Fermented milk-based probiotic preparations improve H. pylori eradication rates by approximately 5-15%, whereas the effect on adverse effects is heterogeneous.

Background: Given the postulated advantages of mother generated index (MGI) in incorporating the patients' viewpoint and in the absence of a validated India specific postpartum quality of life assessment tool we proposed to evaluate the utility of an adapted Mother-Generated-Index in assessing postpartum quality of life (PQOL) in India.

Objective To assess the quality of maternity care in an Indian metropolitan city.Study design Three-stage cluster randomised cross-sectional survey.Setting Sixty selected colonies of Delhi.Population One thousand eight hundred and one subjects (of 2286 eligible) were enrolled from 118 446 houses. Women who had delivered a live viable birth in the past 6 months were selected for the study.Methods In stage 1, 20 wards (of 150) were selected using a probability-proportionate-to-size systematic method. In stage 2, one colony from each income stratum (high, middle and low) was selected from each ward by simple random sampling. In stage 3, a house-to-house survey was conducted to recruit 30 women for administering a peer-reviewed and pilot-trialled questionnaire.Main outcome measures Caesarean section rate, induction rate and episiotomy rate.Results National health targets such as iron supplementation advice (>96%), tetanus vaccination (>81%), and ≥3 antenatal visits (>90%) were largely achieved across health care facilities but not in home deliveries. Conclusion Present practices fall short of evidence-based guidelines, with relative overuse of interventions in private hospitals and deficiency of patient-centred practices such as labour support in public hospitals.Keywords Caesarean rate, evidence-based medicine, India, maternity care, quality of care, survey.Please cite this paper as: Nagpal J, Sachdeva A, Sengupta Dhar R, Bhargava VL, Bhartia A. Widespread non-adherence to evidence-based maternity care guidelines: a population-based cluster randomised household survey. BJOG 2015;122:238-248.

SUMMARY BackgroundSeveral randomized-controlled trials (RCTs) have sought to determine the efficacy of bovine lactoferrin in Helicobacter pylori eradication with equivocal results.