Biomedical subjects
Publications and source records attributed to A Indrayan.
In India a computer-based national health management information system is being implemented by linking more than 450 districts on a network. This and other actions in the field of informatics technology could significantly raise the efficiency of the country's health sector by making decisions more logical, speeding them up and monitoring their impact, and could help to improve the utilization of scarce resources.
The aim of this study was to develop a single comprehensive index of child mortality for longitudinal assessment of health status of children. The need for such a comprehensive index arose from conflicting trends in different child mortality indicators. The data for the study was taken from the Sample Registration System (SRS) reports of the Registrar General of India. SRS is known to provide reliable estimates of births and deaths at the State and the National level. The study included five child mortality indicators, namely, under five mortality rate (U5MR), infant mortality rate, neonatal mortality rate, perinatal mortality rate and still birth rate. These were available for fifteen states of India over the years 1972-1988. To develop this index we modified an earlier method based on factor analysis. Factor analysis of data on various indicators of child mortality revealed two factors which together explained 78% to 93% of the total variation in different years. The first factor was identified as representing mortality after birth and the second as before and during birth. The comprehensive index was obtained as a linear combination of these two factors. The resultant index thus fairly represented all five mortality indicators and provided a comprehensive and reasonably correct picture of child mortality. The lower the magnitude of this index, the better was the child health status. Trends in the index showed that the highest decline in the magnitude was in the state of Kerala followed by Punjab, Andhra Pradesh, Gujarat and Maharashtra in that order. This indicates steady improvement of the child health status over years in these states. In the State of Jammu and Kashmir, the index remained more or less constant over the years though the magnitude was low in the cross-sectional comparison with other states. Thus the comprehensive index developed by using factor analysis of the various mortality indicators can be used for the longitudinal monitoring of child health status in the states of India.
Present cartography procedures for quantitative indicators are arbitrary on choice of the number of categories in which a particular area is to be divided. The choice of initial cutoff and the choice of the width of each category is also arbitrary. To remove this arbitrariness and thus to introduce objectivity, we propose use of a statistical procedure called cluster analysis. This procedure is easy to use on a computer. We also propose using computer based maps. We use these methods on mortality indicators upto age of one year for major states of India to devise objective maps. The terminology of mortality indicators upto age of one year has been used by UNICEF document(1). The mortality indicators analysed are infant mortality rate, neonatal mortality rate, postneonatal mortality rate, perinatal mortality rate and still birth rate. Different indicators reveal different pictures. In this paper, we also propose an innovation to obtain an integrated picture by simultaneously considering all the four indicators in a multivariate setting. Such mapping could help the health managers and planners to devise more effective strategies to control child mortality.
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This study evaluates the use of pulse oximetry to accurately monitor systolic arterial blood pressure in 100 healthy volunteers. Determination of arterial blood pressure using oximetry was made at the disappearance of visual display upon blood pressure cuff inflation, at the reappearance of visual display upon cuff deflation, and by averaging the two. The blood pressures obtained by pulse oximetry were compared with the arterial blood pressures obtained by Korotokoff sounds and noninvasive blood pressure equipment. Good agreement was obtained when the average of oximetry-based systolic blood pressure estimates at the disappearance and reappearance of the waveform were compared with Korotokoff sound pressures and noninvasive equipment pressures. Thus pulse oximetry can be used to measure systolic arterial blood pressure. This technique is specifically important for patients with Takayasu's syndrome (pulseless disease) where conventional techniques often fail to monitor systolic arterial blood pressure.
An index of need for health resources in the Indian States has been developed using the statistical technique of factor analysis. Data on seven selected indicators measuring various aspects of population health in 17 Indian States for the year 1981 were used to extract factors. Two factors were discovered which together explained 83% of the total variation. The first factor alone, identified as 'proximate determinants', explained 67% of the variation. The second, 'sociomedical background' accounted for 16%. Factor analysis results have been used to derive standardized indices which helped to compare quantitatively the health needs of the people of various States.
For better follow up of patient and the immediate retrieval of records, we have developed a computer based application software for histopathological reporting system (HIPRIS). With its help, among others, we can (i) retrieve the biopsy report of a patient from the accession number of the specimen; (ii) find out the number of cases for a particular period as well as can analyse cases by any relevant referral parameter like department, specialty and disease and (iii) find out the time gap between receiving the specimen and reporting of result. Our experience suggests that this system greatly improves the efficiency of the histopathological laboratory.
Complete retrospective fertility histories of 843 ever married women of two villages in Delhi, obtained through house to house survey, were analysed to study various marriage cohorts by decades for trends of child birth spacing over a period of 60 years from 1921 to 1980. Spacing between consummation of marriage and first child birth gradually declined over the last 6 decades. For all other subsequent livebirths remained constant at an average of nearly 30 months. Irrespective of the reasons for such a trend, much more efforts are required to be put in to increase child spacing.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.