Prevalence and Risk Associated With Bladder Injuries During Caesarean Section in a Secondary Care Hospital.

Introduction Bladder injury during caesarean section (CS) is not uncommon. Various factors increase the risk of bladder injury during CS, including prolonged labor with bladder distension, pregnancy with a scarred uterus, suspected intra-abdominal adhesions, distorted local anatomy, cesarean hysterectomy, and an increasing number of previous CS. Vigilant preoperative assessment and surgical precision are essential to mitigate these risks and ensure optimal outcomes for mother and child. Objectives To find out the prevalence and risk factors associated with bladder injuries during caesarean section. Methodology Hospital-based retrospective record review of 3600 pregnant women who had undergone cesarean section during the period January 2015 to December 2023 were included in the study. Data was analyzed using SPSS software, version 22 (trial version) (IBM Corp., Armonk, NY). The Chi-square test and Fisher's exact test were used. Ethical clearance was obtained from the Institutional Ethics Committee at Tata Main Hospital Noamundi (approval number NI/CMO/26/24). Result Bladder injury prevalence was reported to be 1.1%. Bladder injuries were significantly (p<0.0001) more among the CS cases with underlined complications as compared to CS cases without any underlined complications. Repeat CSs were found to have a significantly (p<0.001) higher proportion of bladder injuries compared to primary CS.  Conclusion Bladder injuries during cesarean section are a significant concern. The risk factors identified, such as the number of previous cesarean sections and complications during pregnancy, highlight the importance of careful preoperative assessment and surgical precision to prevent such injuries.

How healthy is the health budget of Amrit Kaal: 2023-24?

Political will is the key to public health policy-making and a major driving force for the attainment of Universal Health Coverage (UHC) in any nation. To achieve UHC, the Indian government laid down National Health Policy in 1983 and updated it in 2002 and recently in 2017. This recent policy emphasized increasing healthcare spending and economic growth. In the current budget, there is an increment in the share of GDP of 0.34% from the previous year's allocation, but still staggering for the envisaged 2.5% to achieve UHC. Enthusiastic announcements of opening 157 new nursing colleges, a separate programme for eliminating sickle cell anemia by 2047, and Centers of excellence establishment for pharma companies for promoting research and development and focusing on Particularly Vulnerable Tribal Groups (PVTGs) are the few overarching and new highlights in the current budget. But, in a country so huge and varied in terms of its needs in every sector, the announcements in the financial budget speech taking India forward in becoming a "shining star" is a matter of debate. This is an attempt to review the budget for this financial year in the healthcare sector and what it means: is the country willing to build a self-driven healthcare sector in the Amrit Kaal with strong public finances and a robust financial sector through "efforts by all"?

Depression, sleep, body image, and lifestyle: Prevalence and associated factors of depression among school-going adolescents in Delhi National Capital Region.

Background: Adolescents are known to be vulnerable to depression, which worsened during the COVID-19 pandemic. They also exhibit poor sleep quality and body image issues (BIIs) which are considered risk factors for depression. There is a paucity of Indian studies regarding adolescent depression and its correlation with lifestyle. Aims: To detect the prevalence of depression in adolescents, and understand its association with sociodemographic variables, sleep quality, BIIs, and lifestyle factors. Materials and Methods: A cross-sectional study was conducted among 392 adolescents attending classes 8th-12th in two schools in Delhi National Capital Region. A pre-tested semi-structured questionnaire was used to collect sociodemographic and lifestyle data. Depression anxiety stress scale-21 was used to detect depression. Pittsburgh Sleep Quality Index and Stunkard Figure Rating Scale were used to evaluate sleep quality and BIIs. Data was analyzed using Statistical Package for Social Sciences Version-25. Results: Depression was present in 40.3% of students. It was more common in girls, older students, students in higher classes, who lacked siblings and whose mothers were engaged in professions as well as those with BIIs. However, after multivariate analysis, the association of depression with poor sleep quality, meal skipping, lack of exercise, family history of mental illness, and inverse association with open discussion of one's thoughts and worries with family remained significant. Conclusions: Depression is common among adolescents and shows associations with poor sleep quality and lifestyle choices. Awareness of these associations may enable better screening and early intervention for vulnerable adolescents.

Occupational Health Hazards of Rickshaw Pullers in Lower Middle Income Country, India.

Background: Rickshaw pullers work in unorganized sector. Ignorance, poverty, and strenuous physical exertion make them vulnerable to ill health and disease. Objectives: To assess the magnitude and pattern of morbidity, associated sociodemographic factors, and health-seeking behavior of the participants. Materials and Methods: A cross-sectional study was conducted on 305 participants. Predesigned, pretested questionnaire was used for data collection. Statistical Package for the Social Sciences (SPSS) 16 version was used for data analysis. Results: About 61% of the participants had morbidity in their lifetime and 49.5% fell sick in the last 15 days. Substance abuse in any form was reported by 73.1%. Grade-1 hypertension was reported in 28.2% and 7.5% was having grade-2 hypertension. Age, monthly income, substance abuse, and availing of health services were significantly associated with the development of health problems. Conclusion: Need to devise interventions that will focus on health awareness and early health-seeking behavior among the participants.