrodesis. The primary objective of this paper was to review the treatment options for RASD in SDs. Methods: Several bibliographic databases were searched for RASD treatment options in SD patients. The demographic outcome measures, the failure rate (defined as the relative risk of recurrence of dislocation postoperation), and the postoperative seizure recurrence rate were recorded. Results: We pooled 171 cases (187 shoulders) from 11 studies. Of these, one, five, two, two, and one reports studied Bankart’s operation with remplissage (27 cases/29 shoulders), the Latarjet procedure (106/118), bone block operation (21/23), arthroplasty (11/11), and arthrodesis (6/6), respectively, in treating SD-associated RASD. The relative risk of failure between SD and non-SD patients was 3.76 (1.3610.38) after the Latarjet operation. The failure rates were 17% and 13% for Bankart’s operation with remplissage and the Latarjet procedure in SD patients, respectively, but 0% each for bone block operation, arthroplasty, and arthrodesis. The total rate of seizure recurrence after operation was 33% of the pooled cases. Conclusions: SD recurrence in the postoperative period, the size of the bone block, and the muscular attachments to a small coracoid autograft are the determinants of failure among various reconstructive operations in SD-associated RASD. Level of evidence: III.
9.The influence of maternal ethnic group and diet on breast milk fatty acid composition.
Lin Lin SU ; Thamarai Chelvi S K ; Su Lin LIM ; Yuming CHEN ; Elizabeth A T TAN ; Namratha Narayan PAI ; Yin Han GONG ; Janie FOO ; Mary RAUFF ; Yap Seng CHONG
Annals of the Academy of Medicine, Singapore 2010;39(9):675-675
INTRODUCTIONBreast milk fatty acids play a major role in infant development. However, no data have compared the breast milk composition of different ethnic groups living in the same environment. We aimed to (i) investigate breast milk fatty acid composition of three ethnic groups in Singapore and (ii) determine dietary fatty acid patterns in these groups and any association with breast milk fatty acid composition.
MATERIALS AND METHODSThis was a prospective study conducted at a tertiary hospital in Singapore. Healthy pregnant women with the intention to breastfeed were recruited. Diet profile was studied using a standard validated 3-day food diary. Breast milk was collected from mothers at 1 to 2 weeks and 6 to 8 weeks postnatally. Agilent gas chromatograph (6870N) equipped with a mass spectrometer (5975) and an automatic liquid sampler (ALS) system with a split mode was used for analysis.
RESULTSSeventy-two breast milk samples were obtained from 52 subjects. Analysis showed that breast milk ETA (Eicosatetraenoic acid) and ETA:EA (Eicosatrienoic acid) ratio were significantly different among the races (P = 0.031 and P = 0.020), with ETA being the highest among Indians and the lowest among Malays. Docosahexaenoic acid was significantly higher among Chinese compared to Indians and Malays. No difference was demonstrated in n3 and n6 levels in the food diet analysis among the 3 ethnic groups.
CONCLUSIONSDifferences exist in breast milk fatty acid composition in different ethnic groups in the same region, although no difference was demonstrated in the diet analysis. Factors other than maternal diet may play a role in breast milk fatty acid composition.
Arachidonic Acids ; metabolism ; Breast Feeding ; ethnology ; Diet ; Diet Records ; Docosahexaenoic Acids ; metabolism ; Eicosapentaenoic Acid ; metabolism ; Ethnic Groups ; Fatty Acids ; metabolism ; Female ; Humans ; India ; ethnology ; Malaysia ; ethnology ; Maternal Welfare ; Milk, Human ; chemistry ; Nutritional Status ; Pregnancy ; Prenatal Nutritional Physiological Phenomena ; Prospective Studies ; Singapore ; Statistics, Nonparametric
10.Surgical management of chronic osteomyelitis: Organisms, recurrence and treatment outcome.
Koushik Narayan SUBRAMANYAM ; Abhishek Vasant MUNDARGI ; Milind Vittal PRABHU ; K U GOPAKUMAR ; D S Ankush GOWDA ; Devagiri Raviteja REDDY
Chinese Journal of Traumatology 2023;26(4):228-235
PURPOSE:
The study aimed to identify the risk factors of recurrence in chronic osteomyelitis (COM) and to document the microbiological patterns pre- and intra-operatively and at recurrence, if any.
METHODS:
We performed retrospective review on COM patients treated with surgical debridement and a 6-week course of antibiotics. The patients with symptoms of osteomyelitis for at least 6 weeks, present or past episodes of discharging sinus, documentation of bone sequestration in operative notes or preoperative images were included in the study. Patients with symptoms of osteomyelitis < 6 weeks, lack of history of discharging sinus or lack of evidence of sequestration in preoperative images or intraoperative notes were excluded. Logistic regression models were used to assess the impact of risk factors of recurrence. Cohen-Kappa scores were derived to see the concordance between pre-operative and intra-operative isolates and at recurrence.
RESULTS:
Totally, 147 COM patients (115 males and 32 females, mean age (33 ± 19) years) were included in this study. Recurrence was noted in 28 patients (19.0%). Polymicrobial growth and extended spectrum beta-lactamase producing Enterobacteriaceae increased the chance of recurrence. Cierny-Mader stage-1, hematogenous aetiology and negative intraoperative culture reduced the chance of recurrence. Concordance between pre-operative and intra-operative cultures was 59.85% (Kappa score 0.526, p < 0.001) and between index surgery and at recurrence was 23.81% (Kappa score 0.155, p < 0.001). Lack of knowledge of causative organism preoperatively did not affect outcome. At mean follow-up (42 ± 15) months, all patients were apparently infection free for at least 1 year.
CONCLUSION
Polymicrobial growth and multi-drug resistant organisms increase the risk of recurrence in COM. Patients' age, gender, diabetes mellitus, previous failed treatment, duration of symptoms, haemoglobin, white cell count, C-reactive protein and erythrocyte sedimentation rate at presentation did not have any impact on the recurrence of infection. Pre-operative isolation of organism is of questionable value. Recurrences of infections do occur and are more of re-infections than relapses. Diligent isolation of organism must be attempted even in re-debridements. Even patients with recurrences do well with appropriate debridement and antibiotic therapy.
Male
;
Female
;
Humans
;
Adolescent
;
Young Adult
;
Adult
;
Middle Aged
;
Debridement
;
Anti-Bacterial Agents/therapeutic use*
;
Treatment Outcome
;
Osteomyelitis/surgery*
;
Recurrence
;
Retrospective Studies