scholarly journals A study on obstetric care in a primary health center of South Assam district, India

Author(s):  
Ajit Kumar Dey ◽  
Debojit Chutia

Background: Maternal and child health are critically important in a country that is experiencing high infant mortality and maternal mortality. Research all over the world has suggested that one of the major solutions to this problem is availability of Emergency Obstetric Care services within the reach of people. Objectives of the study were to examine profile of mothers who have delivered in health facility during a year and the interplay of various factors in child birth and newborn outcome.Methods: Retrospective cross sectional study conducted by collecting information in predesigned format from medical records. Appropriate statistical methods and test of significance performed for qualitative and quantitative variables.Results: Out of 539 women, the majority of 42.9% were in the age group 20-25 years, the mean age (SD) of mother was 24.1 years (±4.09). Out of total 539 vaginal deliveries, 56.6% cases episiotomy was performed. 41.6% deliveries occurred from 8 AM to 4 PM. The mean birth weight was 2.830 kg SD 0.439 and low birth prevalence 16.0%. Parity with time to delivery after admission in different age groups revealed significant association (X2=66.456, p=0.000). Women aged less than 20 years are 12 times more at risk of episiotomy performed. The multivariate logistic regression analysis shows 60.67% specificity and 85.59% sensitivity in predicting episiotomy.Conclusions: From study it is evident that women report to hospital late in labor hence there is urgent need to provide quality antenatal care services at village and PHC level and augment awareness among the community for promotion of safe motherhood.

Author(s):  
Vidyadhar B. Bangal ◽  
Swati D. Gagare ◽  
Samita Bhardwaj ◽  
Sonal Raut

Background: Acute inversion of uterus also called as puerperal inversion of uterus is a rare, but life-threatening complication of third stage of labour. Severe uterine atony, mismanagement of third stage of labour, adherent placenta are some of the common factors associated with the occurrence of acute inversion of uterus. Early recognition and prompt treatment are important to save life of the woman.Methods: A retrospective cross-sectional record-based study was carried out to find out the incidence, presentation and outcome of cases of acute inversion of uterus admitted to Pravara Rural Hospital Loni for a period of three years (October 2015 to September 2018).Results: During the study period, there were 27,134 deliveries including 8,834 caesarean sections. There were six cases of acute inversion of uterus in the hospital during study period. The incidence of acute inversion of uterus was 0.22 per one thousand deliveries (0.27 per thousand vaginal deliveries and 0.11per one thousand caesarean sections). Three cases were referred from outside hospital and three cases had delivered at Pravara Rural Hospital. Five cases had delivered vaginally, where as one case had undergone caesarean section. There were two maternal deaths and four survivals among six cases of inversion of uterus. Severe anaemia, irreversible hypovolemic shock and multi-organ failure were causes of maternal deaths.Conclusions: Prompt recognition of uterine inversion and its immediate reposition under anaesthesia was a key for successful management. Delay in recognition and transfer of cases resulted in haemorrhagic and neurogenic shock, leading to death of a women. Institutional deliveries with practice of principles of active management of third stage of labour (AMTSL) and improvement in emergency obstetric care services at peripheral hospitals, avoiding delays at all levels will help to reduce the incidence, morbidity and mortality associated with acute inversion of uterus.


2019 ◽  
Vol 2 (3) ◽  
pp. 250-252 ◽  
Author(s):  
Prakash Shahi

Improving maternal health was one of the eight millennium development goals (MDGs) in 2000 and later included in SDG as a major agenda in 2015 which was adopted by the international community.  In Nepal, the first elected democratic government developed Health Policy in 1991 and revised in 2014 which has identified safe motherhood as a priority program and institutionalized safe motherhood as a primary health care. In order to effectively address maternal and neonatal morbidity and mortality, the Family Health Division, Department of Health Services (DoHS) developed National Safe Motherhood Long Term Plan 2002- 2017 (revised in 2006) which aimed to establish basic and comprehensive emergency obstetric care services in all districts. To complement this plan, the National Policy on SBA (2006) was developed with the aim of increasing the percentage of births assisted by a skilled birth attendant (as internationally defined) to 60 percent by 2015. Table 1 explains some historical shifts in maternal health policies and programs in Nepal.


1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77


2021 ◽  
Vol 9 ◽  
pp. 251513552110158
Author(s):  
Abdoulreza Esteghamati ◽  
Shirin Sayyahfar ◽  
Yousef Alimohamadi ◽  
Sarvenaz Salahi ◽  
Mahmood Faramarzi

Background: Whole-cell pertussis (wP) vaccine administration is still advocated for children under 7 years of age in Iran. However, there is no recommendation for the administration of a dose of tetanus, diphtheria, and acellular pertussis (Tdap) vaccine to childbearing age/pregnant women in the Iranian vaccination program and it has increased the risk of infection through waning immunity during women’s childbearing age life. The study aimed to assess the levels of anti- Bordetella pertussis antibodies in childbearing age women of different ages in Iran. Methods: A cross-sectional study was conducted on a total number of 360 childbearing age women divided into six age groups, with 5-year intervals from 15 to 45 years old, in 2018–2019. Then, the levels of immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin G (IgG) antibodies against B. pertussis were evaluated using enzyme-linked immunosorbent assay (ELISA). The IBM SPSS Statistics software (version 16.0) (SPSS Inc., Chicago, IL, USA) was used for data analysis. Results: The mean age of the participants was 30.01 ± 8.35 years (range 14–45 years). All the cases were IgM negative, but two IgA-positive individuals (in the age groups of 14–19 and 30–34 years) were reported. Overall, 239 (66.4%) cases were IgG positive. The mean age of IgG-positive cases was 30.37 ± 8.37 years. The IgG-positive cases were mostly in the age groups of 30–34 and 35–39 years [43 (71.1%)]. The odds of IgG positivity were 1.97. The highest odds of IgG positivity were seen in 30–34 and 35–39 years groups (2.52) and the lowest odds were seen in the 20–24 and 25–29 years groups (1.60). Using the Jonckheere–Terpstra test, the increasing trend of IgG changes in different age groups was not statistically significant (Tπ=5.78, p = 0.09). Conclusion: The infants of women of childbearing age might be prone to pertussis in countries using the wP vaccination schedule. It is suggested to administer a dose of Tdap to women before or during pregnancy to increase the immunity of their infants against this disease during early infancy.


Author(s):  
Houda Ben Ayed ◽  
Sourour Yaich ◽  
Mariem Ben Hmida ◽  
Maissa Ben Jemaa ◽  
Maroua Trigui ◽  
...  

AbstractObjectivesThis study aimed to estimate the extent of smoking experience among high and middle school adolescents in Southern Tunisia and to delineate its potential associated factors.MethodsWe conducted a cross-sectional study among middle and high school-adolescents in the governorate of Sfax, South of Tunisia in the 2017–2018 school-years. A questionnaire was anonymously administered to a representative sample of 1,210 school-adolescents randomly drawn.ResultsThe mean age of the school-adolescents was 15.6 ± 4.2 years. The prevalence of lifetime smoking was 16.7% (95% CI=[14.7–18.8%]) (boys 32.6%; girls 5.9%;p<0.001). Among the respondents, 13.9% (95% CI=[11.9–15.8%]) were current smokers. In multivariate logistic regression analysis, independent associated factors of current smoking were male gender (Adjusted (AOR)=10.2; p<0.001), 16–17 and 18–19-year age-groups (AOR=2; p=0.005 and AOR=2.6; p=0.001, respectively), below average academic performance (AOR=5.2; p=0.012), divorced parents (AOR=3.9; p=0.007), family monthly income ≥800 dollars (AOR=2.1; p=0.001), having a part time job (AOR=3.9; p<0.001) and a perceived high stress level (AOR=1.98; p=0.008). Secondhand smoke (AOR=1.8; p=0.011) and concomitant alcohol drink (AOR=14.56; p<0.001) were independent predictors of current smoking, while high education level of the father was independently associated with lower prevalence of current smoking (AOR=0.17; p<0.001).ConclusionThe prevalence of lifetime and current smoking were relatively high in Southern Tunisian middle and high schools. Multilevel influences on youth smoking behavior had been identified, which reflected the need to conceive appropriate school interventions and effective antismoking education program.


Author(s):  
Ntiense Macaulay Utuk ◽  
Anyiekere Ekanem ◽  
Aniekan Monday Abasiattai

Background: Antenatal care is one of the four pillars of safe motherhood and its benefits in preventing adverse feto-maternal outcome is proven. Commencement of antenatal care early has been shown to be key for this benefit to be fully realized. The aim of this study was to determine the antenatal booking pattern of pregnant women and its determinants in our environment.Methods: A cross sectional study of women attending the booking clinic in the University of Uyo Teaching Hospital, Akwa Ibom State, Southern Nigeria over a three-month period.Results: The mean age of the respondents was 28.5 years. The mean gestational age at booking was 18.3 weeks. The majority of the patients were married (94.1%). 68.1% had a post-secondary education. 33.5% of patients were nultiparous, while 3.5% were grand multiparous. The majority of patients (72.4%) booked late for antenatal care. Age group, marital status, mode of delivery was not significantly associated with timing of booking. High levels of patient’s education, high levels of husband’s education as well as grand multiparity were significantly associated with late booking (P<0.05). Majority (65.4%) of patients claimed that it was safe to book at any time during pregnancy.Conclusions: The majority of women booked late for antenatal care. In our study, we have found that general and health education, subsidisation of cost for antenatal care and introduction of focused antenatal care will help to reverse this trend.


2020 ◽  
Author(s):  
Patricia Montenegro ◽  
Carlos Brotons ◽  
Jordi Serrano ◽  
Diana Fernández ◽  
Carlos Garcia-Ramos ◽  
...  

Abstract Background There is a scarcity of information about patients with mild or moderate symptoms during the coronavirus disease 2019 (COVID-19). This is especially true for those who attended and were followed up at primary care settings. Objectives We aim to measure the seroprevalence of antibodies against SARS-CoV-2 infection in a community sample of possible cases and among probable cases followed in primary care. Methods We selected a random sample of 600 individuals stratified by age groups from a total population of 19 899 individuals from a community area in Barcelona. We also invited all the patients that had been followed by General Practitioners (GPs). For both populations, we used COVID-19 rapid lateral flow immunoassays, which qualitatively assess the presence of patient-generated Immunoglobulins G (IgG) and Immunoglobulin M (IgM). Results Three hundred and eleven asymptomatic individuals from the randomly selected sample participated in the study. The mean age was 43.7 years [standard deviation (SD) = 21.79] and 55% were women. Seventeen individuals were seropositive for IgM and/or IgG, resulting in an overall prevalence of 5.47% (95% confidence interval = 3.44–8.58). Six hundred and thirty-four symptomatic patients were followed up by GPs. The mean age was 46.97 years (SD = 20.05) and 57.73% were women. Of these, 244 patients (38.49%) were seropositive. Results of the multivariate logistic regression analysis showed that the odds ratio for a positive test was significantly increased in patients who had fever, ageusia and contact with a patient diagnosed with COVID-19. Conclusions The seroprevalence of antibodies against SARS-CoV-2 among possible cases was lower than expected. Approximately, 40% of the symptomatic patients followed up by GPs during the peak months of the pandemic were positive.


2016 ◽  
Vol 44 (2) ◽  
pp. 67-71 ◽  
Author(s):  
Shayela Farah ◽  
Mohoshina Karim

Appropriate ante-natal care services promote safe motherhood and delivery with improved maternal and neonatal outcome. This population based cross sectional descriptive study was carried out to determine the utilization of antenatal care (ANC) services in a rural community of Bangladesh. Out of the 112 women studied, 63.4% mothers were found to receive antenatal care. Among them one third (32.4%) took it more than 4 occasions, 34(47.8%) pregnant women received antenatal care from government hospitals, 19(27%) from family welfare centre, 6(8.5%) from satellite clinics and around 12(17%) received from private hospitals. Around 71% mothers received ANC service from doctor while 17% mothers received from trained professionals. Seventy four percent mothers received tetanus (TT) injections. Only one fourth (25.3%) mothers had not received it. On an average, 90% mothers received iron tablets during their pregnancy. Regarding have danger signs during pregnancy, it was found that, 58.9% mothers were not aware about the have danger signs and 29.5% respondents knew about all the danger signs. Association between educational status and treatment seeking behaviour for pregnancy complication was found to be statistically significant (p<0.05). However, association between educational status and place of treatment for pregnancy complication was also found significant (p<0.01). Intensive awareness programme, behavioural change interventions and regular pregnancy monitoring may promote antenatal care service utilization in rural Bangladesh.Bangladesh Med J. 2015 May; 44 (2): 67-71


2015 ◽  
Vol 9 (1) ◽  
pp. 11-16
Author(s):  
Fatema Johora ◽  
Abu Sadat Mohammad Nurunnabi ◽  
Sunjida Shahriah ◽  
Rukshana Ahmed ◽  
Shamim Ara

Background: Controversies still prevail on glomerular changes of kidney whether due to normal aging or its association with diseases Objective: The aim of the present study was to see the variation in number and size of the glomeruli of kidney with increasing age in a Bangladeshi population based on autopsy. Methods: This cross-sectional, descriptive study was done in the Department of Anatomy, Dhaka Medical College, Dhaka, from July 2008 to June 2009, based on collection of 140 post mortem human kidneys collected from 70 unclaimed dead bodies from the morgue. All the samples were divided into three age-groups: 10-19 years, 20-39 years and 40-59 years. Histological slides were prepared by using routine Harris’ Haematoxylin and Eosin (H & E) stain. The number of glomeruli was measured by point counting technique, while the size (diameter) was measured by using ocular and stage micrometer. Results: The mean ± SE number of glomeruli per sq. mm found in the right and left kidney were 8.45±0.52 and 8.67±0.80 in group 10-19 years, 9.90±0.42 and 9.92±0.47 in 20-39 years, and 8.52±0.18 and 8.55±0.16 in 40-59 years respectively. Besides, the size (mean ± SE diameter) of glomeruli was found in the right and left kidney were 43.96±3.01ìm and 143.92±2.90ìm in group 10-19 years, 153.69±5.18ìm and 153.61±5.24ìm in 20-39 years, and 140.48±0.95ìm and 140.78±0.88ìm in 40-59 years respectively. Conclusion: No difference was found in number and size of glomeruli between right and left kidney in any group. Similarly, no difference was also evident among different age groups. DOI: http://dx.doi.org/10.3329/jbsp.v9i1.22788 Bangladesh Soc Physiol. 2014, June; 9(1): 11-16


2013 ◽  
Vol 4 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Md Atiqur Rahman ◽  
Md Mahfuzar Rahman

This was a descriptive type of cross sectional study among 522 garments workers as  respondents. It was aimed to identify morbidity pattern, duration of illness among garments  workers and also to determine treatment seeking behavior during illness. The socio-demographic  characteristics of the respondents were the points of investigations.  It was revealed from the findings that the mean age of the respondents were 23.1years. They  were mostly female (80%) and married (60%). About 60% respondents were found primarily  educated and no one found illiterate. 90% respondents were found from nucleated family. The  study shows 79% respondents were suffering from illness during the last 02 months and majority  suffers (18.6%) and (43.6%) were found among 26-30 years age groups and 21-25 years age  groups respectively. However, female sufferers were more (33.6%) than male (10%) in the 21-  25 years age groups. Moreover about 42% respondents were suffering for 1-2 weeks and 28.8  are suffering for less than 02 weeks. On the otherhands, Loose motion, Cough, and  Breathlessness were found prominent sign/symptoms among 38%, 29%, 28% sufferers  respectively. Diarrhoea, Common cold and Respiratory Tract Infections were found as  predominant diagnosis among 40.5%, 22.5% & 15.1% respondents respectively. Nevertheless  majority 56% were seeking treatment from LMAF doctors. Conclusion: The study findings  highlight awareness program among factory owners and garments workers towards preventing  infectious and chronic diseases as well as to undertake modern scientific treatment. Improved  health care facilities in the garments factory may be considered for early detection and treatment  of cases to avoid complications. DOI: http://dx.doi.org/10.3329/akmmcj.v4i1.13678 AKMMC J 2013: 4(1): 10-14


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