IntroductionPresent study was aimed to analyze the impact of education, employment and financial independence in breastfeeding practices among Indian women.MethodologyPresent explorative questionnaire based survey included 256 women (128 pairs) in the final analysis. A pair means – a) pregnant lady (in her third trimester) representing younger generation and b) her mother/mother in law representing the elder generation.ResultsWe found that the overall awareness regarding ‘breast milk’ being the best food for baby was excellent (overall 97.3%; younger generation: 96.9%; elder generation: 97.7%). Overall knowledge regarding the correct technique (28.9% younger generation and 21.9% elder generation) and frequency of breastfeeding (20.3% of younger generation and 34.4% of elder generation) was very poor. Less than 60% (younger generation: 57.8%; elder generation: 58.6%) were aware that the only major contraindication for breastfeeding is a mother infected with human immunodeficiency virus (HIV). On comparing responses obtained from the two generations of women, difference was not statistically significant among most of the issues related to breastfeeding. With regards to the attitude, despite better awareness, only 94.5% women in younger generation and 89.1% women in elder generation were planning to give mother’s milk as the first feed to the newborn. Similarly, less than 75% of women were ready to breast-feed the newborn immediately after birth. This was contradictory to the fact that 86% of pregnant women were aware that the baby should be breast-fed within an hour of birth.ConclusionAwareness with regards to breastfeeding issues had not changed significantly with the educational progress of Indian women. Despite the good level of awareness in the society regarding breastfeeding, attitude to practice the same is lacking.

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Background: Pregnancy-related acute kidney injury (PRAKI) is a common problem in the developing world. Materials and methods: In this retrospective observational study at a tertiary care hospital in South India we evaluated records for the maternal, fetal, and renal outcomes in women with PRAKI. Results: Over a 10-year period, 395 patients of PRAKI were seen constituting 8.1% of all acute kidney injury (AKI). The mean age of patients was 27 ± 3 years. A total of 176 (44.5%) had pre-eclampsia, 132 (33.4%) had puerperal sepsis, 76 (19.2%) had antepartum hemorrhage or postpartum hemorrhage (APH 30/PPH 46), nine (2.2%) had hemolytic uremic syndrome (HUS). Obstruction was seen in two patients. Eleven had underlying glomerulonephritis out of three had lupus nephritis. Forty-five of 395 (11.39%) had hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome, that is, 25.5% of those with pre-eclampsia. Sixteen (4.0%) had placental abruption. A total of 288 (72.9%) presented postpartum. Renal biopsy done in 103 (26%) showed patchy cortical necrosis (PCN) in 25 (22.3%), diffuse cortical necrosis (DCN) in 23 (20.3%), acute tubular necrosis (ATN) in 20 (19.4%), acute interstitial nephritis (AIN) in 10 (9.7%), while nine (8.7%) had thrombotic microangiopathy (TMA). Glomerular disease was seen in 11. Cortical necrosis (CN) was seen in 48 patients of which 10 (20.83%) had abruption placenta, 25 (52%) had puerperal sepsis, 11 (22.9%) had postpartum hemorrhage (PPH), and two (4.1%) had TMA. A total of 290 (73.4%) required dialysis. About 76% improved while 8.3% progressed to end-stage renal disease (ESRD). Maternal mortality (MM) was 5%. There were 42 intrauterine deaths and 30 deaths in the neonatal period. Discussion: Pregnancy-related acute kidney injury in developing countries is more common as compared to the West. Only 49% patients had booked pregnancy, that is, received regular antenatal care. Apart from pre-eclampsia which is also the major cause in the West and was the etiology in 44% of patients with PRAKI in our study, sepsis (33%) and maternal hemorrhage (19%) were also significant. Immediate recovery from PRAKI was 75% however about 8% develop end-stage kidney disease (ESKD) while in the west ESKD occurred in only about 2%. Conclusion: Pregnancy-related acute kidney injury is an important cause of maternal and fetal morbidity and mortality. Pre-eclampsia emerged as the most common cause of PRAKI and CN was the most common histological lesion. Proper antenatal care and management may improve pregnancy outcomes.

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recommended definite treatment protocol exists. Early identification of patients at higher risk of progression and a precise treatment is the main challenge. We retrospectively studied clinical, pathological and treatment outcome of IgAN patients admitted in our hospital from January 2015 to January 2018 Methods: The clinical, laboratory, pathological manifestations and outcomes of these IgAN patients were analyzed retrospectively. A comparison was made between responders and nonresponders with immunosuppressive treatment. We compared baseline characteristics between patients who progressed to ESRD and who responded to various treatments. We also evaluated risk factors for progression to ESRD Results: Total 50 patients with IgA nephropathy were finally analyzed. 30 patients were male and 20 female. Mean age at presentation was 30.64+/-13.8years. The most common clinical presentation was nephritic syndrome (48%) followed by nephrotic syndrome (16%), nephritic nephrotic (12%), rapidly progressive glomerulonephritis(14%) and CKD stage 5 (6%). Hypertension was present in 56% patients and renal insufficiency (eGFR < 60 mim/1.73m 2) in 62% patients. Mean eGFR was 68.55+ 51.55 /mim/1.73m 2. Histopathologically,58% had glomerular mesangial expansion +/-mesangial proliferation, 12% had Diffuse proliferative Glomerulonephritis with crescent, 10% had focal proliferative Glomerulonephritis, 6% had focal segmental glomerulosclerosis and IFTA(interstitial fibrosis and tubular atrophy) >50% present in 14% of patients. 66% patients received tablet prednisolone(dose 1mg/kg body weight with gradual tapering over 6 months), intravenous Methyle Prednisolone(15-30mg/kg bw) for 3 consecutive days followed by pulse inj.cyclophophomide (0.75to 1 gm/m2 body surface area) monthly once for 6 months were given in 24% cases. Remaining patients were managed conservatively. At 6 month, 48% patients achieved remission,32% had progressed to ESRD, 8% not responded and 12% of patients had lost followup. We observed major infectionin 10% of patients. Conclusions: High serum creatinine at the time presentation and IFTA >50% are major risk factor for progression to ESRD. Patients with IFTA < 25% and serum creatinine <1.5 mg/dl responded to various immunosuppressive treatment.