Permanent Method Research Articles

Utilization of long-acting contraceptive methods and associated factors among married women in Farta Woreda, Northwest Ethiopia: a community-based mixed method study

BackgroundAlthough long-acting contraceptive methods are highly effective, safe, and provide uninterrupted protection from unintended pregnancy compared to short-acting methods, evidences suggest that majority of women were relayed on short-acting contraceptive methods. Thus, this study aimed to determine the level of long-acting contraceptive methods utilization and associated factors among married women in Farta Woreda, Northwest Ethiopia, 2021.MethodsA community-based cross-sectional study supplemented with qualitative data was performed among 556 married women from March 1 to 31, 2021. A semi-structured interviewer-administered questionnaire and interview guides were used to collect the data. The data were entered into Epi data version 4.6 and analyzed by SPSS version 23 software. The association between variables was analyzed using bivariate and multivariable binary logistic regression. The level of statistically significant association was determined at a P-value < 0.05. After translation and transcription, manual thematic analysis was applied to the qualitative data.ResultsThe magnitude of long-acting contraceptive methods among married women in Farta Woreda was found to be 14.3% [95% CI 11.5–17.6]. Previous use of long-acting contraceptive methods (AOR = 5.83, 95% CI 3.03, 11.21), positive attitude towards long-acting contraceptives (AOR = 2.74, 95% CI 1.48, 5.07), having formal education for husbands’ (AOR = 3.05, 95% CI 1.5, 6.21), and poor wealth index (AOR = 3.39, 95% CI 1.33, 8.67) were positively associated with utilization of long-acting contraceptive methods. Moreover, fear of side effects, misconceptions, and partner opposition were the most commonly identified barriers by the qualitative data.ConclusionUtilization of long-acting contraceptives among married women in Farta Woreda was low as compared to the 2020/21 national reproductive health strategy plan to increase the long-acting reversible and permanent contraceptive methods use to 50%. Previous use of long-acting contraceptives, positive attitude towards long-acting contraceptives, husband education, and household wealth index was found to be significantly associated with long-acting contraceptive utilization. Hence, it is better to work more on changing women's attitudes and increasing husband education.

Post Tubectomy, Fallopian Tube Recanalization

Bilateral tubectomy is one of commonly used method of contraception worldwide as a permanent method of family planning procedure for women, which can be done laparoscopically or by open method of surgery. Many women regret for their decision of permanent sterilization and some of them come to restore their fertility, because they have lost their press child which is usually male and some come because they have remarried. To restore fertility in post tubectomy women, fallopian tube re-canalization or in vitro fertilization (IVF) is the answer. For post-tubectomy cases, fallopian tube recanalization can be done manually by open surgery or with laparoscope. Since 2014 till date, 18 cases of post-tubectomy fallopian tube recanalization, manually by open method of surgery is done. This method was found to be most feasible, simple and no special instrument or equipment was needed. As such general surgical instruments were used in bilateral fallopian tube anastomosis with too satisfying results.

CASE SERIES: HUMAN ERRORS AND TUBECTOMY FAILURE- REPORT OF FIVE CASES

Female sterilization is the most common permanent method of contraception in India. Most of those procedures are performed in various levels of public health facilities. Tubectomy failures due to spontaneous tubo-pertineal stula formation and recanalization is known in the literature. The human errors are also reported. However, the nature and frequency of human errors leading to failure are addressed in very few reports. This case series addressed the issues of preventable human errors, which helps physicians to revisit the procedure to prevent litigations.

The Development of Ukrainian Local Monographic Studies in the Context of World Humanities in the First Half of the 20th Century

Monographic studies at the local level (of the street, village, town, district) are gaining popularity in the conditions of deep social transformations in the Ukrainian village. The Ukrainian village of the early 21st century is going through a period of changes. The social and common features and their household specific character have not been formed yet. That’s why the local studies are relevant and effective at this stage. As a result of this fact the study of the experience of previous generations of Ukrainian and European scientists (representatives of various social disciplines and humanities) can be useful in shaping the program and methodological approaches for modern researchers of the Ukrainian countryside. It is emphasized in the article that during the 1920s and 1930s versatile local monographic studies have been conducted independently in various countries (the USA, Poland, Hungary, Romania). Ukrainian ethnologists have faced the urgent problem of studying and understanding the cultural and everyday features of various local groups of population and identifying complex links between them at the regional and national levels. Peculiar attention is paid to the activities of ethnographic centers of the Ukrainian Academy of Sciences (Ethnographic Commission, Khvedir Vovk Museum (Cabinet) of Anthropology and Ethnology, etc.). These are just its members who have substantiated and used the method of stationary study of the local areas as the leading one in their research work. The permanent method of field ethnography, being the main one in the process of collection and systematization of factual material for monographic study, is analyzed. It is proved that the local monographic studies have become especially popular in the 1920s and 1930s, in the period of social and political changes of a global scale. The local monograph is especially important and effective in the critical periods or after them. Permanent ethnography allows to determine the qualitative characteristics of the object of study, to develop the main parameters of subsequent mass research. The micro-approach program in choosing the object of study and identifying the relationships between different phenomena (nature, economy, culture, etc.), the confidence that the local approach will enable better understanding of the features of such relationships are common for the researchers of the local groups.

Prevalence and factors associated with the use of long-acting reversible and permanent contraceptive methods among women who desire no more children in high fertility countries in sub-saharan Africa

BackgroundThe proportion of women with family planning needs increased from 74 to 76% between 2000 and 2019, and this improvement has not transcended to a fertility rate stall or decrease in sub-Saharan Africa (SSA). In the face of a continuous increase in the fertility rate in SSA, population experts agreed that the efficient use of reliable family planning methods such as long-acting reversible and permanent contraceptive methods (LARC/PMs) could help reduce the high fertility rate and associated adverse reproductive health outcomes in the region. However, despite the effectiveness of LARC/PMs, its use remains elusive in SSA. Thus, this study examines the prevalence and factors associated with the use of LARC/PMs among women who desire no more children in high-fertility countries in SSA.MethodsSecondary datasets from the demographic health surveys conducted in 20 countries in SSA between 2010 and 2019 were included in the study. A total sample size of 46,290 sexually active women of reproductive age who desire no more children and who met the study inclusion criteria was pooled and analysed. Prevalence of LARC/PMs use was displayed using a graph whilst binary logistic regression was used to determine the associated factors, and results were presented as unadjusted odds ratio and adjusted odds ratio with a statistical significance of p < 0.05.ResultsThe prevalence of LARC/PMs use among women who desire no more children was 7.5%. Ranging from 20.9% in Senegal and as low as 0.4% in Congo. Women within the richest wealth index [aOR = 1.18, 95% CI = 1.03–1.36] and those exposed to mass media [aOR = 1.54, 95% CI = 1.41–1.68] had higher odds of LARC/PMs use among sexually active women of reproductive age who desire no more children compared to those within poorest wealth index and women with no mass media exposure.ConclusionThe study concluded that LARC/PMs use among sexually active women who desire no more children was very low, and women within the richest wealth index and those with mass media exposure were likely to use LARC/PMs. Interventions that will encourage using LARC/PMs should be prioritised to reduce fertility rates in SSA.

Impact of COVID-19 pandemic in safe abortion and safe motherhood services in provincial hospital of rural Nepal: comparison of 3 waves of COVID-19

Introduction: The COVID-19 pandemic has challenged the whole world with a major public health crisis, both directly due to the disease and indirectly in all dimensions of the health care system. This included safe abortion services and safe motherhood services but data quantifying this in a lower resource setting is lacking. This study analyzed the trends of safe abortion services, post abortion contraception opted during pandemic and safe motherhood services at a provincial hospital in rural Nepal during 25 months of COVID-19 pandemic, comparing data of three major waves.&#x0D; Method: This is a retrospective observational study conducted at Pashupati Chaulagain Memorial Hospital. The data were collected from records of abortion and safe motherhood service registers. We compared the overall trends of safe abortion, family planning and safe motherhood services during first, second and third waves of COVID-19 pandemic and analyzed the sociodemographic profile of patients. Data analysis was done using SPSS 25 version.&#x0D; Result: During the study period from February 2020 to February 2022, a total of 634 and 2054 clients received safe abortion services and safe motherhood services respectively. There was reductions in clients visiting for safe abortion services during lockdown periods of first and second waves, but no differences noted during the third wave. More numbers of women opted for condoms as a family planning method during lockdown period of first and second waves with less intake of Long Acting Reversible Contraceptives and permanent methods compared to non-lockdown period.&#x0D; Conclusion: Utilization of safe abortion services was seriously affected in the first two waves due to COVID-19 pandemic presumably due to lockdowns, travel restrictions, home isolation, patient fear of going to hospitals, and health facilities prioritizing only COVID-19 and other emergencies. However, there was no impact in third wave for reproductive and safe motherhood services.

Radiotherapy skin marking with lancets versus electric marking pen - Comfort, satisfaction, effectiveness and cosmesis results from the randomized, double-blind COMFORTATTOO trial

IntroductionSet-up skin markings are performed, in several centers, for radiotherapy (RT) treatments. This study aimed to compare two permanent methods: lancets and an electric marking pen, the Comfort Marker 2.0® (CM). MethodsThis was a prospective, unicentric, randomized study. Patients aged 18 years or older referred to our department to receive RT were recruited. Patients were randomly assigned, in a 1:1 ratio, to receive set-up markings using lancets or CM. The markings arrangement followed our departmental protocols. The coprimary endpoints were patients’ comfort and effectiveness. Secondary endpoints included radiation therapists (RTTs) satisfaction and cosmesis. ResultsBetween October 2021 and January 2022, 100 patients were enrolled (50 received lancets and 50 CM) and assessed for the comfort and satisfaction outcomes. CM was significantly less painful than the lancets, with 44% and 16% of the patients, respectively, considering the tattooing process painless (RR = 2.75; 95% IC: 1.36 - 5.58). On the RTT-reported satisfaction, CM had significantly easier processes than lancets (98.0% vs. 78.0%, respectively; RR = 1.26; 95% CI: 1.08 - 1.46). For effectiveness and cosmesis assessment, 98 patients were analyzed (48 received lancets and 50 CM). Patients receiving CM had a significantly higher proportion of markings graded as good and excellent compared to those receiving lancets (98.0% and 50.0%, respectively, had ≥75% of the tattoos assessed as good/excellent, RR = 1.96; 95% CI: 1.47 - 2.61). On the cosmetic evaluation, patients receiving CM had significantly better cosmetic markings, with a median score of 4.4 (vs. 3.5 for lancets, p <0.001). ConclusionThe trial results demonstrated that tattooing with the CM is significantly less painful, more effective, easier to apply, and cosmetically superior to tattooing with lancets.Implications for practice: Tattooing with CM allows for better results regarding pain, quality, ease and cosmesis.

Comparison of stem anatomy of Bambusa vulgaris Schrad and Schizostachyum brachycladum (Kurz) Kurz (Poaceae) in Lombok

Bambusa vulgaris and Schizostachyum brachycladum are similar but differ in stem shape, branching type, and the presence of aerial roots. B. vulgaris bamboo has various uses, such as a support in concrete construction, and because it is resistant to river abrasion, while its shoots are used as a vegetable. S. brachycladum , which has a very thin stem pith, is used for cooking grilled sticky rice ( lemang ), so it is often called bamboo lemang . The aim of this study was to compare the anatomical structure of the culms of B. vulgaris and S. brachycladum in Lombok. Two methods were used in the preparation of the samples: the permanent slide method with glycerin jelly closure and the maceration method. Transverse and tangential stem slides were used with double staining, using 0.5% safranin O (50% alcohol) and 1% (1 part Aniline Blue + 4 parts picric acid) in 95% alcohol. Fibre slides were prepared using 50% acetic acid maceration solution and staining 50% peroxide and 0.5% Safranin O (50% alcohol). The results showed that the stems of S. brachycladum cv. Green are characterized by short and long cells, a number of vascular bundles in the pith, and a different periderm structure from B. vulgaris . The greatest anatomical differences in the culms of B. vulgaris var. vulgaris and var. striata lie in the arrangement of the periderm tissue and the number of vascular bundles. • Trichome Type of bamboo culm is a combination of stingous, puberulous, scabrous, and machete types. • The shape of the bamboo stem fiber is elongated, narrowed and widened or shortened, slimmed and broadly. • Bamboo pith parenchymal tissues are composed of short cells and long cells.

Laparoscopic Roux-en-Y feeding jejunostomy as a long-term solution for severe feeding problems in children

Enteral feeding is a common problem in children with gastric emptying disorders. Traditional feeding methods in these patients often show a high rate of complications and maintenance issues. Laparoscopic Roux-en-Y feeding jejunostomy (LRFJ) has been described in a few patients as a minimal invasive option for enteral access in these children. The aim of this study is to evaluate the outcomes of the LRFJ procedure in our tertiary referral center. We conducted a retrospective case-series including all patients, aged 0–18 years old, that underwent a LFRJ procedure between August 2011 and December 2020 for the indication of oral feeding intolerance due to delayed gastric emptying. Outcomes evaluated were complications (short and long term) and parenteral satisfaction. In total, 12 children were identified that underwent LRFJ for the indication of oral feeding intolerance due to delayed gastric emptying. A total of 16 complications were noted in 8/12 patients (67%). Severity classified by Clavien-Dindo were grade I (n = 13), grade II (n = 1), and grade IIIB (n = 2). In 11/12 patients, parents were satisfied with the results. Conclusions: Although minor complications after LRFJ are common in our patients, this technique is a safe solution in patients with gastric emptying disorders leading to a definitive method of enteral feeding and high parenteral satisfaction.What is Known:• Traditional tube feeding in children (duodenal, PEG-J-tubes) with severe delayed gastric emptying can be challenging with a high rate of complications and maintenance issues.• Open loop jejunostomy and Roux-en-Y jejunostomy are alternative, permanent methods of feeding but either invasive or are accompanied by severe complications. Little is known in the literature about laparoscopic Roux-en-Y feeding jejunostomy.What is New:• Laparoscopic Roux-en-Y feeding jejunostomy is a permanent, safe and minimal invasive alternative option for enteral feeding in children with severe delayed gastric emptying..

P061Sterilization in the childfree population: an exploratory study

<h3>Objectives</h3> To describe the childfree population seeking surgical sterilization, identify barriers to receiving care, and characterize the incidence of regret. <h3>Methods</h3> We conducted a cross-sectional survey of people in the US, aged 18 or older, who do not have biological children, and who are seeking or have previously sought a sterilization procedure. Participants completed an online REDCap survey distributed over social media platforms, including Reddit, TikTok, and Facebook. <h3>Results</h3> 390 respondents completed the survey, of whom 149 (38%) were sterilized, 38 (10%) were approved for a procedure, 32 (8%) had been unable to find a doctor to do the procedure, 81 (21%) were seeking a doctor, and 90 (23%) had not yet sought a doctor. Respondents were predominantly White (87%), identified as women (82%), and were diverse in sexual orientation (heterosexual, 41%; bisexual, 41%; other, 18%). Reasons for seeking sterilization included not wanting children (96%), fear of pregnancy/childbirth (70%), the current state of the world (68%), environmental reasons (58%), and medical reasons (34%). Barriers to care included cost of the procedure (31%), and inability to find a doctor who would perform the procedure (29%). Of the 149 respondents who had been surgically sterilized, 68 (46%) asked more than one doctor for the procedure. Of those sterilized, 99.3% answered "yes" to "Do you think sterilization as a permanent method of birth control was a good choice for you?" <h3>Conclusions</h3> Childfree individuals have a variety of reasons for seeking sterilization and may be at a lower risk of regret than parous people who are sterilized.

Fertility preferences and unmet need for family planning in women with multiple sclerosis.

Most women with multiple sclerosis (MS) have childbearing potential. Although fertility and pregnancy are not affected by MS, the fertility preferences of women with MS can change due to the risk of complications for the mother and/or adverse pregnancy outcomes resulting from the disease or its treatment. To describe fertility preferences (FPs) and their associated factors, to estimate the Unmet Need for Family Planning (UNFP), use of contraceptives, and history of exposure to disease-modifying therapies (DMTs) during pregnancy in women with MS. In a cross-sectional observational study, a random sample of women with MS were surveyed with the FP subset of the Demographic and Health Survey of Colombia. Factors associated with FP were evaluated through bivariate and logistic regression analysis. The proportion of pregnancies exposed to DMTs, UNFP, and use of contraceptives was estimated. Of the 141 women interviewed, 101 women had childbearing potential, of whom 49 did not want to have children, 38 were sterilized, 33 wanted to have more children, 19 were undecided, and 2 stated they were unable to bear children (menopause or hysterectomy). No MS-related variables were associated with the preference to have more children. Age (OR 0.91; 95% CI 0.84-0.98) and the number of children (OR 0.23; 95% CI 0.09-0.58) decreased the likelihood of desire for children. Of 116 sexually active women, 87.06 % (101) were using contraceptives, and among them, four were using fertility awareness methods and withdrawal. The UNFP was estimated at 6.03% and was not significantly different from the general population. Eighty-two pregnancies were identified, of which 48 occurred after diagnosis, and 25 were exposed to DMTs. Fertility preference in women with MS is not associated with clinical variables. A large proportion of women choose not to have children and prefer to use permanent contraceptive methods. Although the frequency of contraceptive use was high, some women have the UNFP and use low-efficacy contraceptive methods, which may result in unplanned pregnancies.

An Analysis of Contraceptive Method Choice among Married Women of Kanchanaburi Demographic Surveillance site in Thailand

Introduction: The Fertility of Thailand declined to 1.6 in 2014 compared to 6.5 in the early sixties. This fertility revolution was accompanied by a concurrent revolution of contraceptive behavior among Thai people. This study examined the role of individual and geospatial factors to explain the variation in contraceptive method choice among married in two selected districts of Kanchanaburi Province, Thailand.&#x0D; Methods: The sample size in this study was 1468. The study population was currently married women of reproductive age (15-49 years) who were residing in two selected districts of Kanchanaburi province, Sai Yok and Muang districts, collected under the Kanchanaburi Demographic Surveillance Site (KDSS) project from 2004 to 2006. The study performed multinomial logistic regression for statistical analysis and Arc view GIS for spatial analysis to identify the factors associated with contraceptive method choice.&#x0D; Results: The women in the middle age group and urban women were more likely to use permanent methods over non use and temporary methods compared to young and rural women respectively. Women having higher than secondary education used both temporary and permanent contraceptive methods 2.5 times more than uneducated women (AOR 2.43; 95% CI 1.33– 4.46 for temporary versus none and AOR 2.54; 95% CI 1.29 – 5.01 for permanent versus none respectively). If women has no children, they were significantly less likely to use permanent method over non-use as well as over temporary methods. Geo-spatial analysis results showed transportation facilities determine the contraceptive choice.&#x0D; Conclusion: The better transportation network facilitated women to use a permanent contraceptive method rather than the temporary method. It is necessary to establish a better transportation system and education system in the areas, especially in the mountainous regions to improve accessibility and to realize reproductive health services. Further, investments in increasing women's access to various contraceptive options are urgently needed.

Female sterilisation in India: Examining the role of women's own decision making and information given to client.

India has a very high prevalence of female sterilisation compared to other countries in the world, with a prevailing situation of very low level of information about contraceptive options given to women. It is well established in demographic research that, there exists a strong association between knowledge of contraceptive methods and type of contraception chosen. Present study uses data from 3 consecutive rounds of National Family Health Survey (3, 4 & 5). The sample contains currently married women who started using the current method 5 years prior to each round of survey. Multilevel Logistic Regression and Fairlie Decomposition Model are used to analyse the effect of information given to respondents and decision-making power regarding contraceptive methods on choice of female sterilisation. Women, who are informed about available methods, have lower chance (45.8%, 37.5% & 40% for NFHS 3, 4 & 5 respectively) to opt for sterilisation after controlling all other factors. If woman is the sole decision maker for contraceptive choice, the chance of sterilisation reduces than cases where decision is taken only by husband or jointly. Information about other methods also contributes towards reducing the chance of female sterilisation over the time. Information about contraceptive methods is found to be a major factor in controlling choice of temporary or permanent method. Thus, major focus for the policy makers should be to make information regarding contraceptives more accessible for women.

COMPARATIVE CLINICAL, RADIOGRAPHICAL AND HISTOLOGICAL EVALUATION OF CORONAL PULPOTOMY TECHNIQUE WITH PRF AND A NOVEL CROSSLINKED PRF AS AN ALTERNATIVE TO PULPECTOMY FOR PRESERVING THE TOOTH VITALITY IN CONTEXT OF TISSUE ENGINEERING.

Background: Removal of infected pulp tissue from the coronal portion leads to preservation of a remaining vital and functioning pulp. Preservation of pulp vitality by pulpotomy is one of the universally accepted treatment procedure with the aid of latest bioactive materials leading to a more conservative approach in the management of teeth involving the pulp based on clinical conditions To comparatively evaluate the . Aim: clinical and radiological and histological outcome of platelet-rich brin (PRF) and the novel crosslinked PRF (C-PRF) developed by us as pulpotomy agent in context of tissue engineering in permanent teeth. 20 permanent mol Materials and Methods: ar teeth from 20 healthy patient aged 18-40 years with permanent molar teeth cariously exposed pulps and diagnosed clinically as irreversible pulpitis were selected for the study. Written consent from the patients was taken. The patients were then randomly divided into 2 groups (n=10) . One group received PRF pulpotomy anther group received our novel crosslinked PRF (C-PRF) pulpotomy. In all patients coronal pulp was removed after preparation of the access cavity with rubber dam under Lignocaine 2 % local anaesthesia. After hemostasis, exposed pulps were covered using PRF membrane with Biodentine or C-PRF with Biodentine, and then all teeth were restored with glass-ionomer cement. Clinical and radiographic evaluation was undertaken at 1 day, 3month and 6 months intervals. The results were analyzed using appropriate statistical tests. After around six months one case of each group third molar teeth was extracted due to positional problem and causation of cheek ulceration. Histological examination of the extracted teeth was done. Statistical Analysis was performed with he Results: lp of Epi Info (TM) 7.2.2.2 EPI INFO is a trademark of the Centers for Disease Control and Prevention (CDC). Test of proportion was used to nd the Standard Normal Deviate (Z) to compare the difference proportions. p&lt;0.05 was taken to be statistically signicant. C-PRF could improve the prognosis Conclusion: of pulpotomy procedures of mature permanent

Long-acting reversible contraceptives utilization and its determinants among married Yemeni women of childbearing age who no longer want children.

Some contraceptive methods, such as long-acting and permanent methods, are more effective than others in preventing conception and are key predictors of fertility in a community. This study aimed to determine which factors were linked to married women of childbearing age who no longer desired children using long-acting reversible contraceptives (LARCs) in Yemen. We used a population-based secondary dataset from Yemen’s National Health and Demographic Survey (YNHDS), conducted in 2013. The study analyzed a weighted sample of 5149 currently married women aged 15 to 49 years who had no plans to have children. Logistic regression analyses were used to investigate the parameters linked to the present use of LARCs. The final model’s specifications were evaluated using a goodness-of-fit test. An alpha threshold of 5% was used to determine statistical significance. Of the total sample, 45.3% (95% CI: 43.3–47.4) were using contraception. LARCs were used by 21.8% (95% CI: 19.6–24.1) of current contraceptive users, with the majority (63.8%) opting for short-acting reversible contraceptives (SARCs). In the adjusted analysis, maternal education, husbands’ fertility intention, place of residence, governorate, and wealth groups were all linked to the usage of LARCs. According to the findings, women whose spouses sought more children, for example, were more likely to use LARCs than those who shared their partners’ fertility intentions (AOR = 1.44; 95% CI: 1.07–1.94; P = .015). In this study, married women of reproductive age who had no intention of having children infrequently used contraception and long-acting methods. Improving women’s education and socioeconomic status could contribute to increasing their use of LARCs.

Factors associated with use of long-acting reversible and permanent contraceptives among married women in rural Kenya: A community-based cross-sectional study in Kisii and Kilifi counties.

Long-acting and permanent contraceptive methods (LAPM) are effective and economical methods for delaying or limiting pregnancies, however they are not widely used. The Kenya government is promoting the use of modern methods of family planning through various mechanisms. This study aimed to determine the prevalence and factors associated with the use of LAPM among married women of reproductive age in targeted rural sub-counties of Kilifi and Kisii counties, Kenya. Baseline and end line Data from a program implemented on improving Access to Quality Care and Extending and Strengthening Health Systems (AQCESS) in Kilifi and Kisii counties of Kenya were used. Multi-stage sampling was used to sample 1117 and 1873 women for the end line and baseline surveys, respectively. Descriptive analysis was used to explore the respondents' characteristics and use of LAPM on a self-weighted samples. Univariable and multivariable binary logistic regression models using svy command were used to assess factors associated with the use of LAPM. A total of 762 and 531 women for the baseline and end line survey, respectively were included in this study. The prevalence of use of LAPM for baseline and end line survey were 21.5% (95% CI: 18.7-24.6%) and 23.2% (95% CI: 19.6%-27.0%), p-value = 0.485. The use of LAPM in Kisii and Kilifi counties was higher than the national average in both surveys. The multivariable analysis for the end line survey showed having 3-5 number of children ever born (aOR = 2.04; 95% CI: 1.24-3.36) and future fertility preference to have another child (aOR = 0.50; 95% CI: 0.26-0.96) were significantly associated with odds of LAPM use. The baseline showed that having at least secondary education (aOR = 1.93; 95%CI: 1.04-3.60), joint decision making about woman's own health (aOR = 2.08; 95%CI: 1.36-3.17), and intention to have another child in future (aOR = 0.59; 95%CI: 0.40-0.89) were significantly associated with the use of LAPM. Future fertility preference to have another child was significantly associated with the use of LAPM in the two surveys. Continued health promotion and targeted media campaigns on the use of LAPM in rural areas with low socioeconomic status is needed in order to improve utilization of these methods. Programs involving men in decision making on partner's health including family planning in the rural areas should be encouraged.

Identification of Ectoparasites and Gastrointestinal Tract Endoparasites in Stray Cats at Traditional Market of Bojonegoro City

&#x0D; ABSTRACT&#x0D; This study aims to determine the ectoparasites and endoparasites on gastrointestinal tract that infest stray cats in Bojonegoro traditional market. The samples in this study were ectoparasites and feces from 40 stray cats in Bojonegoro traditional market. The ectoparasite samples were examined using the permanent attachment method without staining, while the feces samples were examined using three methods, namely native, simple sedimentation and fulleborn floatation. A positive sample is considered if a parasite is found that matches the characteristics of a parasite in cats sourced from scientific references. The results of the examination of 40 stray cats found 27 positive ectoparasites, 23 positive worms and 6 positive protozoa. The types of ectoparasites found were Ctneocephalides felis (67.5%), Otodectes cynotis (15%) where age and gender did not affect the prevalence, while the endoparasites found were Toxocara cati (42.5%), Ancylostoma sp. (22.5%) and Isospora felis (15%), age has effect on the prevalence obtained and sex has no effect .&#x0D; Keywords : Stray cats, Ectoparasites, Endoparasites in gastrointestinal tract

Ectoparasite Detection in Culling Layer Hen That Sold at Wonokromo Market Surabaya City

The purpose of the research were to identify the species, prevalence, and predilection of ectoparasite in Culling Layer Hen at Wonokromo Market, Surabaya City. The research was conducted from March to May 2021 with total of 100 sample of chickens were examined by the skin and feather body region. Identification of ectoparasite was carried out at The Laboratory Parasitology, Faculty of Veterinary Medicine Universitas Airlangga using permanent mounting methods. The results showed, the species of ectoparasite that infest the culling layer hen were Menopon gallinae 21%, Lipeurus caponis 10%, Ornythonissus bursa 10%, and Dubininia melopsitacci 70%. Predilection of ectoparasite shows that M. gallinae were found in the head-neck, back, wings, and legs region. L. caponis was found in the head-neck, wings, and back region. O. bursa was found in the legs and tail region, and D. melopsitacci was found in the entire body of chicken, the head-neck, back, wings, abdomen, legs, and tail.

Improving the Acceptance Rate of Centchroman As a Postpartum Contraceptive Through a Quality Improvement Initiative.

BackgroundThe unmet need for contraception is two-pronged: a spacing method and a permanent method. Centchroman, a non-hormonal, non-steroidal oral contraceptive, is suitable for both of these purposes. The Government of India provides it free of cost under the name "Chhaya", but its current acceptance rates are lower than expected. We aimed to increase the acceptance rates of centchroman as a postpartum contraceptive through a quality improvement (QI) approach conducted over eight months at a tertiary care hospital in North India.Materials and MethodsThis QI study was done in three phases: a pre-intervention phase of over eight weeks to assess the baseline acceptance and prevalence rates of centchroman use; an intervention phase of over 12 weeks involving three Plan-Do-Study-Act (PDSA) cycles to increase the awareness and acceptance of centchroman among the target population using visual aids and counselling by the nursing staff and resident doctors, respectively; and a post-intervention phase of over 12 weeks to assess the acceptance and continuation rates of Chhaya.ResultsThe acceptance rates for centchroman increased from a baseline of 2.9% to 15.3%, 56.3%, and 78.2% after the first, second, and third PDSA cycles, respectively. On follow-up, continuation rates were 96.7%, 89.5%, and 78.6% at one, three, and six months, respectively. The majority of women reported only minor side effects, with the primary reason for discontinuation being a preference for intrauterine devices or medroxyprogesterone acetate injections over Chhaya. ConclusionThe postpartum period provides an important window of opportunity to counsel women for contraception. Despite an enviable safety profile and dosing schedule, centchroman remains largely under-utilized. Increasing awareness among women as well as health care workers may improve the acceptance of centchroman and help reduce the burden of untimely and unwanted conceptions.

Medical Cannabis Treatments

This research report examines past research studies on marijuana therapy interventions involving individuals who have Autism Spectrum Disorder, Epilepsy, and Tourette’s Syndrome. These results do not ensure marijuana as a permanent method to cure adverse symptoms for these vulnerable populations. However, these large-scale studies have shown a trend of marijuana being effective for some participants involved in decreasing and/or improving their symptom frequency. This report will contribute to the knowledge pool on the safety and effectiveness of marijuana therapy.