ABSTRACT
Background: The health of childbearing women and infants is a major area of concern, which needs special attention. The pregnancy outcome depends on the maternal characteristics which include the utilization of Reproductive and Child Health (RCH) services during pregnancy period. In view of the above, an attempt has been made to study the maternal characteristics and its impact on perinatal outcomes among rural women in India. Objectives: The objectives of this study were to find the incidence of delivering low birth weight (LBW) infants and to examine the association between delivering LBW infants and maternal characteristics. Materials and Methods: A community-based longitudinal study was conducted in Bahour Commune Panchayat of Puducherry, for 1 year and 3 months from January 1, 2012, to March 31, 2013. A total of 258 pregnant women registered in the Anganwadi centres serving Bahour Commune Panchayat from 1st January 2012 to 31st May 2012, and they were selected by universal sampling method, of those 244 pregnant women were responded. They interviewed with the help of questionnaire and followed until delivery. Results: The incidence of delivering LBW infants was 8.6%. Maternal characteristics including utilization of RCH services such as maternal body mass index (BMI), weight gain during pregnancy, maternal hemoglobin, and blood pressure level, history of previous abortion status, and intake of iron and folic acid tablets during pregnancy were significantly associated with the birth weight of the infants by univariate analysis. Some of the above factors such as religion, blood pressure level, and maternal BMI were found to be significantly associated with multivariate analysis also. Conclusions: Overall, integrated approach is needed to improve the health care and utilization of RCH services during pregnancy to reach the better outcomes.
ABSTRACT
B. pseudomallei has been shown to persist intracellularly in melioidosis patients until reactivated by decreasing immunocompetence. We have shown by transmission electron microscopy the internalization of B. pseudomallei by human macrophages via conventional phagocytosis enclosed within membrane-bound vacuoles or phagosomes. Ferritin labeled lysosomes provided evidence of phagosome-lysosome fusion. Ingested bacilli were designated as "intact" or "damaged" on the basis of their ultrastructural features. An intact bacterium was seen with low electron opaque central nuclear region surrounded by dense bacterial cytoplasm, bounded externally by bacterial plasma membrane and cell wall. In contrast, B. pseudomallei were considered damaged when seen with cavitation within the central nuclear region, separation of bacterial cytoplasm from the cell wall, herniation of cytoplasmic contents and lamination of bacterial cell wall and its surrounding electron transparent zone. Our observations indicate that the microbicidal mechanism(s) in B. pseudomallei-infected macrophages failed to ensure complete clearance of the organism and this failure probably facilitates intracellular persistence and proliferation, and this may be one of the survival strategies adopted by this organism.