Biomedical subjects

Madan Singh

Publications and source records attributed to Madan Singh.

2 recordsLinked to original sources

PubMed2006

Migration of Implanon.

OBJECTIVE: To determine whether or not migration of the Implanon rod does occur if correctly positioned and, if indeed migration does occur, to measure the degree of such migration. METHODS: A prospective study of 100 women who requested and had Implanon rods inserted by one fully trained health care professional holding the Faculty of Family Planning and Reproductive Health Care Letter of Competence in Subdermal Contraceptive Implant Techniques. Measurements were made from the insertion site to the distal end of the rods at 3 and 12 months post-insertion. RESULTS: Of the 100 women studied, 95 were seen for follow-up at 3 months. There was no migration of Implanon in 58 (61%) patients. Of the remaining 37 (39%) patients where migration had occurred, 34 showed migration caudally and only three demonstrated cranial migration. With regard to the degree of migration, all but one case showed this to be less than 2 cm either cranially or caudally. At 1-year follow-up 87 patients were seen. No migration was noted in 39 (45%) patients. In the remaining 48 (55%) patients where migration had occurred, 44 showed migration caudally and only four demonstrated cranial migration, which in one case was over 2 cm. With regard to the degree of migration, all but one case showed this to be less than 2 cm either cranially or caudally. The measurement in the single case showing migration over 2 cm at 3 months remained the same at the 1-year follow-up. CONCLUSIONS: These results show that up to 1 year after insertion of Implanon significant migration of the rod does not occur. The degree of migration noted in all cases except one was less than 2 cm. Where migration was noted, in the majority of cases this occurred caudally towards the insertion site. There were no cases of deep migration.

Adolescent↗

PubMed2006

Location and removal of non-palpable Implanon implants with the aid of ultrasound guidance.

BACKGROUND: Implanon insertion appears to be an easy procedure, but in a small minority of cases difficulties have been encountered with removal if the rod is impalpable. METHODS: Patients were referred to the contraceptive and sexual health service with non-palpable Implanon. Following a clinical assessment and examination of the arm where the implant had been inserted, an ultrasound examination was carried out to identify and locate the implant. These implants were subsequently removed, some under general anaesthesia and others under local anaesthesia. RESULTS: Twenty-seven patients were referred to the unit with impalpable Implanon rods. In four cases the rods were palpable and were removed in the clinic setting without the need for further intervention. Positive identification of the implants was achieved in 21 of the remaining 23 cases using ultrasound. No implant was detected in two cases and etonogestrel was not demonstrated serologically in either woman, suggesting non-insertion. All 21 Implanon rods identified by ultrasound were successfully removed. In just over 52% of women a previous attempt at removal had been undertaken prior to referral. CONCLUSIONS: It is possible to identify and locate impalpable Implanon rods with the aid of ultrasound, facilitating their subsequent safe removal. Although previous reports have identified the position of 'lost' implants using ultrasound, this is the first case series to discuss measuring the skin/implant depth. This parameter, together with the precise position of the implant (in muscle or fat), aids removal. All health professionals inserting and removing contraceptive implants should have been appropriately trained.

Adult↗