Determinants of Low Birth Weight in a Tertiary Care Hospital in Eastern India

Introduction: In developing countries like India, low birth weight is a major public health issue. It is a leading cause of disease and mortality in infants. Low birth weight can be avoided by identifying at-risk pregnant women and taking the necessary precautions. Methods: From January to June 2019, a facility based retrospective case control study was conducted among pregnant women who gave birth at the hospitals. The information was gathered from the antenatal care files and the delivery room register and records. SPSS version 24.0 was used to process the data. To find an independent predictor of low birth weight, researchers used binary and multiple bivariate logistic regressions. Result: An aggregate of 450 neonatal birth records were reviewed in this study of which 150 were low birth weight babies and 300 were of normal birth weight. The mean � SD and median [IQR] for birth weight of case group was [2.0�4kg, 2.2[1.8-2.4] kg] and that for control [3.1�4kg, 3.0[2.7-3.3] kg] respectively. Conclusion: Preterm delivery, mothers with hypothyroidism have an increased chance of having low birth weight babies whereas mothers with regular antenatal check-up and mothers with primary and secondary education have a lesser possibility of having low birth weight babies.

Safety and immunogenicity of the intradermal Thai red cross (2-2-2-0-1-1) post exposure vaccination regimen in the Indian population using purified chick embryo cell rabies vaccine.

PURPOSE: To test the immunogenicity of the WHO recommended "2-2-2-0-1-1" post-exposure rabies vaccination regimen in Indian subjects to determine the feasibility of replacing crude sheep brain nerve tissue rabies vaccine with modern tissue culture rabies vaccine at major anti-rabies treatment centers throughout India. METHODS: Purified chick embryo cell vaccine (PCECV) was administered in the dosage of 0.1 mL per site to 53 Indian subjects. RESULTS: All subjects produced rabies antibodies above 0.5 IU/mL by day 14 post-vaccination. Only minor adverse reactions including swelling (6.6%), erythema (5.4%) and pain (1.4%) were observed for which no treatment was required. CONCLUSIONS: This study demonstrated that PCECV is safe and highly immunogenic in Indian subjects when administered intradermally as 0.1 mL/site using the "2-2-2-0-1-1" post-exposure regimen.

Hormonal implication in Bracon-venom-induced paralysation of the host larva of Corcyra cephalonica (Lepidoptera: Pyralidae).

To facilitate oviposition, the ectoparasite Bracon hebetor, injects its venom, a paralysing toxin, to the host Corcyra larva that ultimately dies without showing any metamorphic change, even if allowed to remain unparasitised. At the initial stage of venom injection the rate of heartbeat of the host becomes abruptly high. This has been explained from the synergistic action of the substances of poison gland and calyx. The paralysed larvae subsequent to envenomization die within 240 hr. Application of hydroprene as single dose or with a booster dose after paralysation mostly increases the survival period considering heart beat as the index. The predicted value of survival period (714.4 hr), determined from a fitted equation obtained from the relationship between heart beat and survival period, indicates that a 100 microg treatment/larva with a booster dose of 50 microg/larva most effectively lengthens the period. It is concluded that the venom-induced physiological dysfunction of the immobilised larvae, as indicated in the rate of heart beat and survival period, though can be recovered to some extent after the application of juvenoids, there cannot occur any metamorphic change of these larvae. The parasitoid, therefore, succeeds in completing its development and metamorphosis by arresting the development of its host through an indirect hormonal suppression. The findings indicate an endocrine implication in host-parasite relationship in insect.

Epidemiological characteristics of rabies in Delhi and surrounding areas, 1998.

OBJECTIVE: To describe the epidemiological characteristics of rabies in Delhi in 1998. METHODS: Analysis of the records of hydrophobia cases admitted to the Infectious Diseases Hospital, Delhi (IDH) in 1998. RESULTS: About 46 percent (99/215) of the hydrophobia cases admitted to the IDH in 1998 belonged to Delhi. The remaining came from the adjoining states, both urban and rural areas. In Delhi residents, overall hospitalization rate was 0.81 per 100,000 population. It was significantly higher in 5-14 year old than in other age groups and in males than in females (p <0.0009). Cases occurred round the year. Almost 96 percent cases (206/215) gave history of animal exposure, 13 days to 10 years (median 60 days) before hospitalization. Majority (195/206) had class III exposure. Animals involved were stray dog (193/206 = 90 percent), pet dog, cat, jackal, mongoose, monkey and fox. Most of cases were never vaccinated (78 percent) or inadequately vaccinated (22 percent); only 1 percent each received appropriate wound treatment, or rabies immunoglobulin. CONCLUSIONS: Rabies is a major public health problem in Delhi. Its incidence is significantly higher in 5-14 year old children than in other age groups. The results indicate the need to educate the community and health care workers about the importance of immediate and adequate post-exposure treatment and to start an effective control program for dogs, the principal vector of rabies.

Knowledge, attitude and practice towards malaria in rural tribal communities of south Bastar district of Madhya Pradesh.

A sample survey of 100 household heads was carried out in Bastar district to assess villagers knowledge, attitude and practice (KAP) about malaria and their implications for malaria control. Results show that 64.4% of respondents were illiterate and only 20.6% of respondents know the factor for cause of malaria though 45% of household heads received some form of health education from various sources. Respondents who suffered from malaria in previous year constituted 35.8% while 46.8% respondents reported for treatment to nearby PHC, 59.1% respondents admitted the responsibility of male head-of-family to take decision to seek health care malaria. About 34.6% of respondents suspect malaria to any fever. A meagre respondents (8.2%) knew the drug for treatment of malaria, and majority of respondents (70.9%) had taken a complete course of malaria treatment. About 55% respondents did not take any measure to prevent mosquito bite, while 92.4% admitted that they had not taken any measures to prevent malaria. All most all respondents (99.7%) agreed to allow their houses to be sprayed and 99.1% thought that spraying was necessary. The study shows, for successful control of malaria in tribal areas, proper health education about the disease, awareness of personal protection and preventive measures against malaria should be carried out in such a way that should be need based, suitable for the area concern and acceptable, along with active involvement of the communities.

Acute sporadic viral hepatitis in urban population of a tribal district in Madhya Pradesh.

OBJECTIVE: To estimate the incidence of acute sporadic viral hepatitis and describe its epidemiology in an urban population. DESIGN: A retrospective community survey for jaundice cases. SETTING: Headquarter town of a tribal district, Bastar, in Madhya Pradesh state, India. METHOD: Trained paramedics surveyed about 51,643 population to detect cases of jaundice which occurred in the past one year. Cases were examined to collect clinical and epidemiological data. blood samples were drawn from all cases who had jaundice in the past 3 months for testing them for markers of viral hepatitis. RESULTS: Study estimated the annual incidence of jaundice cases as 244 (95% CI 201-287) per 100,000 population. Almost 95% jaundice cases occurred in summer and monsoon months. People from all socio-economic strata were affected. The incidence of jaundice was found to be the highest in children below 15 years of age (3.7 per 1000) which declined significantly with the increase in age (p = 0.0000). The overall incidence in two sexes was not different statistically (p = 0.7). Of 57 cases who had jaundice in the past 3 months, 19 (33%) were confirmed as having viral hepatitis. Hepatitis A and E combined together contributed 68% (13/19) of acute sporadic cases of viral hepatitis, whereas hepatitis B, C and D accounted for the remaining 32% of the cases. CONCLUSION: The study found the annual incidence of laboratory supported cases of viral hepatitis to be 81 (95 CI 57-106) per 100,000 population, which suggests that it is an important public health problem in India. Hepatitis A was much more prevalent than hepatitis E. Etiology of almost two-thirds of jaundice cases could not be established which require further community studies.

Tricuspid valve endocarditis following elective abortion.

Tricuspid valve endocarditis (TVE) following non-septic abortion without an evidence of pelvic inflammation and clinically audible murmur is rare. We report here two cases of TVE following elective abortion.

Immunity to diphtheria in women of childbearing age in Delhi in 1994: evidence of continued Corynebacterium diphtheriae circulation.

Blood samples from 171 full-term pregnant women (aged 18-38 years) of middle socioeconomic status from Delhi were tested for diphtheria antitoxins by indirect hemagglutination (IHA) test. History of primary immunization/clinical diphtheria during childhood was not ascertainable, but none had been revaccinated against diphtheria at any time. About 94% women had very high antitoxin titers (> or = 0.125 IU/ ml); none had antitoxin titer less than 0.015 IU/ml, the minimum protective level. The titers were uniformly high in all age groups. However, women having 2 or more children had significantly higher antitoxin titers than those having no or one child (p < 0.01). The results from this study and historical data on diphtheria in Delhi are compatible with continued transmission of C. diphtheriae in recent times in Delhi which is of sufficient magnitude to boost the antitoxin levels in adults, especially mothers having two or more children. The study highlights the need of increasing the immunization coverage with DPT among children to reduce the transmission of Corynebacterium diphtheriae.

Present status of Plasmodium malariae infection in Bastar District (M.P.).

Plasmodium malariae infection was detected in Bastar district (M.P.) during malaria survey in 1981-83. The data collected during the survey was compared with the earlier records of P. malariae infection in the area. From the data it can be seen that the infection in this area has declined due to the ecological/developmental activities undertaken by Government. All the cases were found to be indigenous and approximately 62 per cent infection was found in age group of 10-14 years irrespective of sex. More than 60 per cent of P. malariae infections were positive for gametocytes. Three day regimen of 4-aminoquilines for the treatment was found quite effective.