Snakes are found all over the world except in the Arctic, New Zealand and Ireland, and are more commonly distributed in temperate and tropical countries.1 Snakes are most likely to bite human beings when they feel threatened, startled or provoked, and/or have no means of escape when cornered. Snakes are likely to approach residential areas when attracted by prey, such as mice and frogs. The Deccan plateau, with its agricultural land and hot, dry climate, provides an ideal environment for cobras, kraits and vipers.2 Snakebite is generally considered to be a rural problem and has been linked with environmental and occupational conditions.3 Most houses in the rural areas of India are made of mud and have many crevices where rodents flourish. Snakes have easy ingress to such houses and often enter them in search of food. Firewood and dried cow dung, stored in or near the house, provide ready shelter for snakes and rodents. 4 Morbidity and mortality from snakebite envenomation depends on the species of snake, since the estimated fatal dose of venom varies among species. In India, almost two-thirds of the bites are attributed to the saw-scaled viper (as high as 95% in some areas such as Jammu 5 ), about a quarter to Russell's viper, and smaller proportions to cobras and kraits. 6 Snakebite is an important and serious medical problem in many parts of India. However, reliable data for morbidity and mortality are not available since there is no proper reporting system. Moreover, many cases are not recorded in official statistics, as people seek traditional treatment methods. Most snakebite studies in India deal with clinical and management aspects, and there are few epidemiological studies. 7 We studied the epidemiology of snakebite cases over a period of 10 years. Aim and objectivesWe aimed to study the epidemiology of snakebite cases admitted to hospital; trends of snakebite and death from snakebite; seasonal variations; and the outcomes of snakebite cases. MethodsIn a record-based retrospective descriptive study, we evaluated snakebite cases admitted to the hospital from 1999 to 2008. Data were collected from the Medical Records Department of the Dr Shankarrao Chavan Government Medical College. Recorded information was entered in a pre-coded pro forma and included age, sex, residence, site of bite, type of snake poison, whether cases had been directly admitted to this hospital or referred from other health centres, time interval between snakebite and initiation of treatment, and the outcomes of snakebite cases. The total number of hospital admissions for different illnesses during 1999 -2008 was 488 344. As required by the government of Maharashtra, all snakebites are classified as medico-legal cases, whose records are kept separately in the medical records department. The total number of cases registered during the above period was 5 718. We evaluated only the records of snakebite cases where outcomes were recorded as recovered and discharged from hospital, or died while in hospital. Excluded were snakebite patients ...

Background: Pregnancy, although being considered a physiological state, carries risk of serious maternal morbidity and at times death. This is due to various complications that may occur during pregnancy, labor, or thereafter. The major causes of maternal mortality are mostly preventable through regular antenatal checkup, proper diagnosis, and management of labor complications. Therefore, the factors at different levels affecting the use of these services need to be clearly understood. Objective: To assess the maternal mortality ratio (MMR) and the causes of maternal mortality over a period of 3 years in a tertiary care hospital in Maharashtra. Materials and Methods: A hospital record-based study of maternal deaths over a period of 3 years from January 2012 to December 2014. The information regarding demographic profile and reproductive parameters were collected and results were analyzed using percentage and proportion with the help of Microsoft Excel 2007. Result: Average of MMR over 3 years study period (January 2012 to December 2014) was observed to be 410/1,00,000 live births. Most of the maternal deaths occurred in age group of 19-24 years (43.4%). Majority of maternal deaths was observed in multipara (52.2%) and women coming from rural area (52.9%). 44.9% of maternal deaths occurred within 24 h of admission. Hemorrhage was the leading direct cause of maternal deaths (33.8%) followed by eclampsia (10.3%) and sepsis (8.1%). Among indirect causes of maternal deaths anemia (14.7%) was the leading cause. Conclusion: MMR in our study was very high as compared to national average of 167/1,00,000 live births, being a tertiary care hospital as most of the patients were referred from peripheral centers. Most maternal deaths are preventable by intensive health education, basic obstetric care for all, strengthening referral and communication system and emphasizing on overall safe motherhood.

Background: Anaemia in pregnancy has detrimental effects on maternal and child health. WHO says prevalence of anaemia during pregnancy is alarmingly high. The purpose of this study was to assess the knowledge, and practices of pregnant women regarding iron supplements and also to assess the reasons for non -consumption of FSFA tablets.The objectives were to study the knowledge, and practices of pregnant women regarding iron supplementation during pregnancy and to study the reasons for non-consumption of FSFA tablets. Methods: The study was carried out on 350 pregnant women routinely attending the antenatal clinic in a rural training health centre over a period of 3 months from July 2015 to September 2015. Their knowledge and practices regarding iron supplementation were studied. Results: Assessment of knowledge revealed that only 140 (40%) of the participants were aware of significance of consumption of FSFA tablets. Out of 350 only 221 (63.14%) pregnant women consumed the FSFA tablets. Out of 221 only 123 (55.65%) were consuming it correctly. Reasons for not consuming FSFA were forgetfulness in 48 (37.20%), side effects in 35 (27.13%), frustration with daily dose 23 (17.82%), ignorance 21 (16.27%), foul smell to tablets 20 (15.50%), misbelieves 7 (5.42%) and no response was given in 26 (20.15%). Conclusions: The present study indicated the lack of knowledge regarding anaemia, iron rich foods and the importance of iron supplementation during pregnancy Educating antenatal women about importance of consumption of FSFA tablets and implementing this into practice will help for prevention of anaemia.

. Total 208 Nursing Staff were interviewed. 45(21.6%) nurses had attended training or workshop on PEP. Most of the participants 168(80.8%) knew blood born infections that can be transmitted due to occupational exposure but only 86(41.3%) knew types of exposures for which PEP is recommended. Of the respondents, 76(36.5%) knew that the estimated risk of contracting HIV following percutaneous exposure is 0.3%. First aid measures to be taken after someone encounters needle stick injury at work place were known to 97(46.6%). Just 63(30.3%) were aware of the necessity to start PEP immediately within 1 hour following the exposure. Our study also showed that only 118(56.7%) aware about availability of PEP centre in our hospital and where it is located and 112(53.8%) knew timings of PEP centre. A total of 142(68.3%) nursing staff reported having one or more needle stick injury (NSI) in their career.