Demographic and Socio-economic Determinants of Birth Interval Dynamics in Manipur: A Survival Analysis

The birth interval is a major determinant of levels of fertility in high fertility populations. A house-to-house survey of 1225 women in Manipur, a tiny state in North Eastern India was carried out to investigate birth interval patterns and its determinants. Using survival analysis, among the nine explanatory variables of interest, only three factors – infant mortality, Lactation and use of contraceptive devices have highly significant effect (P<0.01) on the duration of birth interval and only three factors – age at marriage of wife, parity and sex of child are found to be significant (P<0.05) on the duration variable

Postpartum Amenorrhoea among Manipuri Women: A Survival Analysis

Among the three major components of a closed birth interval, waiting time to conception can somehow be managed with effective contraceptives while gestation is universally constant in its duration; the duration of postpartum amenorrhoea (PPA) varies in complex nature. The present study aimed to investigate the proximate factors influencing the duration of PPA. A community-based, cross-sectional study was conducted in four valley districts of Manipur, India, during 1 August 1231 December 2009, to analyze the differentials and determinants of duration of PPA, applying the survival analysis technique. In total, 1,225 ever-married women were selected through two-stage cluster sampling. The median duration of PPA was 5.7 months. Among the 11 explanatory variables of interest, only three variables\u2014place of residence (p&lt;0.05), infant mortality from preceding pregnancy (p&lt;0.01), and duration of breastfeeding (p&lt;0.01)\u2014 had a significant effect on the duration of PPA. The findings may be used as baseline information for future researchers and maternal health policy-makers

Current treatment in macrophage activation syndrome worldwide: a systematic literature review to inform the METAPHOR project

Objective: To assess current treatment in macrophage activation syndrome (MAS) worldwide and to highlight any areas of major heterogeneity of practice. Methods: A systematic literature search was performed in both EMBASE and PubMed databases. Paper screening was done by two independent teams based on agreed criteria. Data extraction was standardized following the PICO framework. A panel of experts assessed paper validity, using the Joanna Briggs Institute appraisal tools and category of evidence (CoE) according to EULAR procedure. Results: Fifty-seven papers were finally included (80% retrospective case-series), describing 1148 patients with MAS: 889 systemic juvenile idiopathic arthritis (sJIA), 137 systemic lupus erythematosus (SLE), 69 Kawasaki disease (KD) and 53 other rheumatological conditions. Fourteen and 11 studies specified data on MAS associated to SLE and KD, respectively. All papers mentioned glucocorticoids (GCs), mostly methylprednisolone and prednisolone (90%); dexamethasone was used in 7% of patients. Ciclosporin was reported in a wide range of patients according to different cohorts. Anakinra was used in 179 MAS patients, with a favourable outcome in 83% of sJIA-MAS. Etoposide was described by 11 studies, mainly as part of HLH-94/04 protocol. Emapalumab was the only medication tested in a clinical trial in 14 sJIA-MAS, with 93% of MAS remission. Ruxolitinib was the most reported Janus kinase inhibitor in MAS. Conclusion: High-dose GCs together with IL-1 and IFN gamma inhibitors have shown efficacy in MAS, especially in sJIA-associated MAS. However, the global level of evidence on MAS treatment, especially in other conditions, is still poor and requires standardized studies to be confirme

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Determinants of duration of breastfeeding amongst women in Manipur

Objective: The purpose of present study is to investigate the differentials and determinants of duration breastfeeding (BF) according to various socio-economic and demographic factors. Methods: A cross sectional study of 1225 ever-married women of reproductive age with at least one live birth was conducted in four valley districts of Manipur under cluster sampling scheme. Survival analysis technique has been adopted through SPSS vs 16. Results: The median duration of BF is found to be 20.37 months. Among the six explanatory variables of interest, only two factors - place of residence (relative risk (RR) =1.35) and employment status RR = 1.88) have highly significant effect (P&lt;0.01) on BF and only two factors educational level (RR=1.02) and parity (RR = 0.83) are found to be statistically significant (P&lt;0.05) on BF. Conclusion: The residence, education, employment status and parity have significant effects on the present duration of BF that is about 20 months which is below the India's national figure of 25 months and WHO recommended figure of 24 months. Key words: Fertility; censored case; parity; life table; proportional hazard model DOI: http://dx.doi.org/10.3329/bjms.v10i4.9493 BJMS 2011; 10 (4): 235-239</jats:p

Identification of Factors Influencing Third Birth Transition in Manipur

The third birth transition has a negative impact on the national goal of fertility replacement level (2.1) which is to be achieved by 2010. To identify the factors influencing the demographic phenomenon, a cross sectional as well as community based study consisting of 1397 eligible women was conducted in the four valley districts of Manipur under cluster sampling scheme. Analysing the empirical information through SPSS, 42% of the study subjects transit their 3rd birth and its major determinants could be detected to be sex preference, age at marriage, and educational level each at 0.01 probability level of significance

Postpartum Amenorrhoea among Manipuri Women: A Survival Analysis

Among the three major components of a closed birth interval, waiting time to conception can somehow be managed with effective contraceptives while gestation is universally constant in its duration; the duration of postpartum amenorrhoea (PPA) varies in complex nature. The present study aimed to investigate the proximate factors influencing the duration of PPA. A community-based, cross-sectional study was conducted in four valley districts of Manipur, India, during 1 August−31 December 2009, to analyze the differentials and determinants of duration of PPA, applying the survival analysis technique. In total, 1,225 ever-married women were selected through two-stage cluster sampling. The median duration of PPA was 5.7 months. Among the 11 explanatory variables of interest, only three variables—place of residence (p<0.05), infant mortality from preceding pregnancy (p<0.01), and duration of breastfeeding (p<0.01)— had a significant effect on the duration of PPA. The findings may be used as baseline information for future researchers and maternal health policy-makers