RESUMO
Background: Neonatal sepsis is a continuing problem causing significant burden on health care, especially in developing world. As blood culture has low sensitivity in diagnosis of neonatal sepsis, strong clinical suspicion along with combination of different laboratory tests is required. The data available for extensively studied acute phase reactant, procalcitonin (PCT) remains controversial. This study was done to assess role of PCT alone and in combination with different tests for diagnosing neonatal sepsis.Methods: Blood samples of 275 neonates (>35 weeks of gestation) admitted to NICU, with suspicion of neonatal sepsis were collected for bacterial culture, serum procalcitonin level and sepsis screen (CRP, mESR, I/T ratio, Total Leucocyte Count, Absolute Neutrophil Count).Results: Blood culture was positive in 30.5% of enrolled neonates. At a cut-off value of 0.5 ng/ml the sensitivity, specificity, PPV, NPV of serum PCT in neonatal sepsis cases was 73.8%, 47.1%, 48%, 80.4% respectively. Serum PCT was found raised in 60 (48.8%) clinically suspected cases of neonatal sepsis where sepsis screen and blood culture both were negative, also it was not raised in 17 (32.7%) of clinically suspected cases of septicemia where both blood culture and sepsis screen were positive. Amongst other individual tests, CRP was found to have best sensitivity (79.7%) and NPV (85%) followed by PCT (73.8% and 80.4%) while best specificity was found for I/T ratio (93.7%) followed by mESR (89%) for diagnosis of neonatal sepsis with positive blood culture. Best NPV was seen for combination of PCT+CRP+I/T ratio (95.6%) for the suspected cases of neonatal sepsis.Conclusions: Thus, we conclude that serum PCT can play a useful role when combined with other test markers but may not find its way as a sole diagnostic marker for diagnosing neonatal sepsis in term/near term babies.
RESUMO
Background: Short birth interval adversely affects the maternal and neonatal health. The use of contraceptive methods is still one of the biggest challenges in developing countries despite various programs. Janani Suraksha Yojana was started with aims to achieve national targets for contraception. Methods: The present study was a cross sectional study conducted in Lucknow district amongst the women admitted in three blocks of rural area health centers. The blocks were selected by simple random sampling method. A total of 400 women who delivered in the labor wards of the health centers were interviewed and enrolled. Results: In the present study, out of 400 mothers, 39(9.8%) mothers had their first delivery below the age of 18 yrs. According to modified Udai Pareek Scale, 56.3% of the mothers belonged to 5th socio-economic status. Birth spacing was the purpose to use family planning (FP) methods among 121(55.5%) of the mothers. The use of FP method was significantly associated with occupation of mothers and their husband and education of mothers. It was also found that the use of FP method was significantly (p=0.001) higher among those beneficiaries who had birth interval > 3 years (72.1%) in contrast to 2-3yrs (68.8%), 1-2yrs (60.2%) and < 1yr (36.4%). Conclusions: JSY is a promising program for promotion of contraception. Knowledge about the family planning methods should be provided to the beneficiaries during their ANC visits as during this period they are more receptive to family planning methods.