BACKGROUND The lower segment caesarean section (LSCS) audit shows an increase in caesarean section rates worldwide. Assisted vaginal delivery and, if needed, emergency caesarean section are options available to the obstetrician to handle challenges in the second stage when spontaneous and safe delivery is not imminent. Judicious use of the instrument as well as continuing medical education in the art of assisted vaginal delivery is a must to achieve the twin goal of containing the surging caesarean section rate as well as bring about a successful and safe assisted vaginal delivery. The objective of this study was to quantify the various morbidities associated with assisted vaginal deliveries among patients in a tertiary care teaching hospital in Bengaluru. METHODS It is a retrospective study carried for four years between July 2016 and June 2020 at Ramaiah Medical College at Bengaluru. The total number of vaginal deliveries was 6318 out of which 1020 had a successful assisted vaginal delivery and were studied in terms of outcomes, maternal and foetal indications and morbidity. RESULTS Out of 1020 assisted vaginal deliveries, 86.96 % were vacuum-assisted, 3.9 % were forceps assisted and 9.11 % were both vacuum and forceps assisted. The success rate of forceps deliveries was more compared to vacuum. No significant maternal and neonatal mortality and morbidity were observed in our study. CONCLUSIONS In this study, vacuum was the most used method of assisted vaginal delivery and was safer for mothers and babies. It is also easier to teach and learn. Forceps delivery was more used in preterm delivery. KEY WORDS Assisted Vaginal Delivery, Vacuum, Forceps, Sequential use of Instruments, Maternal and Neonatal Morbidity.
BACKGROUNDAnganwadi Workers (AWWs) are recruited under Integrated Child Development Services (ICDS) scheme for a population of 400-800 in rural/urban areas and 300-800 in tribal areas. The key functions of AWWs include nutrition and health education, growth monitoring, health check-ups, assisting ANMs in provision of health care services, immunization and referral services. The output of the ICDS scheme is to a great extent dependent on the knowledge of AWW. This study is aimed to assess the knowledge of AWWs regarding comprehensive health care of children and to evaluate the impact of the training programme on their knowledge.
Objective- Endometrial thickness <7 mm accepted as a reliable sign of suboptimal implantation potential. Clomiphene citrate (CC) has some
negative effects on the endometrium. We evaluated the effect of concomitant administration of oral sildenal and estradiol valerate on endometrial
thickness
Aim- To compare the combined effect of oral sildenal and estradiol valerate to estradiol valerate alone in patients with clomiphene induced cycles
in infertile women on endometrial thickness.
Material And Method- This randomized study was conducted on infertile women attending infertility OPD in SN Medical College, Agra over a
period of 2 years from January 2019 to December 2020. Infertile patients were randomly divided into two equal groups. In control group, 50
patients were given clomiphene citrate 50 mg daily from D2 to D6 along with estradiol valerate 2 mg thrice daily from 2nd day of the cycle till the
day of trigger of ovulation. In study group, 50 patients were given clomiphene citrate 50 mg daily from D2 to D6 along with estradiol valerate 2mg
12 thrice daily plus oral sildenal citrate 25mg every 8 h from 2nd day of the cycle till the day of hCG trigger.
Results- The results in this study conrm the superiority of using oral sildenal with estradiol for improving endometrial thickness, vascularity and
pregnancy rates.
Conclusion- Addition of oral sildenal citrate to estradiol valerate in ovulation induction cycles has better results in improving endometrial
thickness, endometrial blood ow and pregnancy outcome as compared to estradiol valerate alone in women with anovulatory infertility
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