To study prevalence and treatment efficacy of sexually transmitted diseases in patients attending gynaecology outpatient department of tertiary care hospital

Background: Sexually transmitted infection (STI) is a significant public health problem in developing countries, including India. STI and its complications cause a huge health and economic burden over our country. STIs also enhance the transmission of HIV. To screen, prevent and treat this disease WHO has recommended “syndromic approach”. This study was conducted to estimate the local burden of this serious disease with the aim to determine its prevalence and efficacy of syndromic management measured as symptomatic improvement.Methods: A cross sectional study was carried out for a period of three years from April 2013 to March 2016. All the patients attending gynecology OPD were screened for the presence of an STI and HIV. A detailed history and clinical examination was conducted after informed consent, maintaining privacy and confidentiality. Treatment was given in the form of syndromic management; counseling and partner management and patients were followed up after 7 to 14 days. Improvement in symptoms was noted as “relieved”.Results: Proportion of STI patients was found to be 32.21%. The most common STI diagnosed was VCD (56.20%), followed by LAP (43.3%). Most commonly affected age group was 25 to 44 years. Proportion of HIV positive among all STI patients was 0.35% and that of serological syphilis was 0.23%. The overall efficacy of treatment was 67.38%. 17.54% patients were not relieved and 15.07% did not come for follow up. The STI was found to be more prevalent in condom non users and in those having more number of child birth and abortions.Conclusions: With high incidence of STI, the syndromic approach proves to be an important tool in its screening and early treatment. Most of STIs are preventable and curable. Hence educating people, promoting condom use and wide and consistent implementation of screening methods may lead to reduction in the disease burden

of vitamin D deficiency with occurrence of pre eclampsia among inpatients of tertiary care centre, Gorakhpur, Uttar Pradesh, India

Background: Pre eclampsia has remained a significant public health threat in both developed and developing countries contributing to maternal and perinatal morbidity and mortality globally. Vitamin D has direct influence on molecular pathways proposed to be important in the pathogenesis of pre eclampsia, yet the vitamin D-pre eclampsia relation has seldom been studied. In the present study we aimed to assess the association of vitamin D deficiency with the occurrence of pre eclampsia. If indeed vitamin D deficiency is related to pre eclampsia, this correlation can inform future studies, which hopefully will ultimately lead to a decrease in the incidence of pre eclampsia hence a decrease in adverse maternal and fetal outcomes.Methods: We conducted a comparative cross sectional study carried out for a period of one year from August 2014 to July 2015. A total of 384 patients were selected. 192 pre eclamptic and 192 non pre eclamptic pregnant patients aged 16-45 years attending in-patient department of Obstetrics and Gynaecology BRD Medical college Gorakhpur were included in the study.Results: About 82.8% of pre eclamptic and 31.25% of non pre eclamptic patients were found deficient in vitamin D. Also, severe pre eclamptic patients had more severe deficiency of vitamin D. Majority of these patients (51.78%) had very low vitamin D concentration.Conclusions: Maternal vitamin D deficiency may be an independent risk factor for preeclampsia. Vitamin D supplementation in pregnancy should be explored for preventing preeclampsia and promoting neonatal well-being

Factors influencing women’s preference for health facility deliveries in Jharkhand state, India: a cross sectional analysis

BACKGROUND: Expanding institutional deliveries is a policy priority to achieve MDG5. India adopted a policy to encourage facility births through a conditional cash incentive scheme, yet 28% of deliveries still occur at home. In this context, it is important to understand the care experience of women who have delivered at home, and also at health facilities, analyzing any differences, so that services can be improved to promote facility births. This study aims to understand women's experience of delivery care during home and facility births, and the factors that influence women's decisions regarding their next place of delivery. METHOD: A community-based cross-sectional survey was undertaken in a district of Jharkhand state in India. Interviews with 500 recently delivered women (210 delivered at facility and 290 delivered at home) included socio-demographic characteristics, experience of their recent delivery, and preference of future delivery site. Data analysis included frequencies, binary and multiple logistic regressions. RESULTS: There is no major difference in the experience of care between home and facility births, the only difference in care being with regard to pain relief through massage, injection and low cost of delivery for those having home births. 75% women wanted to deliver their next child at a facility, main reasons being availability of medicine (29.4%) and perceived health benefits for mother and baby (15%). Women with higher education (AOR = 1.67, 95% CI = 1.04-3.07), women who were above 25 years (AOR = 2.14, 95% CI = 1.26-3.64), who currently delivered at facility (AOR = 5.19, 95% CI = 2.97-9.08) and had health problem post-delivery (AOR = 1.85, 95% CI = 1.08-3.19) were significant predictors of future facility-based delivery. CONCLUSION: The predictors for facility deliveries include, availability of medicines and supplies, potential health benefits for the mother and newborn and the perception of good care from the providers. There is a growing preference for facility delivery particularly among women with higher age group, education, income and those who had antennal checkup. In order to uptake facility births, the quality improvement initiatives should regularly assess and address women's experiences of care

"Neither we are satisfied nor they"-users and provider's perspective: a qualitative study of maternity care in secondary level public health facilities, Uttar Pradesh, India.

BACKGROUND: Quality of care provided during childbirth is a critical determinant of preventing maternal mortality and morbidity. In the studies available, quality has been assessed either from the users' perspective or the providers'. The current study tries to bring both perspectives together to identify common key focus areas for quality improvement. This study aims to assess the users' (recently delivered women) and care providers' perceptions of care to understand the common challenges affecting provision of quality maternity care in public health facilities in India. METHODS: A qualitative design comprising of in-depth interviews of 24 recently delivered women from secondary care facilities and 16 health care providers in Uttar Pradesh, India. The data were analysed thematically to assess users' and providers' perspectives on the common themes. RESULTS: The common challenges experienced regarding provision of care were inadequate physical infrastructure, irregular supply of water, electricity, shortage of medicines, supplies, and gynaecologist and anaesthetist to manage complications, difficulty in maintaining privacy and lack of skill for post-delivery counselling. However, physical access, cleanliness, interpersonal behaviour, information sharing and out-of-pocket expenditure were concerns for only users. Similarly, providers raised poor management of referral cases, shortage of staff, non-functioning of blood bank, lack of incentives for work as their concerns. DISCUSSION: The study identified the common themes of care from both the perspectives, which have been foundrelevant in terms of challenges identified in many developing countries including India. The study framework identified new themes like management of emergencies in complicated cases, privacy and cost of care which both the group felt is relevant in the context of providing quality care during childbirth in low resource setting. The key challenges identified by both the groups can be prioritized, when developing quality improvement program in the health facilities. The identified components of care can match the supply with the demand for care and make the services truly responsive to user needs. CONCLUSION: The study highlights infrastructure, human resources, supplies and medicine as priority areas of quality improvement in the facility as perceived by both users and providers, nevertheless the interpersonal aspect of care primarily reported by the users must also not be ignored

Isolation of adh mutant of Lactobacillus rhamnosus for production of L(+) Lactic acid

Lactobacillus rhamnosus , a facultative anaerobe, which produces L (+) lactic acid and ethanol under anaerobic conditions, is used in the present study. An adh- mutant of Lactobacillus rhamnosus MTCC 1408, was developed by chemical mutagenesis, which could produce pure L(+) lactic acid as the only product. Batch fermentation kinetics of the wild type and the mutant strain were studied in glucose-yeast extract medium under conditions of temperature 40\ub0C and pH 6.2 anaerobically. The biomass yield was similar in both wild type and mutant strains, however lactic acid yield increased by 6.6%. A chemically defined media was optimized for supplementation of succinate, acetate and citrate for better biomass formation using single variable optimisation. It was further optimised for varying concentrations of vitamins, amino acids and trace metals by response surface method. The batch biomass yield (0.1g/g) and lactic acid yield (0.88g/g) in the optimised chemically defined media were similar to those obtained in the glucose-yeast extract medium

L (+) lactic acid fermentation and its product polymerization

Lactic acid has been first introduced to us as early as 1780 as a sour component of milk. Ever since we have found its applications in food, pharmaceutical, cosmetic industries etc. Now there are emerging uses as a potential feedstock for the biodegradable polymer industry. The microorganisms being used for lactic acid fermentation, the raw materials reported, the various novel fermentation processes and its processing methods have been reviewed. The properties and applications of lactic acid, its derivatives and polymer have been discussed. The various routes to polymerization and the companies presently involved in lactic acid production have been covered

District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia.

Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making

Reference Evapotranspiration Retrievals from a Mesoscale Model Based Weather Variables for Soil Moisture Deficit Estimation

Reference Evapotranspiration (ETo) and soil moisture deficit (SMD) are vital for understanding the hydrological processes, particularly in the context of sustainable water use efficiency in the globe. Precise estimation of ETo and SMD are required for developing appropriate forecasting systems, in hydrological modeling and also in precision agriculture. In this study, the surface temperature downscaled from Weather Research and Forecasting (WRF) model is used to estimate ETo using the boundary conditions that are provided by the European Center for Medium Range Weather Forecast (ECMWF). In order to understand the performance, the Hamon’s method is employed to estimate the ETo using the temperature from meteorological station and WRF derived variables. After estimating the ETo, a range of linear and non-linear models is utilized to retrieve SMD. The performance statistics such as RMSE, %Bias, and Nash Sutcliffe Efficiency (NSE) indicates that the exponential model (RMSE = 0.226; %Bias = −0.077; NSE = 0.616) is efficient for SMD estimation by using the Observed ETo in comparison to the other linear and non-linear models (RMSE range = 0.019–0.667; %Bias range = 2.821–6.894; NSE = 0.013–0.419) used in this study. On the other hand, in the scenario where SMD is estimated using WRF downscaled meteorological variables based ETo, the linear model is found promising (RMSE = 0.017; %Bias = 5.280; NSE = 0.448) as compared to the non-linear models (RMSE range = 0.022–0.707; %Bias range = −0.207–−6.088; NSE range = 0.013–0.149). Our findings also suggest that all the models are performing better during the growing season (RMSE range = 0.024–0.025; %Bias range = −4.982–−3.431; r = 0.245–0.281) than the non−growing season (RMSE range = 0.011–0.12; %Bias range = 33.073–32.701; r = 0.161–0.244) for SMD estimation