Geospatial mapping and drinking water quality status of fluoride endemic hilly District Doda (J&K), India

In the present study, an attempt has been made to investigate the drinking water quality status of various surface and ground water sources and the supplied water from two water filtration plants supplying drinking water to Doda town and its adjoining areas by using Arithmetic Water Quality Index (WQI) and geospatial mapping techniques. Doda is fluoride endemic district of Jammu and Kashmir State where groundwater fluoride concentration upto 7.0 mg/L is recorded. Water samples collected from about twenty two drinking water sources from two blocks of Doda district (Bhagwah and Doda blocks) were analyzed at pre-determined locations marked using handheld GPS(Montana 650). These locations formed the attribute database for the study based on which fluoride distribution maps have been derived and integrated with Arithmetic WQI through Inverse distance weighted (IDW) interpolation technique. Prepared thematic maps have confirmed the vulnerability of the drinking water sources and water supply systems in the study area, thus, posing a serious public health concern. Based on the WQI, water quality status of Beoli filtration plant (WQI=43.26) falls under the category of good water whereas that of Moochan filtration plant (WQI=157.41) has been classified as unfit for drinking. The geochemical evolution of the water studied using Piper’s diagram has shown mixed type of hydrochemical facies. Coefficient of correlation(r) between different parameters has indicated significant correlation between several parameters.  The study urges the concerned government authorities to make provisions for providing safe drinking water to public which is free of turbidity and low in fluoride concentration

Maternal and perinatal outcome in pregnancy complicated by obstetric cholestasis: study from a tertiary care centre in North India

Background: Intrahepatic cholestasis of pregnancy (IHCP) is the most common pregnancy related liver disorder. It typically presents with troublesome itching and can lead to complications for both mother and foetus. Present study was carried out to study the incidence of Obstetric Cholestasis and its fetomaternal outcome in a tertiary care hospital.Methods: It was a prospective epidemiological study during a period of one year (May 2020 to April 2021) over 120 pregnant ladies suffering from pruritus and detected as having Obstetric Cholestasis. They were followed up and maternal as well as perinatal outcome recorded. Appropriate statistical analysis done as applicable.Results: The incidence of Obstetric Cholestasis in our hospital was 9.3%. Majority of cases delivered at term (78.3%). 41.6% patients delivered vaginally, 43.3% had emergency caesarean section, and 2.5% patients had instrumental delivery. Maternal morbidities are due to sleep disturbance (60%), coagulation abnormality (13.3%), increase chance of operative delivery (55.8%) and postpartum haemorrhage (12.5%). Neonatal complications include meconium aspiration (46.6%), NICU admission (36.6%), prematurity (5%) and perinatal mortality (3.3%).Conclusions: Cholestasis of pregnancy causes maternal pruritus with impaired liver function tests. Maternal morbidity is increased in terms of increased caesarean section rates and discomfort due to pruritus. A timely intervention at 37-38 weeks will reduce the adverse perinatal outcome.

Analysis of caesarean sections using Robson’s classification system in a tertiary care centre in Northern India: an emerging concept to audit the increasing caesarean section rate

Background: There has been an increase in rate of caesarean section over last five decades. This is a matter of international public health concern as it increases the caesarean section related maternal morbidity. The aim of the present study was to evaluate that in a new medical college which clinical situation contributed and led to caesarean deliveries as per Robson’s classification system and to audit the increasing rate of caesarean section.Methods: This study was performed in Government Medical College Kathua in the Union territory of Jammu and Kashmir from November 2020 to April 2021. In the present study, all cases delivered by caesarean section during the period of six months were recorded and classified according to Robson's 10 group classification system.Results: Out of total 1366 women delivered, 630 underwent CS (46.12%). It was observed that majority of caesarean sections belonged to group 2 and group 5 of Robson criteria. Group 5 comprised of patients with one or more previous caesarean section with cephalic presentation according to Robson criteria and maximum number of caesarean sections done in the present study belonged to this group that is 40.3%. Group 2 that is nulliparous singleton cephalic >37 week induced labour or caesarean section before labour comprised 29.2%. Breech pregnancies (groups 6 and 7) had >90% caesarean rates.Conclusions: Women with a previous caesarean delivery represent an increasing proportion of caesarean deliveries. Use of the Robson criteria allows standardized comparisons of data and identifies clinical scenarios driving changes in caesarean rates. Hospitals and health organizations can use the Robson 10-Group Classification System to evaluate quality and processes associated with caesarean delivery

A COMPARATIVE STUDY OF MELATONIN WITH PLACEBO IN ATTENUATION OF HEMODYNAMIC RESPONSES TO LARYNGOSCOPY AND INTUBATION

Introduction: An increase in blood pressure and heart rate is observed during laryngoscopy and insertion of the endotracheal tube. Melatonin is used for sedation in the Intensive Care Unit. Our study was based on the hypothesis that administrating 3 mg and 6 mg of melatonin 90 minutes before induction attenuates hemodynamic responses encountered during laryngoscopy and intubation. Materials and Methods: Seventy-five adult patients scheduled for elective surgical procedures, ASA I and II, were assigned into 3 groups (25 patients in each group) to receive oral placebo, melatonin 3 mg, or melatonin 6 mg 90 minutes prior to induction of anesthesia. Hemodynamic variables were recorded at baseline, before induction, and at 3, 6, 9, 12, 15, and 30 minutes after induction. Analysis of variance (ANOVA) was used for intergroup analysis of data. Categorical variables were compared using non-parametric tests like the Chi-square test or Fisher’s exact test. Bonferroni correction was applied for intergroup analysis. Statistical significance was considered when p < 0.05. Results: An increase in heart rate and blood pressure at 3, 6, and 9 minutes after induction of general anesthesia was observed in the control group compared to the melatonin 3 mg and 6 mg groups administered 90 minutes prior to induction. Oral administration of 6 mg of melatonin was found to provide greater attenuation than 3 mg of melatonin. Conclusion: Oral administration of 3 mg and 6 mg melatonin effectively attenuates the hemodynamic pressor changes observed during laryngoscopy and tracheal intubation

A Review of Defluoridation Techniques of Global and Indian Prominence

Fluoride(F-) is the 13thmost abundant chemical element in the Earth's crust which has been widely recognised for its health benefits at low concentration but poses a serious threat to public health at very high doses. The world health organization has set the fluoride guideline limit of 1.5 mg/l in drinking water. Globally, over 260 million people drink water with high fluoride concentrations. Widespread distribution and high fluoride levels in the potablewater in most of the areas of the world has prompted substantial research and mitigation efforts to address the growing public health concerns related to fluoride contamination. With the recent advances in science, various defluoridation methods such as adsorption, ion exchange, precipitation-coagulation, membrane processes, biological defluoridation and even integrated approaches have been developed for the management of fluoride-contaminated aquatic environments. This review provides an up-to-date insight into thedefluoridation techniques developed and implemented throughout the world and highlightsthe advantages and disadvantages of each technique.The literature survey confirms that despite developing so many novel techniques for defluoridation over the years, there is still no effective fluoride removal technique that can achieve the desired results in a cost-effective and sustainable manner. Therefore, development of a commercially practical, economical, and sustainable technique is required to prevent people especially the most vulnerable from poor and developing nations (dependent on untreated water)from the hazards of fluoride contamination.</jats:p

Geospatial mapping and drinking water quality status of fluoride endemic hilly District Doda (J&amp;K), India

In the present study, an attempt has been made to investigate the drinking water quality status of various surface and ground water sources and the supplied water from two water filtration plants supplying drinking water to Doda town and its adjoining areas by using Arithmetic Water Quality Index (WQI) and geospatial mapping techniques. Doda is fluoride endemic district of Jammu and Kashmir State where groundwater fluoride concentration upto 7.0 mg/L is recorded. Water samples collected from about twenty two drinking water sources from two blocks of Doda district (Bhagwah and Doda blocks) were analyzed at pre-determined locations marked using handheld GPS(Montana 650). These locations formed the attribute database for the study based on which fluoride distribution maps have been derived and integrated with Arithmetic WQI through Inverse distance weighted (IDW) interpolation technique. Prepared thematic maps have confirmed the vulnerability of the drinking water sources and water supply systems in the study area, thus, posing a serious public health concern. Based on the WQI, water quality status of Beoli filtration plant (WQI=43.26) falls under the category of good water whereas that of Moochan filtration plant (WQI=157.41) has been classified as unfit for drinking. The geochemical evolution of the water studied using Piper’s diagram has shown mixed type of hydrochemical facies. Coefficient of correlation(r) between different parameters has indicated significant correlation between several parameters.  The study urges the concerned government authorities to make provisions for providing safe drinking water to public which is free of turbidity and low in fluoride concentration.</jats:p

Maternal and perinatal outcome in pregnancy complicated by obstetric cholestasis: study from a tertiary care centre in North India

Background: Intrahepatic cholestasis of pregnancy (IHCP) is the most common pregnancy related liver disorder. It typically presents with troublesome itching and can lead to complications for both mother and foetus. Present study was carried out to study the incidence of Obstetric Cholestasis and its fetomaternal outcome in a tertiary care hospital.Methods: It was a prospective epidemiological study during a period of one year (May 2020 to April 2021) over 120 pregnant ladies suffering from pruritus and detected as having Obstetric Cholestasis. They were followed up and maternal as well as perinatal outcome recorded. Appropriate statistical analysis done as applicable.Results: The incidence of Obstetric Cholestasis in our hospital was 9.3%. Majority of cases delivered at term (78.3%). 41.6% patients delivered vaginally, 43.3% had emergency caesarean section, and 2.5% patients had instrumental delivery. Maternal morbidities are due to sleep disturbance (60%), coagulation abnormality (13.3%), increase chance of operative delivery (55.8%) and postpartum haemorrhage (12.5%). Neonatal complications include meconium aspiration (46.6%), NICU admission (36.6%), prematurity (5%) and perinatal mortality (3.3%).Conclusions: Cholestasis of pregnancy causes maternal pruritus with impaired liver function tests. Maternal morbidity is increased in terms of increased caesarean section rates and discomfort due to pruritus. A timely intervention at 37-38 weeks will reduce the adverse perinatal outcome. </jats:p