Half of pregnancies in India unintended: Lancet

Agencies
December 15, 2017

New York Dec 15: An estimated 15.6 million abortions took place in India in 2015, with the majority of women taking pills at home without adequate counselling, according to a study which found that about half of the pregnancies in the country were unintended.

Published in The Lancet Global Health, the first national study of the incidence of abortion and unintended pregnancy in India found that 15.6 million abortions were performed in the country in 2015.

This translates to an abortion rate of 47 per 1,000 women aged 1549, which is similar to the abortion rate in neighbouring South Asian countries.

"Women in India face considerable challenges trying to obtain abortion care, including the limited availability of abortion services in public health facilities," said Dr Susheela Singh, vice president for international research at New Yorkbased Guttmacher Institute.

"Our findings suggest that a shortage of trained staff and inadequate supplies and equipment are the primary reasons many public facilities don't provide abortion care," said Singh, co-principal investigator of the study.

Researchers found that the vast majority of abortions (81%) were achieved using medication abortion (which, in India, is commonly referred to as medical methods of abortion, or MMA) that was obtained either from a health facility or another source.

Fourteen per cent of abortions were performed surgically in health facilities, and the remaining 5% of abortions were performed outside of health facilities using other, typically unsafe, methods.

The study also estimated the incidence of unintended pregnancy in India and found that out of the total 48.1 million pregnancies in 2015, about half were unintended meaning they were wanted later or not at all.

Unintended Pregnancy Rate

The estimated unintended pregnancy rate was 70 per 1,000 women aged 1549 in 2015, which is similar to the rates in neighbouring Bangladesh (67) and Nepal (68), and much lower than the rate in Pakistan (93).

"Although abortion has been legal under a broad range of criteria in India since 1971, we have never had a reliable estimate of the number occurring until now," said Dr Chander Shekhar, professor at the International Institute for Population Sciences (IIPS) in Mumbai.

"This new evidence provides policymakers with information that is essential for designing and implementing effective reproductive healthcare programmes," said Shekhar.

The researchers used two direct methods for measuring incidence. One was compiling national sales and distribution data on MMA (mifepristone and mifepristone-misoprostol combipacks), which represents the vast majority of all abortions in India.

The second was implementing a large-scale survey of public and private health facilities in six states - Assam, Bihar, Gujarat, Madhya Pradesh, Tamil Nadu and Uttar Pradesh - where close to half of Indian women of reproductive age live.

Currently, slightly fewer than one in four abortions are provided in health facilities, researchers said.

The public sector - which is the main source of health care for rural and poor women - accounts for only one-quarter of facility-based abortion provision, in part because many public facilities do not offer abortion services.

Close to three in four abortions are achieved using MMA drugs from chemists and informal vendors, rather than from health facilities, researchers said.

They said MMA is safe and effective when used in accordance with World Health Organisation guidelines. The researchers propose a number of steps to improve the availability and quality of abortion services in health facilities, including training and certifying more doctors to provide abortion care.

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Agencies
March 11,2020

With the sales of chicken and mutton going down due to the coronavirus scare, it is the humble 'Kathal' (jackfruit) is emerging as an acceptable alternative.

'Kathal' is now selling at ₹120 per kilogram -- an increase of more than 120 per cent over the normal ₹50 per kilogram.

The jackfruit, in fact, is now priced higher than chicken which is selling at ₹80 per kilogram due to poor demand.

"It is better having a 'Kathal' biryani instead of a mutton biryani. It tastes reasonably good. The only problem is that 'Kathal' has been sold out in the vegetable market and is difficult to find," said Purnima Srivastava whose family savours non-vegetarian food on a regular basis.

The corona scare has hit poultry business so hard and the Poultry Farm Association recently organized a Chicken Mela in Gorakhpur to dispel the misconception that birds are carriers of the deadly virus.

"In fact, we gave away plateful of chicken dishes for Rs 30 to encourage people to savour the delicacies. We cooked one thousand kilograms of chicken for the Mela and the entire stock was sold out," said Vineet Singh, head of the Poultry Farm Association.

However, the Mela did not do much to dispel the fears about chicken, mutton or fish consumption amid the virus outbreak.

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Agencies
March 27,2020

New Delhi, Mar 27: The Centre has restricted sale and distribution of "hydroxychloroquine" declaring it as an essential drug to treat the COVID-19 patients and meet the requirements of emergency arising due to the pandemic.

The Ministry of Health and Family Welfare on Thursday made the announcement making it clear that the order "shall come into force on the date of its publication in the official Gazette".

In the order, the government declared that the Central government is "satisfied that the drug hydroxychloroquine is essential to meet the requirements of emergency arising due to pandemic COVID-19 and in the public interest, it is necessary and expedient to regulate and restrict the sale and distribution of the drug 'hydroxychloroquine' and preparation based thereon for preventing their misuse".

"Now, therefore, in exercise of the powers conferred by Section 26B of the Drugs and Cosmetics Act, 1940 (23 of 1940), the Central government hereby directs that sale by retail of any preparation containing the drug Hydroxychloroquine shall be in accordance with the conditions for sale of drugs specified in Schedule H1 to the Drugs and Cosmetics Rules, 1945."

The order came at a time when the novel coronavirus claimed 16 lives and infected over 600 people across India.

The announcement regarding ban of sale and distribution of the drug was made by the government earlier but it issued an official Gazette notification on Thursday signalling that hydroxychloroquine -- an anti-Malaria drug -- will work as a medicine for treating coronavirus infected patients as well.

Recently, the national task force for COVID-19 constituted by Indian Council for Medical Research (ICMR) has recommended hydroxy-chloroquine as a preventive medication.

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Agencies
June 19,2020

While coughing, fever and difficulty in breathing are common symptoms of COVID-19, a new case study has found that pink eye is also a reason to be tested for the disease.

The study, published in the Canadian Journal of Ophthalmology, determined that conjunctivitis and keratoconjunctivitis can also be primary symptoms of COVID-19.

The researchers noted that in March, a 29-year-old woman arrived at the Royal Alexandra Hospital's Eye Institute of Alberta with a severe case of conjunctivitis and minimal respiratory symptoms.

After the patient had undergone several days of treatment with little improvement -- and after it had been determined that the woman had recently returned home from Asia -- a resident ordered a COVID-19 test.

The test came back positive, according to the researchers.

"What is interesting in this case, and perhaps very different to how it had been recognised at that specific time, was that the main presentation of the illness was not a respiratory symptom. It was the eye," said Carlos Solarte, an assistant professor at the University of Alberta in Canada.

"There was no fever and no cough, so we weren't led to suspect COVID-19 at the beginning. We didn't know it could present primarily with the eye and not with the lungs," Solarte said.

Academic studies at the outset of the pandemic identified conjunctivitis as a secondary symptoms in about 10 to 15 per cent of COVID-19 cases, he said.

Since then, scientists have gained greater knowledge of how the virus can transmit through and affect the body's mucous membrane system, of which the conjunctiva -- the clear, thin membrane that covers the front surface of the eye -- is an extension.

While the finding provides important new health information for the public, it also makes eye exams more complicated for ophthalmologists and staff, the researchers noted.

"The patient in this case eventually recovered well without any issues. But several of the residents and staff who were in close contact with the patient had to be under quarantine," said Solarte.

"Fortunately, none who were involved in her care also tested positive," he said.

Patients coming into an eye clinic with conjunctivitis and keratoconjunctivitis are now treated as potential cases of COVID-19 and extra precautions are taken by staff, according to the researchers.

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