Knowledge, attitude and practice of antenatal care among pregnant women attending antenatal clinic in a tertiary care hospital of Mathura, Uttar Pradesh, India

Background: The objective of this study was to assess the knowledge, attitude and practice of antenatal care among pregnant women attending antenatal clinic in a tertiary care hospital and also to identify factors that are associated with non-usage of antenatal care.Methods: The study was conducted on 150 pregnant women attending antenatal clinic in department of obstetrics and gynecology of K. D. Medical College and associated hospital of Mathura from September 2019 to December 2019. After obtaining consent, randomly selected pregnant women were given a pre-designed, structured questionnaire on socio-demographic variables, knowledge, attitude and practice towards antenatal care.Results: In the present study, out of 150 respondents, 62.7% had knowledge and awareness regarding antenatal care. There was inadequate knowledge about frequency of antenatal visits with 59.3% subjects wanting to deliver in the hospital.Conclusions: To improve effective utilization of ANC services, we need to bring behaviour changes, improve communication and quality of service delivery, along with effective monitoring and evaluation. Awareness should be developed in the community about the importance of registration for ANC, educating women about the detection of complications during pregnancy, importance of TT injection, IFA tablets and extra nutrition

Study of knowledge and contraception practices in low socio-economic women of Delhi

Background: Objective of current study was to assess the knowledge and practice of contraception among the low socio-economic women of reproductive age group in Delhi.Methods: A cross-sectional study was done on 272 low socio-economic women attending a family planning clinic at a Delhi municipal corporation hospital, of which 106 came for Medical Termination of Pregnancy (MTP) and 166 came for family planning advice. They were interrogated through a pre-designed structured questionnaire, to evaluate their knowledge and practices towards regular contraceptive methods, Emergency Contraception (EC) and medical abortion. They were counselled about the available contraceptive methods and allowed to make choices according to their suitability.Results: All women belonged to low socio-economic group according to the modified Kuppuswamy scale. 22.1% were illiterate. 47.8% were ignorant of contraception. 38.3% women were aware of EC. Only 24.2% knew about medical abortion. The main reasons cited for not using contraception was desire for male child (24.6%), fear of side effects (20%), desire for another child (20%), opposition from family members (15.4%), inaccessibility (4.6%) and inconvenience and lack of privacy (5.4%).  Conclusions: This study highlights that lack of education, knowledge and awareness led to inadequate usage of regular methods of contraception in reproductive age group women belonging to low socio-economic status. Thus only availability is not sufficient to reach optimum female health. Accessibility need to be increased by educating females and motivating couples to make adequate use of existing family planning methods and resources. In contrast the awareness for emergency contraception is more than regular methods. It mandates need to educate women that emergency contraception should not replace regular methods.

Spectropolarimetric study of 4U 1630−-47 in Steep Power law state with IXPE and NICER

We probe the spectropolarimetric properties of the black-hole binary source 4U 1630$-$47 in the steep power law state. We detect a significant polarization fraction of $\sim$7 % at a polarization angle of $\sim$21 $^\circ$. The $2-12$ keV NICER spectrum can be fitted with a combination of a thermal and a Comptonization component, the latter characterized by a spectral index, $\Gamma \sim$2.1, along with a reflection feature at $\sim$7.0 keV. In the $2-8$ keV band, the degree of polarization of 4U 1630$-$47 in the steep power law state is 4.4 $\sigma$ different from the value previously measured in the high soft state. In the steep power law state, the polarization fraction increases as a function of energy but exhibits an overall drop in each energy band compared to that of the high soft state. We propose that the decrease in the polarization fraction in the steep power law state could be attributed to the presence of a corona. The observed polarization properties in both states can be explained by the self-irradiation of the disk around a Kerr black hole, likely influenced by the frame-dragging effect.Comment: 6 pages, 7 figures, 3 tables, accepted for publication in MNRA

Unveiling the X-ray polarimetric properties of LMC X-3 with IXPE, NICER, and Swift/XRT

The incoming Imaging X-ray Polarimetry Explorer (IXPE) observations of X-ray binaries provide a new tool to investigate the underlying accretion geometry. Here we report the first measurements of X-ray polarization of the extra-galactic black-hole X-ray binary LMC X$-$3. We find a polarization fraction of $\sim$ 3 % at a polarization angle of $\sim 135^\circ$ in the $2-8$ keV energy band with statistical significance at the 7$\sigma$ level. This polarization measurement significantly exceeds the minimum detectable polarization threshold of 1.2 % for the source, ascertained at a 99 % confidence level within the $2-8$ keV energy band. The simultaneous spectro-polarimetric fitting of NICER, Swift/XRT, and IXPE revealed the presence of a disc with a temperature of 1 keV and a Comptonized component with a power-law index of 2.4, confirming the soft nature of the source. The polarization degree increases with energy from $\sim$3 % in the $2-5$ keV band to $\sim$8 % in the $5-8$ keV band, while the polarization angle is energy independent. The observed energy dependence and the sudden jump of polarization fraction at $\sim$ 5 keV supports the idea of a static slab coronal geometry for the comptonizing medium of LMC X$-$3. We further observed no change in the polarization properties with time over the period of the IXPE observations.Comment: 6 pages, 5 figures, 3 tables, submitted to MNRA

Flux-resolved spectro-polarimetric evolution of the X-ray pulsar Her X-1 using IXPE

We conduct a spectro-polarimetric study of the accreting X-ray pulsar Hercules X-1 using observations with the Imaging X-ray Polarimetry Explorer (IXPE). IXPE monitored the source in three different Epochs, sampling two Main-on and one Short-on state of the well-known super-orbital period of the source. We find that the 2-7 keV polarization fraction increases significantly from ~ 7-9 % in the Main-on state to ~ 15-19 % in the Short-on state, while the polarization angle remains more or less constant or changes slightly, ~ 47-59 degrees, in all three Epochs. The polarization degree and polarization angle are consistent with being energy-independent for all three Epochs. We propose that in the Short-on state, when the neutron star is partially blocked by the disk warp, the increase in the polarization fraction can be explained as a result of the preferential obstruction of one of the magnetic poles of the neutron star.Comment: 7 pages, 4 Figures, 1 Table, accepted for publication in ApJ

Local Anesthetic Systemic Toxicity

Local anesthetics are used very often in medicine and dentistry. They have few adverse effects, but the increased use of these drugs has resulted in a higher incidence of local and systemic anesthetic toxicity (LAST). From the initial symptoms to the deleterious effects on cardiac and the central nervous system, LAST is an important consequence of which we should be aware. LAST is known since the introduction and use of local anesthetics; it was originally associated with seizures and respiratory failure. However, in the 1970s, side effects on the heart were also identified, as the fatal cardiac toxicity associated with bupivacaine was discovered in healthy patients. Prevention and safe administration of regional anesthesia remains primary factors in the avoidance of the toxicity of these drugs. When a patient has LAST, treatment should be started immediately to reduce seizures. If there is cardiac arrest, follow ACLS guidelines. Intravenous lipids improve cardiac conduction, contractility and coronary perfusion by removing liposoluble local anesthetic from cardiac tissue

Coarse race data conceals disparities in clinical risk score performance

Healthcare data in the United States often records only a patient's coarse race group: for example, both Indian and Chinese patients are typically coded as ``Asian.'' It is unknown, however, whether this coarse coding conceals meaningful disparities in the performance of clinical risk scores across granular race groups. Here we show that it does. Using data from 418K emergency department visits, we assess clinical risk score performance disparities across granular race groups for three outcomes, five risk scores, and four performance metrics. Across outcomes and metrics, we show that there are significant granular disparities in performance within coarse race categories. In fact, variation in performance metrics within coarse groups often exceeds the variation between coarse groups. We explore why these disparities arise, finding that outcome rates, feature distributions, and the relationships between features and outcomes all vary significantly across granular race categories. Our results suggest that healthcare providers, hospital systems, and machine learning researchers should strive to collect, release, and use granular race data in place of coarse race data, and that existing analyses may significantly underestimate racial disparities in performance.Comment: The first two authors contributed equally. Under revie

Program Actions as Actual Causes: A Building Block for Accountability

Abstract-Protocols for tasks such as authentication, electronic voting, and secure multiparty computation ensure desirable security properties if agents follow their prescribed programs. However, if some agents deviate from their prescribed programs and a security property is violated, it is important to hold agents accountable by determining which deviations actually caused the violation. Motivated by these applications, we initiate a formal study of program actions as actual causes. Specifically, we define in an interacting program model what it means for a set of program actions to be an actual cause of a violation. We present a sound technique for establishing program actions as actual causes. We demonstrate the value of this formalism in two ways. First, we prove that violations of a specific class of safety properties always have an actual cause. Thus, our definition applies to relevant security properties. Second, we provide a cause analysis of a representative protocol designed to address weaknesses in the current public key certification infrastructure