Aim In view of the spread of the contagious coronavirus disease (COVID-19) globally, the present review focuses on the details of past pandemic diseases, along with comparisons and lessons learned. A general awareness of COVID-19 infection is addressed, and it is compared with the Spanish flu pandemic. Based on the successes, failures and lessons learned in the past, governmental efforts must be undertaken to empower citizens by providing accurate information and implementing post-COVID-19 precautions that need to be taken now to stop the spread and recurrence of the virus locally, and to restore health and economic normalcy. Methods A detailed literature survey of past pandemics is undertaken in order to extract the successes, failures and lessons learned from previous breakouts. The comparison of past pandemics will enable us to determine post-COVID-19 precautions that should be followed. Separate tables are prepared to highlight the lessons learned and measures to be taken. Both general precautions and preventive measures for pregnant women are compiled. Results The literature shows a continuous struggle of humans with disease outbreaks, with the most adverse impact of the Spanish flu killing 20-50 million people. Precautions need to be taken including social distancing, compulsory mask-wearing, avoiding public gatherings and washing hands regularly. The lessons from earlier pandemics show that they were equally devastating, and vaccines were not available at the time of outbreaks. Vaccines developed for polio, H1N1, measles, and other viral diseases have proven to save countless lives. Living with COVID-19 and evolving the work culture of protecting oneself and protecting others also has to be adopted. Conclusions COVID-19 has become an everyday topic of discussion throughout the world, indicating the increasing number of COVID-19 cases, deaths and recoveries. The lessons learned from past pandemics such as social distancing, wearing masks, avoiding public gatherings and adherence to guidelines, along with personal hygiene, are the key measures that must be taken in order to live with COVID-19. Precautions for the elderly and pregnant women advised by medical authorities are to be strictly adhered to. These will help in reducing COVID-19 cases and in turn will reduce the pressure on hospitals to serve those in need. India has learned lessons from the past and the present pandemic and will move towards growth through its self-reliance.
Background: Oligohydramnios is described as a condition with decreased amniotic fluid volume relative to gestational age. It is a severe and common complication of pregnancy which is associated with increased maternal morbidity and adverse perinatal outcomes. This study was conducted to find out the significance of oligohydramnios in determining the maternal and perinatal outcome in pregnant women with oligohydramnios. Methods: The present study is a hospital-based study conducted in the department of obstetrics and gynecology, of SSIMS and RC Davanagere, during the period between August 2018 to April 2019. Detailed clinical history was taken, AFI was measured using Phelan's four quadrant ultrasound technique. All the information was entered in the proforma and analyzed. Results: The mean age group of the study participants was 26.36±4.46 years. Majority (51.9%) of them were primigravida. Gestational age, birth weight and abnormal Doppler study were found to have an association with the perinatal outcome. Perinatal mortality in the present study was 4%. Conclusions: Oligohydramnios is a frequent occurrence in obstetrics and this condition requires intensive surveillance and proper antenatal care.
We are reporting a case of pregnancy with extrahepatic portal venous hypertension. Portal hypertension in pregnancy is an uncommon event. It presents a challenge to the obstetrician in management as physiological hemodynamic changes associated with pregnancy worsen with portal hypertension. Thus, increasing risk of life threatening complications like variceal haemorrhage and hepatic decompensation to many folds during pregnancy. Management requires knowledge of effects of portal hypertension on maternal and fetal outcome and vice-versa.
Objective: Globally, early and optimal feeding practices and strategies for small and vulnerable infants are limited. We aim to share the challenges faced and implementation lessons learned from a complex, mixed methods research study on infant feeding. Design: A formative, multisite, observational cohort study using convergent parallel, mixed-methods design. Setting: 12 tertiary/secondary, public/private hospitals in India, Malawi, and Tanzania Population or Sample: Moderately low birthweight infants (MLBW; 1.50-2.49kg) Methods: We assessed infant feeding and care practices through: 1) assessment of in-facility documentation of 603 MLBW patient charts; 2) intensive observation of 148 MLBW infants during facility admission; and 3) prospective one-year follow-up of 1114 MLBW infants. Focus group discussions and in-depth interviews gathered perspectives on infant feeding among clinicians, families, and key stakeholders. Results: Hospital-level guidelines and provision of care for MLBW infants varied across and within countries. 89% of charts had missing data on time to first feed; 56% lacked discharge weights. Among 148 infants observed in-facility, 18.5% were discharged prior to meeting stated weight goals. Despite challenges during COVID, 90% of the prospective cohort was followed until 12 months of age. Conclusions: Enrolment and follow-up of this vulnerable population required additional effort from researchers and the community. Using a mixed-methods exploratory study allowed for a comprehensive understanding of MLBW health and evidence-based planning of targeted large-scale interventions. Multi-site partnerships in global health research, which require active and equal engagement, are instrumental in avoiding duplication and building a stronger, generalizable evidence base.
ObjectiveGlobally, early and optimal feeding practices and strategies for small and vulnerable infants are limited. We aim to share the challenges faced and implementation lessons learned from a complex, mixed methods research study on infant feeding.DesignA formative, multi‐site, observational cohort study using convergent parallel, mixed‐methods design.SettingTwelve tertiary/secondary, public/private hospitals in India, Malawi and Tanzania.Population or SampleModerately low birthweight infants (MLBW; 1.50–2.49 kg).MethodsWe assessed infant feeding and care practices through: (1) assessment of in‐facility documentation of 603 MLBW patient charts; (2) intensive observation of 148 MLBW infants during facility admission; and (3) prospective 1‐year follow‐up of 1114 MLBW infants. Focus group discussions and in‐depth interviews gathered perspectives on infant feeding among clinicians, families, and key stakeholders.Main Outcome MeasuresThe outcomes of the primary study were: (1) To understand the current practices and standard of care for feeding LBW infants; (2) To define and document the key outcomes (including growth, morbidity, and lack of success on mother's own milk) for LBW infants under current practices; (3) To assess the acceptability and feasibility of a system‐level Infant and Young Child Feeding (IYCF) intervention and the proposed infant feeding options for LBW infants.ResultsHospital‐level guidelines and provision of care for MLBW infants varied across and within countries. In all, 89% of charts had missing data on time to first feed and 56% lacked discharge weights. Among 148 infants observed in‐facility, 18.5% were discharged prior to meeting stated weight goals. Despite challenges during COVID, 90% of the prospective cohort was followed until 12 months of age.ConclusionsEnrolment and follow‐up of this vulnerable population required additional effort from researchers and the community. Using a mixed‐methods exploratory study allowed for a comprehensive understanding of MLBW health and evidence‐based planning of targeted large‐scale interventions. Multi‐site partnerships in global health research, which require active and equal engagement, are instrumental in avoiding duplication and building a stronger, generalisable evidence base.
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