Validation of Targets Related to Maternal and Child Health Services in the Rural Area of the Bhavnagar District, Gujarat: A Cross Sectional Study

Introduction: Despite ‘Target free approach’ being implemented since more than 20 years, the targets related to MCH services are still decided and distributed by top to bottom approach in Gujarat. Irrational distribution of targets may lead to under or over achievement of the targets by SCs and PHCs. Objective: To validate the targets related to MCH services in the rural areas of the Bhavnagar district, Gujarat for the year 2019-2020. Method: A cross-sectional study was carried out to count the actual number of MCH beneficiaries by visiting each house of the selected villages (One village each from a good performing and a poor performing SCs of two randomly selected PHCs from each block of Bhavnagar district) and interviewing a family member of the household. This numbers from the villages were compared with the targets assigned to the respective villages. Results: The actual number of antenatal women was found to be 26.6% lower and 38.8% higher than the assigned targets for early pregnancy registration in the villages of poor and good performing SCs respectively. Similarly the actual number of deliveries was found to be 47.2% lower than the assigned targets for institutional deliveries in poor performing SCs. It was also observed that the actual number of children eligible for full immunization in the respective area was found to be much lower in both the groups of SCs than the assigned targets. Conclusion: Assigned MCH targets were found improper in the villages of Bhavnagar district

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy.

Peer reviewe

Bladder injuries during obstetrical and gynecological surgeries

Background: The reproductive and urinary tracts in women are closely related anatomically and embryologically. Knowledge of this anatomy plays an important role in the prevention of urinary tract injury during gynaecologic surgery. The primary approach to prevention is careful surgical dissection and knowledge of the position of urinary tract structures within the surgical field.Methods: Prospective interventional study consisted of 28 patients with obstetrics and gynecological surgeries was carried out at department of surgery, new civil hospital, Surat during December 15th to January 16th. Out of 28 patients 13 patients had bladder injuries which repaired and studied in detail.Results: Out of these 28 patients undergone various obstetrics and gynecological surgeries, 13 patients were having iatrogenic urinary bladder injuries. Bladder injury occurred commonly during in LSCS and in hysterectomies. Out of 13 urinary bladder injuries, 8 injuries repaired in 2 layers by Vicryl 2-0 without insertion of SPC and 5 injuries were managed by primary repair with vicryl 2-0 with insertion of SPC (SPC= suprapubic cystostomy).Conclusions: Surgery adjacent to or within urinary bladder continue to result in occasional iatrogenic injury. These injuries can be minor with no long-term sequelae, or they can result in significant morbidity and inconvenience to patients.</jats:p

Thallium Induced Sub-chronic Toxicity Profile in Wistar Rats

Thallium (Tl) is one of the most toxic heavy metals affecting both humans and animals, yet is one of the least studied for its toxicological effects. A total of 40 male Wistar rats were randomly divided into four Groups with 10 rats in each  Group. Group I received distilled water only and served as a control. Group II, III, and IV received thallium sulfate (I) at 0.48, 0.93, and 1.33 mg/kg body weight, respectively, in drinking water for 90 days. In Group IV rats, lethargy, dehydration, weakness, mild diarrhea, weight loss and 100% morality in male Wistar rat were noted. Group II and III rats showed significant reduction in cholesterol, phosphorus, triglyceride level, and absolute and relative spleen weight. Microscopically, thallium sulfate (I) found to cause lymphoid depletion in white pulp of spleen in all treatment Groups. In kidney of Group IV rats, tubular necrosis, cytoplasmic vacuolation or clearing of tubules, cast, and thrombosis were found. Dose dependent hyperkeratosis was found in non-glandular stomach in all three treated Groups. In conclusion, spleen, kidney and stomach were primarily affected organs in sub-chronic thallium toxicity.</jats:p

Sustainable Intensification of a Rice–Maize System through Conservation Agriculture to Enhance System Productivity in Southern India

Integrated management of rice–maize systems is an emerging challenge in southern India due to improper rice residues and tillage management in maize crops. Conservation agriculture (CA) practices such as a reduced tillage and maintaining stubble mulch may hold the potential to increase yields, reduce crop establishment costs and increase farm incomes. A five-year trial was performed to study the effect of different CA and establishment methods in rice on system productivity, profitability, and soil carbon status in a rice–maize system. In the rainy season, the trial consisted of two main treatments: (i) normal manual transplanting and (ii) direct-wet seeding, and three sub-main treatments at different sowing dates with fifteen day intervals. In addition, in the winter season, two tillage treatments (conventional and minimum tillage) were imposed over the rainy season treatments. Both rice and maize were grown under irrigated conditions. The results showed that sowing times at 15 day intervals did not impact the yield significantly. Transplanted rice obtained a significantly higher grain yield during the first four years, but in the last year, the yield was similar in both of the establishment methods. In the winter season, conventional tilled maize recorded a higher cob yield than under the minimum tilled treatment, except for the last year, where both the tillage treatment effects were the same. System productivity of CA-based minimum tilled rice–maize was inferior during the first three years but was superior to the conventionally tilled method in the fourth and fifth year. Pooled analysis revealed that the conventionally tilled rice–maize system resulted in a similar system productivity as that of the CA during the study period. The cost–benefit analysis revealed that transplanted rice and conventionally tilled maize fetched higher net returns of INR 111,074 and INR 101,658/ha, respectively, over the direct-wet seeded rice and CA. In addition, the 15 July rice sown followed by the maize system led to an increase in irrigation water productivity by 15.7%, and the total water (irrigation + rainfall) productivity by 27.1% in the maize crop compared with the 30 July sown system. The CA-based rice–maize system resulted in a significantly higher very labile (0.194%) and labile (0.196%) carbon concentration at a 0–5 cm depth of soil compared to those under the conventional system. Thus, CA can be recommended for southern India and similar agro-ecological tropic and sub-tropic conditions. This system can be followed with appropriate location-specific modification in South-Asian countries, where crop yields and soil health are declining as a result of continuous cereal–cereal crop rotation.</jats:p