scholarly journals Analysis of incidence of caesarean sections in primigravida

2021 ◽  
Vol 10 (4) ◽  
pp. 1433
Author(s):  
Suyujna D. Joshi ◽  
Rajeshwari Rai ◽  
Ruksar Banu ◽  
Jayasakthi G.
Keyword(s):  
Caesarean Section ◽  
Middle Class ◽  
Rural Areas ◽  
Urban Areas ◽  
District Hospital ◽  
Meta Analysis ◽  
Caesarean Section Rate ◽  
Lower Class ◽  
Background Current ◽  
Male Fetus

Background: Current study was conducted to determine the incidence of caesarean sections in primigravida.Methods: A total number of 1698 primigravidas were admitted in the department of DNB district hospital Ballari, out of which 501 primigravidas who underwent caesarean section were included in the study.Results: Caesarean section rate in primigravida was observed to be 29.5%, 55% of women were from rural areas and 45% from urban areas, 69.9% women belonged to lower class 31.1% belonged to upper middle class, 25% were illiterate while 75% were literate.Conclusions: Meta-analysis suggests that the occurrence of pregnancy complications differ according to fetal sex with a higher cardiovascular and metabolic load for the mother in the presence of a male fetus. 

scholarly journals Alliance of Ummah in Rural Areas: A New Perspective on Islamic Populism in Indonesia

2020 ◽  
Vol 4 (4) ◽  
pp. 239-250
Author(s):  
Rojabi Azharghany ◽  
Hotman Siahaan ◽  
Akh. Muzakki
Keyword(s):  
Middle Class ◽  
Rural Areas ◽  
Urban Areas ◽  
Lower Class ◽  
Ruling Elite ◽  
Large Cities ◽  
The People ◽  
Ruling Elites ◽  
New Perspective ◽  
Research Show

Islamic populism in Indonesia is perceived as an alliance of the people on behalf of the ummah in urban areas, against the ruling elites who enjoy the promises of peace and prosperity more than capitalism, modernism and democracy. This paper though intends to disclose the Islamic populism in rural areas through the power of capital and symbols as part of the cultural heterogenity between alliances in rural areas and large cities that simply focuses on political power. This research embraces the socio-cultural approach by applying the theory of generative structuralism penned by Pierre Bourdieu in order to analyze the resistance of cultural heterogenity by invigorating the cultural reproduction and symbols dominance to thwart the ummah alliance in urban areas. The results of this research show that the Islamic populism in rural areas upholds the belief in salvation, peace and unity, by reinforcing the cultural heterogenity among the congregations on various bases. In spite of domestication process in Islamic populism by the ruling elite, the ummah alliance in rural areas cannot be triggered due to their firm belief in salvation, which differs from the Islamic populism in large cities where a symbol of injustice of the bourgeoisie and the ruling elites prevails. The Islamic populism in rural areas has caused the failure of Islamic populism in large cities since their main discourse solely considers the middle class, in contrast to the Islamic populism in rural areas that might may welcome both the middle class and the lower class.

scholarly journals POLITICAL ABSTENTION IN THE INDIAN MIDDLE CLASS, THE RISE OF POPULISM AND THE REINFORCEMENT OF RENT

2018 ◽  
Author(s):  
Arkaprabha Pal
Keyword(s):  
Middle Class ◽  
Urban Areas ◽  
Lower Class ◽  
Religious Fundamentalism ◽  
Parliamentary Democracy ◽  
New Middle Class ◽  
Political Relationships ◽  
Urban Indian ◽  
English Speaking ◽  
Major Section

The Indian middle class witnessed a reconfiguration in its composition after the failure of the secular nationalists in their method of development and redistribution of resources. This reconfiguration used cultural and religious fundamentalism in the form of Hindutva as its instrument to assert their right to access the resources and strive towards a non-State centric redistribution. However, this new middle class, which was mainly conversing in the vernacular and had its base in the smaller urban areas, was also faced with the assertion of the lower class identarian groups. In such a situation, a large section of the urban Indian middle class shied away from taking part in the electoral process citing moral crises of the corrupt secular English speaking elite on one hand and the lowly criminal nature of the lower class political assertion on the other. Taking hints from the works of Christophe Jaffrelot, I would try to argue in this paper, that non-participation of a major section of the urban middle class was a manifestation of securing the rechanneled and partially redistributed rent legitimised through the instrument of Hindutva. This has led to increased persona-centric populist narratives from the mid-1990s to the present times with efforts to undermine parliamentary democracy (which is associated as an institiution of the immoral secular nationalists). This in turn, I would try to argue by the end of this paper, has again assisted in concretising the very rent-seeking practices and patron-client political relationships that the new middle class had initially opposed to rise to political prominence throughout the late 1970s and 1980s

scholarly journals Socioeconomic and Geographical Inequalities in Births by Caesarean Section Persist in the Context of Free Maternal Health Care: Evidence from a Cross-Sectional Survey of Southwestern and North Central, Nigeria

2019 ◽  
Author(s):  
Anthony Idowu Ajayi
Keyword(s):  
Health Care ◽  
Secondary Education ◽  
Maternal Health ◽  
Caesarean Section ◽  
Rural Areas ◽  
Urban Areas ◽  
Positive Impact ◽  
Health Care Service ◽  
Maternal Health Care ◽  
Monthly Income

Background User fee exemption for maternal and child health care service policy was introduced with a focus on providing free caesarean sections (CS) in Nigeria from 2011 to 2015. This policy had a positive impact on access to facility-based delivery, but its effect on socioeconomic and geographical inequality remains unclear. This study’s main objective is to examine access to birth by CS in the context of free maternal health care. Specifically, the study examines socio-demographic and geographical inequality in access to birth by CS among women who gave birth between 2011 and 2015 under the free maternal health care policy using a population-based survey data obtained from two of the six main regions of the country. Methods Data were obtained from 1227 women who gave birth during the period the policy was in operation selected using cluster random sampling between May and August 2016. Adjusted and unadjusted binary logistic regression models were used to examine whether there is socio-demographic and geographical inequality in access to birth by caesarean section. Results The overall caesarean section rate of 6.1% was found but varies by income (14.1% in monthly income of over $150 versus 4.9% in income of $150 and below), education (11.8% in women with higher education versus 3.9% among women with secondary education and less) and place of residence (7.8% in urban areas versus 3.6% in rural areas). Women who earn a monthly income of $150 or less were 48% less likely to have a birth by CS compared to those who earn more. Compared to women who were educated to tertiary level, women who had secondary education or less were 54% less likely to have birth by caesarean section. Conclusion This study shows that inequality in access to CS persists despite the implementation of free maternal health care services. Given the poor access to facilities with capabilities to offer CS in most rural areas, free maternal healthcare policy is not enough to make birth by CS universally accessible to all pregnant women in Nigeria.

scholarly journals Re-imagining freedom as elderly female porters: A study of buruh gendong at Beringharjo traditional market of Yogyakarta

Simulacra ◽  
2021 ◽  
Vol 4 (2) ◽  
pp. 169-184
Author(s):  
Gilang Mahadika ◽  
Setiadi Setiadi
Keyword(s):  
Rural Areas ◽  
Industrial Production ◽  
Urban Areas ◽  
Working Hours ◽  
Lower Class ◽  
Living Condition ◽  
Historical Background ◽  
Elderly Female ◽  
Traditional Market ◽  
Urban And Rural Areas

This paper expects to reveal the struggle of elderly female porters or buruh gendong who mostly had a historical background of working in industrial production (factory) but ended up being self-employed at Beringharjo traditional market of Yogyakarta. They used to work as factory workers. However, most factories collapsed in the aftermath of the 1997 economic crisis, especially in Southeast Asia. These older people from peri-urban (and rural) areas with lower-class status ended up in urban areas to be self-employed and became precarious workers. Therefore, the research questions are how they cope with the income uncertainties only to meet their daily needs and still desire their children to have a better living condition. Observations and interviews were done with 25 elderly female traditional porters as the research methods from 2020. They are primarily in the age range of late 50-80 years old. The results show that income uncertainties and social insecurity bring about precariousness. Buruh gendong have to work every day only to make ends meet. However, these conditions could also open up alternative perspectives that they often found themselves liberated from the control of industrial production. They do not work for capital owners or bosses; they work for themselves (self-employed). They are free or more flexible on working hours, but, at the same time, they have to accept their insecure employment. Buruh gendong also have desires for their children to be able to achieve a higher education level. Eventually, the desires are mostly unfulfilled; their children get unfortunate work and still live barely.

scholarly journals Study of knowledge, attitude and practices of contraception in breast-feeding mothers

2019 ◽  
Vol 8 (4) ◽  
pp. 1473
Author(s):  
Aiyleen Shiza Shawl ◽  
Vidya Thobbi
Keyword(s):  
Breast Feeding ◽  
Rural Areas ◽  
Urban Areas ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Lower Class ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Knowledge And Attitude ◽  
The Government

Background: In India, as in many other countries, postpartum family planning is usually initiated after 6 weeks postpartum. Early resumption of sexual activity coupled with early and unpredictable ovulation leads to many unwanted pregnancies in the first year postpartum. Increase in hospital deliveries provides an excellent opportunity to sensitize women and provide effective contraception. Hence the present study was done at our tertiary care centre to assess the knowledge, attitude, practice regarding contraception and to find out the relationship between knowledge and attitude regarding contraception among breast feeding mothers.Methods: A hospital based observational study. The patients admitted at our tertiary care centre in the Department of Obstetrics and Gynecology.Results: Majority of the participants (72%) were in the age group of 21-25 years. 21.2% of the study group was educated up to primary level while 33.2% and 18.4% of the participants studied till SSC and HSC respectively. Majority of participants were from middle class (50%) followed by lower class (36.4%) and upper class (13.6%). 69.6% participants resided in rural areas while 30.4% participants were from urban areas. It was observed that age, education and mode of delivery were the significant factors.Conclusions: As the government gives incentives to couples who opt for permanent sterilization, which is an effective drive, it should also give incentives to couples who follow temporary methods and delay pregnancies. Couples who adopt one child norm or 2 children norm should be encouraged by benefits either in the form of children’s education or health insurance.

scholarly journals Vitamin D insufficiency is high in Malaysia: A systematic review and meta-analysis of studies on vitamin D status in Malaysia

2021 ◽  
Author(s):  
Shamin Mohd Saffian ◽  
Nor Aini Jamil ◽  
Nor Asyikin Mohd Tahir ◽  
Ernieda Hatah
Keyword(s):  
Vitamin D ◽  
Rural Areas ◽  
Urban Areas ◽  
Meta Analysis ◽  
Vitamin D Insufficiency ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Malaysian Chinese ◽  
Healthy Participants

Abstract Vitamin D plays an important role in the immune system and many non-communicable diseases. The prevalence of vitamin D deficiency for the overall population of Malaysia is unknown. This study systematically reviewed and pooled studies that report vitamin D status from participants residing in Malaysia. PubMed, Scopus, Web of Science and MyJurnal were searched up to June 2021 without language restrictions. We include studies that reported the 25-hydroxyvitamin D (25(OH)D) concentrations and defined their cut-off for deficiency or insufficiency from healthy participants residing in Malaysia. Random effects model was used to pool vitamin D status using established cut-offs of < 30nmol/L, < 50nmol/L, and < 75nmol/L according to age group. We identified 203 studies, of which we included 31 studies in the meta-analysis. The pooled proportion for < 30nmol/L was 21% (95% CI 9–36, n = 2,438 from 10 studies), while the pooled proportion < 50nmol/L was 64% (95% CI 55–72, n = 13,927 from 29 studies), and < 75nmol/L was 85% (95% CI 61–100, n = 1,376 from 5 studies). Heterogeneity was high (I² ranged from 98–99%). Higher proportions of vitamin D insufficiency (defined as < 50nmol/L) were found in participants living in the urban areas (compared to rural areas), in females (compared to males), and in Malays and Malaysian Indians (compared to Malaysian Chinese) ethnicities. In conclusion, vitamin D insufficiency is highly prevalent in Malaysia, despite being a country that is close to the equator. We strongly urge prompt public health measures to improve the vitamin D status in Malaysia.

Birth Seasonality in Quebec, 1680-1799

1969 ◽  
Author(s):  
Xiangtao Meng
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Seasonal Pattern ◽  
Economic Cost ◽  
Lower Class ◽  
Upper Class ◽  
Birth Seasonality ◽  
Work Cycle ◽  
The One ◽  
Birth Pattern

Human birth seasonality is ubiquitous. Using over one million baptismal records in Quebec from 1680 to 1799, I show that the seasonal pattern of births exhibited a global peak in spring and a local peak in September. Over time, the magnitude of the spring peak declined, whereas the magnitude of the September peak rose. This pattern of births resembles the one in the 20th century from previous research. Using occupational and geographical data, I find that the pattern of births differed in social classes and locations. The magnitude of the peak in September magnified in the upper class in urban areas. Given the prohibition on family planning in Catholicism, I suggest an explanation from the seasonal work cycle. The high intensity of work in the fall correlated with a trough in the conception rate of the upper class in urban areas, and the relatively slack time in June and July during the farming season correlated with a peak in conception for the lower class in rural areas. The birth pattern was optimal, and it minimized the economic cost and the mortality risk. This study has established correlations, but the causal relationship remains a puzzle.  

scholarly journals Central Neuraxial Blockade-Assisted External Cephalic Version in Reducing Caesarean Section Rate: Systematic Review and Meta-Analysis

2009 ◽  
Vol 2009 ◽  
pp. 1-8 ◽  
Author(s):  
Ibrahim Bolaji ◽  
Lillian Alabi-Isama
Keyword(s):  
Caesarean Section ◽  
Motor Nerve ◽  
Meta Analysis ◽  
Caesarean Section Rate ◽  
Economic Value ◽  
Cost Savings ◽  
External Cephalic Version ◽  
Group Code ◽  
Neuraxial Blockade ◽  
Randomized Controlled Studies

We review the medical literature on the success, safety and economic value of central neuraxial blockade-assisted (CNB) external cephalic version from randomized controlled studies identified from 1951 to 2009. The result showed that more women had successful ECV with regional anaesthesia with corresponding reduction in caesarean section rate. They were 1.5 times more likely than women not receiving anaesthesia to have a successful ECV. The number to treat is six women needed to receive anaesthesia for 1 baby to be turned from breech to cephalic presentation. Feto-maternal morbidity was not increased in the CNB-aided group consisting of only transient bradycardia. Although the appropriate amount of force for safe version has not been quantified, there was no report of uterine rupture despite removal of these patients from “excessive force-pain biofeedback loop” induced through motor nerve blockade. We can attribute 30% of cost savings amounting to £42,150.00 directly to CNB using the most up to date Health Resource Group Code (HRG4). The initial results are encouraging but until the benefits and safety of CNB-aided ECV are substantiated by large randomized, blinded controlled trials, this practice cannot be universally recommended.

scholarly journals Are we operating unnecessarily?: caesarean audit in a single unit of a private tertiary care hospital in North India

2020 ◽  
Vol 9 (3) ◽  
pp. 975
Author(s):  
Nidhi Singh ◽  
Manjusha .
Keyword(s):  
Caesarean Section ◽  
Urban Areas ◽  
Single Unit ◽  
Financial Burden ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
North India ◽  
Care Hospital ◽  
Appropriate Use ◽  
Maternal Request

Background: Caesarean section emerged as a lifesaving surgery in situations where vaginal delivery could put the mother and fetus at risk. Over the years global rise in caesarean delivery rate has been alarming and may be attributed to changes in medical practice and societal expectations, especially in urban areas and developing countries. Rising caesarean rate is worrisome as it increases maternal morbidity, exposes the mother to future obstetric risks, besides increasing financial burden on the health care system. Caesarean audits could be an effective tool to analyse, understand and propose solutions to reduce caesarean rates. Hence, this retrospective study was conducted to audit caesarean sections done over a period of 5 years (2011 to 2015) in a single unit of a tertiary care private hospital in North India.Methods: The case records of all caesarean deliveries from January 2011 to December 2015 were analysed retrospectively for demographic profile, clinical parameters and recorded indication of caesarean section on the basis of Robson’s classification.Results: The caesarean section rate in the study was 61.8%. According to Robson’s 10 system classification, Group 2, 5 and 10 were the largest contributors. The commonest indication was previous LSCS (18.7%) followed closely by fetal distress (15.4%) and prolonged labor/failed induction (13.3%). Maternal request contributed 10.6% of the Caesarean deliveries.Conclusions: The caesarean section rate in our study is way higher than the national average. We need to re-duce caesareans in primigravidae and consider VBAC where appropriate. Use of Electronic fetal monitoring during labor needs to be optimized. Appropriate use of oxytocics, proper monitoring and using robust criterion to infer non progress of labor are important. Appropriate counselling and assured pain management during labor may help reduce caesareans on maternal request.

scholarly journals Epidemiology of animal bite in Iran during a 20-year period (1993–2013): a meta-analysis

2019 ◽  
Vol 47 (1) ◽  
Author(s):  
Maliheh Abedi ◽  
Amin Doosti-Irani ◽  
Fatemeh Jahanbakhsh ◽  
Amirhossein Sahebkar
Keyword(s):  
Incidence Rate ◽  
Rural Areas ◽  
Urban Areas ◽  
Meta Analysis ◽  
Control Program ◽  
Accurate Data ◽  
Cross Sectional ◽  
Significant Difference ◽  
Efficient Resource ◽  
Incident Rate

Abstract Background Rabies is a fatal disease that still kills 2–6 people a year in Iran. A meta-analysis was conducted in order to generate accurate data on animal bite exposure, and to estimate the incidence of animal bite across the country. Materials and methods Major national and international electronic databases were searched using the keywords “animal bite,” rabies, prevalence, incidence, and Iran. Web of Knowledge, PubMed, Scopus, Ovid, and ScienceDirect were used as international databases, and the national databases included Science Information Database, MagIran, and IranDoc. Descriptive cross-sectional studies addressing the incidence of animal bite were selected and screened by two authors, and pre-specified data were extracted. The population of provinces or cities of studies was extracted from the Statistical Centre of Iran. The overall incidence of animal bite in Iran was estimated using a random-effects model with 95% confidence interval (CI). Study quality was assessed using the STROBE recommended checklist. Results A total of 34 studies were selected for the meta-analysis out of 1215 retrieved studies. The number of animal bites in the studies during 1993–2013 was 230,019 cases. The overall estimated incidence rate of animal bite in Iran was 13.20/1000 (95%, CI 12.10, 14.30) and the mean age of people was 26.23 (SD = 5.02) year. The incidence rate of animal bite among males (14.90/1000) was much higher than females (4.55/1000), and was higher in rural areas (17.45/1000) compared with urban areas (4.35/1000). The incident rate was highest among students compared with other reported occupations. The incidence rate of dogs was 10.40/1000 followed by cats, cows, wolves, jackals, and foxes. Domestic animals had a higher incidence rate than stray and wild animals. The incidence rate of animal bite during spring was 4.90/1000; however, the incidence rate in other seasons had no significant difference. In the retrieved studies, the highest incidence rate of animal bite was found in the West Azerbaijan Province (146.83/1000). Conclusion The current study is the first comprehensive analysis of the published animal bite studies in Iran. Accurate data on animal bite incidence may lead to more effective policy-decisions towards more efficient resource allocation to primary health care for reducing rabies case. Such information is a primary and major necessity for rabies control program in the country. Animal bite reduction can significantly minimize the risk of rabies infection, thereby reducing public health costs for the expensive post-exposure treatment.

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