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Background: PPH is the prime cause of maternal mortality worldwide. The incidence of PPH can be drastically combatted by application of uterotonic in active management of third stage labour. Timing of its administration is a matter of concern. This study aimed to assess whether timing of administration of oxytocin would have any impact on incidence or mean blood loss of PPH.Methods: It was a single blinded randomized controlled trial conducted in the department of Obstetrics and Gynecology, Bankura Sammilani Medical College for 6 months where 100 antenatal mothers admitted for normal delivery in labour room were allocated randomly in study and control group considering inclusion and exclusion criteria. Incidence of PPH and mean blood loss had been identified clinically by following them for 24 hours.Results: Only 9% of study population had experienced PPH. There was no statistically significant difference in incidence of PPH with difference in timing of administration of oxytocin (p >0.05). But there was statistically significant decrease in mean blood loss if oxytocin was administered before the placental delivery. The mean blood loss with oxytocin administered before placental delivery was 296.8 ml (102.45) and after placental delivery was 452.0 (128.87) ml respectively.Conclusions: Policy makers should keep in mind not only the incidence of PPH, but the mean blood loss amount too in a setting where anaemia in pregnancy is quite prevalent.
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Background: Lung cancer is the commonest cancer worldwide considering its incidence and mortality. It not only affects the life of the patient, but also has significant impact on the life of the primary caregivers too. The study aimed to assess the Quality of Life (QOL) among caregivers of lung cancer patients and to find out its determinants.Methods: It was an institution based cross-sectional study conducted in a tertiary care center of Kolkata with the help of a predesigned, pretested, structured, standardized questionnaire where 210 patient-caregiver dyads were included by complete enumeration method to assess quality of life of the caregivers and its possible predictors.Results: Half of the caregivers experienced poor quality of life (overall QOL score ≤ median score) as assessed by QOLLTI-F (Quality of Life in Life-Threatening Illness-Family Carer Version). Multivariate analyses suggested that gender, religion, area of residence, financial burden, stage and type of lung carcinoma, disability and depression among the patients were important determinants of quality of life of the caregivers.Conclusions: Comprehensive care covering different domains like financial risk protection, psycho-social assistance through governmental and also different non-governmental initiatives, self-help groups are the needs of the hour to address this important public health issue as caregiver’s life is equally important as that of the patient and they are highly interdependent.
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Background: Postpartum intrauterine contraceptive device (PPIUCD) is a safe, highly effective postpartum contraceptive, yet to be popularized at the community level in a diversified developing country like India where still the unmet need for spacing remains high. This study aimed to assess the knowledge regarding PPIUCD among users and the predictors of its retention.Methods: A case-control study had been conducted using multi-stage sampling technique in Nadia district of West Bengal. Face to face interviews of the cases and the controls had been done with the help of a predesigned pretested semi-structured schedule. Data were entered in MS Excel and analysed in SPSS 20.0 version.Results: Majority of the acceptors (55.2%) had poor knowledge regarding PPIUCD. Most of the participants (62.2%) retained their PPIUCD at least for 6 months. Acceptors who belonged to Hindu religion, higher socio-economic class (I and II), nuclear family, educated up to or above secondary level, ever counselled on PPIUCD, satisfied using that in day to day life, undergone follow-up visits and had correct knowledge regarding different aspects of PPIUCD had higher odds of retention of PPIUCD.Conclusions: Regular awareness campaigns, counselling at household level, advocacy are the utmost needs of the hour to motivate the eligible couple for its acceptance and retention.
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Background: The unmet need for contraception remains high in the postpartum period. Postpartum intrauterine contraceptive device (PPIUCD), despite being an effective and well-suited contraceptive method for this period, many women discontinue its use due to various reasons just after a few days or weeks. The study aimed to identify the factors associated with the removal of the same.Methods: A community-based case-control study had been conducted in Nadia district of West Bengal. A multi-stage sampling technique had been applied to identify and interview the cases and controls with the help of a predesigned pretested semi-structured schedule.Results: The overall removal and expulsion rates were found to be quite high (21.5% and 16.3% respectively). Multivariate analysis revealed that acceptors belonging to joint family, educated only up to middle level, if place of delivery and insertion of PPIUCD was BPHC, the same had been inserted by nursing staff, experienced pain after insertion, not given consent before insertion, not counselled ever on PPIUCD, not decided to accept PPIUCD before delivery, not satisfied with its use and undergone no follow up visit after its insertion, were having higher odds of removal of the same.Conclusions: Rigorous counselling during the antenatal period should be focused to achieve a declining trend regarding PPIUCD removal.
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Background: Improper biomedical waste management, inadequate precautions to prevent needle stick injuries and air-borne infections among health care workers can lead to several hazards not only to them, but community can also be in danger due to environmental pollutions or risk of transmission of diseases. Sub-centres are the peripheral most points to deliver health services and health assistants posted there are in a unique position to get infected frequently if they are not adhering to standard protocols to manage these problems. The current study aimed to assess the status of infrastructure of sub-centres, knowledge and practices of the health assistants related to biomedical waste management and infection control.Methods: A cross-sectional study had been conducted in 40 sub-centres of Chakdaha block, Kalyani subdivision, Nadia district, West Bengal, selected purposively. All the health assistants were interviewed after taking informed consent with a pretested predesigned semi-structured questionnaire. An observational checklist had been used to assess infrastructure of the sub-centres and also some practices of the health assistants.Results: More than half of the study population (61.6% and 63%) secured poor score regarding knowledge and practices related to biomedical waste management and infection control respectively. There was no relationship between knowledge and practices of the same (p=0.187).Conclusions: Pre-service and also frequent in-service training should be conducted to improve the knowledge and practices of the health assistants. Regular monitoring, supervision of their day to day work by the higher authority, can improve their attitude and practices related to such an important public health issue.
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Background: ASHA acts as a ‘bridge’ between the rural people and health service outlets and plays a central role in achieving national health and population policy goal. ASHAs form the backbone of the NRHM. They need to provide preventive, promotive and curative health facilities in the rural community. Maternal and child health is an important public health issue which indicates level of socio-economic development in each and every country. ASHA workers are the main front-line workers in primary health care delivery system who are expected to work in this domain to bring out betterment in RCH indicators.Method: It was a mixed method study. Quantitative portion was descriptive, cross-sectional and qualitative part was focus group discussion (FGD). The study had been conducted in one block (Deganga block) of North 24 parganas district of West Bengal which was previous to selected purposively for the study. All ASHAs of Deganga block and one beneficiary mother (mother who had a baby of less than 1 year) for each ASHA from her area of work had been included as study population. ASHA- Beneficiary dyad had been interviewed with a predesigned pretested questionnaire after taking informed consent.Result: More than half of the study population (64.7% and 50.5 %) had overall good knowledge and practice score related to maternal-child health and family planning respectively, though they had poor knowledge in updated dosage schedule of iron folic acid tablets, proper attachment techniques for successful breast feeding, missed doses of OCP, ECP, IUCD and safe period. They performed less efficiently in areas like counselling about harmful effects of addiction during pregnancy, birth preparedness and complication readiness, colostrum feeding, weaning, ECP and MTP. Mainly inadequate remuneration and lack of job satisfaction were the factors hindering their performance.Conclusion: Frequent refresher courses, regular monitoring and supportive supervisions by respective higher authority, administrative steps for combating their dissatisfaction are of utmost importance to improve their performance.
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Background: Lung cancer is one of the commonest cancer worldwide and also in India. Being a chronic disease, it is expected to result in disability during the course of the illness. Disability in turn results in deterioration of mental health and leads to poor quality of life. The present study intended to assess the degree of disability among lung cancer patients and to find out the covariates of the same.Methods: An institution based cross-sectional study had been conducted over a period of six months among lung cancer patients attending a tertiary care centre. Exit interview had been conducted with a pretested schedule after taking informed consent. Disability had been assessed by WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Data were entered and analysed in SPSS 20.0 version.Results: A total of 210 patients were recruited in this study. Half of the study population were suffering from higher level of disability. Multivariate analysis revealed degree of disability was higher among the patients who were financially dependent to others, had advanced stage of the disease and when time since diagnosis was more than one month.Conclusions: Holistic approach needs to be taken up to address this alarming issue of disability and its consequences among lung cancer patients. The approach should include various rehabilitative measures, social security schemes by the government and active involvement of non-governmental organisations.