A study on evaluation of ASHAs for their knowledge, attitude and practice towards newborn care in Howrah district of West Bengal

Background: : Accredited Social Health Activist (ASHA) is a trained female community health activist. ASHAs are local women trained to act as facilitator and promoters of health care in their communities. ASHA is trained to work as an interface between the community and the public health system. ASHA play an important role in newborn care to reduce their morbidity and mortality.Methods: Data were collected from ASHAs working in Shibbur area of Howrah District, west Bengal. The study sample consisted of 70 ASHAs working in the Shibpur area that fulfilled the inclusion criteria. A predesigned pretested questionnaire of ASHA was used to collect data in the study.Results: The mean age of ASHAs was 35.74 years. Only 32 (45.71%) had received middle level (class VIII) education. Only 45.71 % of ASHAs had good knowledge and practice regarding hypothermia and its complication and the procedure of providing warmth the baby after delivery. Only 57.1% of ASHA had good knowledge regarding counseling and problem solving on breast feeding. Only 38.57% had good knowledge and practices on identification and basic skill on management of Low Birth Weight (LBW) having birth weight of <2.5kg and pre-term baby (<37 weeks of gestation).Conclusions: In the present study, we found that Knowledge, Attitude and Practice of ASHAs were inadequate in some aspects of newborn care. This gap of knowledge should be taken seriously during training procedures so that effective knowledge and essential skill for newborn care can be imparted. During recruitment of ASHAs higher literally status should be given preferences

Clinical profile of children with metabolic liver diseases presenting in a tertiary care hospital of Eastern India

Background: Metabolic liver diseases (MLDs) in children can present with a wide range of clinical features. Aims and Objectives: This study aims to increase the high index of suspicion among physicians and awareness among caregivers regarding early diagnosis of MLD. Materials and Methods: This hospital-based prospective observational study has been conducted in the Paediatric Outpatient Department and Inpatient Department of RG Kar Medical College, Kolkata, over 2 years from 2021 to 2023. A total of 47 children aged up to 12 years were diagnosed as various MLDs who fulfilled inclusion and exclusion criteria were included in the study. Template was generated and analysis was done on SPSS software. Results: The study sample was 47 children with MLDs. Mean age was 4.21±3.81 years. Males: female ratio was approximately 2.35:1. History of consanguinity among parents was present in 23.40% cases which affirmed the autosomal recessive mode of inheritance in most of the MLD. History of sibling deaths was there in 10 cases. The most common symptom was yellowish discoloration 21 (44.68%) followed by abdominal distension 12 (25.53%). There were diverse modes of presentations. The most common presentations were hepatomegaly 47 (100%) and splenomegaly 30 (63.83%). Of 47 MLDs, Wilson disease cases were maximum (27.66%) followed by glycogen storage disease (23.40%). Conclusion: High index of suspicion should be prevalent among physicians for early diagnosis of cases to reduce disease mortality and morbidity

A study on birth preparedness and complication readiness in the field practice area of RHTC of a tertiary care establishment in Central India

Background: Every pregnant woman faces the risk of sudden, unpredictable complications that could end in death or injury to herself or to her infant. Birth preparedness and complication readiness is a strategy that encourages pregnant women, their families, and communities to effectively plan for births and deal with emergencies, if they occur. Objectives were to study the Knowledge of Birth Preparedness &amp; Complication Readiness among the study subjects in the field practice area of RHTC of a tertiary care establishment in Central India. Methods: This cross-sectional study was carried out from January 2016 to June 2017 in the field practice area of RHTC of a tertiary care establishment in Central India. In the study d 420 women were included as per criteria. Data was recorded in the predesigned and pre tested proforma and were analysed by using SPSS V.20 software. Results: Out of the total 420 mothers, 75% belonged to the age group 20-25 years. Maximum study subjects (33.1%) belonged to General Category while 23.1% of mothers were Schedule Caste. Maximum mothers (70%) were homemakers, the rest were occupied in various capacities. The BPCR index overall was 49.86, with 85% institutional deliveries; ANC visits initiation at 68%. General awareness shows certain gaps which needs attention of health care workers. Conclusions: Lack of awareness about possible complications during the time of pregnancy, that of time of delivery or post-natal period was observed while interviewing the mothers

Comparative study on ultrasonic placental grading among normotensive pregnancy and pregnancy-induced hypertension and its correlation with fetal outcome

Background: Placenta is essential for the fetal well-being, growth, and development which can be evidenced as early as possible through ultrasound at 6 weeks of gestation. The placenta mediates the intrauterine interaction between a mother and her baby. Aims and Objectives: This study aims to compare the pattern of placental grading among normotensive and pre-eclampsia mothers in a tertiary care hospital. Materials and Methods: This hospital-based observational analytical study has been conducted in the labor ward and outpatient department of the Department of Obstetrics and Gynaecology, Bankura Sammilani Medical College and Hospital from April 2021 to September 2022. A total of 69 pre-eclampsia mothers (study group) and 69 normotensive mothers (control group) who fulfill inclusion and exclusion criteria were included in the study. Template was generated and analysis was done on Statistical Package for the Social Sciences software. Results: A total of 138 pregnant women with 69 pregnant normotensive and 69 pregnant preeclampsia mothers were included in the study. The mean age of the study participants was 21.3 years (standard deviation=3.6). About 81.2% and 89.9% of the normotensive and hypertensive mothers, respectively, resided in rural areas. Cesarean/instrumental delivery was higher among the hypertensive pregnant women (42.0%) when compared to normotensive pregnant women (27.5%) and it was found to be statistically significant. Birth asphyxia was observed to be higher among the neonates in the hypertensive group (15.9%) when compared to the normotensive group (4.3%) and it was found to be statistically significant. Neonatal intensive care unit admission was more among the neonates of the mother with hypertension and it was found to be statistically significant. There was no significant difference in the birth weight of the newborn with the placental grading among the normotensive pregnant women. Conclusion: Ultrasonographic placental grading could be used as a screening tool for antepartum fetal surveillance in the obstetric population. Placental grading will help us to early diagnosis and to formulate line of management and timely intervention to reduce maternal and perinatal complications

An Observational Study on Neonatal Seizures in a Tertiary Care Hospital

Background: Seizures are the most frequent clinical manifestation of central nervous system dysfunction in the newborn with the incidence varying from 1-5%. Neonatal seizures often signal an underlying ominous neurological condition, most commonly hypoxia-ischemia, and others include stroke, intraventricular hemorrhage or intraparenchymal hemorrhage, meningitis, sepsis, and metabolic disorders. Neonatal seizures can permanently disrupt neuronal development, induce synaptic reorganization, alter plasticity and "prime" the brain to increased damage from seizures later in life. The objective of this study was to observe neonatal seizures in a Tertiary Care Hospital. Methods: This study was a hospital-based, prospective, observational study conducted in the sick new born care unit of department of pediatrics in a tertiary care hospital from March 2017 to February 2018. Out of 2654 admitted neonates, 234 notates having symptom of seizures were included in the study after informed consent from the mother of the neonate. The data like history, clinical examination and investigation findings was recorded in the pre-designed, pre-tested, semi structured questionnaire. Template was generated in MS excel sheet and analysis was done on SPSS software. Results : The incidence of neonatal seizures was higher in male neonates. Subtle types of seizures were the commonest type of seizures. out of 234 neonates, 68 (29.06%) were preterm while 166 (70.94%) were term neonates. Out of 68 term neonates, 26 (38.23%) neonates had subtle seizures, 16 (23.52%) neonates had focal clonic seizures. Out of 166 term neonates, 56 (33.73%) neonates had subtle seizures, 42 (25.30%) neonates had focal clonic seizures. Almost 68 (29.05%) developed seizures within 24 hours, 84 (35.91%) neonates had seizures between 25-48 hours, 54 (23.08%) neonates developed seizures between 2-7 days and 28 (11.96%) neonates developed seizures after 7 days. Common causes of neonatal deaths in our center were severe birth asphyxia, intra-ventricular hemorrhage (IVH), septicemia and meningitis. Conclusions: Neonatal seizures are common and may be the first manifestation of neurological dysfunction after a variety of insults. Most of the causes of neonatal seizures are preventable by good perinatal care and early interventions while metabolic seizures need a sharp vigilance and early suspicion