Trends in Average Living Children at the Time of Terminal Contraception: A Time Series Analysis Over 27 Years Using ARIMA (p, d, q) Nonseasonal Model.

BACKGROUND: India's National Family Welfare Programme is dominated by sterilization, particularly tubectomy. Sterilization, being a terminal method of contraception, decides the final number of children for that couple. Many studies have shown the declining trend in the average number of living children at the time of sterilization over a short period of time. So this study was planned to do time series analysis of the average children at the time of terminal contraception, to do forecasting till 2020 for the same and to compare the rates of change in various subgroups of the population. MATERIALS AND METHODS: Data was preprocessed in MS Access 2007 by creating and running SQL queries. After testing stationarity of every series with augmented Dickey-Fuller test, time series analysis and forecasting was done using best-fit Box-Jenkins ARIMA (p, d, q) nonseasonal model. To compare the rates of change of average children in various subgroups, at sterilization, analysis of covariance (ANCOVA) was applied. RESULTS: Forecasting showed that the replacement level of 2.1 total fertility rate (TFR) will be achieved in 2018 for couples opting for sterilization. The same will be achieved in 2020, 2016, 2018, and 2019 for rural area, urban area, Hindu couples, and Buddhist couples, respectively. It will not be achieved till 2020 in Muslim couples. CONCLUSION: Every stratum of population showed the declining trend. The decline for male children and in rural area was significantly faster than the decline for female children and in urban area, respectively. The decline was not significantly different in Hindu, Muslim, and Buddhist couples.

Effectiveness of the addition of citicoline to patching in the treatment of amblyopia around visual maturity: a randomized controlled trial.

AIM: To study the effectiveness of the addition of citicoline to patching in the treatment of amblyopia in the age group of 4-13 years. MATERIALS AND METHODS: A randomized controlled trial, which included patients who were randomly divided into two groups. Both the groups received patching therapy till plateau was achieved in phase 1 of the study. Then in phase 2, group I received citicoline plus patching and group II continued to receive only patching. OUTCOME MEASURES: Outcome was measured by the visual acuity in logMAR every month in phase 1 till plateau was achieved and then for 12 months in phase 2. RESULTS: No significant difference was found in the mean visual acuities in these two groups in phase 1 till plateau was reached. In phase 2, for the initial four months, there was no significant difference in the visual acuities in these two groups, at the respective intervals. However, five months onward, up to 12 months, there was a significant difference in the visual acuities in these groups.The result was the same in younger patients (< seven years of age) as well as in older patients (> seven years of age). In phase 2, the mean proportional improvement in group I was significantly more than that in group II, at two months and onward, at the respective intervals. CONCLUSION: The improvement in visual acuity with citicoline plus patching was significantly more than that with patching alone, in one year of treatment.

Maternal risk factors associated with term low birth weight neonates: a matched-pair case control study.

OBJECTIVE: To study maternal risk factors associated with full term low birth weight (LBW) neonates. DESIGN: Matched pair case control study. SETTING: Multicenter study including 2 medical colleges and 1 civil hospital, between July 2009 to December 2009. PATIENTS: Of 2382 neonates screened, 274 full term LBW babies (of 638) and 274 pair matched controls (of 1744) were included in the study. 364 LBW babies were excluded because of premature delivery/gestational age not known (314), unavailability of suitable matched controls (18), and insufficient data (32). METHODS: Maternal factors including birth spacing, height, pre-delivery weight and pregnancy weight gain, age, parity, educational and economic status, type of family, antenatal care (ANC), maternal exposure to tobacco, hypertension and anemia were studied. RESULTS: Birth spacing <36 months, maternal height ≤ 145 cm, pre-delivery weight ≤ 55 kg, pregnancy weight gain <6 kg, exposure to tobacco, inadequate antenatal care, maternal hypertension, low socio-economic status, maternal anemia and less maternal education were associated with delivery of a low birth weight infants. Conditional logistic regression analysis showed that significant risk factors associated with low birth weight were inadequate ANC (OR-4.98, 95% CI-2.64 to 9.39), maternal weight before delivery ≤ 55 kg (OR-4.81, 95% CI-2.53 to 9.15) and height ≤ 145 cm (OR-4.13, 95% CI-2.04 to 8.37). CONCLUSION: Maternal malnutrition, inadequate antenatal care and poor weight gain during pregnancy are significant predictors for delivery of a low birth weight neonate.

Ante natal care services utilization, delivery practices and factors affecting them in tribal area of north maharashtra.

BACKGROUND: Utilization of Ante natal care (ANC) services is poor in the tribal areas, causing increased maternal morbidity and mortality. OBJECTIVE: This study was carried out to find out ANC services utilization, delivery practices and factors affecting them in a tribal area of North Maharashtra in Nashik district. DESIGN: Cross-sectional study. MATERIALS AND METHODS: The study was carried out in two tribal blocks of Nashik district. Cluster sampling technique was used. 210 mothers in the selected clusters, who had delivered within last 1 year, were interviewed. Information about the ANC services utilization and place of delivery was recorded. Relevant socio-demographic data were also collected. RESULTS: Adequate ANC services utilization was found to be 64.76%. Home deliveries were 34.29% and home deliveries conducted by untrained persons were 15.24%. CONCLUSION: The utilization of ANC services and deliveries at health centers were significantly associated with education of the women and their spouses, and the socioeconomic status of the family. Main reasons for inadequate utilization of ANC services were financial, unawareness about ANC services, etc. Place of delivery was associated with the type of the family. Traditional practices were the most common reason for conducting the deliveries at home.