Knowledge and attitude of menstruation hygiene, contraception and sexual transmitted disease among school girls of Lunawada, Mahisagar, Gujarat, India

Background: Around ¾th of adolescent girls have experiencing menstrual dysfunction and it disturbs the routine daily workout4. UNICEF reported that total number of adolescent girls in India is 243 million which cover almost 20% of the Indian population. The objectives of the current study were to observe the knowledge and attitude regarding menstruation, contraception and sexually transmitted diseases among secondary and higher secondary school girls.Methods: A cross-sectional study was conducted in the city of Vadodara during August 2016 to September 2016. The study included girls high school of standard 8th to 12th of Vadodara city. Around 310 adolescent students of standard 8th, 9th, 10th, 11th, and 12th. From each standard, 62 girls were selected by simple random technique with the help of their attendance register.  Results: Around 71.4% participants believed that menstruation is natural process and 22.7% believed as abnormal process. Around 62.6% of participants believed for reason of menstruation is “Female becomes capable of child bearing”. Almost 9.0% participants did not know about organ of reproduction and 18.4% did not know about the physical changes during puberty. only 14.5% participants believed that coitus is the culprit of STD transmission. Teacher and mother were the main source of information for participants regarding STD. Almost 55.4% participants were aware about condom as contraceptive method followed by oral pills and permanent sterilization.Conclusions: Menstrual hygiene and prevention of STD diseases should be considered important issue at all the levels of health care system, where number of factor influence in the awareness and practice in rural area. Education regarding reproductive health should be included in the curriculum in all schools

Can perineal tear be predicted by severity of striae gravidarum score?

Background: The objective of this study was to wether perineal tear predicted by scoring of severity of striae gravidarum. The objective of this study was to predict perineal tear by simple non-invasive method and help to prevent maternal morbidity.Methods: Three hundred ninety four patients delivered normally were included in this study. Striae gravidarum score was assessed using the Atwal numerical scoring system. The association was examined between striae and perineal tear as the outcome measure, defined by tears or laceration, and the total striae scores (TSS) was obtained.Results: In present study population mean age was 25.16 years ranging from 16-40 , mean gravidity was 2.16 ranging from 1 -8 ,average baby birth weight was 2.713 kg ranging from  1.62-4.58 The only predictors of perineal tears that were found to be statistically significant in our study were severity of striae gravidarum and episiotomy given or not. In patients with moderate to severe striae there was tear in 90 patients as compared to 29 patients with no or mild striae. 224 patients belonging to no or mild striae group delivered without any perineal tear whereas 51 patients in moderate to severe striae group delivered without tear. Out of these 51 patients 5 were given episiotomy. 2 patients who were given episiotomy had perineal tear as compared to 117 patients who were not given episiotomy. This shows that patients who had an episiotomy were less likely to have perineal tear in most cases.Conclusions: This study demonstrates a significant relation between severity of striae gravidarum and perineal tear. The findings suggest that striae gravidarum assessment may be used in the clinical setting even by paramedical staff as a simple and noninvasive tool to better define women at risk for perineal tear

MANAGING SLEEP DISORDERS IN THE ELDERLY WITH AYURVEDA

Sleep is a basic human need, important for good health & therefore considered as one of the Trividh upastambhas. Sleep is a natural phenomenon of giving adequate rest to the body and mind. Sleep disturbances increase with aging and it is estimated that nearly 67% of the elderly people have at least one sleep-related complaint. Various sleep disorders identified in elderly people include long time to fall asleep, disturbed sleep at night (Khandit nidra) and insomnia (Anidra). An improper diet and lifestyle causes aggravation of Vata that travels through the channels of the head causing sleeplessness. Suppressed emotions, disturbed sleeping patterns, worries, anger, overexcitement and ill health may be other responsible factors for sleep disorders. Abhyanga & Sanvahan (massage), Udsadan, Udvartan (Rubbing medicated paste & powder), Snana (bath), Karnapuran & Akshitarpan, Shirobhyanga & Padabhyanga, Shirodhara, Takra dhara etc are desirable for best results in management of sleep disorders. Yoga with a combination of Asanas specifically Shavasana, Pranayam, and meditation (Dhyan) along with proper, balanced diet & lifestyle giving due respect to the biological clock proves beneficial. Yoga is considered to be a means for physical, mental and spiritual growth of an entity. So, it is found that the complete package of palliative, Panchakarma treatment, Yoga-pranayama provides good results in elderly sleep disorders

Lactic dehydrogenase as a biochemical marker of adverse pregnancy outcome in severe pre-eclampsia, Gujarat

Background: Serum LDH levels can be used to assess the extent of cellular death and thereby the severity of disease in this group of women. This will help in making decision, about the management guidelines to the better the maternal and fetal outcome. Objective of present study was compare serum LDH levels in the normal pregnant women and in women with preeclampsia and eclampsia in ante-partum period and to study the association of maternal and perinatal outcomes with serum LDH levels.Methods: It is a prospective study done at Obstetrics and Gynecology department, GMERS medical college and civil hospital, Gandhinagar during August-September 2016. Participants were divided into four groups according to severity of disease and into three groups according to serum LDH level.Results: Mean level of LDH (IU/l) in Control, Mild pre-eclampsia, Severe pre-eclampsia & Eclampsia was 302.33, 398.56, 675.26 & 1589.85 respectively. Out of total 34 cases with LDH level >800 IU/L, 47.1% cases had ≥160 mm hg SBP & 52.9% had ≥110 mm hg DBP, mean gestational age and mean baby weight was 36.88 week and 1950 gm, mean apgar score at 10 min was 6.96, 47.1% had uneventful outcome, whereas 58.8% had neonatal complications and 5.9% had neonatal death. Almost 26.5% still births, 47.1% perinatal deaths.Conclusions: Higher serum LDH levels during pregnancy have significant association with severity of disease and maternal and fetal outcomes in patients of preeclampsia and eclampsia and can be considered as a supportive prognostic tool from early third trimester

Deep phenotyping and genomic data from a nationally representative study on dementia in India

The Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD) is a nationally representative in-depth study of cognitive aging and dementia. We present a publicly available dataset of harmonized cognitive measures of 4,096 adults 60 years of age and older in India, collected across 18 states and union territories. Blood samples were obtained to carry out whole blood and serum-based assays. Results are included in a venous blood specimen datafile that can be linked to the Harmonized LASI-DAD dataset. A global screening array of 960 LASI-DAD respondents is also publicly available for download, in addition to neuroimaging data on 137 LASI-DAD participants. Altogether, these datasets provide comprehensive information on older adults in India that allow researchers to further understand risk factors associated with cognitive impairment and dementia.Peer reviewe

Estimating global injuries morbidity and mortality : methods and data used in the Global Burden of Disease 2017 study

Background: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results: GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions: GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Estimating global injuries morbidity and mortality : methods and data used in the Global Burden of Disease 2017 study

Background While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.Peer reviewe