Prevalence of intimate partner violence among pregnant women attending a public sector hospital in Bengaluru, southern India

Background Intimate partner violence (IPV) is recognized as an important public health problem globally as well as in India. It may result in adverse physical and mental health consequences for the victim or unfavourable pregnancy outcomes if it happens during pregnancy. The possible risk factors for IPV can be explained by four levels of ecological factors: individual, partner, household and community. We estimated the prevalence of IPV and its association with selected ecological risk factors among pregnant women availing of antenatal care at a public sector hospital in Bengaluru, southern India. Methods We included 350 women above the age of 18 years with a confirmed pregnancy of less than 24 weeks and having no obstetric complication. We used the Conflict Tactics Scale to determine the presence of IPV. The risk factors measured were—individual level: respondent’s age, education, occupation, gravidity, planned or unplanned pregnancy, substance abuse, presence of depression and anxiety; partner-related: spouse’s education, occupation and marital discord; household/community-related: socioeconomic status, social support, religion and consanguinity. Results The prevalence of IPV was 3.7%. Factors that were significantly associated on multivariate analysis were higher age (above 20 years) (adjusted odds ratio [AOR] 1.82 [1.12–2.97], p=0.016) and presence of depression (AOR 6.84 [1.76–26.61], p=0.005). Conclusion The prevalence of IPV was less in our study population compared to figures reported from other Indian study settings.

Advance Laparoscopy in Minimal Resource Settings: Experience from a Public Sector Hospital in a Lower Middle Income Country.

Background: To share our experience of performing advanced laparoscopic procedures with minimal resources in a public sector hospital.Methods: A retrospective study of laparoscopic cases performed from December 1st 2016 till Dec 31st 2020 was done. All the cases were done by single surgical unit but with different surgical teams both as elective as well as emergency procedure. Type of procedure, conversion to open, and immediate post operative complications and outcomes were recorded. Complications were recorded on the basis of the Clavian Dindo Classification. Results: In 49 months a total of 1550 procedures were performed. 1133 basic and 417 advanced laparoscopic procedures were performed. Only advanced laparoscopic procedures are discussed further. Median patient aged was 33 years (Range 10 to 70 years). Male to female ratio was 1:1.2 (191:226). There was a conversion rate of 8.6% with 36 operations converted to open due to either technical issues or any complication. Median hospital stay was 2 to 12 days. Median operative time was 90minutes. Complications were seen in 48 patients. Grade 1/2 complications in 38 patients. Grade 3 complications were seen in 9 patients. Grade 4 in 1 patient. No Grade 5 (Mortality) complications were seen. Conclusions: Advanced laparoscopic surgery can be safely undertaken in public sector hospitals in low resource countries with limited resources.

An Improved Queuing Model for Reducing Average Waiting Time of Emergency Surgical Patients Using Preemptive Priority Scheduling

Our research objective is to reduce the Average Waiting Time for patients in an Emergency Department of public sector hospital. We have based our model on M/M/s Queuing System, our study revealssignificant findings on arrival rate of patients. During this simulation, we have used a preemptive priority scheduling model. In our practice, the arrival rate followed a Poisson distribution, averaging 30 patients per hour, with the Mean Service time of1.5 hours and Average Waiting Time recorded around 12.13 minutes. This research offersvaluable help to achieve better time management in emergency departments of high-density medical facilities.

Correlation of Serum Uric Acid Level with Blood Pressure in Middle-aged Population: A Cross-Sectional Study from Public Sector Hospital of Islamabad

In Pakistan hypertension is the leading cause of mortality and morbidity and is affecting approximately one‐third of the population, meanwhile hyperuricemia is also highly prevalent and has important clinical implications, but association of hypertension and hyperuricemia is still a matter of debate in Pakistani population. To determine the correlation between serum uric acid and Hypertension. Cross-sectional analytical study of six month duration was carried out at at tertiary care public sector hospital of Islamabad from February to August 2019. After taking the informed written consent 100 middle-aged (40 to 65 years) asymptomatic individuals visiting tertiary care hospital for the test of serum uric acid for the first time were enrolled. Beckman Coulter AU analyzers and uriucase method was used to measure uric acid as per manufacturer’s instructions. Blood pressure of all enrolled participants was measured through a mercury sphygmomanometer. Demographic information of the study participant, clinical history, height, weight, family history, uric acid level and blood pressure were recorded on pre-structured questionnaire. BMI was calculated by using WHO formula. Among 100 enrolled study participants, 50 (50%) were males and 50 (50%) were females. The mean age was 50±8 years. The frequency of hyperuricemia was 16.0% and among these 93.8% were hypertensive with a significant Pearson correlation coefficientp value of 0.014. There is a significat correlation between hyperuricemia and hypertension. Our findings remain to be confirmed in future prospective studies.

Healthcare without borders: A cross-sectional study of immigrant and nonimmigrant children admitted to a large public sector hospital in the Gauteng Province of South Africa

Background Human migration is a worldwide phenomenon that receives considerable attention from the media and healthcare authorities alike. A significant proportion of children seen at public sector health facilities in South Africa (SA) are immigrants, and gaps have previously been noted in their healthcare provision. The objective of the study was to describe the characteristics and differences between the immigrant and SA children admitted to Kalafong Provincial Tertiary Hospital (KPTH), a large public sector hospital in the urban Gauteng Province of SA. Methods and findings A cross-sectional study was conducted over a 4-month period during 2016 to 2017. Information was obtained through a structured questionnaire and health record review. The enrolled study participants included 508 children divided into 2 groups, namely 271 general paediatric patients and 237 neonates. Twenty-five percent of children in the neonatal group and 22.5% in the general paediatric group were immigrants. The parents/caregivers of the immigrant group had a lower educational level (p < 0.0001 neonatal and paediatric), lower income (neonatal p < 0.001; paediatric p = 0.024), difficulty communicating in English (p < 0.001 neonatal and paediatric), and were more likely residing in informal settlements (neonatal p = 0.001; paediatric p = 0.007) compared to the SA group. In the neonatal group, there was no difference in the number of antenatal care (ANC) visits, type of delivery, gestational age, and birth weight. In the general paediatric group, there was no difference in immunisation and vitamin A supplementation coverage, but when comparing growth, the immigrant group had more malnutrition compared to the SA group (p = 0.029 for wasting). There was no difference in the prevalence of maternal human immunodeficiency virus (HIV) infection, with equally good prevention of mother-to-child transmission (PMTCT) coverage. There was also no difference in reported difficulties by immigrants in terms of access to healthcare (neonatal p = 0.379; paediatric p = 0.246), although a large proportion (10%) of the neonates of immigrant mothers were born outside a medical facility. Conclusions Although there were health-related differences between immigrant and SA children accessing in-hospital care, these were fewer than expected. Differences were found in parental educational level and socioeconomic factors, but these did not significantly affect ANC attendance, delivery outcomes, immunisation coverage, HIV prevalence, or PMTCT coverage. The immigrant population should be viewed as a high-risk group, with potential problems including suboptimal child growth. Health workers should advocate for all children in the community they are serving and promote tolerance, respect, and equal healthcare access.