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Introduction:Monitoring the pattern of psychiatric illness among inpatients is essential for understanding the burden and trends of disease, in addition to designing and developing focused preventive and interventional strategies. Given the significant regional variation in the prevalence of mental illness, the present study evaluated the profile of psychiatric illness among inpatients admitted to a tertiary care center situated in the North East of India. Methods:Information from case records of consecutively admitted patients aged 18 years and above over the preceding three years, coded under the International Classification of Diseases, 10th edition (ICD-10), was reviewed. Details of socio-demographic parameters and psychiatric illness as well as substance use were extracted and represented by using descriptive statistics. Results:There were 371 admissions over the above-mentioned time frame. Subjects had a mean age of 36.5±10.45 years and 80.05% of them were males. Substance use disorders (77.62%) were the most commonly noted among study participants, with the majority being diagnosed with opioid dependence (43.93%) and alcohol dependence (29.92%), followed by tobacco dependence (2.16%). Psychotic disorders (5.12%), anxiety disorders (6.19%) and mood disorders (1.88%) were noted in a much lower proportion than anticipated. More than half (n=248) of subjects were aged 18-34 years. Conclusion:A disproportionate overrepresentation of substance use disorders among psychiatric inpatients in the North Eastern state of Arunachal Pradesh in India contrasts with the profile noted in other parts of the country. Notably affecting the younger age group, the findings of the present study highlight the need for the development of targeted preventive and interventional strategies to address the same. The study could help inform mental health policy initiatives and guide focused mental health care provision. These could include the establishment of centers for addiction medicine, enhancing training in addiction medicine for health professionals, counseling services and development of long-term rehabilitation for those suffering from substance use disorders.
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Iron-folic acid (IFA) and calcium supplementation are nutritional interventions recommended prophylactically (against maternal anemia and preeclampsia, respectively) to all antenatal mothers in India under basic antenatal care (ANC) services. Using Health Management Information System data (reporting period: 2018-19 to 2020-21), we mapped the coverage of antenatal IFA and calcium distribution across the remote northeastern region of India relative to the number of pregnant women (PW) who registered for ANC, disaggregated by states and districts. Variations in coverage were also investigated by subgroups based on contextual attributes, viz., physiography (hilly/ plateau/ plain), socioeconomic development ("aspirational"/ "non-aspirational") and proportion of early ANC visits (low/ medium/ high). Full course of antenatal IFA and calcium supplements were received by 79.36 (95% CI: 79.31-79.40) and 61.26 (95% CI: 61.21-61.32) PW per 100 ANC registered women, respectively. There was widespread heterogeneity in outreach, with calcium coverage generally trailing behind IFA coverage. Among states, coverage of the two interventions (per 100 ANC registered women) was highest in Assam (97.06 and 78.11 PW, respectively) and lowest in Nagaland (24.87 and 16.77 PW, respectively). At the district-level, the two interventions failed to reach even 50 PW per 100 ANC registered women in 32 (out of 115) districts. The coverage tended to be inferior in districts that were hilly, "non-aspirational" and had low proportion of early ANC visits. The granular information provided by our findings will facilitate monitoring, root cause analyses, microplanning, informed resource allocation and tailoring of locally appropriate solutions to achieve targeted coverage improvements.
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Background: Centchroman (INN: Ormeloxifene), was developed at CDRI, Lucknow in 1967. This drug was finally approved and licensed in 1991 and launched as Saheli and Choice-7 for marketing in 1992. The Ministry of Health and Family Welfare, India has now introduced centchroman in national family planning programme under the trade name “Chhaya” from April 2016. Centchroman is a novel nonsteroidal contraceptive that inhibits the fertilised ovum from implantation and thus prevents pregnancy. The aim of this study was to assess the effectiveness, side effects, discontinuation rates and failure rate among the users of Centchroman (Chhaya).Methods: The retrospective study was conducted by reviewing the records of Centchroman (Chhaya) contraceptives acceptor over the period of one year from September 2017 to August 2018 in family welfare clinic of Department of Obstetrics and Gynecology at Tomo Riba Institute of Health and Medical Science, a tertiary level center in Naharlagun, Arunachal Pradesh, India.Results: A total of 146 women were evaluated for the study. Majority of the women were in the age group of 20-30 years (76.02%) with mean age of 26 years. Most of the centchroman acceptors were multipara (74.65%) and women in post-abortion (38.35%) and postpartum group (36.3%). Duration of use ranged from 3 months in 146 women to 12 months in 98 women. The discontinuation rate was 31.5%. The major menstrual complaint was delayed menstrual cycle in 15.06% women and irregular cycle in 10.95%. Of the 146 women in the study group, pregnancy occurred in 3 women. Pearl index calculated for centchroman was 2.05/HWY.Conclusions: Centchroman is a non-steroidal, non-hormonal oral contraceptive drug with good therapeutic efficacy and a favourable side effect profile. Centchroman has an important place in postpartum contraception due to its safety profile in breastfeeding women.
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Background: Maternal mortality is defined as the death of a woman while being pregnant or within 42 completed days of termination of pregnancy. The aim of this study was to study the maternal mortality and analyze the complications leading to maternal deaths.Methods: A retrospective study of hospital records and death summaries of all maternal deaths over the period of two year from April 2017 to March 2019 was conducted in the Department of Obstetrics and Gynecology, Tomo Riba Institute of Health and Medical Science, a tertiary level healthcare referral center in Naharlagun, Arunachal Pradesh, India.Results: There was a total of 6 maternal deaths out of 6311 live births giving maternal mortality ratio (MMR) of 95.07 per 1,00,000 live births. The majority of deaths were reported in the age groups 30-40 years (66.66%). More deaths were reported in multiparous women (83.33%) as compared to primiparous women (16.66%). Most of them were unbooked cases (66.66%). Haemorrhage (33.33) and pregnancy induced hypertension (33.33%) were the major direct cause of maternal deaths.Conclusions: Haemorrhage and pregnancy induced hypertension were found to be major cause of maternal deaths. In our study, there was no maternal death from anemia and other medical disorder.
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Primary malignant melanoma of the uterine cervix is a rare neoplasm and the overall prognosis of patients with this disease is very poor. Herein, authors report a case of 45-year-old woman who presented with vaginal bleeding for one months and examination showed an exophytic, 6 cm polypoid blackish-pigmented tumor on the cervix involving vaginal fornix. She underwent abdominal radical hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy and further received adjuvant concurrent chemo-radiation with cisplatin (CDDP) and temozolamide but died 7 months after surgery.