ABSTRACT
Context: The World Health Organization proposed the Robson’s classification system as a global standard for assessing and comparing cesarean section (CS) rates within health-care facilities over time and between facilities. Aims: This study aims to assess the frequency and indications of CS and to identify the groups within the obstetric population contributing to CS using Robson’s classification. Settings and Design: A retrospective chart review was conducted in a Tertiary Care Teaching Hospital in Imphal, Manipur. Methods: All women who delivered between January and December 2019 were classified using the Robson’s Ten Group Classification System. The overall CS rate and the CS rate in each Robson’s group were calculated. The indications for CS were also recorded. Statistical Analysis Used: Descriptive statistics, such as frequency, percentage, mean, and standard deviation, was used. Results: A total of 10,282 births were reported. The overall CS rate was 35.2%. Group 3 (multiparous women without previous CS in spontaneous labor) (27.6%) and Group 1 (nulliparous women in spontaneous labor) (23.7%) contributed to most of the obstetric populations. The majority of CS belonged to the women in Group 5 (multiparous women with previous lower segment CS) (11%), followed by Group 2 (nulliparous women with labor induced or prelabor CS) (8.6%) and Group 4 (multiparous women without previous CS were induced or taken for prelabor CS) (5.5%). Conclusions: The study revealed that Groups 5, 2, and 4 contributed to the high CS rate. Efforts to reduce the overall CS rate should be directed at increasing vaginal births after CS, performing effective pelvic examinations, and encouraging obstetricians to perform versions when indicated.
ABSTRACT
Background: India is experiencing a rapid health transition with a rising burden of noncommunicable diseases (NCDs), causing significant morbidity and mortality. Cost?effective interventions for comprehensive NCD management can only be designed after assessing the readiness of various health facilities. Objectives: This study aimed to assess the preparedness of healthcare facilities of Manipur in the management of NCDs and to assess the knowledge of doctors regarding NCDs. Methods: A cross?sectional study was conducted in 21 public healthcare facilities in seven districts of Manipur during October 2021. Readiness of these facilities was assessed through observation and interview of doctors and nurses using a checklist adapted from the WHO Package of Essential NCDs. Knowledge of 153 doctors was also assessed using a self?administered, structured questionnaire. Data were entered in SPSS?26 and expressed using descriptive statistics. Results: General readiness index of primary health centers(PHCs), community health centers(CHCs), district hospitals(DHs), and tertiary care centers(TCCs) was 47%, 66.3%, 73.2%, and 70%, respectively. CHCs were ready in the domains of patient care services (80%), human resources (75%), and advocacy (91.7%). DHs and TCCs were ready in terms of patient care services, human resources, record maintenance, referral system, and advocacy. PHCs were not ready in any of the nine domains. Majority of the doctors (88%) had inadequate knowledge regarding NCDs. Conclusion: PHCs and CHCs were not adequately prepared, but DHs and TCCs were ready to manage NCDs. More than four?fifth of the doctors had inadequate knowledge. Strengthening PHCs and CHCs and training of healthcare workers are needed for integrated NCD management.
ABSTRACT
Background: Vaccine hesitancy has been recognized as a public health issue which needs to be addressed urgently. Pregnant women with COVID-19 are at increased risk of adverse pregnancy outcomes. An assessment of the determinants of vaccine hesitancy will aid in the acceleration of vaccine administration among pregnant women. Objectives: The present study aimed to determine COVID-19 vaccine hesitancy among pregnant women in Imphal, Manipur and assess associated factors. Methods: A cross-sectional study was conducted among pregnant women attending Obstetrics and Gynecology Department of a Tertiary Care Institute in Imphal, Manipur during August 2021. One hundred and sixty-three pregnant women were interviewed using a structured questionnaire over phone calls. Univariate analysis was carried out using the Chi?square test and multivariable logistic regression was performed to determine the factors significantly associated with vaccine acceptance. Results: The mean age of the participants was 28.3 ± 5.5 years and majority, 102 (62.6%) were multigravida and 27 (16.6%) had comorbidities. Vaccine hesitancy was found in 127 (77.9%) participants. Logistic regression analysis indicated that awareness on COVID?19 vaccine eligibility (P = 0.002), disagreement of vaccine being unsafe during pregnancy (P = 0.005), and agreement on vaccine benefiting the baby (P = 0.003) were the significant predictors of vaccine acceptance. Conclusion: Nearly four out of every five pregnant women had COVID?19 vaccine hesitancy. Pregnant women should be informed about the benefits and encouraged to take COVID?19 vaccine.
ABSTRACT
Background: Osteoporosis has become a major public health problem and is increasingly being recognized as an important cause of morbidity and mortality among women. Data on prevalence of osteoporosis and osteopenia among women varies in different age groups and states across India. Objective: To determine the prevalence of osteoporosis and osteopenia among females in Manipur. Methods: A cross-sectional study was conducted among 2700 pre and postmenopausal women with intact ovaries in the age range of 21 to 70 years in three districts of Manipur namely Imphal West, Thoubal and Churachandpur districts. Bone mineral density (BMD) was measured by using Lunar Prodigy DXA, GE Healthcare Company, USA. Descriptive statistics like mean(SD), percentage were used. Anova and post-hoc tests were used to determine significance of the findings. A p-value of <0.05 was considered as statistically significant. Results: Prevalence of osteoporosis was 23.7%, 21.1%, 19% for Imphal, Thoubal and Churachandpur districts respectively. However, high prevalence of low BMD among the study population were noted; 61.9% for Imphal, 58.2% for Thoubal and 57.9% for the Churachandpur district. Statistically significant association was found between age groups 25-39 and 40-59 years with three districts and osteoporosis; age groups and osteoporosis when all districts are combined. Conclusion: Overall prevalence rate of osteoporosis and osteopenia was 21.3% and 36.6% respectively. Among the districts, it was highest in Imphal followed by Thoubal and Churachanpur districts, representing urban, rural and hill region.
ABSTRACT
Background & objectives: It is well documented that the Northeast State of Manipur in India has been dealing with the dual problems of injecting drug use and HIV for the last two decades, but the hepatitis C problem has not been so well characterized. The aim of this study was to assess the prevalence of hepatitis C virus (HCV) infection and HCV/HIV co-infection among people who inject drugs (PWID) in Manipur, and identify factors associated with infection. Methods: Data were obtained from the Integrated Behavioural and Biological Assessment (2009-2010), a cross-sectional survey among 821 male PWID in two districts of Manipur (Churachandpur and Bishnupur). Information about drug use, sexual and injecting risk behaviours, and exposure to interventions was obtained, and biological specimens tested for HIV and HCV. Logistic regression analyses identified factors associated with HCV infection and HCV/HIV co-infection. Results: HCV prevalence was 74 per cent (91% Churachandpur, 56% Bishnupur), and HCV/HIV co-infection was 29 per cent (38% Churachandpur, 21% Bishnupur). Among the 31 per cent of HIV positive PWID, 95 per cent were co-infected. HCV infection was associated with district, longer duration of injecting, injecting at least once daily, generally injecting with a used needle and syringe, and having had an HIV test. HCV/HIV co-infection was associated with district, older age, being employed, being widowed/divorced, longer duration of injecting, and feeling at risk of HIV infection. Interpretation & conclusions: The HCV/HIV co-infection among PWID in Manipur was very high, highlighting the urgent need for effective prevention, diagnosis and treatment.
ABSTRACT
Background: Adverse health outcomes are associated with ingestion of unsafe water and poor personal hygiene. Approximately 3.1% of deaths (1.7 million) and 3.7% of DALYs (54.2 million) worldwide are attributable to unsafe water, poor sanitation and poor personal hygiene. Methods: This was a cross sectional study conducted among students of Central Agricultural University, Imphal during the period of 18/3/2014 to 4/4/2014. Data was collected by a self-administered questionnaire. Data entry and analysis was done using IBM SPSS version-21. Results: About 85.5% of the respondents knew correctly the meaning of personal hygiene. Nearly half of the respondents said that diarrhea can be prevented by maintaining good personal hygiene but only 5.8% of the respondents said that skin diseases can be prevented. Out of the 7 steps of proper hand washing, only 2 steps were known to the respondents. About 56.5% of the respondents knew the meaning of water borne diseases. Diarrhea was the most common water borne disease known to majority (63.5%) of the respondents. Only 34.4% of the respondents had the habit of washing hands after work and only 9.4% of the respondents washed their hands after playing. Conclusions: It is recommended to conduct further studies to assess their personal hygiene practices in detail and demonstrate them proper hand washing and hygiene practices.
ABSTRACT
A study was carried out among primigravid women attending a secondary level hospital in a district of North India. The objective of the study was to determine seroprevalence rate of Toxoplasma gondii infection using enzyme-linked immunosorbent assay (ELISA) test. Associations between toxoplasma seropositivity and selected variables (socio-demographic and biologically plausible variables) were also studied. Five hundred three women were enrolled from the antenatal clinic between August, 1996 and September, 1997. Of these, 210 women (41.75%) were seropositive for Toxoplasma gondii infection. These results indicate that a large number of the study subjects were vulnerable to toxoplasma infection. If these infections had occurred during the pregnancy, their foetuses would have been at high risk of infection. There was no statistically significant association between toxoplasma seropositivity and the variables studied except, in the case of type of meat usually consumed. There is a need to provide health education to pregnant women in order to prevent primary toxoplasma infection during pregnancy.