Essays on development: education and intra-household dynamics

This thesis empirically investigates three questions of key importance to policy making in developing countries such as India. The first chapter documents the effect of preschools on cognitive skills in rural India. Using a lagged score value added model, the analysis finds that children who attend preschool before starting primary school have a significant premium in cognitive test scores as compared to children who attend primary school without any preschool exposure. On further investigation into the management type of the preschool, I find that this result is driven by those who attended private preschool. The second chapter studies the intra-household decision-making process in extended households in rural Uttar Pradesh, India. Using a series of public goods games played between pairs of adult household members, the study finds that spouses residing in extended households are less efficient than those in nuclear households. Moreover, the study finds that relationships within extended households are not equally efficient, with the relationship between daughter-in-law and mother-law particularly inefficient. Supplementary evidence suggests inefficiencies arise from fragmented decision-making power, and limited ability of young married women to assert their preferences in extended households. The final chapter studies the impact of a two-month long female adult literacy programme on a range of female empowerment measures. Set up as a randomized control trial, the programme increases the treated woman’s freedom of movement, such as, going to the shops or calling her natal family without requiring permission. Additionally, the treated woman is more likely to open a personal bank account. An investigation into spillovers reveals that the program has a positive externality on the control woman’s freedom of movement as well. This suggests that while the freedom of movement effects might be a result of increased confidence and a ‘role model’ effect, opening a bank account might be linked directly to becoming literate

Hysteroscopic evaluation in infertile patients: a prospective study

Background: Hysteroscopy is the gold standard procedure for uterine cavity exploration. However, hysteroscopy is only recommended by the WHO when clinical or complementary exams (ultrasound, HSG) suggest intrauterine abnormality or after in vitro fertilization failure. Nevertheless, many specialists feel that hysteroscopy is a more accurate tool. The aim of this prospective study is to assess the value of diagnostic hysteroscopy in a primary workup of infertility by describing hysteroscopy findings in a population of 324 infertile patients during 18 months (December 2010 - May 2012).Methods: We analysed prospectively 324 infertile patients in gynaecology OT setting. Diagnostic video-assisted hysteroscopy was performed using a flexible hysteroscope. Hysteroscopy was performed with a standard sequence, inspecting the endocervical canal, uterine cavity, endometrium, and tubal ostia and findings recorded.Results: Hysteroscopy was normal in 65.12% of patients. Cervico-isthmic abnormalities were present in 6.48% of patients with cervical stenosis being the major abnormality. Uterine cavity was normal in 86% of patients. Observed abnormalities were septate uterus in 10 cases, intrauterine synechiae in 16 cases, sub mucus myoma in 2 cases, deformed cavity in 10 cases and endometrial polyp in 2 cases. Ostial fibrosis was observed in 29 patients. Endometrial abnormalities (fibrosis, inflammation) were observed in 30 patients. Seven patients turned out to be of genital tuberculosis with endometrial biopsy. No significance was found regarding the total number of intrauterine pathologies when comparing the groups of primary versus secondary infertility.Conclusions: Rates of abnormal findings in infertile patient who underwent diagnostic hysteroscopy was 34.88% in our study. Our data are an additional argument to suggest hysteroscopy as part of investigation in infertile woman. Routine diagnostic hysteroscopy should be part of an infertility workup in primary and secondary infertility

Screening and Brief Intervention in Substance Use Disorders: Its Clinical Utility and Feasibility Update from Available Literatures

It is found that substance use and related complications extend from occasional mild risky/harmful/hazardous use to severe conditions. The screening instruments may help to identify them in the initial state. The brief intervention (BI) is to bring change in unhealthy or risky substance use. The intervention is carried out by a vast array of trained professionals in various settings and it is valid across substances, age and ethno-culture groups. It has six common elements summarized by the acronym FRAMES (Feedback, Responsibility, Advise, Menu for change, Empathy and enhancing Self-efficacy). The BI has shown significant evidence of efficacy reducing substances and their harmful consequences with improving functionality and quality of life

Development of Tropical Fruit Bars and Assessment of its Shelf Life

Five tropical fruits are chosen to make fruit bars on three important aspects namely high nutritive value, easy availability and cost effective. These different fruit bars prepared from a new process with better textural and sensory properties are assessed for storage stability with three different packaging materials. The bars are subjected to accelerated shelf life study by varying temperature and relative humidity. Changes in the soluble solid content, pH, titrable acidity and microbiological attributes are monitored. Minimally processed fruit bars are microbial sensitive entities. The data given provide an useful tool for describing microbial spoilage and seems expandable to specific microorganisms. Microbial growth is affected by pH, storage temperature or relative humidity. The sugar content did not change during the first weeks of storage but significant small declines are observed after prolonged storage. The proliferation of mesophilic bacteria, which are dominant in the product will explain these slight depletions

Study of the clinical spectrum of AUB (FIGO AUB Systems) and women’s attitude towards its management at Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India

Background: AUB has significant impact on quality of life of women related to health specially in developing countries including India. FIGO AUB systems are universally accepted. Aim was to study the clinical spectrum of AUB according to the FIGO AUB systems and women’s attitude towards its management.Methods: Cross sectional prospective study was carried out in the department of Obstetrics and Gynaecology, ANMMCH, Gaya, a tertiary care center, among women of 15-55 years age groups having complain related to abnormal uterine bleeding, for 1 year from 1st May 2019 to 30th April 2020 on 1000 patients. Data was collected and analyzed by percentage and proportions.Results: Prevalence of AUB was maximum among 15-30 years age group of patients (46.80%). Most of the patients belong to lower (62.5%) class, rural area (68%) and were anaemic (62.5%). Ovulatory dysfunction (55%) was most common cause for AUB, maximum patients choose surgical management (hysterectomy) but after counselling, most of them shifted to medical management.Conclusions: This study suggests more conservative approach for management of AUB and emphasizes the importance of awareness for clinical spectrum of AUB among women so that they can be self-motivated for early treatment and unnecessary hysterectomy can be avoided

In vitro study of some plant extracts against Alternaria brassicae and Alternaria brassicicola

Madhya Pradesh is an important rapeseed-mustard producing state of India contributing nearly of the total production in the country. The present study aims to evaluate the effectiveness of some botanicals viz., Neem, Eucalyptus, Datura, Pudina, Tulsi, Lantana under crude and Forms @ against 10% Alternaria brassicae under in vitro condition by poisoned food technique. Neem and Eucalyptus were also evaluated in the oil forms.  Nearly all the tested botanicals found effective against these fungi. Among the crude extract 10 per cent the minimum growth was recorded in Neem followed by Eucalyptus, Tulsi, Lantana, Datura and Pudina. Neem was significantly superior over Tulsi, Lantana, Datura and Pudina but at par with Eucalyptus. Under boil forms the minimum radial growth was also recorded in Neem. The oil extract (Neem and Eucalyptus) were found less effective as compared to crude and boil extracts

Comparative study of (0.5%) levobupivacaine and (0.75%) ropivacaine in supraclavicular brachial plexus block by lateral approach

Background: As compared to general anaesthesia, brachial plexus block for upper limb surgery gives fewer side effects and better postoperative analgesia. The objective of this study was to evaluate the effects of 0.5% levobupivacaine and compare it with 0.75% ropivacaine.Methods: For this prospective randomized, controlled study, 60 patients of both sexes of ASA grade 1 and 2 were enrolled and divided into two groups and supraclavicular brachial plexus block was performed by lateral approach using 30 ml of 0.5% levobupivacaine and 0.75% ropivacaine. The onset of sensory and motor block, duration of sensory and motor block and analgesia and possible adverse events were recorded.Results: No statistically significant difference was observed in the onset of sensory block in both groups. Onset of motor block was significantly faster in levobupivacaine group (P<0.05). Duration of sensory block, motor block and analgesia was significantly longer in levobupivacaine group (P<0.05).Conclusions: 0.5% levobupivacaine is better alternative to 0.75% ropivacaine in brachial plexus block in term of early onset of sensory block and long duration of analgesia