An assessment of admission and outcome trends among neonates admitted in special newborn care unit (SNCU) of Jalgaon, Maharashtra

Background: Children face the highest risk of dying in their first 28 days of life (neonatal period). Simple interventions have been tested and found to be effective in reducing the neonatal mortality. Facility Based Newborn Care (FBNC) has a significant potential for improving newborn survival. SNCU is a neonatal unit in the vicinity of labor room which is to provide special care (all care except assisted ventilation and major surgery) for sick newborns. Aims and objectives: To study the trend of neonatal admissions and their outcomes over a period of 7 years i.e. from the year (2013) of establishment to current year (2019) at SNCU in a district level hospital in Maharashtra. Materials and method: The present descriptive observational study with longitudinal design was conducted in the Government supported SNCU of District Hospital of Jalgaon District of Maharashtra which included all the neonates admitted in SNCUs from January 2013 to December 2019.The SNCU monthly report which is in a predefined format from Ministry of Health and Family Welfare, Government of India, which includes data on admission information, reasons of admission, course of admission, and mortality reasons (if any) with treatment outcomes was used for data collection. Result: It was seen that during the study period (i.e. from January 2013 to December 2019) total 16489 neonates were admitted to the SNCU. During the first year (2013) total 1182 neonates were admitted which went on increasing in subsequent years as 2494, 2916, 2944, 2525, 2078 and 2350 neonates were admitted in the year 2014,2015, 2016, 2017, 2018 and 2019. Yearwise data shows proportions of males and females were approximately similar with male preponderance in each year. Proportion of outborn neonates went on steadily increasing (26.90% in 2013 to 46.26% in 2019) and that of inborn neonates went on decreasing (73.10% in 2013 to 53.74% in 2019). Yearwise trend shows that more and more (54.65% in 2013 to 68.13% in 2019) LBWs were admitted as compared to NBWs neonates (45.35% in 2013 to 68.13% in 2019). Decreasing trend in the mortality was observed from 2013 to 2019 as neonatal mortality rate went on decreasing. It was recorded 18.75% in 2013, 12.43% in 2014, 11.48% in 2015, 12.59% in 2016, 10.54% in 2017, 4.75% in 2018, and 5.77% in 2019. Conclusion: Over a period of 7 years from 2013 to 2019 neonatal mortality went on decreasing including decrease in LBW. and preterm neonates.

First and second wave of COVID-19: A comparative study of tertiary care hospitalized patients in Jalgaon, Maharashtra

Background: Most of the countries including India have witnessed two or more waves of Covid 19 pandemic. The present study was conducted to compare the differences in clinico-demographic characteristics and outcomes of Covid 19 patients admitted in first and second wave of Covid 19 pandemic in a tertiary care hospital at Jalgaon, Maharashtra. Methods: A retrospective observational study was conducted at a tertiary care Dedicated Covid hospital for Covid 19 at Jalgaon, Maharashtra. All microbiologically proven corona positive patients were included in the study. The demographic records and clinical history was extracted from the case history sheets of the patients from first as well as second wave using standardized data collection form. Clinical outcome of the patients, i.e., development of complications, death or discharge was also recorded for each enrolled subject. Results: 3845 patients of Covid-19 admitted in the hospital during the first wave of epidemic and 2956 patients during second wave of the epidemic were included in the study. The mean age of patients admitted in the second wave was significantly lower as compared to first [48.77(15.31) years vs 50.23 (14.33) years, P<0.005]. There is increase in proportion of patients in the age group of < 15 years in second wave as compared to first wave (74/2956, 2.5% vs 52/3845, 1.3%). The number of patients requiring admission in ICU at the time of admission increased by 13% in second wave as compared to first wave. [827/2956 (28%) vs 577/3845(15%), P<0.0001]. More than half of the patients who got admitted for Covid 19 in first as well as second wave were having one or more comorbidities.But the proportion of the patients with previous co-morbities was significantly higher in second wave (1684/2956, 57% vs 1960/ 3845, 51%, P= 0.0004). The mortality was also higher in second wave (533/2956, 18.03% vs 541/3845, 14%, P=0.0004). Conclusions: The demographic, clinical characteristics and outcome of Covid 19 patients was different in first and second wave of pandemic with involvement of younger patients, increased rates of admission to ICU and more mortality in the second wave as compared to first wave of the pandemic.

Risk factors appraisal for Hypertension among rural community of Western Maharashtra: A field-based study

Background: Hypertension is a leading risk factor for cardiovascular diseases. WHO has drawn attention to the fact that, Hypertension and related cardiovascular diseases are our modern epidemic. This contributes to high morbidity, cardiovascular disabilities and increasing mortality in the population. Such trends put an excessive burden on the quantum and quality of health care and necessitate more focus on more costly secondary and tertiary health care. Methods: A field based cross sectional descriptive study was conducted among rural population above 40 years. A pretested and structured questionnaire was used to record requisite information. A JNC VII criterion was used for blood pressure measurements. Data was analyzed with univariate and multivariate analysis. Results: Overall prevalence of hypertension among study participants observed was 5.92% (213 cases). Study participants having ‘Sedentary’ type of physical activity showed maximum number of cases (117 cases) than ‘Moderate’ or ‘Heavy’ physical activity group. Prevalence of hypertension was seen higher among upper class social-economic status population. Study participants consuming alcohol with varied frequency showed 158 cases out of total 213 cases while non-alcoholic participants (1995), had 55 cases of hypertension. Conclusions: The risk of hypertension increases with Advancing age positive family history and in male gender. Use of tobacco, alcohol consumption and resorting to non-vegetarian diet are the other contributory factors and the risk is more in the widowed persons as well as in those who are obese. Screening programmes with continuing health education for timely diagnosis and further treatment are to be stressed at policy formation.