Undernutrition and its association with socio-demographic factors among pregnant women attending tertiary health care hospital in northern Maharashtra: a cross sectional study

Background: Maternal nutrition is one of the most important health and welfare problems among women in developing countries. Only limited research has been conducted on the prevalence and determinants of maternal nutritional status in Maharashtra. Particularly, data on the nutritional status of pregnant women are lacking. The aim of this was to assess prevalence and determinants of undernutrition among pregnant women attending antenatal care center.Methods: An institution based cross-sectional study was conducted during September to December, 2018. Randomly selected 303 pregnant women were included in the study. Nutritional status was estimated using mid-upper-arm circumference. Data on potential determinants of undernutrition were gathered using a structured questionnaire. Statistical analysis was done using logistic regression. p<0.05 at 95% confidence interval was considered as statistically significant.Results: Overall prevalence of under-nutrition among study participants was 21.8%. Using a logistic regression model, factors significantly associated with the under nutrition were rural residence (AOR=0.675; 95%CI 0.307-1.485), having less than three years duration of marriage (AOR=6.650;95%CI 2.268-19.501), living with joint family (AOR=4.128;95%CI 1.606-10.611), no utilization of family planning methods (AOR=0.319; 95%CI 0.131-0.775), less no. of ANC visit (AOR=3.253; 95%CI 1.342-7.888) and having less frequency of meal (AOR=0.319 (0.149-0.683). Remaining all factors like religion, education, occupation, family size, gravida, parity, consumption of iron and calcium tablet, getting USG done, anti-tetanus vaccination, support from family and husband were not found as significant risk factors for undernutrition.Conclusions: Integrated approach is must to combat malnutrition among pregnant women.

A cross-sectional study to evaluate malnutrition prevalence in under 5 children and health seeking behaviour of their parents in an urban slum area of a metropolitan city

Background: Malnutrition is widespread in rural, tribal and urban slum areas and it is a significant public health problem described as a silent killer, silent emergency, and invisible enemy affecting those who cannot express their voice and have to depend upon others for their advocacy. Numerous studies showed that education of parent’s, especially maternal education emerges as a key element of an overall strategy to address malnutrition. The best global indicator of children’s wellbeing is growth. Assessment of anthropometry is the single measurement that best defines the nutritional and health status of children, and provides an indirect measurement of the quality of life of the entire population.Methods: Community based cross-sectional study was carried out in an urban slum area of Mumbai city, Maharashtra. Total 300 children of 0-5 years of age were enrolled in the study. A list of all the children below five years of age belonging to study area was taken from the health post situated in premises of UHTC. All mothers or primary care takers of the children were interviewed and weight and height of the children was recorded.Results: Prevalence of underweight, stunting and wasting was 69.33%, 60.33% and 45.66% respectively. Mother’s literacy, low birth weight and morbidities like diarrhoea, fever and cough in previous fifteen days were significantly associated with malnutrition.Conclusions:Chronic malnutrition was more prevalent in this area. Mother’s literacy had a much higher impact on better nutritional status of children. Morbidities like diarrhoea, fever and cough had made the children nutritionally vulnerable as malnutrition was higher in those children.

Epidemiological investigation of an acute gastroenteritis outbreak in a tribal village near Madhya Pradesh-Maharashtra border

Background: Diarrhoeal diseases represent a major health problem in developing countries. Conservative estimates place the global death toll from diarrhoeal diseases at about two million deaths per year (1.7 - 2.5 million deaths), ranking third among all cases of infectious disease death worldwide. The prime purpose of an outbreak investigation is to control the outbreak, limit its spread to other areas and assess how preventive strategies could be further strengthened to reduce or eliminate the risk of such outbreak in future. Methods: It was a descriptive cross sectional study of epidemic occurred in Khetiya village, Dist Barwani (MP), population of 67,500 during 17 October 2016 to 17 November 2016. All the cases reported within last one week around the market place village in Khetiya, presenting with symptoms and signs of AGE (as per standard case definition of IDSP) and willing to participate in the investigation. Results: Males were 56.96%, & female cases were 43.03%. Majority of the study subjects lied between 20-40 years. The mean age was 30.15±5 years. Majority of the cases belonged to lower middle class SES (38%). 87% population was tribal, 48% cases were labourers, 42% were farmers and 10% were others. Conclusions: Males were 56.96%, & female cases were 43.03%. Majority of the study subjects lied between 20-40 years. The mean age was 30.15±5 years. Majority of the cases belonged to lower middle class SES (38%). 87% population was tribal, 48% cases were labourers, 42% were farmers and 10% were others.

Phytochemical constituents and pharmacological activities of Lagerstroemia floribunda Jack. (Kedah bungor): A Review.

This is the first report on review of Lagerstroemia species which includes the detailed description on phytochemistry and its pharmacological research. Despite being rich in important phytochemicals and having possible medicinal value there is no enough information available on this plant. Lagerstroemia floribunda Jack also known as Thai crape myrtle and kedah bungor, is a species of flowering plant in the Lythraceae family. This delightful ornamental plant is native to subtropical and tropical South-East Asia, from southern China to Myanmar, Thailand, Cambodia, Indo-China and Peninsular Malaysia. The phytoconstituents of Lagerstroemia floribunda includes 23-hydroxyursoIic acid, alphitolic acid, ursolic acid, dihydro-β-cyclopyrethrosin, sesamin, β -sitosterol, clauslactone-K, betulinic acid, lingueresinol, ent-isolariciresinol. Some of the researches that are being carried out on this plant include total phenolic contents and antioxidative activity of its flowers. This review will help to provide detailed information on recent researches done on this plant.

A Study on the Morphometric Asymmetry of Atlas Vertebrae

The commonly used examination procedures of the upper cervical spine depend upon the symmetry for comparison and interpretation of joint functions. If symmetry is not normal, then these assessments may mislead the examiners, allowing them implementation of incorrect treatment plans. Objectives of this study are to explore the possibility that asymmetry is more common than symmetry and, if it is true, to find out the effects of asymmetry on the biomechanics of these joints. The study was carried out on 30 atlas vertebrae of cadavers of Indian origin. The different intra-atlas distances were measured on both sides by digital vernier calliper. All the parameters studied showed statistically significant differences between the right and left side i.e. a p value of < 0.05. The anteroposterior diameter of the foramen transversarium, the transverse diameter of the foramen transversarium, the distance from the midline to medial edge of the vertebral artery groove (inner as well as outer cortex) and the length of the superior articular facets were more on the right side as compared to the left side. The breadth as well as the length of the inferior articular facet, the breadth of the superior articular facet and the difference of posterior arch thickness at the site of vertebral artery groove were more on the left side as compared to the right side. These differences may be explained by the handedness of an individual, which influences the intra-osteal asymmetry in a characteristically distinct manner, which needs to be confirmed or refuted in a further study.

Pharmacognostical, Phytochemical and Total Phenolic Content of Artocarpus altilis (Parkinson) Fosberg Leaves.

Objective: This research was aimed to investigate the pharmacognostical, phytochemical and total phenolic content of Artocarpus altilis(Parkinson) Fosberg leaves. Method: Macroscopy, microscopy, physicochemical, phytochemical analysis and thin layer chromatography of Artocarpus altilis leaves were carried out. Folin-Coicalteau method was used to determine the total phenolic content. Results: Morphological study showed that the leaves were alternate or irregular, ovate and finger-like shaped with an average of 30.21cm in length and 24.25cm in width. Microscopy on leaves and powder showed the presence of anomocytic stomata, trichomes, xylem, starch grains, lignin, and calcium oxalate crystals. Phytochemical test showed the presence of mucilage, flavonoid, steroid, tannin and phenolic compound and anthraquinone glycosides. Physicochemical analysis showed 11.64% of loss on drying, 9% of total ash value; and water soluble extractive value of 21.32% as highest. Total phenolic content was found to be 26.22 mg GAE/g. Conclusion: From this study, it can be concluded that the ethanolic extracts of Artocarpus altilis leaves possess modest amount of phenolic compounds in the leaves of this plant.

A retrospective epidemiological study of delay for updated Thai red cross intradermal anti-rabies vaccination schedule amongst animal bite cases attending ARV clinic at a tertiary care centre.

Background: Rabies is an acute viral disease, which causes encephalomyelitis in virtually all the warm blooded animals, including man. Almost 20000 deaths occur in India. The present study conducted with objective to analyze the delays and compliance for anti-rabies vaccination as per schedule and its some factors among the animal bite cases. Methods: Retrospective cross sectional record based study of cases attended Anti-Rabies Vaccination (ARV) clinic during the period of April 2012 to March 2013. The data extracted from records included socio-demographic variables, animal bite history treatment received and completion of ARV schedule. Data entered and analyzed using SPSS 21. Results: Total of 3548 animal bite cases attended the ARV clinic. Out of these cases, 18.2 %, 20.3% and 14.2% of cases not reported on scheduled date for 2nd, 3rd & 4th dose of ARV respectively. Only 34.3% of cases completed the schedule. Delay for receiving ARV among women, cases from rural area & class II animal bite was statistically significant. Conclusions: Counselling regarding follow up of ARV schedule at the time of first visit to the anti-rabies vaccine clinic must be strengthened to avoid poor compliance and delaying of schedule.

A Review on Artocarpus altilis (Parkinson) Fosberg (breadfruit).

Artocarpus altilis (Family: Moraceae) is commonly referred to as breadfruit as it is similar to freshly baked bread. Synonyms of Artocarpus altilis are Artocarpus communis and Artocarpus incisus. Basically Artocarpus species consists of phenolic compounds which include flavonoids, stilbenoids, arylbenzofurons and Jacalin, a lectin. Breadfruit (Artocarpus altilis) is originated from A. camansi Blanco (bread nut) which is native to New Guinea, Moluccas (Indonesia) and the Philippines. Many on-going researches are testing the pharmacological activities of Artocarpus altilis. Some of the researches that are being carried out on this plant includes antiinflammatory, antioxidant, antifungal, sexual behavior, immunomodulatory effect, antidiabetic effect and antibacterial effect. This review will help to provide detailed information on recent researches done on this plant.

Distance between Midline and Vertebral Artery Groove of Atlas – A Real Aid to the Neurosurgeon

The knowledge of the relationship of the vertebral artery with the atlas is very important, in order to avoid any injury to the vertebral artery, during surgeries in the craniovertebral region. Different researchers have measured the distance of the vertebral artery from the midline along the posterior arch of atlas (oblique distance), but some authors have measured the perpendicular distance of vertebral artery from the midline. Usually, it is the perpendicular distance along which the surgeons are exploring in this region. Hence, the present study was planned to study and compare both oblique and perpendicular distances of the vertebral artery from the midline and find out statistical differences between these two parameters. It was carried out on 30 atlas vertebrae of Indian origin. The oblique and perpendicular distances of vertebral artery groove from midline and the thickness of vertebral artery groove were measured. The results suggest that dissection on the posterior aspect of the arch of atlas should remain 17.00 mm lateral to the midline and dissection on the superior aspect of the arch of atlas should remain 8.00 mm from the midline to prevent injury to the vertebral artery. It was also observed that “oblique distances of vertebral artery groove from the midline to the medial margin of inner and outer cortex are larger than the corresponding perpendicular distances from the midline”. Although, the differences of oblique and perpendicular distances are not statistically significant but it may be clinically significant for the surgeons operating in the craniovertebral region. Hence, it is concluded that the surgeon should be aware of both the distances while operating in the craniovertebral region to avoid any iatrogenic injury to the vertebral artery.

Open appendicectomy stump: invaginate or not to invaginate.

Acute appendicitis remains the most common abdominal surgical emergency. Appendicectomy is the standard treatment of acute appendicitis, which performed by open or laparoscopic approach. During open method, after removal of appendix, stump simple ligation or simple ligation and invagination. A prospective randomized study conducted at Smt SCL General Hospital, Smt NHL municipal Medical College, Ahmedabad between October 2009 to September 2011 to evaluate the necessity of appendicular stump invagination during appendicectomy. A total 110 patients were studied and randomized into two group, Group I stump simple ligation, transfixation and invagination and Group II stump simple ligation and transfixation only. There was no statically significant difference in the rate of postoperative complication and post operative hospital stay between the two groups. The mean operating time was significantly shorter in group without invagination. The rate of postoperative paralytic ileus was more in group I. We conclude that simple ligation of the appendicular stump during appendicectomy is safe, simple and shortens operating time.

Surgery for inguinal hernia in pediatric age.

Inguinal hernia repair is one of the most frequently performed surgical procedures in pediatric patients. An inguinal hernia does not resolve spontaneously and must be repaired because of high risk of complications. A retrospective analysis was performed on the hospital records including operative notes of admitted pediatric patients, aged up to 12 years, who underwent inguinal herniotomy. On observation, male affect more than female , right side inguinal hernia more common than left, due to let decent of testis on right side. Early detection and repair of inguinal hernia in pediatric is essential to decrease the potential morbidity and operative complications rate. This needs an increase in popular and pediatric awareness.