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Introduction: Severe anemia in pregnancy increases maternal and neonatal morbidity and mortality in the antenatal period. Objective: To find out the maternal and fetal outcomes in severely anemic pregnant women and explore the reason for the persistence of severe anemia in pregnant women. Materials and Methods: Sequential explanatory mixed method study (Quan-Qual) was conducted in the Government Women and Children Hospital for a period of 1 and half years. Most of the people were from rural backgrounds and belonging to low socioeconomic status have been registered. Quantitative data were collected from 125 severe anemic cases; a consecutive sampling technique was applied. In-depth interviews were conducted among purposively selected severe anemic patients (n = 15) who were vocal and willing to explore the reason for the persistence of anemia. The interviews were conducted till the point of saturation. Ethical principles were adhered throughout the study. Quantitative data were anlyzed using SPSS software. Manual content analysis was done for qualitative data. Results: Among 125 severe anemic patients, 12.8% patients had preterm labour, about 23.2% had inadequate lactation, and 13.6% had a puerperal febrile illness. It was found 41.6% of neonates had respiratory distress and 33.6% had the refusal of feeds. When compared to vaginal delivery, women undergoing cesarean section have 3.2 times (95% confidence interval 1.39-7.32) higher odds of developing maternal complications. Nagelkerke's R2 value for the model was 11.1%. Five broad categories namely Family centric nature, Lack of awareness, Pill burden, Food Fads, and Myths related to iron intake emerged from the study. Conclusion: Complications can occur in mothers and neonates if anemia is not corrected in early trimester. [ABSTRACT FROM AUTHOR]

Background: Pregnant Health Care Professionals (HCPs), who serve as front-line warriors of COVID-19 will invariably experience a stressful pregnancy period. Ensuring their well-being during this COVID-19 pandemic period is a big challenge and guidelines or standard operating procedures (SOP) for the same are non-existent or are scarce. Objectives: To explore the challenges and experiences of pregnant HCPs during the COVID-19 pandemic. Methods: A qualitative study was conducted among 19 pregnant HCPs (14 Doctors and 5 staff nurses) working in Pondicherry, who were selected using purposive sampling for in-depth interviews. After obtaining informed written consent, face-to-face interviews were conducted until the attainment of the point of saturation. Audio recordings of the interviews were transcribed in English. Transcripts were proofread and manually analyzed for content. Codes obtained from the analysis of transcripts were merged to form broad categories. Results: The majority 15 (78.9%) of HCPs belonged to the clinical department and had work experience from 2--4 years. The mean age of the respondents was 29.4 ± 3.6 years. Four broad categories (of challenges), namely, Personnel level (Fear of infection in workplace, Inadequate antenatal care), Family level (Family pressure to quit job, Guilt of spreading the infection to family members), society level (Criticism by neighbor for working, Stigma), and work level challenges (Fear of losing the job, Uncomfortable work environment) emerged from the study. Conclusion and Recommendations: Challenges faced by the pregnant HCPs due to their nature of work remain by and large not addressed. Hence, specific guidelines or SOPs addressing these issues of pregnant health care workers and their swift and strict implementation are the need of the hour. [ABSTRACT FROM AUTHOR]

Background: In India, routine Pap smear screening is an ongoing process for the detection of cervical cancer, but the follow-up component remains unaddressed. The objectives of the present study were to find out the proportion of abnormal Pap smear results among women aged 30 years screened through the cervical cancer screening program at RHTC, their follow-up status, and explore the reasons and solutions for loss to follow-up (LTFU). Methodology: An explanatory mixed-method study (quantitative: A record-based cohort study followed by qualitative: Five in-depth interviews with loss to follow-up patients and 14 key informant interviews with stakeholders who were purposively selected to identify barriers and possible solutions for LTFU using an interview guide) was conducted in RHTC over 3 months. Ethical principles were adhered to. Results: The results showed that 307 of the 1328 women screened had abnormal Pap smear results. Of the 31 women with precancerous lesions, 26 (83.9%) were on regular follow-ups, and 5 (16.1%) were on irregular follow-ups. Manual content analysis showed five broad categories as barriers to LTFU, namely: (1) general awareness and practical issues; (2) family-related issues; (3) economic issues; (4) cultural issues; and (5) healthcare-associated issues. Community-level awareness generation for capacity building through health education constantly; displaying creative health information models (information, education, and communication); a positive deviance approach; a family and partner-centered approach; the formation of support groups; proactive intervention; and an incentive-based follow-up approach were possible solutions to mitigate the rate of LTFU. Conclusion: Improper knowledge, socio-cultural myths, and a lack of support from partners and family members were the main barriers identified for LTFU. Hence, to strengthen the follow-up component after the initial screening test, periodical sensitization and initiating an incentive-based follow-up approach should be recommended. [ABSTRACT FROM AUTHOR]

Background: COVID-19 is a rapidly spreading infectious pandemic. Increase in the level of systemic inflammatory markers is known to play fugitive role in the prognosis of the patients. This study retrospectively correlates the various hematological parameters with computed tomography severity score in COVID-19 patients. Method: The demographic, hematological, and radiological parameters of 150 patients were collected and analyzed. The performance of complete blood count (CBC) indexes for monitoring and predicting the severity of COVID-19 in patients was evaluated by analyzing and comparing CBC results with radiological severity score. Results: Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) correlated positively while lymphocyte correlated negatively with chest computed tomography severity score. Neutrophil, lymphocyte, eosinophil, monocyte, NLR, and PLR showed a significant difference between radiologically mild and severe COVID-19 cases (P < 0.05). Conclusion: The prognostic value of NLR in predicting the severity of illness is well established in our study. Increased NLR should prompt the clinicians to predict increased lung involvement by COVID-19 and should cater the treatment accordingly. [ABSTRACT FROM AUTHOR]

Introduction: Proper positioning and attachment play a key role in exclusive breastfeeding. Whereas incorrect breastfeeding techniques lead to poor milk transfer and early discontinuation of breastfeeding. Objectives: 1. To assess the breastfeeding techniques among postnatal mothers and to identify the factors associated with improper positioning and poor attachment. 2. To prioritize the action points to improve the poor breastfeeding practices according to the viewpoint of the staff nurses. Materials and Methods: A hospital-based mixed-methods study was carried out in Puducherry for 6 months. In quantitative phase, 99 postnatal mothers were interviewed consecutively and breastfeeding techniques were observed based on Baby Friendly Hospital Initiative and Integrated Management of Neonatal and Childhood Illness guidelines. In qualitative phase, 45 staff nurses ranked the action points to improve the poor breastfeeding practices. Bivariate and multivariate analyses were employed. Mean rank and Kendalls' Concordance Coefficient were calculated for the ranked data. Results: About 28.3% and 27.3% of mothers demonstrated improper positioning and poor attachment, respectively. Young mothers, housewives, <10 days old infants, and failure to receive breastfeeding counseling were associated with poor breastfeeding techniques. Poster displays, healthcare workers' training, targeted counseling, and assistance were the priority action points suggested by the staff nurses. Conclusion: Maternal age, maternal occupation, infants' age, and breastfeeding counseling influenced breastfeeding techniques. The prioritized action points need to be implemented to achieve the level of Baby Friendly Hospital. [ABSTRACT FROM AUTHOR]

Introduction: Perception of women about postmenopausal bleeding (PMB) may have a greater influence on their treatment-seeking behavior. Objectives: The objective was to explore the perceptions of causes and treatment of PMB among menopausal women and to quantify its perceived reasons. Materials and Methods: It was a sequential exploratory mixed-method study design, with two group interviews (qualitative phase), followed by a survey among 1530 postmenopausal women (quantitative phase). The qualitative data were analyzed by thematic analysis and quantitative data using descriptive statistics. Results: Lack of seriousness about PMB and stigma were stated as barriers for the treatment of PMB. Among 1530 women, 40.8% of them did not know the cause for PMB. The problem in the uterus, cancer, and improved nutrition were stated as reasons by 17.6%, 16.8%, and 15.8% of women, respectively. Conclusion: Most of the women did not know the reason for PMB and its awareness is crucial for better uptake of screening and detection of pathology at an early stage. [ABSTRACT FROM AUTHOR]

Introduction: Postmenopausal bleeding (PMB) is a common and early symptom of cervical and endometrial cancer. Its early detection can improve the cure rate and reduces mortality. Objectives: The objective of the study is to find out the prevalence and determinants of PMB in a rural community setting and the reasons for not undergoing cervical cancer screening among postmenopausal women. Materials and Methods: A sequential exploratory mixed methods study where qualitative (group interviews) phase followed quantitative (survey) phase in the community. The survey was undertaken among the representative sample of 1,530 postmenopausal women in 34 villages of Villupuram district, Tamil Nadu. Data were collected by house-to-house survey. Analysis: Bivariate and multivariate analysis was done using SPSS 24 software package. Results: The prevalence of PMB was found to be 1.8%. Only 5.6% women had undergone screening. The majority did not go for screening due to lack of awareness, or they did not have any symptoms or feared about negative results. Occupation (daily wage laborers), use of oral contraceptive pills at least for 1 year, recurrent abortions (> three abortions), reproductive tract infection (more than 10 episodes in lifetime), abdominal obesity (increased waist-hip ratio), and underweight were identified as significant risk factors for PMB. Conclusion and Recommendations: Nearly 2% of women have PMB, and most of the factors identified as determinants are preventable. Cervical cancer screening rate was poor among the respondents and lack of awareness was stated as the major reason for it. Hence, the promotion of healthy lifestyles and contraceptives in early reproductive life and awareness for the need of early screening is recommended. [ABSTRACT FROM AUTHOR]