Validation of Postnatal Care Health Data Reported Under Health Management Information System by the Primary Health Centers of Rural Vadodara, Gujarat

Postnatal care (PNC) is a part of maternal and child health (MCH) and important for the good health of both motherand child. Therefore, the present study was conducted with the aim to study the PNC data reported by primary health center/subcenter (PHC/SC) and validate them at the village level and assess quality of care given. Material and methods: A sampleof 20 PHCs, 13 rural and seven tribal, was selected using stratified random sampling. For every PHC, 2 SCs and for every SC,one village were selected. Data on PNC were collected from the PHC/SC records and validated by interviewing five beneficiariesfrom the village. Results: The district availability of PNC was 31.8%, while the overall accessibility was 52.2%. Adjustedutilization for the district was 74.7% for SBA and 14.7% for TBA. Effective coverage, adjusted for quality of care, for the districtwas 25.2%. Conclusions: The gap between the reported and validated data ranged from 15% to 51% of the reported

Women’s and Providers’ Experiences with Injectable Contraceptives (Depo-Provera): A View from Vadodara, India

Objective: To compare users’ and providers’ perspectives on injectable contraceptives (IC). Methods: This qualitative study employed semi-structured in-depth interview technique. Sixty women with experience of using IC and 10 doctors involved in providing IC were selected. Telephonic interviews of doctors were also conducted. Results: Over 50% of the women had side effects and had discontinued use within 1 year. The most common ‘likes’ according to women included ease of use, being tension free for 3 months and being effective and those of the providers were that it reduced anemia, privacy could be maintained, noncontraceptive benefits, good substitute, not to be taken daily like pills, safe and effective. The most common ‘dislikes’ reported by providers and clients were excessive bleeding, amenorrhea, irregular periods, spotting, weight gain and frequent pregnancy tests. Conclusion: Although certain distinct advantages of IC have been expressed, the associated problems are equally significant and therefore IC should not be an over-the-counter contraceptive

EPIDEMIOLOGY LENSES : A PRESENTATION

The presentation started with his nostalgic memory with Professor NR Mehta, Professor DH Trivedi and Professor AK Niyogi with whom he had the opportunity to work as a student and then as a colleague. He refreshed his memory as warden of Dr. Jivraj Mehta Hall where his predecessors were Prof NR Mehta and Professor DH Trivedi and he remembered to be the first time examiner with Prof. Niyogi who was examiner with him for the last time in his career ....

Impact Of Vitamin - A Supplementation On Diarrhoea among Children 12 - 71 Months Of Age In Baroda Cantonment A Double Blind Randomised Cntrolled Trail

Research question: Does vitamin- A supplementation in children under five of age reduce diarrhoea incidence and its duration? Objectives: To study whether vitamin â€" A supplementation among children of 12-71 months of age reduces the risk and rate of diarrhoea and qualify if it does. Study design: Randomised double â€" blind controlled trail. Settings: Military Hospitals, Baroda Participants: Children of 12- 71 months of age of military staff members of Baroda cantonment Results and conclusions: The study suggested a reduction of risk and rate of diarrhoea in vitamin A supplemented group as compared to the placeup by about 23% and 22% respectively. However, it failed to show any reduction in the duration of an episode

Safety of Nonsteroidal Anti-inflammatory Drugs in Major Gastrointestinal Surgery: A Prospective, Multicenter Cohort Study

Background Significant safety concerns remain surrounding the use of nonsteroidal anti-inflammatory drugs (NSAIDs) following gastrointestinal surgery, leading to wide variation in their use. This study aimed to determine the safety profile of NSAIDs after major gastrointestinal surgery. Methods Consecutive patients undergoing elective or emergency abdominal surgery with a minimum one-night stay during a 3-month study period were eligible for inclusion. The administration of any NSAID within 3 days following surgery was the main independent variable. The primary outcome measure was the 30-day postoperative major complication rate, as defined by the Clavien–Dindo classification (Clavien–Dindo III–V). Propensity matching with multivariable logistic regression was used to produce odds ratios (OR) and 95 % confidence intervals. Results From 9264 patients, 23.9 % (n = 2212) received postoperative NSAIDs. The overall major complication rate was 11.5 % (n = 1067). Following propensity matching and adjustment, use of NSAIDs were not significantly associated with any increase in major complications (OR 0.90, 0.60–1.34, p = 0.560). Conclusions Early use of postoperative NSAIDs was not associated with an increase in major complications following gastrointestinal surgery

Body mass index and complications following major gastrointestinal surgery: a prospective, international cohort study and meta-analysis.

AIM: Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a meta-analysis of all available prospective data. METHODS: This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien-Dindo Grades III-V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. RESULTS: This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery for malignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49-2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46-0.75, P < 0.001) compared to normal weight patients. CONCLUSIONS: In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease

Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study

Background Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. Methods This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. Results Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51–19.97) than planned admissions (OR: 2.32, 95% CI: 1.43–3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8–51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. Conclusions After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies