Background: Since independence, the Government of India has made great eff orts to curb maternal mortality and morbidity by introducing various women-oriented developmental programs. Despite this, India is still struggling with a high maternal mortality and morbidity, which is compounded by low utilization of maternal health care services. Aim: The study is aimed to fi nd out the status of maternal health care services utilization and associated factors among recently delivered women in a block of Darjeeling district of West Bengal Subjects and Methods: A cross-sectional study was carried out among 953 recently delivered women residing in tea gardens of Darjeeling district of West Bengal. Utilization of maternal health care services including antenatal care during pregnancy, provision of safe delivery and postnatal care after delivery was assessed among them. The data were analyzed using SPSS version 16 (IL, Chicago, USA). Logistic regression analysis was done. P values less than 0.05 were considered as signifi cant. Results: The utilization of full antenatal care was 48.6% (463/953), institutional delivery 73.5% (700/953) and adequate postnatal visit was 72.6% (692/953) among the study population. The important factors associated with low utilization of services were belonging to Islam, Scheduled tribe, lower socioeconomic status, and lower literacy level of both the husband and wife. The major barrier towards utilization of these services was ignorance followed by distance to the health care center. Conclusion: The present study revealed low utilization of pregnancy-related health care utilization among the study population; especially in case of antenatal care. The study can provide new insight for policy makers to devote resources for achieving the best possible quality of maternal and child health services.

Pluripotent embryonic stem cells (ESCs) contain the potential to form a diverse array of cells with distinct gene expression states, namely the cells of the adult vertebrate. Classically, diversity has been attributed to cells sensing their position with respect to external morphogen gradients. However, an alternative is that diversity arises in part from cooption of fluctuations in the gene regulatory network. Here we find ESCs exhibit intrinsic heterogeneity in the absence of external gradients by forming interconverting cell states. States vary in developmental gene expression programs and display distinct activity of microRNAs (miRNAs). Notably, miRNAs act on neighborhoods of pluripotency genes to increase variation of target genes and cell states. Loss of miRNAs that vary across states reduces target variation and delays state transitions, suggesting variable miRNAs organize and propagate variation to promote state transitions. Together these findings provide insight into how a gene regulatory network can coopt variation intrinsic to cell systems to form robust gene expression states. Interactions between intrinsic heterogeneity and environmental signals may help achieve developmental outcomes.

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Background: Adolescence is defi ned as the teenage period of life, involving major biological changes and psycho-social development. In adolescence, the girls fi rst experience menstruation and good hygiene is essential during this period. Menstrual hygiene is an issue that is insuffi ciently acknowledged and has not received adequate attention in the reproductive health in developing countries. Aim: To elicit the knowledge, attitude and practice of menstrual hygiene in adolescent slum dwelling girls of Siliguri city. Subjects and Methods: A cross sectional, community based study was conducted in slums of Siliguri city of West Bengal and cluster sampling was used to select 798 post menarcheal adolescent girls residing in the slums. Data on knowledge, attitude and practices regarding menstruation were collected with the help of a pre-tested and semi-structured schedule. Simple descriptive statistics were used to analyse the data using SPSS 16 software (Chicago IL, USA). Descriptive statistics were applied to calculate proportion, mean and standard deviation and Chi square test was used to test the association between categorical variables and a P<0.05 was considered signifi cant. Results: The knowledge of the respondents was assessed and it was found that only 23.4% (187 out of 798) knew about menstruation before menarche, whereas 653 out of 798 girls remarked sanitary napkins as the ideal absorbent. Regarding attitude towards menstruation, 55% of girls attributed menstruation as a debilitating event and 37.6% of them agreed that their periods resulted in no negative eff ect. When enquired about the menstrual practices 71.3% used sanitary napkins as absorbent material. Majority of the study participants had fair knowledge and practice about menstruation. Conclusion: The results of the present study highlights the fact that more eff orts should be made to create awareness about hygienic practices during menstrual period, especially in underserved areas like slums.