Early Registration Research Articles

Trial Waste in Hyaluronic Acid-Related Randomised Controlled Trials.

A notable obstacle in applying the findings of hyaluronic acid (HA)-related randomised controlled trials (RCTs) to real-world patient treatment is trial waste (TW). To date, the extent of TW in RCTs for HA is not clear. To analyse the extents of TW within HA-RCTs and identify protective factors against TW. In July 2024, we searched the ClinicalTrials database using the 'hyaluronic acid' as keyword. We documented the data available and then explored PubMed and Scopus for the publication status. Reporting adequacy was evaluated using the CONSORT checklist. Design limitations were analysed based on bias risk and whether the article referenced a relevant systematic review. Subsequently, we evaluated extent of TW (unpublished studies, insufficient reporting and design flaws). One hundred and eighty-four RCTs met the inclusion criteria. The analysis of TW excluded 53 RCTs completed after June 2020 that remained unpublished. Among the remaining 131 RCTs, 72 were published, 47 had adequate reporting and 19 had design limitations. Taken together, 96 RCTs (73.3%) exhibited at least one characteristic of TW. Characteristics of these RCTs included early registration (p < 0.001) and the absence of a multi-blind approach (p = 0.007). Registration prior to 2014 (p < 0.001) and the open-label or single-blinding design (p = 0.003) emerged as independent risk factor for TW. We delineated the features of 184 HA-related RCTs. 73.3% of the RCTs included in TW analysis exhibited TW. The diverse traits of the different TW indicators identified could serve as valuable insights for conducting future HA-RCTs more rationally and efficiently.

MATERNAL AND PERINATAL OUTCOMES OF EARLY TRIMESTER BLEEDING

Bleeding per vagina is one of the most everyday presentations in the first trimester, with an incidence of 15- 25%. These pregnancies end up in pregnancy loss and multiple poor feto-maternal outcomes requiring early registration and treatment. Objectives: To evaluate for maternal perinatal outcomes in normal intrauterine pregnancies complicated by first-trimester vaginal bleeding Methods: This cohort study was conducted at the Gynecology and Obstetrics department of Lady Reading Hospital Peshawar from January 2024 till the required sample size is obtained in May 2024. Data were collected from 195 pregnant females. Women were divided into two groups. All pregnant women with singleton pregnancy and with or without vaginal bleeding during the first trimester, defined as up to the first 12 weeks of pregnancy, both delivering at our institute, were selected. Results: Miscarriage rates were notably higher in the exposed group (20.4% vs. 10.3%, OR 3.5, p=0.02), as were preterm births (22.4% vs. 15.5%, OR 2.8, p=0.01) and placental complications (12.2% vs. 5.2%, OR 4.2, p=0.03). The exposed group also had higher rates of postpartum hemorrhage (14.3% vs. 10.3%, OR 2.2, p=0.01), though cesarean section rates were similar between groups (30.6% vs. 30.9%, OR 2.0, p=0.15). Conclusion: It is concluded that early trimester bleeding is associated with an increased risk of adverse maternal and perinatal outcomes, including miscarriage, preterm birth, placental complications, and low birth weight.

Assessment of knowledge and utilization of antenatal care services among tribal women of Palakkad district, Kerala: a cross-sectional study

Background: Nearly 800 women die out of preventable causes associated with pregnancy and childbirth worldwide every day, with low and middle-income countries contributing approximately 90% of the mortality. The majority of pregnancy-related deaths are preventable with the provisioning of cost-effective services like antenatal care (ANC). Despite Kerala having a good human development index compared to other states in India, marginalized groups like Dalit, Adivasi, and fisher folks are still behind the development process, including the utilization of ANC services. This study assessed the knowledge and utilization of ANC services among tribals in Kerala, India. Methods: A cross-sectional study was conducted among 45 tribal women of Palakkad district, Kerala, who registered for ANC and delivered child. Convenient sampling was used to select study participants. Descriptive statistics were used to obtain frequency and percentage. The chi-square test was carried out to see the association between identified variables. Results: Among 45 participants, 28.89% fell under the adequate ANC utilization. 64.46% did early ANC registration, 73.3% visited ANC more than four times, 75.56% completed the 2 tetanus toxoid (TT) injections, and 66.67% consumed more than 100 iron-folic acid tablets. About 73.3% of participants knew the importance of immunizing children against vaccine-preventable diseases. Conclusions: Even in an egalitarian state like Kerala with high literacy, ANC service utilization among tribal communities is still below 70%. The issue is multifaceted and requires a more nuanced approach. The health system must adopt comprehensive, context-specific, and community-based approaches.

“Maternal and Perinatal Outcome in Preterm Placenta Praevia”

Introduction: Placenta previa (PP) is a significant cause of maternal and fetal morbidity and mortality worldwide. However, there is limited data from developing countries on the maternal and fetal outcomes and complications associated with placenta previa. Aim of the study: The aim of this study was to evaluate maternal and perinatal outcome in preterm placenta praevia. Methods: This prospective observational study was conducted in the Department of Gynae and Obstetrics of Dhaka Medical College Hospital, Dhaka, Bangladesh during the period from March 2010 to August 1010. Result: Total 66 patients were diagnosed with placenta previa. We found, the majority (42%) of participants were aged between 26-30 years and with lower socio-economic status significantly associated with higher prevalence due to lack of regular antenatal care. The majority were admitted at 35-37 weeks gestation, with the highest perinatal loss occurring before 30 weeks. Initial bleeding was generally small, and many presented with labor pain and anemia. Ultrasonography diagnosed 55% of cases, with cesarean sections frequently used, leading to better outcomes compared to vaginal deliveries. Severe postpartum complications like hemorrhage and urinary tract infections were common in more severe cases. Conclusion: Placenta previa is a major cause of maternal and perinatal morbidity and mortality. Early registration, regular antenatal care, early detection of high-risk cases, and timely referral to higher centers with good NICU services and blood bank facilities can help prevent these adverse outcomes.

P-599 Oestradiol/Progesterone ratio Impact on Frozen Embryo Transfer (FET) and pregnancy outcomes

Abstract Study question Are oestradiol (E2) levels and oestradiol/progesterone (P4) ratio related to higher implantation rates and reduced risk of miscarriage? Summary answer We concluded that higher E2 levels and an increased E2/P4 ratio on the day before FET were associated with lower implantation rates. What is known already A progesterone threshold &amp;lt; 9.2 ng/ml on the day of FET has been related to lower rates of clinical pregnancy. Progesterone is responsible for increasing endometrial vascularization and exerting an immunomodulator effect that allows blastocyst implantation. How oestradiol affects implantation is not well described yet. An appropriate luteal phase support is essential to synchronize the endometrium, ensure proper implantation and reduce the risk of abortion. However, no studies exist regarding E2 levels and E2/P4 ratios related to pregnancy outcomes in the first weeks of pregnancy. Study design, size, duration This is a prospective cohort study. From February 2023 to July 2023, 35 patients who underwent IVF in a private ART medical center were enrolled. Only euploid embryos after PGT- A were transferred and only the first single FET per patient was included. All embryos were transferred in blastocyst stage. Mosaic embryos, fresh cycles, patients with no PGT-A, miscarriages beyond 10 weeks and chemical pregnancies (no evidence of gestational sac) were excluded. Participants/materials, setting, methods 35 patients who underwent IVF-ICSI were retrospectively analyzed. Serum oestradiol, serum progesterone and E2/P4 ratios were measured the day before embryo transfer and later in three moments: 15 days after positive BHCG test, when gestational sac was visualized; 10-15 days after visualization of the gestational sac, when positive embryo heart rate was verified, and in any moment of vaginal bleeding until the 10th week of pregnancy. Main results and the role of chance Our study supported the hypothesis that E2/P4 ratio before FET may be an important factor to predict the risk of threatened abortion considering that all patients had P4 levels &amp;gt; 10 ng/ml before FET. Multiple logistic regression revealed that E2 and E2/p4 ratio on the day before FET are variables related to the risk of threat of abortion. The resulting adjusted OR for E2 on the day before FET in patients who suffered a threatened abortion vs patients who did not experience threat of abortion was 1,025 (95% CI: 1,001-1,049), p value 0,041. The OR for E2/p4 ratio before FET in patients with treat of abortion vs those without threat of abortion was 1,235 (95% CI: 1,035-1,472), p value 0,019. ROC curves showed a significant predictive value for E2 levels &amp;gt;220 pg/ml [AUC of 0,88 (95% CI: 0,73-1,0), p value 0,009] and E2/P4 ratio &amp;gt; 23 [AUC 0,91 (95% CI: 0,78-1,0), p &amp;lt; 0,05], the day before FET indicating a higher risk of threat of miscarriage and loss of pregnancy. Multiple logistic regression did not find significant statistical differences, either E2 or E2/P4 ratio, between the two groups of patients in subsequent determinations at 4 and 6 weeks after transfer. Limitations, reasons for caution The main limitation of this study is the sample size with the lack of further serial measurements of oestradiol and p4 in patients that presented threat of abortion/ miscarriage before the 10th week of pregnancy. Wider implications of the findings E2/P4 ratio the day before FET seems to be the most important factor to decrease threat of abortion in patients with P4&amp;gt; 10 ng/ml. Our study may hold predictive value regarding endometrial receptivity and provide clinicians a guide to individualise FET protocols and to prevent early pregnancy losses Trial registration number N/A

Assessment of knowledge of accredited social health activists regarding antenatal &amp; neonatal care in a block of Haryana

Improving maternal &amp; child health has been an essential tool for achieving health for all. The discourse on the Accredited Social Health Activist’s (ASHA’s) role centers around three typologies -as an activist, as a link worker or facilitator, and as a community level health care provider.To assess knowledge of ASHA workers regarding antenatal and neonatal care in a block of Haryana. The present cross-sectional, community-based study was conducted in block Barwala, district Hisar of Haryana. Universal sampling technique was used. A predesigned, pretested, semi-structured schedule was used to collect the information, which included details of socio-demographic profile of ASHA workers and questions about knowledge of antenatal &amp; postnatal care. Appropriate statistical tests like frequencies and percentages test were applied to analyze the collected data.Only 6.9% ASHA workers told about benefits of early registration of pregnancy. Majority of ASHA workers had inadequate knowledge about identification of danger signs during pregnancy and infancy, duration of trimester. Majority of ASHA workers had adequate knowledge about breast-feeding practices however about half of ASHA workers had inadequate knowledge about duration of colostrum. Only about one third ASHA workers had adequate knowledge regarding weighing machine &amp; colour zone used for identify malnutrition.: It is important to reorient ASHA workers at field level and supportive supervision also plays an important role.

Knowledge, Attitudes and Practice of Pregnant Women about Anemia during Pregnancy in Baghdad Teaching Hospital

Objectives: to assess the level of knowledge, attitude and practice of pregnant women about anemia. To assess the association between knowledge of pregnant women and their socio – demographic variances. To assess the association between the practice of pregnant women and their socio – demographic variances. Methods: cross sectional study, carried out among pregnant at Baghdad Teaching Hospital, from 25th February to 28th April, 2023. A total of 300 pregnant women participated in the study. The tool of study was questionnaire. Results: The study revealed 63.3% of pregnant women had good knowledge, positive attitude found in 65.3% and health practice in 59.3% among pregnant women regarding anemia, the study show association between the knowledge of the pregnant woman and educational level of her and her husband, also there is association between the practice of pregnant woman and her occupation. Conclusion: A noticeable general good level of knowledge , attitude and practice among pregnant women regarding anemia during pregnancy, level of knowledge in pregnant woman associated with the educational level of her and her husband and healthy practice increase in employed pregnant woman. Recommendations: Raise the level of knowledge and practice for prevention, learn pregnant women healthy dietary habit and encourage pregnant women to early registration in primary health care center.

IJCM_92A: Pregnancy outcomes associated with antenatal care service utilization &amp; barriers and enablers affecting the utilization of antenatal care services in South-East Delhi: A community-based cross-sectional study

Background: Antenatal care provides preventive health care, through which women can learn from skilled health personnel. Women who don’t consume Iron Folic Acid Supplements as prescribed would experience iron and folic acid (IFA) deficiency anemia. Iron deficiency has negative effects on mothers and newborns while folic acid deficiency in pregnancy causes pre-eclampsia, preterm delivery, neural tube defects, fetal malformation, type 2 diabetes, and obesity in the newborn. Comprehensive antenatal care is early registration of pregnancy (within 12 weeks), at least four ANC visits at a health facility, two doses of tetanus toxoid, and at least 100 days of IFAS consumption. Objectives: 1-To assess pregnancy outcomes associated with antenatal care service utilization in participants aged 18-49 years residing in the field practice areas of a Medical College in South-East Delhi. 2-To determine the barriers and enablers affecting the utilization of antenatal care services in the given population. Methodology: It is a community-based cross-sectional study conducted in South-East Delhi. The sample size was calculated as 300 considering a 5% absolute error for a 95% confidence interval and 10% non-response rate. Out of 300, the current data of 200 participants will be depicted here. Stratified systematic random sampling with the Probability Proportional to Size technique was applied to the population registered at RHTC &amp; UHTC. Households were selected by systematic random sampling. Pregnant women aged between 18-49 years were selected from the household. A self-designed, pre-tested, validated structured questionnaire was used. Results: Out of the total number of participants, 66.0% had knowledge regarding early registration of pregnancy. 80.0 % had permission to attend a health facility, 70.5 % had an accompanying person, 62.5 % of participants had been residing more than 6 km away from the health facility. 58.0 % of participants could meet the expenses of health care services. Out of all newborns, 90.0 % had normal birth weights, 10% had low birth weights, 81.0% participants had NVDs, and 19% were caesarean sections. Conclusion: Enablers are knowledge regarding early registration, presence of accompanying person. Permission for health visits, expenses for health care services &amp; distance to health facility were barriers.

Pregnancy-related Factors Responsible for Delivering Low Birth Weight Babies: An Institutional-based Cross-sectional Study, Jamnagar, Gujarat.

The WHO defines LBW as "Birth weight less than 2500 grams" regardless of gestational age. Being born with a low birth weight also incurs enormous economic costs, including higher medical expenditures and social service expenses, and decreased productivity in adulthood. To study distribution of newborns' according to pregnancy related factors and its association with newborns' birth weight. An institutional based cross-sectional study. New-borns delivered at study institute were considered as study participants. Estimated final sample size was 500. Guardians (mothers) were face-to-face interviewed and also recorded data were collected from the case file and Mother and Child Protection Card. Prevalence of LBW newborns was higher in mothers with late ANC registration, <4 ANC visits, chronic medical conditions, infection during pregnancy, PIH, anemia, consuming tobacco, exposure to second hand smoke, LSCS/Assisted delivery, in female newborns', current pregnancy birth order number more than 2, in pre term newborns' and mothers with bad obstetric history. Create awareness and adoption of suitable family planning methods. Need to do early (within 12 weeks) ANC registration with minimum four ANC visits for better pregnancy outcome. Effective tracking and suitable intervention provided to improve current pregnancy outcome. Health care professional should pay special attention to high-risk pregnancy. Develop social culture in such a way that females are neither addicted nor exposed to any tobacco containing products in their life.

To leave no one behind: Assessing utilization of maternal newborn and child health services by all the 13 particularly vulnerable tribal groups (PVTGs) of Odisha, India.

Indigenous tribal people experience lower coverage of maternal, newborn and child healthcare (MNCH) services worldwide, including in India. Meanwhile, Indian tribal people comprise a special sub-population who are even more isolated, marginalized and underserved, designated as particularly vulnerable tribal groups (PVTGs). However, there is an extreme paucity of evidence on how this most vulnerable sub-population utilizes health services. Therefore, we aimed to estimate MNCH service utilization by all the 13 PVTGs of the eastern Indian state of Odisha and compare that with state and national rates. A total of 1186 eligible mothers who gave birth to a live child in last 5years, were interviewed using a validated questionnaire. The weighted MNCH service utilization rates were estimated for antenatal care (ANC), intranatal care (INC), postnatal care (PNC) and immunization (for 12-23-month-old children). The same rates were estimated for state (n = 7144) and nationally representative samples (n = 176843) from National Family Health Survey-5. The ANC service utilization among PVTGs were considerably higher than national average except for early pregnancy registration (PVTGs 67% versus national 79.9%), and 5 ANC components (80.8% versus 82.3%). However, their institutional delivery rates (77.9%) were lower than averages for Odisha (93.1%) and India (90.1%). The PNC and immunization rates were substantially higher than the national averages. Furthermore, the main reasons behind greater home delivery in the PVTGs were accessibility issues (29.9%) and cultural barriers (23.1%). Ours was the first study of MNCH service utilization by PVTGs of an Indian state. It is very pleasantly surprising to note that the most vulnerable subpopulation of India, the PVTGs, have achieved comparable or often greater utilization rates than the national average, which may be attributable to overall significantly better performance by the Odisha state. However, PVTGs have underperformed in terms of timely pregnancy registration and institutional delivery, which should be urgently addressed.

JARVIS - Customer Support Chatbot with ML

Embarking on an unprecedented venture, this avant-garde initiative unveils a state-of-the-art customer support chatbot meticulously crafted to revolutionize the intricate landscape of global course registration for students hailing from diverse academic institutions. Positioned as a beacon of efficiency and accessibility, this platform facilitates seamless online enrollment across ten distinct subjects, transcending geographical and institutional boundaries to welcome students from around the world. In this digital haven for academic pursuits, each course commands a registration fee of 10,000 units, an investment in knowledge with the added allure of an exclusive 30% discount for early registrants, fostering a culture of expeditious and strategic engagement with the enrollment process. This innovative incentive structure not only propels swift registrations but also underscores a commitment to making quality education financially accessible. Navigating through this educational portal, aspiring learners encounter a dedicated helpline, a virtual concierge ready to address and assuage any queries related to the intricate registration process. As the enrollment journey unfolds, the system dynamically orchestrates a delicate ballet, promptly notifying users when the coveted cap of 60 students per subject is reached. This transparent communication ensures users are informed of seat unavailability in real-time, fortifying the platform's commitment to fairness and openness. However, the journey doesn't end here. For those facing unresolved challenges or encountering roadblocks during registration, the chatbot deftly orchestrates a seamless handoff to a specialized support clientele. This strategic escalation ensures that every student's concern is meticulously addressed by a dedicated team, fostering an environment where no query goes unanswered and no registration challenge remains insurmountable. In scenarios where course quotas reach their zenith, the support team takes center stage. Diligently reviewing and addressing concerns, they become the architects of successful registrations for students navigating the labyrinth of challenges. This comprehensive and user-centric approach doesn't merely strive for efficiency; it aspires to craft an immersive and transformative online course registration experience. Aiming beyond transactional engagements, this initiative envisions itself as a catalyst for global International Journal of Scientific Research in Engineering and Management (IJSREM) Volume: 08 Issue: 01 | January - 2024 SJIF Rating: 8.176 ISSN: 2582-3930 © 2024, IJSREM | www.ijsrem.com DOI: 10.55041/IJSREM28053 | Page 2 educational opportunities, prioritizing not only customer satisfaction but also the holistic resolution of any issue encountered on the educational journey. In essence, it seeks to redefine the paradigm of online education, making it not just accessible but an enriching and empowering experience for students worldwide.

Coverage of Antenatal Care Services in a Rural Area of District Nuh, Haryana

Background: The district Nuh has been declared as the most backward district of Haryana state and is also listedamong the 108 most backward districts of India identified by the National Institute for Transformation of India(NITI) Aayog. National Family Health Survey-4 (NFHS-4) conducted during 2015-16 reported that only 6.5% ofmothers utilize four antenatal check-ups in district Nuh. This study was carried out to estimate the coverage ofantenatal care services in district Nuh.Methods: A total of 300 pregnant women who were in their 1st trimester were recruited from the rural area ofPrimary Health Centre Nagina starting from January 2022 till December 2022. All eligible study participants wereinterviewed through house-to-house visits to assess the coverage of antenatal care received by them.Results: A total of 83 (27.6%) participants were primigravida, and 217 (72.3%) were multigravida. Only 25 (8.33%)participants reported receiving full antenatal care services which include early registration of pregnancy (within12 weeks), a minimum of four ANC visits, at least one dose of diphtheria-tetanus toxoid vaccine, and 100 days ofiron &amp; folic acid supplementation.Conclusion: The coverage of antenatal care services received by pregnant women is low despite the availabilityof free government services.

Fetomaternal outcome of HIV-infected pregnant women delivering at a tertiary health-care center of South Gujarat.

The aim of this study was to document the fetomaternal outcome in HIV-infected pregnant women delivering at a tertiary health-care center of South Gujarat. This study was a secondary data analysis of pregnant HIV-infected women delivering between May 2017 and April 2021 in the Department of Obstetrics and Gynecology, a tertiary health-care center of South Gujarat. Secondary data analysis was performed using IBM SPSS ver. 20.0 (IBM SPSS Corp., Armonk, NY, USA). A total of 145 HIV-infected pregnant women were delivered at our institute during the study period. Thirteen (8.97%) participants had preterm delivery. Eighty-eight (60.68%) of the 145 participants had vaginal delivery and 57 (39.32%) underwent cesarean section. One hundred and forty-three (98.62%) of our 145 participants had live births, whereas 2 (1.38%) had stillbirths. Most of the newborns, i.e., 96 (64.43%) had a birth weight of between 2 and 3 kg, and 25 (16.77%) had a birth weight of <2 kg. Out of 147 live-born babies, 36 (24.48%) babies were admitted to the neonatal intensive care unit NICU. Although the HIV positivity in our general population is <1%, it entails a slightly higher risk of preterm birth and stillbirth for the HIV-positive pregnant women. Early registration and appropriate antenatal care are necessary for optimizing the fetomaternal outcome.

Improving health indicators of mothers and newborns by empowering communities in urban slums of Mumbai, Maharashtra, India

Abstract Background: Newborns represent the most vulnerable segment of our society, constituting nearly 30% of all under-5 mortality cases. Despite well-established healthcare systems in metropolitan areas, urban slum dwellers, comprising approximately 50%–60% of the population, often lack access to these services. The Society for Nutrition, Education, and Health Action (SNEHA) operates within urban slums, aiming to enhance health outcomes for mothers and children. At SNEHA, we firmly believe that a healthy society starts with the well-being of mothers and infants. Our organization is dedicated to empowering communities to improve the health status of newborns in urban slums. Material and Methods: As part of the intervention, 7819 households with a population of 35,000 were targeted. SNEHA’s field workers conducted regular visits to these households, providing counseling on breastfeeding immunization and identifying potential health risks. Married women of reproductive age were specifically identified and consistently educated about the significance of early pregnancy registration. Pregnant women received support for registering their pregnancies, attending regular antenatal care (ANC) check-ups, adhering to ANC visit schedules, and maintaining adequate iron, calcium, and nutrition intake. Additionally, they were informed about the advantages of institutional delivery and encouraged to prepare for childbirth. Mothers of children under 2 years were urged to bring them to primary health centers for routine immunizations. Furthermore, they were advised on contraception methods to ensure proper spacing between children. Results: Our endeavors have resulted in a 34% rise in early pregnancy registration, a 22% increase in the number of women attending four antenatal check-ups, an 11% uptick in institutional deliveries, a 24% improvement in exclusive breastfeeding rates, and a notable 67% surge in the prevalence of contraception. Conclusion: Our intervention has proven that it is possible to improve the health indicators of women and children through behavior change communication, regular home visits, and community awareness.

Implementation of Machine Learning and Its Interpretation for Mapping Social Welfare Policy in Indonesia

This research leverages data from the 2022 Early Socio-Economic Registration (Regsosek) activity to develop a machine learning model capable of predicting family expenditure levels based on the Proxy Mean Test (PMT) with high accuracy. By integrating the SHAP (SHapley Additive exPlanations) method for model interpretation, we identify the contributions of socio-economic features to expenditure predictions and link them to relevant social assistance programs. We compare two regions, Kulonprogo Regency and Yogyakarta City, representing varying poverty levels, and identify unique characteristics influencing family welfare in each area. The results highlight that effective policy interventions must be tailored to the unique characteristics of each region and family, taking into account dimensions such as housing, education, income, and community expenditures. This research provides valuable insights for policymakers, demonstrating that successful poverty alleviation policies are data-driven and adaptable to the diverse socio-economic realities across regions.

Addressing Disparities in Maternal and Child Health Services: A Focus on Uttar Pradesh, India

Background: India faces a critical challenge in maternal and child health, having reported the highest maternal and child deaths globally in 2010 and 2009, respectively. Despite a 70% decline in maternal mortality from 1990 to 2015, India still accounts for 15% of global maternal deaths. This study focuses on Uttar Pradesh, India's most populous state, where under-five child mortality rates are alarming, particularly in rural areas. Despite governmental efforts, accessibility, availability, and affordability of maternal and child health services remain problematic. Data and Methods: This study utilizes publicly available multi-level data from the HMIS portal of the Ministry of Health and Family Welfare, focusing on Uttar Pradesh. The HMIS is a crucial tool for monitoring and implementing national health programs. Examining data from 2018 to 2020, the study assesses the spatial distribution of Maternal and Child Health (MCH) coverage at the district level using descriptive statistics. The findings contribute to understanding MCH service utilization in Uttar Pradesh. Result and Discussion: This research investigates maternal health service utilization across districts in Uttar Pradesh, India, analyzing key indicators from 2018 to 2020. The study reveals significant variations in early registration, antenatal care, vaccination, and delivery preferences. Positive changes, notably in Basti and Kanpur Dehat, contrast with negative trends in Meerut and Varanasi. The findings underscore the need for targeted interventions to address disparities and enhance maternal health outcomes in Uttar Pradesh. Conclusion: Maternal health service utilization is vital for community well-being. Despite increased awareness, persistent gaps exist due to barriers like inadequate infrastructure and cultural norms. Addressing these demands a multi-faceted approach, including policy reforms, education, and innovative technologies. Optimizing maternal health requires holistic efforts to bridge socio-economic gaps and build resilient communities.

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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

Breakthrough mother-to-child transmission of HIV in a low-health facility in Uganda

ObjectivesMother-to-child transmission (MTCT) of HIV can be minimized using elimination of MTCT (eMTCT) services. This study aimed to determine the proportion of infants who tested positive for HIV despite receiving eMTCT services in a rural setting in Northern Uganda. MethodsWe retrospectively reviewed the early infant diagnosis register for the year January 2019 through June 2021 to collect data on participants enrolled in eMTCT services at Lalogi Health Centre IV in Omoro district, Uganda. Breakthrough HIV infection was defined as a positive HIV RNA on a dried blood sample at 18 months in a patient who received eMTCT services as recommended by national guidelines. ResultsA total of 118 infants were enrolled in the study, 64 (54.2%) of whom were female. Most of the participants (n = 111, 94.1%) were on nevirapine prophylaxis for at least 6 weeks, 115 (97.5%) were exclusively breastfed, two (1.7%) were on complementary feeding, and one (0.8%) was not breastfed. Only five (4.2%) infants were lost to follow-up, four (3.4%) had incomplete data, and three (2.5%) had breakthrough HIV infections (positive HIV RNA and HIV antibody tests). All three cases of breakthrough HIV infection (one male and two female infants) were born to mothers who were diagnosed with HIV at delivery and were on nevirapine prophylaxis for less than 6 weeks. ConclusionOur findings indicate that while eMTCT services were largely successful in minimizing vertical transmission of HIV in the rural setting in Northern Uganda, there were still some cases of breakthrough HIV infection associated with non-adherence to nevirapine prophylaxis and delayed maternal HIV diagnosis. Therefore, adhering to the national guidelines on nevirapine prophylaxis for at least 6 weeks for children born to mothers with HIV is recommended to further reduce the risk of vertical transmission of HIV.

Antenatal care and its association with pregnancy outcomes at tertiary care hospital, Jhalawar

Background: Low birth weight is a major public health problem in India. Amongst several many factors affecting birth weight, the two factors are demographic characteristics of mothers and utilization of antenatal care services after timely registration of pregnancy. Aims were to access ANC and its association with pregnancy outcomes at Jhalawar medical college, Jhalawar Rajasthan. Methods: All the pregnant women were admitted to the maternity ward for delivery in November 2022. The interview consisted of a demographic characteristic of mothers, utilization of ANC services, live birth weight of the baby, and records of the mother from the hospital. Data collection was done from the maternity ward and vaccination site. It was a hospital-based cross-sectional study. Results: Among mothers who registered in 1st trimester, 81.6% delivered at full term, 77% of new-born were normal birth weight and only 8.5% of new-born needed NICU admission; compared to those who registered in 2nd and 3rd trimesters delivered at full term 67.1% and 55% respectively, 63.3% and 50% new-born had normal birth weight and NICU admission needed by 17.7% and 55% new-born needed NICU admission respectively. Those mothers who received ≥4 ANC visits had delivered 186 (78.8%) new-born with normal birth weight and required NICU admission for 24 (10.2%) new-born as compared to those who had &lt;4 ANC visits delivered 109 (64.9.8%) new-born with normal birth weight. Conclusions: Early registration of pregnancy prevents chances of LBW baby, long stay in NICU also leads to a reduction in preterm delivery.