Frequency of early initiation of breastfeeding among women in Thatta, Sindh and factors associated with it: A secondary data analysis

Introduction: It is recommended by the World Health Organization to initiate breastfeeding within first hour of birth. In recent time, many efforts are being taken by international and national stakeholders to promote mothers to initiate early breastfeeding. However, only 42% of newborns in South Asia and 45% of newborns in world are put to breastfeeding within first hour of birth. The aim of this study was to determine the prevalence of early initiation of breastfeeding and factors associated with it in rural areas of Sindh, Pakistan. Methodology: The data for this study were extracted from the survey related to Exclusive breastfeeding among women in Thatta, 2019. Survey was implemented in areas of Thatta registered in Maternal and Neonatal Health Registry (MNHR). MNHR is a population-based study for low- and middle-income countries (LMICs) to assess pregnancy related outcomes. About 397 women with complete information on timing of initiation of breastfeeding were used in the analysis. Results: The early initiation of breastfeeding to their newborn baby i.e. within first hour of the birth, were found in 20.4% of mothers. Factors associated with early initiation of breastfeeding include adequate knowledge (AOR=3.63, 95% CI= 1.99-6.59), place of delivery AOR=2.66  (95% CI=1.51-4.67), gestational age of baby (AOR= 1.89, 95% CI=1.10-3.24) and Age of mother (AOR=1.07, 95% CI=1.02-1.13). Conclusion: Providing counselling and health education for mother before, during and after the pregnancy are important to motivate mothers to initiate breastfeeding early and continue exclusive breastfeeding for recommended period i.e. 6 months

Charlson Comorbidity Index predicts postoperative complications in surgically treated hip fracture patients in a tertiary care hospital: Retrospective cohort of 1045 patients

Introduction: Hip fractures are of major concern due to the aging population worldwide. Surgery on this vulnerable population carries high risk. Charlson comorbidity index (CCI), has been reported to predict the mortality in these patients. Investigators in this study aimed at studying the prediction effect of CCI on hip fracture surgery complications after controlling other patents\u27 and procedures\u27 related factors.Methodology: We conducted a retrospective cohort of 1045 patients with hip fractures who were treated surgically at our tertiary care and level 1 trauma Centre between 2010 to 2018. Primary exposure was CCI and primary outcome was in-hospital and 30 days postoperative complications (major and minor). Cox proportional algorithm analysis was done at univariate and multivariable levels to report Crude Relative Risk (RR) and Adjusted Relative Risk (aRR), respectively. Results were reported in line with STROBE criteria.Results: Exposed group included 867 (83%) of patients with 340 (39%) males. Postoperative complications occurred in 449 (43%) of the patients in exposed group with (62) 6% patients admitted in ICU postoperatively. At multivariable model, CCI was significantly associated with postoperative complications; patients with moderate-severe systemic diseases were 1.45 times (95% CI: 1.05-1.99) at risk of developing postoperative complications as compared to patients with low CCI scores after controlling for other variables in the model. Other significant factors included ASA status and postoperative ICU admission.Conclusion: CCI can be a good predictor independent variable of postoperative complications after hip fracture surgery. These patients need extra care and counseling to reach an informed decision keeping in mind the benefits versus risks of surgery. We recommend multi-center studies for corroboration