Objective To assess the rates, timing and causes of neonatal deaths and the burden of stillbirths in rural Uttar Pradesh, India. We discuss the implications of our findings for neonatal interventions. Methods We used verbal autopsy interviews to investigate 1048 neonatal deaths and stillbirths. Findings There were 430 stillbirths reported, comprising 41% of all deaths in the sample. Of the 618 live births, 32% deaths were on the day of birth, 50% occurred during the first 3 days of life and 71% were during the first week. The primary causes of death on the first day of life (i.e. day 0) were birth asphyxia or injury (31%) and preterm birth (26%). During days 1-6, the most frequent causes of death were preterm birth (30%) and sepsis or pneumonia (25%). Half of all deaths caused by sepsis or pneumonia occurred during the first week of life. The proportion of deaths attributed to sepsis or pneumonia increased to 45% and 36% during days 7-13 and 14-27, respectively. Conclusion Stillbirths and deaths on the day of birth represent a large proportion of perinatal and neonatal deaths, highlighting an urgent need to improve coverage with skilled birth attendants and to ensure access to emergency obstetric care. Health interventions to improve essential neonatal care and care-seeking behavior are also needed, particularly for preterm neonates in the early postnatal period.Bulletin of the World Health Organization 2006;84:706-713.Voir page 711 le résumé en français. En la página 712 figura un resumen en español. IntroductionEvery year, there are an estimated 4 mill l lion neonatal deaths, accounting for all l most 40% of deaths in children younger than 5 years.1,2 About a quarter of global neonatal deaths occur in India, which has a neonatal mortality of 43 per 1000 live births. 1,3 Therefore, interventions to address neonatal mortality are crucial if child mortality is to be reduced globally and in India. 2,4l6 Globally, the main causes of neonal l tal deaths are thought to be preterm birth (28%), sepsis or pneumonia (26%), and birth asphyxia (23%).1,2 In the Southl East Asia Region, WHO has attributed 30% of neonatal deaths to preterm birth, 27% to sepsis or pneumonia, 23% to birth asphyxia, 6% to congenital abnorl l malities, 4% to tetanus, 3% to diarrhoea and 7% to other causes. 7 However, most stillbirths or neonatal deaths occur at home and vital registration systems are incomplete, 3,4,8 and as such current estimates have been generated from a limited set of data.2,9,10Verbal autopsies, which are interl l views with caregivers, 11,12 have been used to establish causes of neonatal deaths. 8,[13][14][15][16][17][18][19][20][21] Data on timing and causes of neonatal deaths are very important for the design of interventions to reduce mortality, yet only one study with a small sample size (n = 40) has previously described causes of neonatal deaths by day. 13 Here, we describe the rates, causes and timing of 1048 neonatal deaths and stillbirths in a rural population in Uttar Pradesh, India, where the neonatal mortality...

Objectives:To study the knowledge and practices related to newborn care in urban slums of Lucknow city, UP, and to identify critical behaviors, practices, and barriers that influence the survival of newborns.Materials and Methods:A cross-sectional study in urban slums of Lucknow city, UP, included 524 women who had a live birth during last 1 year preceding data collection. Data were analyzed using statistical software SPSS 10.0 for windows.Results:Study findings showed that about half of the deliveries took place at home. Majority (77.1%) of the mothers believed that baby should be bathed with warm water and dried with clean cloth and 79.7% mothers practiced it. Only 36.6% mothers initiated breast-feeding within 1 h of birth and 30.2% initiated after 1 day. The mothers who have not given colostrum to their baby, in majority the reason was customs.Conclusion:In majority of cases, correct knowledge and correct practices regarding newborn care were lacking among mothers and this should be promoted through improved coverage with existing health services.

The dielectric theory of ionicity has been used to calculate the bond ionicity in the 3 "B' C& semiconductors. Our calculated values of bond ionicities, dielectric constants, and homopolar and heteropolar energy gaps are in excellent agreement with the values reported by several workers.fi, x&' --Cxr /Es xy . 2 2

Nitric oxide (NO) has been shown to contribute to ovarian development and function. In non-ovarian tissues NO can be altered by ethanol (ETOH), a drug considered to be a gonadal toxin in men as well as male and female rats. The present study was undertaken to determine if some of the detrimental effects of chronic ETOH exposure on prepubertal ovarian function could be due to ETOH-induced alterations in the intraovarian NO system. Rats were implanted with intragastric cannulae on day 24 and began receiving control or ETOH diets on day 29. All rats were killed on day 34, determined to be in the late juvenile stage of development, and their ovaries and blood were collected. We analyzed the expression of the two constitutive forms of nitric oxide synthase (NOS), i.e. neuronal (n) NOS and endothelial (e) NOS, as well as the inducible (i) form of NOS protein in the ovaries of control and ETOH-treated rats by Western immunoblotting. Results demonstrate that eNOS protein increased markedly (P<0·02; 140 kDa) in ETOH-treated rats compared with controls. ETOH treatment did not alter the protein expression of nNOS (155 kDa) and only slightly increased that of iNOS (130 kDa). We also assessed NOS activity as determined by nitrite accumulation and by the conversion of -[14 C]arginine to -[ 14 C]citrulline. In this regard, the ETOH-treated animals showed an increase in ovarian nitrite generation (P<0·05), as well as an increase in ovarian citrulline formation (P<0·0001), when compared with control animals. Along with the above described ETOH-induced increases in ovarian eNOS and NO activity, the serum levels of estradiol were concomitantly suppressed (P<0·001) in the ETOH-treated rats. These results demonstrate for the first time the ETOH-induced changes in the prepubertal ovarian NO/NOS system, and suggest that these alterations contribute to the detrimental actions of the drug on prepubertal ovarian development and function.

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