Trends in caesarean section rates in a rural block of southern India

Background: Over the last decade many programmes have been implemented to improve the health of pregnant women and neonates. This study aims to look at the changes in modes of delivery and perinatal mortality rates in a rural block of Tamil Nadu between 2006 and 2015.Methods: Data on all the births that have occurred in this rural block of Tamil Nadu that has been prospectively collected between 2006 and 2015 was analysed. A longitudinal analysis was done to calculate the primary and overall caesarean section rate and the average annual rate of increase. The perinatal mortality rate was also calculated.Results: The primary LSCS rate has increased from 9.08% in 2005 to 16.1% in 2015. The overall caesarean section rate has increased from 11.7% to 19.2% in the same time with an average annual rate of increase of 5.1%. During this period the perinatal mortality has decreased from 33 per 1000 live births to 17 per 1000 live births.Conclusions: Though the overall caesarean section rate is higher than the 15% prescribed by WHO the rates are lower than the rest of the country and rural Tamil Nadu

Maternal and fetal outcome in pre-eclampsia in a secondary care hospital in South India

Background: Hypertensive disorders in pregnancy are one of the common causes for perinatal and maternal morbidity and mortality in developing countries. Pre-eclampsia is a condition which typically occurs after 20 weeks of gestation and has high blood pressure as the main contributing factor. The aim was to study the effects of pre-eclampsia on the mother and the fetus in rural South Indian population. Materials and Methods: This was a descriptive study conducted in a secondary level hospital in rural South India. A total of 1900 antenatal women were screened for pre-eclampsia during the period August 2010 to July 2011 to study the effects on the mother and fetus. Results: Of the 1900 women screened 93 were detected with pre-eclampsia in the study. Among these, 46.23% were primigravida, 30.1% belonged to socio-economic class 4 and 48.8% were among those with BMI 26-30. The incidence of severe pre-eclampsia was higher in the unregistered women. The most common maternal complication was antepartum hemorrhage (13.9%) and the most common neonatal complication was prematurity (23.65%). Conclusions: Treating anemia and improving socioeconomic status will improve maternal and neonatal outcome in pre-eclampsia. Antenatal care and educating women on significance of symptoms will markedly improve perinatal morbidity and mortality. Prematurity, growth restriction and low birth weight are neonatal complications to be anticipated and dealt with when the mother has pre-eclampsia. A good neonatal intensive care unit will help improve neonatal outcomes

Quality of life of a patient with type 2 diabetes: A cross-sectional study in Rural South India

Background: With a high prevalence of diabetes in India, there is a need to study the impact of this disease on the quality of life (QoL) of the patients. Materials and Methods: This facility-based cross-sectional study assessed the QoL of patients attending the diabetic clinic using the World Health Organization (WHO) QoL BREF instrument in Tamil Nadu. The QoL was analyzed domain-wise and various socio-demographic factors affecting the QoL were studied. Results: The mean total score of the QoL scale was 58.05 (95% CI, 22.18-93.88). Domain-wise, 63% had good physical, 69% had good psychological, 27% had good social and 85% had good environmental QoL scores. Males, currently married and those with BMI more than 25 had a statistically significantly better QoL compared to their counterparts. Conclusions: Diabetes does impair the QoL of patients but not to a great extent. There is a need to specifically target and improve the QoL of women, widowed and separated, and non-obese diabetics who are at risk of a poor QoL. QoL assessment should be routinely practiced in diabetic clinics

Diet and physical activity among women in urban and rural areas in south India: A community based comparative survey

Introduction: Noncommunicable diseases (NCDs) such as diabetes, hypertension, and heart diseases are increasing in India. There is a clear need to study risk factors for NCDs in various population groups in the country. Materials and Methods: This community based cross-sectional survey was conducted to study the diet and physical activity of women in urban and rural areas in Vellore district. Dietary data was collected using 24-h dietary recall and physical activity was collected using the International Physical Activity Questionnaire (IPAQ). Sociodemographic variables were collected to assess the risk factors for unfavorable diet and physical activity. Results: The odds of the rural women engaging in high physical activity are 3.61 times greater than urban women (95% confidence interval (CI) = 2.36-5.54). The odds of the urban women consuming a high calorie diet are 1.923 times that of the rural women (95% CI = 1.282-2.857). The odds of the urban women being overweight/obese are 5.555 times than that of the urban women (95% CI = 3.333-10). Women who were housewives and not doing household work were significantly less physically active, took higher calorie diet, and were more overweight and obese compared to women who were involved in active household work. Conclusions: Urban women had unfavorable diet and physical activity levels compared to rural women. They also had higher levels of overweight and obesity. There is a need for targeted NCD prevention interventions among urban women

Whole-genome characterization of common rotavirus strains circulating in Vellore, India from 2002 to 2017: emergence of non-classical genomic constellations

Abstract Rotaviruses (RVs) are the most common etiological agent of acute gastroenteritis among young children, even after vaccine introduction in low-income countries. A whole-genome classification representing the 11 RV genes, was introduced for surveillance and characterization of RVs. This study characterized the common circulating strains in Vellore, India from 2002 to 2017 to understand rotavirus strain diversity and evolution using Whole genome sequencing (WGS) carried out on Illumina MiSeq. The 89% (92% of Wa-like, 86% of DS-1-like) of strains had classical constellations, while reassortant constellations were seen in 11% (8% of Wa-like, 14% of DS-1-like) of the strains. The rare E6-NSP4 in combination with DS-1 like G1P[8] and the emergence of the OP-354 subtype of P[8] were identified. Phylogenetics of RV strains revealed multiple subtypes circulating in the past 15 years, with strong evidence of animal to human gene transmission among several strains