Evaluation of the Efficacy and Threshold of Serum Anti-mullerian Hormone (AMH) Levels for Diagnosis and Prediction of Polycystic Ovary Syndrome (PCOS) Among Indian Women.

Purpose: PCOS women exhibit higher levels of AMH and has been proposed to add value to diagnosis of PCOS incase ambiguity. However, variable cutoffs of AHM for PCOS prediction have been reported. This study was designed to determine diagnostic threshold of serum AMH levels and its correlation with clinical, hormonal and ultrasonographic parameters among women with PCOS.Materials: In this prospective study, 113 women with PCOS as per Rotterdam criteria 2003 and 75 normo-ovulatory women were included. Clinical, biochemical, hormonal and sonographic assessment in addition to serum AMH levels were determined using standard methodology.Results: Mean age was comparable (23.43±3.42vs.24.21±3.18 years) between cases and controls. The mean number of menstrual cycles per year were lower while as mean BMI, FG score, and serum testosterone were higher in cases than controls (p<0.05). The mean serum AMH level was significantly higher in PCOS group (7.84±3.67vs. 3.23 ±1.56 ng/mL) than controls. The serum AMH levels showed a positive correlation(p<0.05) with LH/FSH ratio (r = 0.206, p = 0.029), number of ovarian follicles(r=0.461) and volume,(r=0.521), but no correlation significant with age and BMI. As per receiver operating characteristic (ROC) curve, cut-off was worked out to be 3.76 ng/mL with 86.7% sensitivity and 62.7% specificity. Conclusion: Serum AMH levels correlate positively with PCOM among PCOS women and may be a potent diagnostic marker of ovarian dysfunction either alone or in conjunction with other tools to ensure timely diagnosis and early treatment of the disorder.

Wavelet Packet Analysis of ECG Signals to Understand the Effect of Cannabis Abuse on Cardiac Electrophysiology of Indian Women Working in Paddy Fields

This chapter is aimed at identifying the variation in the cardiac electrophysiology due to the abuse of the cannabis products (bhang) in a non-invasive manner. ECG signals were acquired from 25 Indian women working in the paddy fields. Amongst them, 10 women regularly abused bhang and the rest 15 women never abused bhang. The ECG signals were preprocessed and subjected to wavelet packet decomposition (WPD) up to the level 3 using db04 wavelet. Ninety-six statistical features were extracted from the wavelet packet coefficients and analyzed using linear and non-linear statistical methods. The results suggested a variation in the cardiac electrophysiology due to the abuse of bhang. Artificial neural networks (ANNs), namely, radial basis function (RBF) and multilayer perceptron (MLP) were able to classify the ECG signals with an accuracy of ≥95%. This supported the hypothesis that abuse of bhang may alter the cardiac electrophysiology. The results of the study may be used to increase awareness among people to avoid the abuse of cannabis products.

UNDERSTANDING THE EFFICACY OF TELECONSULTATION IN ASSUAGING ABUSE AGAINST INDIAN WOMEN DURING COVID-19 OUTBREAK

Covid-19 pandemic has impacted societal well-being in different and interacting contexts and its long duree consequences on human health, both biological and psychological serves to be a key element in the public discourse. The “pandemic-lockdown” in the Indian context made the health and social faultlines existing in the country hypervisible making one question the ‘normal’ we were existing with, in the pre-Covid times. As the virus took its toll on the fragile health system, nearly crushing it, individual’s rights to a safe and dignified life got threatened in the private spaces. The psycho-social effects of the pandemic arising from the exploitation in the public/private domains can be recognized as infringements with severe and sustained negative repercussions on the vulnerable sections of society. While analysing the intersecting vulnerabilities on varied fronts, another intense predicament related to women and elderly abuse in the (un)safe homely space awaits address and redressal. The nature of stressors underlying such abuse reflects on a complex interplay among several factors at an individual, community, and collective levels. The use of digital platforms, social media sites, and teleconsultation in moments of unprecedented crisis suggests towards creating an alternative paradigm for addressing the psychosocial dimension of the pandemic that lies intertwined with the “underlying injustices and social conditions”. In the backdrop of the Covid context, this paper would analyse how teleconsultation and telepsychiatry became an apparent channel to ensure health based services and extend support and safety to those victims and survivors of family abuse who remain marginalized in the society on sexist and ageist constructs.

Impactful role of women for freedom struggle in India and their contribution

The untold, unheard and unseen facts of the struggle for an Independent India. The role of Indian women freedom fighters in the journey of freedom struggle. Everyone speaks about the prominent role played by the male freedom fighter. However, without female freedom fighters achieving Independent India would remain a dream. From being considered as second citizens, being victims of domestic violence, uneducated population, practising sati system to transforming themselves into great freedom fighter leaders has remained unknown to a lot of people. Indian women have played an impactful role in this journey from being part of the non-cooperation movement to practising saytagraha and promoting Khadi and picketing up of liquor shops. Women like Usha Mehta, Rajkumari Gupta, Aruna Asaf Ali, Rani Lakshmibai of Jhansi, Rani Gaidinliu, Amal Prabha Das, Azizam Bai, Gulan Kaur, Sarojini Naidu has played paramount role in making India free from British rules. Their participation in all the freedom struggle is significant and respectful.

Rāṅgey Rāghav’s Literary Biographies, Loī kā tānā and Ratnā kī bāt, in the 1950s and the Debates on the Status of Indian Women and Dalits

The article proposes to investigate the political and ideological uses of Hindi literary biography, with focus on two texts by Rāṅgey Rāghav, Loī kā tānā (“Loi’s Warp’’) and Ratnā kī bāt (“Ratna’s Speech”), based on lives of Kabir and Tulsīdās respectively. The relevance of Rāghav’s biographies goes beyond the merely literary and derives from the ideological and political functions played by these texts in the period they were written. Viewed by Rāghav as complementary works with a didactic and ideological value, they move away from the ‘brahmanical’ interpretations of the early modern Hindi poets by scholars of the 1920s and 1930s. To understand Rāghav’s motives and strategies, one needs to examine the ideological and political context in which he recast values linked to the main figures of the early modern devotional (bhakti) literature. As the 1950s witnessed debates on the status of Indian women and Dalit communities, the same becoming crucial to Hindi literary sphere, special attention needs to be paid to the representation, in Rāghav’s biographies, of Loī and Ratnā—Kabīr’s and Tulsīdās’ wives respectively—who embody some of the politically and ideologically progressive slogans which Rāghav projected on to these poets. The present work, based on recent studies on literary biography (Benton 2005, 2011, Middlebrook 2006, Miller 2001), is also an attempt to investigate some of the intellectual and ideological aporias which seem to have affected Hindi literary progressivism since the first decades of the postcolonial period.

Birth cohort differences in height, weight and body mass index among Indian women aged 15-30 years: Analyses based on three cross-sectional surveys

Objective: To explore long-term trends in height, weight and body mass index (BMI) across birth cohorts among Indian women aged 15-30. Design: Nationally representative cross-sectional surveys. Setting: Data from three National Family Health Surveys conducted in 1998-99, 2005-06 and 2015-16. Height and weight were modeled jointly, employing a multivariate regression model with age and birth cohorts as explanatory variables. The largest birth cohort (born 1988-92) was the reference cohort. Stratified analyses by place of residence and by marital status and dichotomized parity were also performed. Participants: 437,753 non-pregnant women aged 15-30 years. Results: The rate of increase in height, weight and BMI differed across birth cohorts. The rate of increase was much lower for height than weight, which was reflected in an increasing trend in BMI across all birth cohorts. In the stratified analyses, increase in height was found to be similar across urban and rural areas. Rural women born in the latest birth cohort (1998-2001) were lighter, whereas urban women were heavier compared to the reference cohort. A relatively larger increase in regression coefficients were observed among women born between 1978-82 compared to women born between 1973-77 when considering unmarried and nulliparous ever-married women and, one cohort later (1983-87 vs. 1978-82), among parous ever-married women. Conclusion: As the rate of increase was much larger for weight than for height, increasing trends in BMI were observed across the birth cohorts. Thus, cohort effects show an important contributory role in explaining increasing trends in BMI among young Indian women.

Why I said #MeToo: An Exploration of the Purpose of Disclosure Among Indian Women

The surge of sexual abuse disclosures by women during the #MeToo movement raised awareness about an important social issue that has garnered much attention. However, apart from the changes the movement initiated, the issue of why women chose to disclose in the context of the movement has not been extensively examined. Why women disclose such a sensitive topic in the public domain, often via social media, within the Indian cultural context, where matters such as sexual abuse are considered taboo, warrants further examination. This article explores the reasons for disclosure among Indian women participating in the #MeToo movement, through qualitative research, using the interpretative phenomenological approach. The emergent themes include reactions to the injustice, expectations of validation and closure, addressing stigma, initiation of dialogue and social change, as well as expression of solidarity, as the purpose for which disclosures were undertaken.

Clinical characteristics, predictors and pregnancy outcomes in Indian women with peripartum cardiomyopathy

Background Predictors, pregnancy and subsequent pregnancy outcomes in women with peripartum cardiomyopathy (PPCM) are poorly understood in our geographical region. Methods We retrospectively analysed 58 women with PPCM diagnosed using criteria by the European Society of Cardiology during 2015 to 2019. The main outcome measures were predictors of left ventricular (LV) recovery. LV recovery was defined as return of LV ejection fraction to over 50%. Results Nearly 80% of women had LV recovery during 6 months follow up. Univariate logistic regression revealed LV end diastolic diameter (adjusted odds ratio (OR); 0.87; 95% CI, 0.78–0.98; p = 0.02), LV end systolic diameter (OR; 0.89; 95% CI, 0.8–0.98; p = 0.02) and inotrope use (OR; 0.2, 95% CI, 0.05–0.7; p = 0.01) as predictors of LV recovery. Relapse was not seen in any of the nine women who had a subsequent pregnancy. Conclusion LV recovery was higher than those reported in contemporary PPCM cohorts from other parts of the world.

Multi-Layered Catastrophic Health Spending of Inpatient Women by Broad Group of Diseases in India

Healthcare for Indian women needs prioritizing, as they continue to face social and economic discrimination over their healthcare, often with high out-of-pocket payments. The study examines the amount inpatient women have to pay for treatment of major diseases, re-classified into four groups as infectious, reproductive, non-communicable diseases (NCDs), and disabilities & injuries, across the country to comprehend the extent of catastrophic health spending (CHS) they experienced. The study is based on India’s 75th round of the National Sample Survey (NSS), i.e., Household Social Consumption: Health (2017-2018), consisting of 26,938 inpatient women aged 12 and above from India's urban and rural areas. We examine the prevalence of the four categories of diseases by individual, household, community, and healthcare characteristics. Expenditure estimates were derived from cross-tabulation, followed by binary logistic regression to assess the association between covariates and inpatient expenditures for the diseases. Indian women are more likely to be hospitalized for infectious diseases (43%), but the burden of CHS (overall) is highest for disabilities and injuries (INR 24,414), followed by NCDs (INR 23,053). Duration of hospitalization and possession of health insurance by women indicate maximum variation with medical spending. Almost 97% of women have incurred out-of-pocket expenditure on hospitalization, from which we identify three layers of CHS. A substantial proportion of women (23 to 50%) experienced CHS, i.e., up to 0-10%, 11-30%, and >30%, which varies distinctively by place of residence and across the six regions. Covariates like age, economic status, and healthcare are highly significant and associated with disease-wise CHS thresholds. Women in India face divergent financial hardships for healthcare. Given the heterogeneity of morbidities and socio-economic characteristics, the need for women-sensitive public health services and interventions are evident.