Awareness About Folic Acid Supplementation in First-Trimester Pregnant Women of Rural Raipur District, Chhattisgarh, and Its Determinants: A Cross-Sectional Study.

BACKGROUND: Women are supplemented with folic acid (FA) during pregnancy as well as preconceptionally to prevent neural tube defects (NTDs) in newborns. To understand the importance of FA supplementation, women need to have awareness about the same, which in turn may be influenced by different factors. It is also known that both FA and vitamin B12 deficiency tend to cause NTDs in newborns and anemia. Very few studies have studied the relationship between hemoglobin, FA, and vitamin B12 levels. In this study, we aim to estimate the level of awareness of FA supplementation among pregnant women in the first trimester of pregnancy and the factors determining the presence of awareness regarding the same. Also, we aim to estimate any correlation between hemoglobin, FA, and vitamin B12 levels among a subset of pregnant women. METHODS: A cross-sectional study was conducted in the Abhanpur Block of Raipur district in Chhattisgarh among 399 pregnant women in their first trimester of pregnancy, in which their knowledge was assessed using a pretested semistructured questionnaire. Each participant's knowledge score regarding FA supplementation was calculated and scored based on six indicators and classified as low, intermediate, and high scores. Logistic regression was applied to find out any significant association between knowledge about FA supplementation with any other sociodemographic variables. Scatter plots were used to assess the correlation of FA with hemoglobin, vitamin B12, and knowledge scores among 104 participants. RESULTS: The majority (77.9%) of women had low knowledge scores with a mean score of 1.4 (0.15). It was found that only 45.6% of the participants knew the importance of FA supplementation, and the majority (23.1%) were informed by auxiliary nurse midwives (ANMs) followed by doctors. The majority (41.6%) of the study participants also did not know when to start FA, and only 1.3% knew that FA should be taken preconceptionally. On multivariable logistic regression, women who lived in joint families had significantly higher odds of having intermediate knowledge compared to those who lived in nuclear families. Although not statistically significant, there was a positive correlation between serum vitamin B12 and FA levels and also between hemoglobin and serum FA levels. However, a significant positive correlation was found between serum FA levels and the knowledge scores of the study participants. CONCLUSION: The majority of study participants had poor knowledge and awareness regarding FA supplementation. So, health education, as well as information, education, and communication (IEC) activities, is required to improve the knowledge about FA supplementation among women of reproductive age in the community. A better understanding of FA supplementation can lead to adherence to FA consumption and prevent NTDs among newborns.

Comparison of Different Anthropometric Indicators for Assessment of Nutritional Status Among Adolescent Girls in an Urban Resettlement Colony in New Delhi: A Cross-Sectional Study.

Background In India, 44.8% of adolescent girls are under-nourished, while about 8%-13% of girls are overweight. Though several studies have been done regarding the nutritional status of adolescent girls over the years, there have been no significant changes. Also, there are several different anthropometric indicators for nutritional status assessment, due to which there are huge variations in the prevalence of malnutrition across different studies. So the objectives of this study were to determine the prevalence of malnutrition using different anthropometric indicators and compare them. Methods A random sample of 426 girls was taken from Health Management Information Systems (HMIS) of the Centre for Community Medicine (CCM), All India Institute of Medical Sciences (AIIMS), and a semi-structured questionnaire was administered among 386 of them to determine associated factors. Height, weight, and mid-upper arm circumference (MUAC) were measured for 386 girls, and BMI for age and height for age z scores were calculated using WHO AnthroPlus. Mid-upper arm circumference for age z scores (MUAC for age) were calculated using Lambda-Mu-Sigma (LMS) charts by the CDC for girls aged one year to 20 years. Results It was found in this study that using BMI for age z scores (BAZ), 33.4% of the adolescent girls were malnourished; 18.9% (95% CI 15.1-23.2) being underweight, 10.6% (95% CI: 7.7-14.1) being overweight, and 3.9% (95% CI: 2.2-6.3) were obese. While using BMI solely as an indicator, the prevalence of thinness was 51.8% (95% CI: 46.9-56.9), while that of overweight and obesity was 10.6% (95% CI: 5.7-11.5) and 1.0% (95% CI: 0.2-2.6), respectively. The prevalence of under-nutrition by MUAC for age z scores was 53.4% (95% CI: 48.2-58.4), and that of over-nutrition was 1.8% (95% CI: 1.0-3.7). BMI for age z scores positively and strongly correlated with both MUAC and MUAC for age z scores and had a significant association with both on univariable linear regression. Though there was a negative correlation between BMI for age z scores and height-for-age z scores, it was not significant. Height-for-age z scores, even though positively correlated with MUAC for age z scores, the correlation was not that strong.

Role of Intravenous Iron Sucrose in Severe Anemia in Late Pregnancy: A Case Report From Rural Ballabgarh, Haryana.

Severe anemia is a high-risk factor in pregnancy and needs to be treated appropriately to prevent poor maternal and fetal outcomes. A pregnant woman with severe anemia reluctant for blood transfusion due to issues of accessibility was given four doses of 300 mg intravenous iron sucrose (IVIS) in 300 ml normal saline starting at 31 weeks 5 days of gestation and her hemoglobin level increased by 4.2 gm/dl over a period of five weeks without any complications and without any intake of iron and folic acid tablets during the entire duration. Intravenous iron sucrose is a useful intervention for severe anemia of pregnancy even in late pregnancy with rapid increase in haemoglobin levels and can be used regularly for treating severe anemia in pregnant women alternative to blood transfusion who have limited accessibility to blood transfusion facilities.

Geriatric Depression and its predictors in the National Capital Territory (NCT) of India - A quantitative study.

In India, the world's second most populous state, an increasing proportion of its population are elderly. Older people invariably face special psychiatric challenges. In a community-based cross-sectional study, depression was found to be present in almost a third of the elderly; furthermore, low family income, poor literacy and uncertain employment status were found to be significant associations.

Quality of Life of Patients With Major Amputations in the Tertiary Care Center of Western Rajasthan: A Prospective Observational Study in 2019-2020.

Introduction Amputation of a limb is a loss of physical integrity that has disastrous consequences for a person's mental, physical, and social well-being. Aim We aim to analyze the quality of life (QoL) after major amputations and long-term outcomes. Method and materials A prospective, observational study has been conducted in a health care institute in western Rajasthan from January 2019 to July 2020. This study included 64 patients who had major upper or lower limb amputations. We analyzed the sociodemographic factors of the patients, the type of procedure, postoperative hospital stay, complications, and follow-up status with both the SF-12 and the World Health Organization Quality of Life (WHOQOL)-BREF questionnaires. Mean, median, range, standard deviation, percentages, univariable, and multivariable logistic regression were analyzed with SPSS version 23.0 software (IBM Corp., Armonk, NY). Results The mean age of the study patients was 53.6 years (SD 2.6) and they were mostly male (71.9%). Atherosclerotic peripheral vascular disease (PVD) was the most common indication (37.5%) of amputation, and below-the-knee amputation (46.88%) was the most commonly performed procedure. There was a significant increment in both PCS (p-value= 0.001), MCS scores (p-value=0.0001) of SF-12 and physical (p-value=0.0001) and psychological domains (p-value=0.001) of the WHOQOL-BREF questionnaire in the postoperative period. A total of 83.9% of patients have used prostheses, and 15.6% had mortality. Conclusions Major amputations can significantly affect the quality of life of patients, and all efforts should be made to avoid factors that adversely affect their quality of life.