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Background: UP has the 2nd highest MMR which is 197 compared with national average of 113 (RGI-SRS-2016-2018).Although institutional deliveries in India has been increased from 78.9% (NFHS-4) to 89% (NFHS-5) [ UP from 67.8% to 83.4%] but still we are far away from SDG -3 target. It reflects that there may be increase in crude coverage but not in effective coverage. Materials and Methods: It is a cross sectional study conducted in May-June 2017. Out of 8 blocks of rural Varanasi, 4 blocks were selected randomly. Best functioning facility for EmOC services in each selected block were assessed using Facility Gap Assessment Schedule of IPHS. Result: None of the facility met the recommended standard for BEmOC .Tracking of drop out of ANC and PNC services, use of Partograph, treatment of abortion-related complications, were not found at all the 4 facility. Blood grouping and RH typing was also not functional at 2 of the 4 centers. Caesarean section and availability of blood bank were also lacking in CHC (FRU). Conclusion: If condition of best functioning facility in a block is not according to the recommendation then how can we expect to provide a good maternal health service to public. [ABSTRACT FROM AUTHOR]

Background: Birth Preparedness and Complication Readiness is practise of planning for events related to child birth and making necessary arrangements, so that timely and adequate medical care can be provided to the mother. Objective: The objective of the study was to assess the Birth Preparedness and Complication Readiness of pregnant and recently delivered women in rural areas of Varanasi. Materials and Methods: A total of 633 pregnant and recently delivered women were interviewed using 11 components related to antenatal care and preparations done for child birth. Results: Out of all the respondents, less than half (46.4%) among Pregnant women and nearly the same proportion (45.1%) among recently delivered women were found "Well Prepared." Conclusion: The study revealed that there is a need to create awareness among the people about the importance of proper planning and making arrangements in advance to avert the danger to the life of mother and child. [ABSTRACT FROM AUTHOR]

Background: Pregnancy and motherhood are natural processes and considered to be full of positive experiences. However, for various reasons many women end up dying during pregnancy, childbirth, and the postpartum period. Improving maternal health and reducing maternal mortality have been prioritized in several international declarations and national policies. Objectives: The objective of the study is to assess delays, cause, and its contributing factors related to maternal deaths in rural Varanasi. Methodology: Verbal and Social Autopsy have been done for each maternal death occurred between April 2015 and March 2016 in four randomly selected blocks of rural Varanasi. The "3 Delay Model" and "Pathway analysis" concept was used in collection and analysis of data through in-depth interview of three people (family member, neighbor, and a health worker) for each maternal death. Cause of death and delays was identified by two reviewers (obstetrician) independently. Results: In almost half of the autopsied cases two different delays were found, and in one-third case, only one delay was found. Direct obstetric cause found in more than half (54%) cases. Hemorrhage and anemia were found major direct and indirect obstetric cause, respectively. Other causes identified were sepsis (direct), jaundice, and meningitis. A number of social, behavioral, and cultural factors were identified, that had been contributed to different delays related to the maternal deaths. Conclusions: First delay was present in most of (90%) cases. Nonbiological (social, behavioral, and cultural) and health service factors were also identified in this study. [ABSTRACT FROM AUTHOR]

Background: There have been very few studies in India where both partners' involvement in family planning is seen. The present study was undertaken to assess the spousal agreement level regarding family planning adoption and unmet needs. Materials and Methods: Married couples where wife was in reproductive age group (15-44 years) were included. A pretested, semi-structured interview schedule was used for the study. Sterilized couples were excluded. Interview of both husband and wife was done on the same day but in isolation. Results: There was excellent to poor agreement was reported among husbands and wives in fertility desire (κ = 0.769), current use of contraception (κ = 0.581), unmet need for family planning (κ = 0.416), ideal family size (Spearman correlation = 0.329), and approval for the use of contraception (κ = 0.300). In 6.1% of cases, husband-only unmet need was reported. Conclusion: There is need to encourage spousal communication so that they can make informed decisions on contraceptive choice. Husband-only unmet need for family planning was found, so man may be a potential entry point of national demographic health surveys to improve the contraceptive usage among couples and reduce the unmet need of them. [ABSTRACT FROM AUTHOR]

Understanding the hydrogeochemical processes that govern groundwater quality is important for sustainable management of the water resource. A study with the objective of identifying the hydro-geochemical processes and their relation with existing quality of groundwater was carried out in an intensively cultivated district of Punjab, India. The study approach includes conventional graphical plots and multivariate analysis of the hydrochemical data to define the geochemical evaluation of aquifer system based on the ionic constituents, water types, hydrochemical facies and factors controlling groundwater quality. The results suggest that different natural hydrogeochemical processes like simple dissolution, mixing, weathering of carbonate minerals locally known as “kankar” silicate weathering and ion exchange are the key factors in the pre-monsoon, which was superseded by leaching processes loaded with anthropogenic inputs in the post-monsoon. Limited reverse ion exchange has been noticed at few locations of the study area especially in pre-monsoon periods. There was a significant effect of monsoon observed in terms of hardness and the significant amount of area with temporary hardness (Ca2+–Mg2+–HCO type) in the pre-monsoon switched to permanent hardness domain, i.e. (Ca2+–Mg2+–Cl− type) by the post-monsoon. At most, factor analyses substantiate the findings of conventional graphical plots and provide greater confidence in data-interpretation. Thus, the study highlights the descriptive capabilities of conventional and multivariate techniques as effective tools in groundwater evaluation. [ABSTRACT FROM AUTHOR]

Punjab is the most cultivated state in India with the highest consumption of fertilizers. Patiala and Muktsar districts are two agricultural dominated districts of Punjab located in extreme south-east and south-west of the state. This paper highlights temporal variations of the groundwater quality and compares its suitability for irrigation and drinking purpose in these two districts. Water samples were collected in March and September 2003, representing the pre-monsoon and post-monsoon seasons, respectively. Water samples were analysed for almost all major cations, anions, dissolved heavy metals and turbidity. Parameters like sodium adsorption ratio, % sodium, residual sodium carbonate, total hardness, potential salinity, Kelley’s ratio, magnesium ratio, index of base exchange and permeability index were calculated on the basis of chemical data. A questionnaire was also used to investigate perception of villagers on taste and odour. Comparison of the concentration of the chemical constituents with WHO (world health organization) drinking water standards of 2004 and various classifications show that present status of groundwater in Patiala is better for irrigation and drinking purposes except for a few locations with a caution that it may deteriorate in near future. In Muktsar, groundwater is not suitable for drinking. Higher total hardness (TH) and total dissolved solids at numerous places indicate the unsuitability of groundwater for drinking and irrigation. Results obtained in this forms baseline data for the utility of groundwater. In terms of monsoon impact, Patiala groundwater shows dilution and flushing but Muktsar samples show excessive leaching of different chemical components into the groundwater leading to the enrichment of different anions and cations indicating pollution from extraneous sources. No clear correlation between the quality parameters studied here and perceived quality in terms of satisfactory taste response were obtained at electrical conductivity values higher than the threshold minimum acceptable value. [ABSTRACT FROM AUTHOR]

Objective: Acute kidney injury (AKI) is a frequent presentation in malaria infections. Several cases of AKI that are accompanied by clinical symptoms of malaria infection, such as fever, nausea, respiratory distress, and anemia remain undiagnosed due to challenges in accurate diagnosis using peripheral blood microscopy and rapid diagnostic tests that are currently used in clinical settings. This is particularly true for P. vivax and P. knowlesi infections. As a result, these patients are not able to receive anti-malarial therapy in a timely manner. The objective of the present study was to investigate if patients presenting with AKI harbored any of the five human Plasmodium species (P. falciparum, P. vivax, P. knowlesi, P. malariae, and P. ovale) within their renal tissues., Results: We found that renal biopsies from malaria associated AKI patients harbor the human malaria parasites P. falciparum, P. vivax and P. knowlesi as mono- and mixed species infections. Presence of microvascular injury in a majority of the malaria associated AKI cases suggested vascular involvement of P. vivax and P. knowlesi. This research note also highlights P. knowlesi as an emerging pathogen in the Indian subcontinent.

Introduction: BK polyomavirus is ubiquitous and remains dormant in the urothelial tract, reactivating and replicating in the immunocompromised state especially in the setting of post-renal transplantation where it is believed to be directly oncogenic based on recent reports. Its oncogenic role in the immunocompetent host is controversial. This study aimed to investigate the association of BK polyomavirus in Urothelial Carcinoma., Material and Methods: Patients with suspected urothelial carcinoma (UC) admitted under Department of Urology over a period of one year were recruited and transuretheral bladder tumor (TURBT) resection was performed, along with sampling of cystoscopically normal-appearing urothelium away from the tumor. In addition, cystectomy specimens with UC were included, with sampling of grossly normal-appearing urothelium away from the tumor. Immunohistochemistry (IHC) for SV40 T-Antigen and chromogenic in situ hybridization (CISH) using BK polyomavirus specific probe was performed on the paired samples (tumor and normal)., Results: Twenty-three TURBT and 14 cystectomy specimens were assessed. None of the cases showed evidence of BK polyomavirus infection in tumor or in surrounding mucosa by IHC. CISH performed in ten cases were also found to be negative. In comparison, one post-renal transplant urothelial carcinoma in our experience showed diffuse SV40 staining., Conclusions: This study suggests that BK polyomavirus infection is not associated with urothelial malignancy in the immunocompetent setting unlike in the immunocompromised setting where it should always be investigated for., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Schizophrenia is a severe psychiatric disorder with lifetime prevalence of ~1% worldwide. A genotyping study was conducted using a custom panel of Illumina 1536 SNPs in 840 schizophrenia cases and 876 controls (351 patients and 385 controls from North India; and 436 patients, 401 controls and 143 familial samples with 53 probands containing 37 complete and 16 incomplete trios from South India). Meta-analysis of this population of Indo-European and Dravidian ancestry identified three strongly associated variants with schizophrenia: STT3A (rs548181, p=1.47×10(-5)), NRG1 (rs17603876, p=8.66×10(-5)) and GRM7 (rs3864075, p=4.06×10(-3)). Finally, a meta-analysis was conducted comparing our data with data from the Schizophrenia Psychiatric Genome-Wide Association Study Consortium (PGC-SCZ) that supported rs548181 (p=1.39×10(-7)). In addition, combined analysis of sporadic case-control association and a transmission disequilibrium test in familial samples from South Indian population identified three associations: rs1062613 (p=3.12×10(-3)), a functional promoter variant of HTR3A; rs6710782 (p=3.50×10(-3)), an intronic variant of ERBB4; and rs891903 (p=1.05×10(-2)), an intronic variant of EBF1. The results support the risk variants observed in the earlier published work and suggest a potential role of neurodevelopmental genes in the schizophrenia pathogenesis., (Copyright © 2015 Elsevier B.V. All rights reserved.)