Drug Utilization Pattern During Pregnancy.

Background: Pregnancy is a special physiological condition where drug treatment presents a special concern. The rationale for use of drugs during pregnancy requires a careful assessment as in addition to the mother, the health and life of her unborn child also concerns. Research Question: What is the pattern of drug utilization during pregnancy in females of field practice area of Urban Health Centre? Aim: To study the drug utilization pattern during pregnancy. Methodology: 500 pregnant women included in study. A house to house survey was conducted during September 2009 to February 2010. Various study parameters like; educational status, duration of pregnancy, family income per capita per month, number of antenatal visits, self medication practices, number of drugs used, number of herbal/homeopathic drugs used included the study. Results: A total of 972, 864 and 399 drugs, with an average of 6.61, 3.66, 3.41 drugs per pregnant woman were used during first, second and third trimester of pregnancy respectively. Category A is considered the safest category while category X is absolutely contraindicated in pregnancy. A majority of drugs used, were from category A, followed by category B and category D. However, category C and X drugs constituted 4.28 and 0.51% of the drugs used during the third trimester and first trimester, respectively. Herbal/ homeopathic drugs constituted 10.49% (102), 4.86% (42) and 1.94% (5) of the drugs used during first, second and third trimester of pregnancy respectively. It was found that self-medication and homeopathic/ herbal drugs were used more in illiterates, than in literates (p <0.001 and <0.001 respectively). Conclusion: There is a need to educate and counsel the women of child bearing age, regarding the advantages and disadvantages of drug use during pregnancies.

Birth weight and anthropometry of newborns.

OBJECTIVE: To determine the relationship between birth weight and the anthropometric measurements of newborn to screen for low birth weight. METHODS: 1,252 newborns have been enrolled in the study. The birth weight, mid-arm, head and chest circumferences were measured by standard techniques. RESULT: The highest correlation of birth weight was found with chest circumference (r = 0.70). The maximum sensitivity of detecting low birth weight was seen with chest circumference (94.26%). CONCLUSION: Measurement of chest circumference being simple, easy, cheap and reliable method for identification of low birth weight in the community.

Sociomedical correlates of missed opportunities for immunisation.

Missed opportunity for immunisation is one of the hurdles in the achievement of 85 percent or more immunisation coverage. It is essential to screen every child for immunisation status and advise necessary immunisation at every opportunity otherwise full immunisation coverage may not be possible. Present survey was carried out at Indira Gandhi Medical College and Hospital, Nagpur to study the sociomedical correlates of missed opportunities for immunisation in children below 2 years of age attending the hospital. Missed opportunities for immunisation in these children was found to be 39.9%. It is mostly for B. C. G. (21.8%) and measles (9.8%) and maximum for booster doses of DPT and polio (43%).

Sociomedical problems of institutionalised women.

The inmates of this institute form a special group in the society which is a reflection of various social pressures and problems. These institutionalised female largely come from poor socioeconomic families and often from families with serious social problems like family disharmony (30%), marital disharmony (20%), poverty (10%), unwedmotherhood (8%), broken homes (51.1%) etc. 90% inmates had one or more morbid conditions. Average number of morbid conditions per inmate was 2.16 at the time of study. Institution which assumes the custody of these women should provide them with medical services towards the rehabilitation and discharge of a healthy, productive, well adjusted citizens. An effective health education programme comprising of nutrition education, sex education, personal hygiene, alcohol and drug abuse should be specifically drafted and should be undertaken for the inmates.

Study of 'at risk' factors in rural under five children.

1. In the present hospital based cross sectional study, 64.97% under five children in rural area were found to be 'at risk'. 2. The most common 'at risk' factor found in these under five children was weight below 70% of the reference (39.1%) followed by acute gastroenteritis and respiratory infections (19.3%), spacing of less than 2 years (13.2%) and working mothers where the child was being looked after by a substitute (12.2%). 3. More than one 'at risk' factors were found in 43 (21.8%) children. 4. Statistically significant association was found between 'at risk' children and illiteracy and poverty.

A study of some etiological factors and morbid conditions in mentally handicapped children.

In the present study most of the subjects belonged to mild and moderate degree of mental handicap i.e. 30.8% and 44.9% respectively while severe degree of mental handicap was present in 22.7% subject. The factors responsible for mental handicap include prenatal factors (34.6%), perinatal factors (15.1%) and post natal factors (37.9%). In 12.4% cases etiology was not known. The associated behaviour problems were observed in 33% of the study subjects while other morbid conditions were present in 47% of the study subjects.