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Objectives-To study effectiveness of temporary aortic clamping as a method of limiting blood loss at in women with placenta accrete spectrum Methods-Data was collected from records of 14 patients with PAS who had Paily's aortic clamp applied after delivery of baby and prior to Caesarean hysterectomy from January 2016 to December 2021 at Government Medical College Hospital, Thrissur, Kerala, India. Results-6(42.9 %) cases were diagnosed intraoperatively. 12 (85.7 %) had a Classical Caesarean and 2(14.3 %) had a lower segment Caesarean followed by total hysterectomy. Mean duration of application of the clamp was 28.21±12.49 min(Range 15-60 min). The mean blood loss was 1.77 ± 0.96 litres(95% CI 1.21-2.33). Mean units of blood transfused was 2.64 (95 % CI 1.67-3.62). None of the patients required ionotropes or critical care. There were 2 cases(14.2 %) of bladder injury, both occurred in FIGO type 3b PAS. There were no cases of vascular injury, organischemia, thrombosis or relaparotomy for bleeding. Mean duration of hospital stay was 11.35 ± 5.38 days. Conclusion-Aortic clamping prior to Caesarean hysterectomy is a safe and effective method to reduce blood loss in Placenta Accreta Spectrum. [ABSTRACT FROM AUTHOR]

Background In this study, we wanted to assess the menstrual awareness among urban and rural adolescent girls and compare the menstrual hygiene practices among them. Methods This was a hospital based cross-sectional study conducted among 170 adolescent girls attending the OPD of Gynaecology, Paediatrics and General Medicine at Government Medical College, Thrissur District, Kerala. It was carried for a period of one year after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. They were provided with a validated questionnaire to assess menstrual awareness hygiene practice among them. Results Majority (89.4%) from the urban area of residence believed that it was physiological, while majority (54.1%) from the rural areas didn't know the actual cause for menstruation. This difference between the rural and urban areas on awareness about the cause of menstruation was found to be statistically significant. More than half of the subjects used sanitary pads during menstruation. The frequency of changing pads at school was less in both urban and rural groups. The reusage of pads was almost similar among rural and urban study subjects with around 23.5% and 22.4% of them reusing the pads respectively in both the groups. Awareness regarding menstrual cup was more in urban group compared to rural. But restrictions during menstruation was practised more in rural group that is 70% compared to urban group which was roughly 52%. Conclusion Menstrual health forms the most important stepping stone to women's sexual and reproductive health. One third of the study population was not at all aware of the cause of menstruation. There was significant difference in various menstrual hygiene practices among urban and rural girls. Many restrictions were practiced during menstruation more in rural group. A concerted effort from parents, educational institutions and existing healthcare institutions along with media may ensure safe and secure reproductive health prospects for adolescents in the region. [ABSTRACT FROM AUTHOR]

Background In this study, we wanted to assess the awareness of screening techniques for detection of carcinoma cervix and utility of HPV vaccine in women aged between 18 years and 65 years. Methods This was a hospital based cross sectional study conducted among 155 women attending the Department of Obstetrics and Gynaecology, Government Medical College, Thrissur, Kerala, India, for awareness of preventive strategies against carcinoma cervix, for a period of one year from January 2022 to December 2022 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. Results 85.8% had heard about carcinoma cervix and its symptoms, but only 56.8% believed that ca cervix is preventable. 50.3% had heard about pap smear and 20.6% had actually done the same. No one had ever done HPV testing, 71.6% of them because they had never heard about the test, 23.9 % because it was too expensive. 31% had only heard about the HPV vaccine, but no one had ever taken it mostly because it is expensive (31%) and not in government supply (19%). 77% were only willing to vaccinate their children, mostly because it is expensive. 89.7% were willing to take HPV vaccine if it is in government supply. Conclusion Even though carcinoma cervix is the second commonest malignancy in India around one fifth are not aware of the disease itself. Almost half of the participants do not believe it to be preventable. There is a large gap in knowledge of screening strategy like pap smear and HPV testing. Notwithstanding there exists a knowledge gap in the awareness of HPV vaccine, willingness for vaccination is hampered by its high cost and nonavailability in government sector. [ABSTRACT FROM AUTHOR]