Effect of maternal education on antenatal care utilization, maternal and perinatal outcome in a tertiary care hospital

Background: Antenatal Care (ANC) utilization facility is available but poorly utilized because of many factors which play indirect role in inadequate utilization of antenatal care facility: low social status of women in the society, less opportunity for basic education, less ability to make decisions. Therefore, the present study is an attempt to study the effect of maternal education on antenatal care utilization, maternal and perinatal outcome in a tertiary care hospital.Methods: A prospective study was carried out on 525 cases delivered during period of one year at Dayanand Medical College and Hospital, Ludhiana, Punjab, India; a tertiary care hospital catering both urban and rural population. All cases were categorized into two groups: booked and unbooked. The age, parity and education of each patient in booked and unbooked cases was noted. Further, its impact on antenatal care utilization, maternal and perinatal outcome was studied.Results: On studying education pattern, among illiterate subjects 50% were booked and 50% were unbooked; For graduate and above were 80.6% and 19.4%respectively. Among mothers who were illiterate 90.9% had low birth weight babies and 13.6% had stillborn. Among those graduates and above 38.7% had low birth weight babies,1.5 % stillborn and 1.2% neonatal deaths.Conclusions: The educational status of the women came out as a significantly important variable and predictor of perinatal outcome. Hence, whole hearted efforts should be directed in educating women population and also improving health care facilities in rural areas to provide early referral to higher centers

Effect of sewage-water irrigation on physico-chemical parameters with special reference to heavy metals in agricultural soil of Haridwar city

The present study revealed that use of sewage for irrigation of agricultural soil of Haridwar city improved the water holding capacity (+27.98%), electrical conductivity (+196.15%), sulphate (+2.34%), organic carbon (+30.48%), total Kjeldhal nitrogen (+87.5%), available potassium (+25.77%) and available phosphorous (+59.97%) and fertility status of the soil in comparison to natural water irrigated soil. Further sewage irrigation also resulted in a significant build-up of total Pb (+98.95%), Ni (+128.29%), Cu (+253.17%), Fe (+39.74%), Cd (+30.92%), Zn (+696.03%) and Cr (+13.15%) than the natural water irrigated soil. The mean concentrations of these metals were below the permissible limits of Indian standards. The enrichment factor (Ef) for Cu (9.62) was maximum and minimum for Cr (1.13).The Ef for different metals was in the order of Cu> Zn > Ni > Pb > Cd > Cr > Fe. Pollution index (Pi) value of the sewage water irrigated soil ranged from 0.505 to 0.901 which indicated that the soil was not yet polluted

Idiopathic clubfoot treated by Ponseti method: a series of 300 cases

Background: Clubfoot is a complicated deformity of the foot. It is one of the commonest congenital deformities in children. The main aim of this study was to evaluate the efficacy management of clubfoot by Ponseti method.Methods: This prospective study included 300 children (456 club feet) below the age of 2 years with idiopathic clubfeet from January 2013 to December 2017. In all the cases the Ponseti method was used for the management. The severity of the deformity was assessed with the help of the Pirani score and clinical evaluation of the foot was done.Results: Out of 300 patients 204 patients were male and 96 patients were female and 144 were unilateral clubfoot and 156 were bilateral cases of clubfoot. The mean number of casts required for correction was 5.4 (4–10). Out of 456 clubfeet 356 (78%) feet were required tenotomy. There was relapse seen in 36 (7.9%) feet which had to be managed with 2–3 serial manipulations and casting and these resolved. Excellent result found in our study in 92% cases, good results were found in 5% cases and poor results were found in 3% cases.Conclusions: Ponseti technique is a very useful and effective method of management of idiopathic clubfoot up to 2 year of age

The impact of freight transport capacity limitations on supply chain dynamics

We investigate how capacity limitations in the transportation system affect the dynamic behaviour of supply chains. We are interested in the more recently defined, 'backlash' effect. Using a system dynamics simulation approach, we replicate the well-known Beer Game supply chain for different transport capacity management scenarios. The results indicate that transport capacity limitations negatively impact on inventory and backlog costs, although there is a positive impact on the 'backlash' effect. We show that it is possible for both backlog and inventory to simultaneous occur, a situation which does not arise with the uncapacitated scenario. A vertical collaborative approach to transport provision is able to overcome such a trade-off. © 2013 Taylor & Francis

Proximal femoral nail- outcome and complications: a prospective study of 125 cases of proximal femoral fractures

Background: Fractures of the proximal femur are relatively common injuries in adults and common source of morbidity and mortality among the elderly. Fractures of the proximal femur include trochantric and subtrochantric fractures. The present study was designed to evaluate and analyze the role of proximal femoral nail (PFN) in the treatment of proximal femoral fractures.Methods: It was a prospective study on 125 cases of proximal femoral fractures. The fractures were classified according to AO classification. Salvati and Wilson Score were used for functional assessment.Results: In this study at 6 months follow up, union was achieved in 123 cases, open reduction was performed in 11% of cases (14 cases). Technical and mechanical complications were noted in 21% cases (27 cases). Reoperation rate was 4% (Five cases). According to Salvati and Wilson scoring system excellent results were seen in 36% of cases (45 cases), good results in 46% cases (58 cases), fair result in 13% cases (16 cases) and poor results in 5% cases (6 cases). Conclusions: It is concluded from our study that proximal femoral nailing is an attractive and suitable implant for Proximal Femoral Fractures and its use in unstable intertrochantric fractures is very encouraging