Dietary Diversity and its Association with Anaemia among Adolescents of Central India: Findings from Baseline Cross Sectional Study

Background: Anaemia continues to be a major public health concern in the country owing to varied dietary practices, socio-demographic and cultural influencers. Poor nutrition as a principal underlying factor is less explored among the adolescents among the high focus states in India. Objectives: To study the dietary diversity i.e., food habits, preferences, frequency of food consumption among adolescents and its association with anaemia. Material and Methods: This cross-sectional study, from a baseline adolescent health survey (November 2017 – March 2018) included 3213 adolescents (10-19 years). The participants were selected using multi-stage stratified random sampling technique from 6 districts of Madhya Pradesh. Data collection was done by filed investigators through paperless real time method that included sociodemographic details, anthropometric measurements, haemoglobin food frequency questionnaire. Results: The most common daily consumed food items were cereals, tea and pulses by adolescents. Overall prevalence of anaemia was 1715 (53.4%). Those consuming occasional fruits, green non leafy vegetables, red and yellow vegetables, roots and tubers and milk products were at higher risk of developing anaemia compared to other food items regularly. Conclusion: Although association exists between occasional consumption of certain food groups, their temporal relationship needs to be established.

Evaluation of competency and skills of skilled birth attendants in Madhya Pradesh, central India

The National Health Mission tracks the proportion of women delivered by skilled birth attendants (SBAs). We assessed SBAs competence in Madhya Pradesh, India, using structured evaluation tools. It is a cross-sectional study conducted from 2014 to 2015. We evaluated 335 trained SBAs using multistage stratified random sampling. Of total, 335 skilled births attendant selected 41.8% were auxiliary nurse midwife, 47.8% were staff nurse, and 10.4% were lady health visitors. Grouping all provider and knowledge test versions, SBAs were correct on 75.4% of the questions. By topic, results ranged from 77.9% correct for the management of normal pregnancy and childbirth to 70.2% correct for intranatal care. The skill evaluation score was 88.1% of infection prevention practices to 74.3% for postnatal care. The present study found significant variations in knowledge and skill competency scores of the SBAs. There is a critical need to improve the training quality of skill birth attendants.

Hepatitis E epidemic with bimodal peak in a town of north India.

INTRODUCTION: An epidemic of viral hepatitis occurred in Mandi Gobindgarh town of Punjab in northern India during year 2005-06. An attempt was made to study the outbreak clinically, serologically, and etiologically. METHODS: Line listing and spot mapping of all cases of jaundice presented to civil hospital was done. An active search of cases was made through house-to-house visit with the help of 33 teams and 6 supervisors. Twenty two blood samples collected from acute cases were tested for anti-HAV IgM and anti-HEV IgM by ELISA. HEV specific PCR was also carried out. Sanitary survey was also done and water samples were tested for coliforms. RESULTS: In house to house survey 3170 cases of jaundice were reported; of them 2171 (68.5%) were males. Mean age was 28.8 years. Overall attack rate was 5.2%. The epidemic continued for more than a year and bimodal peak was observed. Civil hospital campus which has separate water supply had no jaundice case. About 95% blood samples from icteric patients were found to be positive for IgM and IgG antibodies of HEV. Eighteen persons died during the epidemic, mostly in old age group. Case fatality ratio was 0.57%. No deaths occurred among 17 pregnant women who had developed hepatitis. CONCLUSION: The epidemic was caused by hepatitis E virus, which was transmitted due to faecal contamination of municipal water supply.

Pregnancy induced hypertension and antithrombin-III.

This study was undertaken to determine the coagulation profile of women with pregnancy induced hypertension and to evaluate the changes in the level of AT-III in pre-eclampsia and eclampsia and its correlation with severity of disease in order to evaluate if it can be used as a marker for severity of PIH. 119 women with PIH in the third trimester of pregnancy constituted the study group. Age and parity matched 25 normal pregnant and 25 non-pregnant women were taken as control group. No significant difference between the coagulation profile of non-pregnant and normal pregnant women was seen. There is evidence of consumption coagulopathy in PIH patients and AT-III activity shows a gradual and almost linear reduction in various groups ranging from normal pregnant women to eclampsia. Reduction in AT-III activity has positive correlation with PIH and it can be a useful marker for severity of PIH.