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Biomedical subjects

D Chandramohan

Publications and source records attributed to D Chandramohan.

31 records · Page 2Linked to original sources
PubMed1995

The effect of stay in a maternity waiting home on perinatal mortality in rural Zimbabwe.

A hospital-based cohort study was carried out in a district hospital in Zimbabwe to evaluate the effect of a maternity waiting home on perinatal mortality. Information on antenatal risk factors, use of antenatal care, access to the hospital and stage of labour on arrival was collected for each woman delivering at the hospital during the period 1989-1991 (n = 6438). Women who stayed in the maternity waiting home had a lower risk of perinatal death compared to women who came directly from home to the hospital during labour. The crude relative risk of perinatal death for the women coming from home was 1.7 (95% confidence interval (CI) 1.1-2.6; P < 0.05). After adjusting for the effect of potential confounding variables, the relative risk decreased to 1.5 (95% CI 0.95-2.5, P = 0.07). However, when the analysis was restricted to women with antenatal risk factors there was a significant 50% reduction in the risk of perinatal death for the women who stayed at the maternity waiting home compared to women who came from home during labour (adjusted relative risk 1.9; 95% CI 1.1-3.4; P < 0.05). The use of maternity waiting homes has the potential to reduce perinatal mortality in rural areas with low geographic access to hospitals and merits further evaluation.

Adolescent↗
PubMed1994

Effects of a maternity waiting home on adverse maternal outcomes and the validity of antenatal risk screening.

OBJECTIVES: To evaluate the effect of a maternity waiting home (MWH) on adverse maternal outcomes and the validity of antenatal risk criteria in predicting dystocia. METHOD: A hospital-based cohort study was conducted at a district hospital in Zimbabwe. Information on the presence of antenatal risk factors, stay at an MWH, and mode and outcome of delivery was collected for each woman delivering at the hospital during 1989-1991. RESULTS: The risk of obstructed labor was 16 times higher for those not attending an MWH (n = 2915) than for those who did attend an MWH (n = 1573) (1 vs. 0.06%, P < 0.005). Among the non-users, 0.3% suffered a ruptured uterus compared with none of the MWH users. The presence of any one of the antenatal risk criteria used in Zimbabwe had a sensitivity of 78%, a specificity of 51% and positive predictive value of 25% for predicting dystocia. CONCLUSION: MWHs and antenatal risk screening are policy options for safe motherhood programs in settings where emergency obstetric services are not easily accessible.

Developing Countries↗
PubMed1994

Verbal autopsies for adult deaths: issues in their development and validation.

BACKGROUND: The verbal autopsy appears to be an attractive technique for the assessment of causes of adult death in settings where the proportion of people who die while under medical care is low. Verbal autopsies have been used extensively to assess causes of childhood deaths. The existing experience in verbal autopsies for adult deaths is limited mainly to maternal deaths. This paper aims to highlight the critical issues in verbal autopsies to assess causes of adult death which need further research. METHODS: This paper reviews the methods of verbal autopsy used in 35 published studies and discusses issues in the development of verbal autopsies, including mortality classification, design of questionnaires, interviewers, respondents, recall periods, procedures for deriving a diagnosis and the recording of single versus multiple causes of death. It also discusses issues in the validation of verbal autopsies, including the choice of reference diagnosis and the required sample size. RESULTS: The methodological approaches used in verbal autopsy studies have varied widely. Very few studies of the validity of verbal autopsies have been conducted. In these studies, the reported sensitivity and specificity varied widely between different causes of death and between studies. CONCLUSIONS: The information available is inadequate to draw firm conclusions on preferred methodological approaches for verbal autopsies for adult deaths. Before these tools are used more widely for adult deaths, further research is required to compare alternative methods and to evaluate the validity of this tool in a range of settings.

Adolescent↗
PubMed1990

Effect of lead, mercury and cadmium on a sulphate-reducing bacterium.

A sulphate-reducing bacterial strain isolated from the south-west coast of India resembling Desulfosarcina in its physiology was tested for its behaviour towards HgCl(2), CdSO(4) and Pb(NO(3))(2). The order of toxicity to growth of these metal salts in a lactate-based medium at 50 microg ml(-1) concentrations was Cd>Pb>Hg and to respiration Pb>Cd>Hg. Inhibitory concentrations (viz. 100 microg ml(-1) of HgCl(2) and 200 microg ml(-1) of Pb(NO(3)(2)) had a stimulatory effect when the substrate was changed to acetate. With sodium acetate at 0.1% concentration, Hg and Pb had maximum stimulatory effect for growth and sulphide production. Experiments conducted directly with sediment slurries amended with lactate showed that all three metals (at levels below their inhibitory concentrations, i.e. 50 microg ml(-1) of metal salt for Cd and Hg and 100 microg ml(-1) for Pb) inhibited sulphate-reducing activity (SRA) with Pb decreasing the peak production by 68%. The order of toxicity in both lactate and acetate-amended slurry was Pb>Cd>Hg and Pb>Hg>Cd, respectively. With acetate, SRA in the presence of Cd and Hg was stimulated 110% and 27%, respectively. Pb inhibited SRA by 11%. There is a general reduction in the inhibition of sulphide production in slurries as compared with pure culture of the isolate.

Journal Article↗
PubMed1988

D- center in GaAs.

Explore the source record for details and available documents.

Journal Article↗
PubMed1985

Fish flesh agar medium--a suitable experimental medium for the detection of spoilage bacteria.

The spoilage characteristics of bacterial strains were studied by growing them at 28 +/- 2 degrees C in agar and broth media prepared with sterile fish and prawn flesh homogenates. The percentage of spoilers found among the bacterial isolates tested, as shown by odour production and halo zone formation, was independent of the source of flesh used. Indole and fluorescent pigment production were also observed in the broth. Pseudomonas, Vibrio and Acinetobacter exhibited faster growth in flesh media than in the usual artificial media. Decrease of protein and lipid concentration in the clear zone of agar media suggests the utilization of the available substrate by spoilage bacteria.

Acinetobacter↗