Obstetric care practice in Birbhum District, West Bengal, India.

BACKGROUND: The study area is the Birbhum district of the State of West Bengal in India. It is one of the backward districts in India. OBJECTIVE: The paper investigates the existing pattern of obstetric health care practices and the factors associated with the utilization of such care. METHOD: The present analysis includes 495 adult married women of both rural and urban areas of nine Blocks of Birbhum district. Besides performing chi2 tests to see the association of the relevant individual and household characteristics, logistic regression was also carried out to measure the effect of these characteristics on the use of obstetric health care. RESULTS: In Birbhum district of West Bengal 65 percent mothers go to doctors for antenatal check-up during their pregnancy, but only 26 percent mothers deliver their babies in institutions and 30 percent mothers get the help of professional health assistants during delivery. Educated women have emphasized role in the practice of obstetric health care. Husband's education and the standard of living of the family also have some effect on the practice of antenatal check up, place of delivery and assistance of health professional. While most of the family background variables have significant effect on the practice of antenatal check up, these variables do not have much effect on the choice of delivery or seeking assistance of health professionals. Contrary to the popular belief the working status of women does not have favourable influence on the obstetric health care practices. In developing countries like India, it is the poverty, which compels the women to take jobs-that too in low paid jobs especially in rural backward areas. CONCLUSION: The status of literacy of mothers and standard of living of the family are of prime importance in improving the obstetric health care practices.     

Embryotoxicity and fetotoxicity of orally administered hexavalent chromium in mice

The embryotoxic and fetotoxic potential of hexavalent chromium (Cr⁺⁶) in mice was investigated by administering 250, 500, and 1000 ppm of potassium dichromate daily through drinking water during the entire gestation period. An increase in embryonic deaths was observed; however, in the mothers treated with the highest dose, there was complete absence of implantation sites. No major abnormality was observed in the fetuses except that Cr⁺⁶ exposure increased the incidences and types of external and skeletal malformations. It is concluded that oral exposure to Cr⁺⁶ causes dose-dependent embryolethal effects in mice.     

The association between aneurysm formation and systemic hypertension in Takayasu's arteritis

We have studied the incidence and patterns of aneurysm formation in 88 consecutive patients with Takayasu's arteritis by utilizing digital subtraction pan-aortoarteriography by the intravenous and/or intra-arterial route. Seventy-two patients underwent initial intravenous angiography of which 64 (89%) were diagnostic. All the intra-arterial studies (n = 24) were diagnostically adequate. Arterial aneurysms were seen in eight patients (9.1%) and the saccular variety (75%) was the most common. Clinical and angiographic features of these eight patients were compared with those of the remaining patients. No major differences were observed except that longstanding uncontrolled hypertension was present in all patients with aneurysm formation. In comparison, hypertension was observed in 30 (49.2%) of the remaining 61 patients in whom clinical details were available. Angiographic localization of the aneurysm is important since there are no clinical features that distinguish these patients and rupture of a strategically located aneurysm can prove fatal. The association between hypertension and aneurysm formation suggests that hypertension in these patients should be aggressively managed at the onset of disease. In this regard percutaneous transluminal renal angioplasty may prove a possible management adjunct.     

Utility of coaxial technique for renal angioplasty in patients with a difficult-to-cross stenosis

The aim of this study was to evaluate the feasibility of coaxial approach in difficult-to-cross lesions in patients with failed percutaneous transluminal renal angioplasty by conventional over-the-wire exchange technique. Twelve stenoses in 10 patients (six women and four men; age range 19 ± 7 years) with uncontrolled hypertension were treated by this method. The stenosis was caused by nonspecific aortoarteritis in 8 patients and fibromuscular dysplasia in 2 patients. It was ostial in seven and post-ostial in five vessels. Conventional exchange technique was unsuccessful in all of them. All procedures were done by femoral route. Technical success was seen in 11 (92 %), without complication. The stenosis improved from 90 ± 2.1 % (range 80–100 %) to 6 ± 7 % (range 0–20 %), blood pressure decreased from 198 ± 12.3 mm Hg (range 180–220 mm Hg)/130 ± 6.7 mm Hg (range 120–140 mm Hg) to 119 ± 5.7 mm Hg (range 110–130 mm Hg)/83 ± 3.9 mm Hg (range 80–90 mm Hg), and number of drug treatments for hypertension fell from 3.6 ± 0.52 (range 3–4) to 1 ± 0.94 (range 0–3; p < 0.01). Percutaneous transluminal renal angioplasty resulted in “cure” in 3 patients and “improvement” in 7 patients. Follow-up period was 3–21 months (mean 6.4 months). No restenosis was detected. Coaxial approach is safe and effective in treating difficult-to-cross lesions in which renal angioplasty by conventional exchange technique is unsuccessful. Received: 7 May 1998; Revision received: 10 November 1998; Accepted: 25 November 1998     

Fertility, mortality and maternal anaemic status in a village population of West Bengal, India

The present study was conducted on a Mahishya agricultural caste population of Chakpota village, Howrah district, West Bengal, India to enquire into the possible relations of anaemia, and fertility and mortality. The results confirm that negative relations exist between heamoglobin level of the mother, on the one hand, and fertility and offspring mortality, on the other.