Awareness regarding abortions and medical termination of pregnancy act among medical students in Puducherry, India

Background: Maternal mortality is an important indicator of women’s health and social well-being. According to the WHO report,each year, an estimated 190 women for every 100,000 live births die due to maternal causes. In India, unsafe abortion and related complications accounts for 9% of all maternal deaths. Abortion was made legal in India by the Medical Termination of Pregnancy (MTP) act, which was enacted by Indian Parliament in the year 1971. But the number of unsafe abortions has not declined.Methods:A present study was conducted by the Department of Obstetrics and Gynaecology of Pondicherry Institute of Medical Sciences, in Puducherry, India. All undergraduate students of VIIth semester MBBS participated in the study. A pre-designed semi-structured questionnaire was used to collect information regarding the awareness and perceptions on abortion care and Medical Termination of Pregnancy Act in India. Data were entered in Microsoft Excel 2007. Averages were calculated and chi square test was applied to find the significant difference.Results: Among a total of 75 participants, 41(54.7%) were female and 34 (45.3%) were male students. Majority of the students (97.3%) were aware of the fact that unsafe abortions are a serious health problem in India and all of the students (100.0%), were aware of the MTP Act of India. But only 36.0% students were aware of the fact, that consent from husband was not required to undergo abortion. To reduce the number of unsafe abortions in India majority of the medical students (45.3%) were of the opinion that easy access to MTP services in the community is an effective measure.Conclusions: Legalization of abortions through the MTP Act in India resulted in a considerable decrease in maternal mortality through the decline in abortions but it has failed to ensure effective implementation and access to medically safe abortion services. Training in basic contraceptive counseling and abortion care should be incorporated in basic medical education in India.

Awareness about PCPNDT act among undergraduate students of a medical college in Puducherry

Background: Sex selective abortions have become a significant social phenomenon in contemporary India. In order to curb sex selective abortions, the Pre-Natal Diagnostic Techniques (PNDT) Act was passed in the year 1994.Methods: A cross-sectional study was conducted by the Department of Obstetrics and Gynecology in Puducherry among 75 medical under-graduate students. A semi-structured, pre-designed questionnaire was used to collect the information on their knowledge, attitude and perception regarding gender discrimination and prenatal sex determination act.Results: Only 34 (45.3%) students were correctly aware of the prevailing sex ratio in India. Most common source of information for awareness was internet (44.1%), followed by newspaper (41.1%), and family/friends (14.7%). Majority (74.7%) of the students were aware of the PCPNDT Act. Awareness about PCPNDT Act among female students (85.4%) was higher as compared to male students (61.8%). Only half of the students (56.0%) correctly reported about the punishment for sex determination and implication of feticide (fine and imprisonment both).Conclusions: Awareness regarding the altered sex ratio and the PCPNDT Act was poor among medical undergraduates. In order to combat the poor awareness regular workshops and continuing medical education sessions (CMEs) should be conducted

WATER PURIFICATION: A BRIEF REVIEW ON TOOLS AND TECHNIQUES USED IN ANALYSIS, MONITORING AND ASSESSMENT OF WATER QUALITY

Drinking water sources are regularly polluted by various human activities that cause severe health problem all over the world. In recent years, water quality research has drawn great attention from scientific communities. A lot number of tools and techniques are used for proper water quality analysis, monitoring and assessment. This paper includes brief information about some of the them namely, physio-chemical water analysis (PCWA), adsorption, metal pollution index (MPI), water quality index (WQI), water quality modelling tools (WQMT) and multivariable statistical models that include five multivariate data mining approaches i.e. cluster analysis (CA), principal component analysis (PCA), factor analysis (FA), multiple linear regression analysis (MLRA), discriminant analysis (DA). Present paper also explores the interaction between science and technologies and provides basic knowledge of emerging tools and techniques used in water purification

Diabetes control, dyslipidemia, hsCRP and mild cognitive impairment in non-elderly people with type 2 diabetes mellitus

Background: Mild Cognitive Impairment (MCI) a transitional stage between normal aging and dementia has been observed more in people with diabetes when compared with general population. The risk factors for MCI in type 2 diabetes mellitus (T2DM) have been defined in elderly patients and aging may itself contribute to declining in cognitive functions. As the large number people with T2DM are under 60years, the prevalence of MCI and factors contributing to it are not much studied. So, this study aimed to find out the factors contributing to MCI in non-elderly T2DM patients.Methods: In this cross-sectional study, 257 patients with T2DM underwent cognitive assessment by Montreal cognitive assessment test and the cognitive levels were correlated with their glycosylated hemoglobin, lipid profile, and highly sensitive C-reactive protein (hsCRP).Results: The prevalence of mild cognitive impairment (MCI) was 64.2%.  MCI significantly correlated with duration of diabetes, socioeconomic status, HbA1c, serum triglycerides, low-density lipoprotein, very low-density lipoprotein and hsCRP levels. The factors that were statistically insignificant were body mass index and high-density lipoprotein levels.Conclusions: Cognitive impairment is seen even in non-elderly T2DM patients. It should be considered along with the other complications of diabetes and individuals with T2DM should be screened for cognitive impairment to prevent progression to dementia

Effect of Syzygium cumini (jamun) seed powder on dyslipidemia: a double blind randomized control trial

Background: Diabetes is a metabolic syndrome characterized by disturbance in carbohydrate, fat and protein metabolism. Dyslipidemia, commonly associated in diabetes, is major risk factor for macrovascular complications leading to CAD, major contributor to mortality associated with diabetes. Managing DM without side effects is challenge that attracts researchers toward plant based new products. Many studies have found anti-diabetic and anti-hyperlipidemic properties of seeds of Syzygium cumini, attributed to saponins, glycosides and flavonoids. So it should be further explored for its benefits.  The aim was to study the effect of jamun seed powder on dyslipidemia in type 2 DM. Methods: Patients with type 2 DM were randomly divided in two groups- group A was supplemented with 10 gms/day jamun seed powder and group B was given placebo powder. Patients and investigators were blinded about treatment allocated. Lipid profile was noted at baseline and 30th, 60th and 90th day. All the data was collected and analyzed at the end of study.Results: Improvement in dyslipidemia was seen after 60 days of supplementation with S. cumini seed powder. Statistically significant decrease in cholesterol levels by 10.55% and 15.79% in mean triglyceride levels by 8.28% and 13.66%, LDL-c levels by 10.29% and 14.50% was noticed at 60th and 90th day, respectively, reduction in VLDL-c levels by 9.38%, 12.90% and 20.69% was noted at 30th, 60th and 90th day. HDL-c increased significantly by 11.11% and 13.89% in males and 10.81% and 16.21% in females after 60 and 90 days of supplementation with S. cumini seed powder.Conclusions: A significant overall effect of S. cumini supplementation was found in improvement of lipid profile in type 2 diabetes subjects. However, above results are seen in small number subjects, further multicenter studies with larger sample size, supplementation dose and time should be planned and its effects in detail should be explored.

Grain Yield Stability of Rice Genotypes

Stability analysis identifies the adaptation of a crop genotype in different environments. The objective of this study was to evaluate promising rice genotypes for yield stability at different mid-hill environments of Nepal. The multilocation trials were conducted in 2017 and 2018 at three locations viz Lumle, Kaski; Pakhribas, Dhankuta; and Kabre, Dolakha. Seven rice genotypes namely NR11115-B-B-31-3, NR11139-B-B-B-13-3, NR10676-B-5-3, NR11011-B-B-B-B-29, NR11105-B-B-27, 08FAN10, and Khumal-4 were evaluated in each location. The experiment was laid out in a randomized complete block design with three replications. The rice genotype NR10676-B-5-3 produced the highest grain yield (6.72 t/ha) among all genotypes. The growing environmental factors (climate and soil conditions) affect the grain yield performance of rice genotypes. The variation in climatic factors greatly contributed to the variation in grain yield. Polygon view of genotypic main effect plus genotype-by-environment interaction (GGE) biplot showed that the genotypes NR10676-B-53 and NR11105-B-B-27 were suitable for Lumle; NR11115-B-B-31-3 and NR11139-B-B-B-13-3 for Pakhribas; and 08FAN10 and NR11011-B-B-B-B-29 for Kabre. The GGE biplot showed that genotype NR10676-B-5-3 was stable hence it was near to the point of ideal genotype. This study suggests that NR10676-B-5-3 can be grown for higher grain yield production in mid-hills of Nepal

The COVID‐19 Pandemic Not Only Poses Challenges, but Also Opens Opportunities for Sustainable Transformation

The COVID-19 pandemic has impacted social, economic, and environmental systems worldwide, slowing down and reversing the progress made in achieving the Sustainable Development Goals (SDGs). SDGs belong to the 2030 Agenda to transform our world by tackling humankind's challenges to ensure well-being, economic prosperity, and environmental protection. We explore the potential impacts of the pandemic on SDGs for Nepal. We followed a knowledge co-creation process with experts from various professional backgrounds, involving five steps: online survey, online workshop, assessment of expert's opinions, review and validation, and revision and synthesis. The pandemic has negatively impacted most SDGs in the short term. Particularly, the targets of SDG 1, 4, 5, 8, 9, 10, 11, and 13 have and will continue to have weakly to moderately restricting impacts. However, a few targets of SDG 2, 3, 6, and 11 could also have weakly promoting impacts. The negative impacts have resulted from impeding factors linked to the pandemic. Many of the negative impacts may subside in the medium and long terms. The key five impeding factors are lockdowns, underemployment and unemployment, closure of institutions and facilities, diluted focus and funds for non-COVID-19-related issues, and anticipated reduction in support from development partners. The pandemic has also opened a window of opportunity for sustainable transformation, which is short-lived and narrow. These opportunities are lessons learned for planning and action, socio-economic recovery plan, use of information and communication technologies and the digital economy, reverse migration and “brain gain,” and local governments' exercising authorities

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress

Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODErn), to generate cause fractions and cause specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings At the broadest grouping of causes of death (Level 1), non-communicable diseases (NC Ds) comprised the greatest fraction of deaths, contributing to 73.4% (95% uncertainty interval [UI] 72.5-74.1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 186% (17.9-19.6), and injuries 8.0% (7.7-8.2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22.7% (21.5-23.9), representing an additional 7.61 million (7. 20-8.01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7.9% (7.08.8). The number of deaths for CMNN causes decreased by 222% (20.0-24.0) and the death rate by 31.8% (30.1-33.3). Total deaths from injuries increased by 2.3% (0-5-4-0) between 2007 and 2017, and the death rate from injuries decreased by 13.7% (12.2-15.1) to 57.9 deaths (55.9-59.2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000-289 000) globally in 2007 to 352 000 (334 000-363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118.0% (88.8-148.6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36.4% (32.2-40.6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33.6% (31.2-36.1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respirator}, infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990 neonatal disorders, lower respiratory infections, and diarrhoeal diseases were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd.Peer reviewe