Low weight at birth continues to remain a major public health problem in India in contrast to what is observed in most developed and many developing countries of the world (Table I) (1). This raises several issues relating to the persistently high infant mortality and the difficulties in providing adequate care for these "at risk" infants because of the vastness of the country and its marked geographic, cultural, religious and socio-economic variations. Despite these numerous unresolved problems, those concerned with delivery of health care are faced with the stupendous task of achieving a reduction in low birthweight rate from the present estimated 30% to 10% by 2000 A.D. The present communication deals with an overall view of the problem of low birthweight (LBW) in India and suggests possible areas of action for its prevention.

Female↗

PubMed1987

Sonography in the diagnosis and management of acute acalculous cholecystitis.

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Adolescent↗

PubMed1987

Optic disc vasculitis in epidemic dropsy.

During an outbreak of epidemic dropsy in Delhi, 233 patients were studied. Retinal changes including venous dilatation and tortuosity, haemorrhages and disc oedema were observed. A clinical picture compatible with type I optic disc vasculitis was seen in 13 eyes and that of type II in 3 eyes. Fluorescein angiography was carried out in 23 randomly selected cases. Relevant angiographic findings included dilated and tortuous retinal veins, prominent vascular staining, blocked fluorescence, microaneurysms, disc oedema and peripapillary dye spillage. Presence of positive angiographic findings correlated well with the severity of the systemic disease, glaucoma, however, revealed no correlation. Papillophlebitis, a new ocular manifestation of Argemone mexicana oil toxicity, as also the fluorescein angiographic picture in epidemic dropsy is being reported for the first time in the literature.

Disease Outbreaks↗

PubMed1986

Delivery of perinatal care in India: priorities and policies.

Delivery of appropriate perinatal care at primary, secondary and tertiary levels is becoming an urgent and important issue in countries of the Third World where maternal, perinatal and neonatal mortality rates remain at an unacceptably high level. A recent WHO report on perinatal morbidity and mortality in the South-east Asian region (Table I) shows the current state of the problem in this region (1). In India, the perinatal mortality rate (PNMR) varies from 12.5 to 147.2/1000 (2), with most centres reporting rates of 70-90/1000 (Table II) (2-5). Ghosh et al. (6) have reported intranatal asphyxia, pulmonary conditions, cerebral birth trauma and neonatal infections as the leading necropsy causes of perinatal death. Several studies have also documented low birth weight as a major contributory factor in perinatal and neonatal mortality. In India a large proportion of perinatal deaths are preventable. High fetal and childhood mortality adversely affect the acceptance of family planning (7). Therefore, perinatal care is important for India and must form an integral part of national goals of "health for all" by 2000 AD.

Female↗

PubMed1986

Emergencies in pediatrics.

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Child↗

PubMed1986

Anaphylaxis.

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Anaphylaxis↗

PubMed1986

Renal function in relation to metabolic control in juvenile onset diabetes of different duration.

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Adolescent↗

PubMed1985

Mid-arm and chest circumferences at birth as predictors of low birth weight and neonatal mortality in the community.

In developing countries, where about three quarters of births occur at home or in the community, logistic problems prevent the weighing of every newborn child. A study was performed to see whether other simpler measurements could be substituted for weight to identify neonates of low birth weight and those at risk. A study of 520 hospital births showed a strong correlation (p less than 0.001) between other anthropometric variables and birth weight, but the correlation was maximum for chest circumference (r = 0.8696) and mid-arm circumference (r = 0.8110). A mid-arm circumference of less than or equal to 8.7 cm and a chest circumference of less than or equal to 30 cm had the best sensitivity and specificity for identifying neonates with a birth weight of 2500 g or less. Measurements on 501 consecutive live births in the community were recorded and the infants followed up at specified ages. Mid-arm circumference was again significantly correlated to birth weight (r = 0.6918). Neonatal mortality showed an inverse relation but postneonatal mortality an inconsistent relation with mid-arm circumference. A mid-arm circumference of less than or equal to 8.7 cm and a birth weight of less than or equal to 2500 g were equally useful in predicting neonatal outcome. Mid-arm and chest circumferences are simple, practicable, quick, and reliable indicators for predicting low birth weight and neonatal outcome in the community and can be easily measured by paramedical workers in developing nations.

Abdomen↗

PubMed1985

Epidemic dropsy following transcutaneous absorption of Argemone mexicana oil.

Four cases manifesting features characteristic of epidemic dropsy following body massage with contaminated mustard oil are reported. A transcutaneous route of absorption for the toxin (sanguinarine) resulting in epidemic dropsy has not been documented previously in man. Oil used for body massage was found to be adulterated with Argemone mexicana oil, while hydrogenated vegetable fat used for cooking did not reveal any contamination. Diagnosis of the disease was confirmed by establishing the presence of sanguinarine in the urine and serum of all four cases.

Adult↗

PubMed1985

Current status of infant growth measurements in the perinatal period in India.

Analysis of currently available information in the Indian literature on the present status of fetal growth measuring birthweight and gestation distribution, and the intra-uterine growth potential of the fetus has pointed to several interesting findings. The incidence of low birthweight is 24-39% and of preterms, 7-22%. In general the process of labour seems to begin at an stage of earlier gestation. A significant proportion of infants that are born with birth weight between -1 SD and -2 SD show high morbidity and mortality, suggesting the need for them to be categorized as a distinct group. The early neonatal mortality varies between 1.5 and 8.4%. The results show a wide variation between hospital and community care, and between privileged and underprivileged. Logistic problems prevent the recording of birth weight at home or in the community. Recent observations reveal that mid-arm circumference (MAC) of newborns has a strong correlation with birth weight and neonatal mortality. MAC can be reliably used to assess fetal growth and for screening high-risk neonates in community care.

Birth Weight↗

PubMed1985