Résumé
Background: Anaemia is a major public health problem in developing countries like India and is especially seen among women of childbearing age, during pregnancy and lactation. Nearly two-thirds of pregnant and one-half of non-pregnant women in developing countries have anaemia, which increases the risk of maternal and fetal mortality and morbidity. Aims & Objective: The study was designed to assess the prevalence of anaemia in pregnant women and to report the socio-demographic factors associated with anaemia during pregnancy. Material and Methods: This is a Cross sectional study. The study was conducted in Block Hajan, the rural field practice area under the department of community medicine, Sher-i-Kashmir Institute of Medical Sciences (SKIMS) Soura.482 pregnant women were examined and screened for anaemia. Haemoglobin level, age, education, income, type of family and parity were among the various variables studied. Statistical analysis was done by using Chi-square test using SPSS statistical package version (Chicago 11, IL). Results: A high prevalence (91%) of anaemia (Hb<11g/dl) was observed. The prevalence of anaemia was significantly higher in those aged ≥ 35 years. A highly significant association was found with woman’s age, parity, educational and socio-economic status. However, family type and birth interval were not significantly associated with anaemia. Conclusion: There is a high prevalence of anaemia among pregnant women and there is need for correcting this to improve the overall health of pregnant women.
Résumé
AIM : To identify factors at the time of admission that predict in-hospital mortality in patients with gastro-esophageal variceal hemorrhage. METHODS : Case records of patients admitted with gastro-esophageal variceal hemorrhage between January 1998 and October 2003 were retrospectively analyzed. Relevant clinical and laboratory parameters and their relationship to mortality, were studied. Clinical parameters assessed included Child-Pugh class, ascites, portosystemic encephalopathy (PSE) and occurrence of rebleed within 24 hours of esophago-gastroduodenoscopy. The laboratory parameters assessed were: hemoglobin, prothrombin time, serum bilirubin, creatinine and albumin. RESULTS : Of the 343 patients admitted during the study period, 30 (8.7%) died in hospital. Serum bilirubin (2.4 versus 1.6 mg/dL) and serum creatinine (2.1 vs 1.1 mg/dL) levels were higher among non-survivors than among survivors. Non-survivors were also more likely to suffer from PSE (53%) than survivors (17%), while re-bleeding within 24 hours of endoscopy occurred in 40% and 5% of these groups, respectively. On multivariate analysis, serum creatinine > 1.5 mg/dL at the time of admission (p < 0.001), serum bilirubin > 3 mg/dL (p < 0.001), presence of PSE (p = 0.003) and rebleed within 24 hours of endoscopy (p < 0.001) were significant predictors of mortality. CONCLUSION : Serum creatinine and bilirubin levels, presence of PSE and re-bleeding within 24 hours of initial endoscopy are independent predictors of mortality in patients with gastro-esophageal variceal bleeding.