Comparison of Central Fat Accumulation Indices with Body Mass Index in Women with Polycystic Ovary Syndrome.

Background: Polycystic ovary syndrome (PCOS) is an endocrinopathic disorder commonly affecting women in the reproductive age group, predisposing them to risk of metabolic syndrome. Currently, body mass index (BMI) is used as a marker to assess obesity. However, it is the central obesity which is a prevalent characteristic of PCOS which goes undetected in many women who exhibit an apparently lean PCOS. Recently, indices, such as body fat percentage (BFP), visceral adiposity index (VAI) and lipid accumulation product (LAP), have been deemed more effective, as they present formulas, anthropometric indices and biochemical measures. The aim of this study was to compare the other central fat accumulation indices-VAI, LAP and BFP with BMI in women with PCOS. Methods: The descriptive type of cross-sectional study was conducted in a tertiary care hospital which included 110 women, aged 18-40 year fulfilling the Rotterdam criteria for diagnosis of polycystic ovary syndrome. Height, weight and lipid profile were measured, and BMI, LAP and VAI were calculated. Body fat percentage was measured by the body fat analyser using the bioelectrical impedance method. All indices were then compared. Results: BMI showed a significant positive correlation with BFP (r = 0.68). VAI and LAP showed significant correlation with each other (p < 0.05). LAP and VAI were found to weakly correlate with BFP. However, lean PCOS also had higher values of visceral adiposity indices and hence did not show strong correlation. Conclusion: Central fat accumulation indices should be integral in assessing body fat distribution. BFP, VAI and LAP assess fat distribution and function both and, hence, present complete information at low cost.

Caesarean Delivery in the Second Stage of Labour at a Tertiary Care Hospital.

Caesarean section performed in the second stage of labour has many implications for maternal and neonatal morbidity as well as for subsequent pregnancies. A study was conducted to analyse the indications and maternal and neonatal prognosis of caesarean sections performed in the second stage of labour. Four percentage of caesarean sections were performed in the second stage of labour; 60% of these were referred cases. Most common indication was non-descent of head. Forty-three percentage of newborns were admitted in the neonatal intensive care unit. Hospital stay was prolonged which further increased the hospital burden. A proper judgement is required by the obstetrician to take decision for instrumental delivery or caesarean section. Early diagnosis and timely referral with a good infrastructure would help to decrease the maternal and neonatal morbidity.

Knowledge and Behaviour Regarding Birth Prevention of Healthcare Providers.

INTRODUCTION: Healthcare providers are an important link with the general public to impart knowledge regarding contraception. They are an important source of providing information regarding different methods of contraception, their proper use and removing the myths from the couple's mind. However, their own attitude and practice of contraception are often lacking. OBJECTIVE: This study was conducted to assess the attitude and practice of contraception over the last 1 year of nurses in a tertiary care hospital in Jaipur. METHODS: The study was conducted on 410 nurses in a tertiary care hospital. All were given a questionnaire that was duly filled by them, and the data obtained was analysed. RESULTS: All were aware of at least one family planning method. Only 84% knew that contraceptives could space the pregnancy. Very few had correct knowledge about the fertile period or lactational amenorrhoea. Few were aware of emergency contraception and its proper implication (6.83%) The commonest was the barrier method (70%) followed by natural method (41.46%). There was shifting from natural method to barrier method and OC pills for few cycles. CONCLUSION: Health workers have knowledge regarding contraception yet fail to use it regularly. Proper attitude and practice are essential to prevent unintended pregnancies and prevention of STDs. Their use will enhance counselling skills for general population.

Comparison of different regimes of misoprostol for the termination of early pregnancy failure.

BACKGROUND: Nearly 20% of all confirmed pregnancies end in spontaneous abortion. Misoprostol's use in early pregnancy failure is varied and dose and route are not well established. The aim of this study was to compare the efficacy and the side effects of different regimes of misoprostol in causing expulsion of products of conception in early pregnancy failure. METHOD: Women patients with an ultrasound diagnosis of early pregnancy failure, less than 12 weeks gestation were divided into two, Group-A: tab. Misoprostol 800 mcg 6 hourly vaginally, upto 3 doses. Group-B tablet misoprostol 600 mcg 6 hourly, sublingually for 3 doses. All observations were noted and statistical analyzed. RESULTS: Mean gestational age was 7.93 weeks. Mean induction abortion interval 18.183 h. Women patients with less than six weeks gestational age had least mean induction-abortion interval time, 15.75 ± 2.82 h in vaginal group but was highest in sublingual group 22 ± 2 h and 18.43 h in overall (P = 0.02). Though after 8 weeks, both routes were equally effective. Mean dose required in group-A was 20044 mcg and in group-B was 1564 mcg (P < 0.001). Efficacy of protocol was 88.89% in group-A and 92.85% in group-B. CONCLUSION: Both regimes had comparable efficacy, acceptability (90%) and side effects. In women patients less than six weeks period of gestation, the vaginal (800 mcg) route was distinctly superior, in women patients with 6-8 weeks the sublingual (600 mcg) route was more advantageous. The correct dose must be used for the route chosen. The route of administration should be decided in accordance with the preference of the patient and the clinical situation.