Based on data collected through interview of 2142 mothers who had experienced live births and/or infant deaths within one year preceding the date of survey in selected slums of Calcutta Metropolis and Raipur City, this study attempts to elucidate and explain the levels, differentials, causes and determinants of infant mortality in the Indian slums. The infant mortality rate (IMR) in the slums was found to be quite high but lower than that in rural India, underlining the importance of`urban residence' as a major controlling factor of infant mortality. The IMR in the slums of Calcutta was about one and a half times that in the slums of Raipur, suggesting that slum infant mortality is far worse in metropolises than in smaller cities. A number of individual-level, household-level and slum-level determinants were examined, and all played some explanatory role, but the differences in neighbourhood environment contributed most substantially to the infant mortality differential between the slums of Calcutta and Raipur. The study also reveals that mere literacy or low educational level is not an effective depressant of infant mortality.
Background: This article outlines the results of audit for feasibility and reliability of use of local anaesthesia as a routine practice in inguinal hernia surgery in an Indian district hospital setup. Through this prospective study an effort have been made to analyse practicability of local anaesthesia for inguinal hernia surgery in terms of cost effectiveness, minimizing recovery period, and reducing routine case load on hospitals with a goal to provide health for all, in a set up where patient load outnumber resources both in expertise and facilities.Methods: A prospective analysis and auditing of 120 patients with unilateral inguinal hernia who underwent inguinal hernia surgery by Lichtenstein tension free mesh repair under local anaesthesia at Sehore district hospital during the study period was done. The primary outcomes of the study were analysed on grounds of cost benefit, patient satisfaction levels, complications such as infection, haematoma, chronic pain, and recurrence.Results: The mean age of patients in present study was 44.23 years (20-76 years). The mean operating time was 70 minutes (40-90). The mean post operative room stay was 3.3 hours (2-6 hours). Intraoperatively 30 patients (25%) had problems such as pain, bradycardia/tachycardia, hypotension, perspiration. Recurrance was observed in 1 patient (0.83%) during the mean follow-up of 3.6 months (1-6 months).Conclusions: In hernia repairs local anaesthetic is reliable, easy, safe and cost effective technique and its use can dramatically reduce waiting period for operation in planned surgeries.
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