A prospective study to evaluate the acceptance, efficacy, side effects and expulsion rates of post-placental intrauterine device

Background: This study was conducted to know the factors associated with acceptability of immediate post placental IUCD insertion in women and to know the level of safety, efficacy and expulsion of post placental insertion of IUCD.Methods: This study was conducted in Obstetrics and Gynecology Department of Kasturba General Hospital, Mumbai over a period of 1 year. Women admitted and delivered at KGH were informed and counselled regarding intrauterine devices regarding its insertion, efficacy and side effects. Cu T 380A was inserted within 15 minutes of delivery of placenta and membranes in women who gave consent and had no contraindications for IUD insertion. All these women were followed for 6 months in the post insertion period.Results: Total number of women counselled was 400 over the period of six months from August 2015 to January 2016. Out of these only 250 women gave consent for PPIUCD insertion. 50 were lost to follow up. 200 women were followed, out of which 15 women had expulsion, 15 women had excessive bleeding, 20 women complained of pelvic pain, bleeding and abdominal pain together was found in 25 women. 160 out of 200 continued with the method while the rest discontinued.Conclusions: Based on present study it may be concluded that post placental intrauterine device is an effective method of contraception. Proper counselling and insertion techniques would further improve the acceptability and reduce the expulsion rates.

Prediction Control for Brachytherapy Robotic System

In contemporary brachytherapy procedure, needle placement at desired location is challenging due to a variety of reasons. We have designed and fabricated an image-guided robot-assisted brachytherapy system to improve the needle placement and seed delivery. In this article we have used two different predictive control strategies in order to investigate the needle insertion efficacy and system dynamics during prostate brachytherapy. First, we used neural network predictive control (NNPC) to predict an insertion force. The NNPC uses the linearized state-space model of the robotic system to predict future system performances. Second, we used feedforward model predictive control (MPC) which allows the controller to compensate the influence of a measured disturbance's impact immediately rather than waiting until the effect appears in the system. Feedback control problem for the contact force regulation is considered. The simulation results and experiments for both cases are presented and compared.