ABSTRACT
Background: The incidence of maternal morbidity and mortality gets reduced if antenatal care (ANC) is provided since it focuses on providing birth preparedness, good health maintenance measures, and awareness regarding pregnancy complications as well as danger signs. Methodology: The present study was conducted in the selected 10 villages in the Bahadarbad block of Haridwar (Uttarakhand). 479 out of 580 pregnant women (who had visited Antenatal Health Camps), responded to the questionnaire thus, leading to a response rate of 82.8%. Most respondents, i.e. 96% (n=461), were 21–30 years old. Result: Out of 461 pregnant women, only 45% visited Antenatal Health Camps and 58% were found anemic. The study also indicated that of the pregnant women who visited Antenatal Health Camps during this period, more than 72% of women gave their previous birth in less than two years. Only 15% of women obtained complete ANC (4 Visits) during the study period, just half of the previous year’s coverage (31%) for the same duration. The study found that home deliveries increased significantly during the lockdown period. From April to June 2020, the percentage of home deliveries was 41% while from July to December 2020 it was 24%. Conclusion: The study suggested reduced utilization of ANC services during the pandemic and significant factors were women’s age, residence, educational status, repurposing of maternity healthcare services, fear of COVID-19 transmission, and transportation disruptions. Thus, efforts should be taken to enhance maternal health services.
ABSTRACT
Background: Menopause has become a popular topic of study as life expectancy rises around the world. The average age at menopause in both developed and developing countries ranges from 45 to 53 years. Factors influencing the extent of ovarian follicle reserve dwindling, such as sociodemographic, menstrual, reproductive, and dietary factors. Aim and Objective: The present study aimed to determine the mean age of menopause and to find out the various factors affecting menopause onset. Methods: A community based cross-sectional study conducted in rural and urban areas of District Dehradun for a period of 1 year starting 1st August 2020 to 31st July 2021. Data were collected using multistage stratified random sampling from 211 cases of natural menopause. Chisquare was applied as statistical test of significance and p < 0.05 was considered statistically significant. Results: According to current study, average age menopausal age is 46 years. Variables like sociodemographic characteristics, lifestyle habits, reproductive and menstrual factors were found to have a significant relationship with onset of menopause. Conclusion: Menopause, whether it occurs early or late in life, several factors are responsible for deciding its onset. As a result, it is critical to identify the factors influencing the onset of menopause.
ABSTRACT
Background: Pregnancy-Induced Hypertension (PIH) is a high-risk condition which implies a threat to pregnancy, either by means of the mother’s health or the health of the fetus. In PIH, the underlying basic pathology is endothelial dysfunction and intense vasospasm affecting almost all the vessels, particularly those of uterus, kidney, placental bed, and brain result the symptoms called vascular symptoms. Thus, PIH affects QOL of pregnant women and perinatal outcome. Objectives: The aim of this study was to assess the effect of Vascular Symptom Management Package (VSMP) on vascular symptoms, QOL of pregnant women with PIH & perinatal outcome. Materials and Methods: Quantitative approach with true experimental design was adopted. Ten pregnant women with PIH were selected for the study using purposive sampling technique. Subjects were randomly assigned to the experimental and control group using Sequentially Numbered, Opaque Sealed Envelopes (SNOSE) (5 in the experimental group and 5 in the control group). VSMP includes two sessions: 1-Instructions on strategies to manage each vascular symptoms, fetal well-being assessment, sleep health behavior education, warning signs of complications, and importance of compliance to interventions. 2- Demonstration on Systematic muscle relaxation techniques, Diaphramatic breathing and muscle stretching exercises. The tools used to collect the data were as follows: (1) Demographic questionnaire, (2) vascular symptom assessment scale, (3) Women’s Health Initiative Insomnia Rating Scale (WHIIRS), (4) Edinburg Postnatal Depression Scale (EPDS), (5) WHOQOL–BREF, and (6) perinatal outcome questionnaire. Informed written consent was taken from each participant. Baseline assessment was done on the 1st day and the first session of intervention was implemented on the same day. The second session of intervention was implemented after 1 week. Post-assessment was done after 4 weeks. Mothers were followed till immediate puerperium and perinatal outcome was assessed. Phone calls & weekly meeting were done to make the mother to adhere in practice. The data analyzed using descriptive and inferential statistics. Results: The post-test mean rank of vascular symptoms of the experimental group was lower (P ≤ 0.05) than that of the control group. The mean post-QOL score of the experimental groups was higher (P ≤ 0.05) than that of mean post-QOL score of the control group. The mean rank of all parameters of perinatal outcome in the experimental group was lower (P ≤ 0.05) than that of the control group. Hence, it can be interpreted that VSMP is effective to improve the reduce the vascular symptoms, improve the QOL & perinatal outcome. Conclusion: PIH is a life-threatening condition. The findings of this study show that the effectiveness of VSMP improves the QOL. Hence, VSMP is a nurse-led intervention which can be implemented to effectively reduce the vascular symptoms and improve the QOL of pregnant women with PIH.
ABSTRACT
Introduction: Maternal morbidity and mortality in India continues to remain high despite concerted efforts during the past decades. Objective of this study was to determine the prevalence and indicator of Potentially Life Threatening Conditions (PLTC) and ‘near miss’ obstetric cases at different tiers of health care. Material and Methods: A cross-sectional epidemiological study was carried out over a period of 12 months as per the WHO criteria for ‘near miss’. Probability sampling was done to systematically and randomly select health facilities i.e. two primary health centers (PHC), one community health centre (CHC) and a tertiary hospital all from Doiwala block of Dehradun, Uttarakhand, India. The study included all the women attending health-care facilities, who were pregnant, in labour, or who had delivered or aborted up to 42 days ago arriving at the facility. A convenient sampling was done (a hundred percent enumeration of eligible study subjects) for the audit. Result: A total of 937 pregnant women who accessed health care had 688 live births and 231 women had one or more of the Potentially Life Threatening Conditions (PLTC). Among them, 61 women had Severe Maternal Outcome (SMO) - 51 with maternal ‘near-miss’ and 10 maternal deaths. The Severe Maternal Outcome Ratio (per 1000 live births) was 88.66. The Maternal ‘near miss’ Mortality Ratio (MNM-MR) and Mortality Index (MI) were 5.1 and 16.39% respectively. Conclusion: The WHO ‘near miss’ approach has been found to be an effective measure to assess quality of care in maternal health across countries including India.
ABSTRACT
The attractive response and sexual activity elicited by pre-ovulatory steroid sulphate and post-ovulatory 15K-PGF pheromones are greater in wild caught tubercular males and immature males which express breeding tubercles on the snout (at 12-13 days post androgen implant) than in non-tubercular and non-androgen implanted males of freshwater fish Barilius bendelisis. This shows that circulatory androgens exert an activational effect on olfactory receptors of male fish. Wild caught tubercular males and androgen implanted juvenile males exhibit a high responsiveness to steroid sulphate at the water temperature and pH which fish experience during the pre-spawning phase. The male's sensitivity to 15K-PGF is almost equally high at the water temperature and pH which they experience in wild during the both pre-spawning and spawning periods. This suggests that the differential olfactory sensitivity to the two classes of pheromones in androgen implanted males is due to the varied temperature and pH of water, and that during the breeding season the male's olfactory sensitivity to PGF pheromone is more widespread than to the steroidal pheromone. An increased and decreased olfactory sensitivity in mature males to sex pheromones and L-alanine respectively during the breeding phase is in agreement with the hypothesis that pheromonal stimuli dominate over feeding stimuli to promote spawning success.