An exploratory study to evaluate the utility of an adapted Mother Generated Index (MGI) in assessment of postpartum quality of life in India

<p>Abstract</p> <p>Background</p> <p>Given the postulated advantages of mother generated index (MGI) in incorporating the patients' viewpoint and in the absence of a validated India specific postpartum quality of life assessment tool we proposed to evaluate the utility of an adapted Mother-Generated-Index in assessing postpartum quality of life (PQOL) in India.</p> <p>Methods</p> <p>The study was integrated into a community survey conducted in one district of Delhi by two-stage cluster randomized sampling to recruit women who delivered in the last 6 months. PQOL was assessed using MGI. Physical morbidity and Edinburgh- postnatal-depression-scale (EPDS) were also recorded for validation purposes.</p> <p>Results</p> <p>All subjects (249 of 282 eligible) participating in the survey were approached for the MGI evaluation which could be administered to 195 subjects due to inadequate comprehension or refusal of consent. A trend towards lower scores in lower socioeconomic stratum was observed (Primary index score-2.9, 3.7 and 4.0 in lower, middle and higher strata; Secondary Index Score-2.6, 3.2 and 3.0 in lower, middle and higher strata). 59.4% mothers had scores suggestive of possible depression (EPDS; n = 172). Primary index score had a good correlation with validator scores like EPDS (p = 0.024) and number of physical problems (p = 0.022) while the secondary index score was only associated with EPDS score (p = 0.020).</p> <p>Conclusion</p> <p>The study documents that the MGI, with its inherent advantages, is a potentially useful tool for postpartum quality of life evaluation in India especially in the absence of an alternative pre-validated tool.</p

Direct Cost of Maternity-care Services in South Delhi: A Community Survey

The study was conducted to estimate the direct maternity-care expense for women who recently delivered in South Delhi and to explore its sociodemographic associations. A survey was conducted using the two-stage cluster-randomized sampling technique. Two colonies each from high-, middle- and low-income areas were selected by simple random sampling, followed by a house-to-house survey in each selected colony. Information was collected by recall of healthcare expenses for mother and child. In total, 249 subjects (of 282 eligible) were recruited. The mean expense for a normal vaginal delivery (n=182) was US$370.7, being much higher in a private hospital (US$ 1,035) compared to a government hospital (US$61.1) or a delivery in the home (US$ 55.3). Expenses for a caesarean delivery (n=67) were higher (US$ 1,331.1). Expenses for the lowest-income groups were ∼10% of their annual family income at government facilities and ∼26% at private hospitals. The direct maternity expense is high for large subsections of the population

Direct Cost of Maternity-care Services in South Delhi: A Community Survey

The study was conducted to estimate the direct maternity-care expense for women who recently delivered in South Delhi and to explore its sociodemographic associations. A survey was conducted using the two-stage cluster-randomized sampling technique. Two colonies each from high-, middle- and low-income areas were selected by simple random sampling, followed by a house-to-house survey in each selected colony. Information was collected by recall of healthcare expenses for mother and child. In total, 249 subjects (of 282 eligible) were recruited. The mean expense for a normal vaginal delivery (n=182) was US$370.7, being much higher in a private hospital (US$ 1,035) compared to a government hospital (US$61.1) or a delivery in the home (US$ 55.3). Expenses for a caesarean delivery (n=67) were higher (US$ 1,331.1). Expenses for the lowest-income groups were ~10% of their annual family income at government facilities and ~26% at private hospitals. The direct maternity expense is high for large subsections of the population

The quality of media reporting of suicide news in a high suicide state of India against World Health Organization guidelines: A content analysis study of major newspapers in Chhattisgarh

Objectives: Suicide rates in India are amongst the highest in the world, resulting in an estimated 250,000 suicide deaths annually, and suicide rates in the state of Chhattisgarh are more than double the national average. Responsible media reporting is one of the few population-level suicide prevention interventions. To inform media interventions, the objective of our study was to assess the quality of newspaper reporting of suicide-related news in Chhattisgarh against World Health Organization (WHO) suicide reporting guidelines. Methods: We used content analysis to assess the quality of suicide reporting against WHO guidelines in the thirteen most highly read Hindi- and English-language daily newspapers in Chhattisgarh between February and July of 2019. Results: A total of 441 suicide articles were retrieved. The mean number of suicide articles per day per newspaper was 0.6 (range 0.2–1.1) and 33.3% of the articles were 10 sentences or less. The vast majority (97.8%) of articles primarily focused on reporting of specific suicide deaths and attempts. Harmful reporting practices were very common (for example, a detailed suicide method was reported in 38.7% of articles) while helpful reporting practices were rare (for example, just 0.5% gave contact details for a suicide support service). Conclusions: We observed that short and explicit articles covering suicide incidents was commonplace amongst newspapers in Chhattisgarh. Attempts should be made to devise context-specific strategies to boost the positive contribution that media can make to suicide prevention in Chhattisgarh

Recovery of value added products of Sm and Co from waste SmCo magnet by hydrometallurgical route

Recovery of value added products of samarium and cobalt from the waste SmCo magnet was carried out by leaching and solvent extraction. Prior to the leaching the magnet was demagnetized by roasting at 1123 K. Leaching of Sm and Co from the roasted SmCo magnet was optimized by varying different process parameters such as acid type, acid concentration, pulp density, stirring speed and temperature. Under the optimized conditions of 4 M HCl, 368 K, 100 g/L pulp density, 500 rpm almost complete leaching of Sm and Co was obtained. Mechanism of leaching was established by studying the kinetics and characterization of leached residue. Kinetic study shows that the leaching of Sm and Co in HCl from roasted SmCo magnet is chemically controlled and proceeds through the surface chemical reaction of the particles with the acid. Samarium and cobalt from the leach liquor were separated by solvent extraction with Cyanex 572 at the phase ratios of 2:1 in 2-stages and 1-stage, respectively. From the purified solutions of Sm and Co, Sm2(C2O4)3·10H2O and Co2C2O4·2H2O were prepared by treating with stoichiometric amounts of oxalic acid. Oxalates of Sm and Co were roasted at 1073 K and 673 K, respectively for 240 min to produce Sm2O3 and Co3O4. The oxides of Sm and Co were characterized by chemical analysis, XRD and SEM-EDS studies

Is hepatectomy safe following Yttrium-90 therapy? A multi-institutional international experience

Background: Single institution reports demonstrate variable safety profiles when liver-directed therapy with Yttrium-90 (Y-90) is followed by hepatectomy. We hypothesized that in well-selected patients, hepatectomy after Y90 is feasible and safe. Methods: Nine institutions contributed data for patients undergoing Y90 followed by hepatectomy (2008–2017). Clinicopathologic and perioperative data were analyzed, with 90-day morbidity and mortality as primary endpoints. Results: Forty-seven patients were included. Median age was 59 (20–75) and 62% were male. Malignancies treated included hepatocellular cancer (n = 14; 30%), colorectal cancer (n = 11; 23%), cholangiocarcinoma (n = 8; 17%), neuroendocrine (n = 8; 17%) and other tumors (n = 6). The distribution of Y-90 treatment was: right (n = 30; 64%), bilobar (n = 14; 30%), and left (n = 3; 6%). Median future liver remnant (FLR) following Y90 was 44% (30–78). Resections were primarily right (n = 16; 34%) and extended right (n = 14; 30%) hepatectomies. The median time to resection from Y90 was 196 days (13–947). The 90-day complication rate was 43% and mortality was 2%. Risk factors for Clavien-Dindo Grade>3 complications included: number of Y-90-treated lobes (OR 4.5; 95% CI1.14–17.7; p = 0.03), extent of surgery (p = 0.04) and operative time (p = 0.009). Conclusions: These data demonstrate that hepatectomy following Y-90 is safe in well-selected populations. This multi-disciplinary treatment paradigm should be more widely studied, and potentially adopted, for patients with inadequate FLR