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Background: Despite a commendable rise in the number of women seeking delivery care at public health institutions in South India, it is unclear if the benefit accrues to wealthier or poorer socio-economic groups. The study's aim was to investigate at how the public subsidy is distributed among Indian women who give birth in public hospitals in the southern regions. Methods: Data from the Indian Demographic Health Survey's fifth wave (NFHS-5, 2019–21) was used in this study. A total of 22, 403 were institutional deliveries across all the southern states of India were included. Out-of-pocket expenditure (OOPE) on childbirth in health institutions was the outcome variable. We used summary statistics, Benefits Incidence Analysis (BIA), concentration index (CI), and concentration curve (CC) were used. Results: Most women in the lowest, poorest, and medium quintiles of wealth opted to give birth in public facilities. In contrast, about 69% of mothers belonging to highest quintile gave birth in private health institutions. The magnitude of CI and CC of institutional delivery indicates that public sector usage was concentrated among poorer quintiles [CIX: − 0.178; SE: 0.005; p < 0.001] and private sector usage was concentrated among wealthier quintiles [CIX: 0.239; SE: 0.006; p < 0.001]. Benefit incidence analyses suggest that middle quintile of women received the maximum public subsidy in primary health centres (33.23%), followed by richer quintile (25.62%), and poorer wealth quintiles (24.84%). These pattern in the secondary health centres was similar. Conclusion: Poorer groups utilize the public sector for institutional delivery in greater proportions than the private sector. Middle quintiles seem to benefit the most from public subsidy in terms of the median cost of service and non-payment. Greater efforts must be made to understand how and why these groups are being left behind and what policy measures can enhance their inclusion and financial risk protection. [ABSTRACT FROM AUTHOR]

BACKGROUND AND AIMS: The duration and quality of analgesia is improved when a local anesthetic is combined with alpha 2 adrenergic agonist. Though, the effects of clonidine on local anesthetics have been extensively studied, there are limited studies demonstrating the effects of epidural dexmedetomidine on local anesthetics. The aim of the study is to compare the efficacy of dexmeditomedine and clonidine as adjuvant to levobupivacaine for epidural anesthesia in lower abdominal and lower limb surgeries. MATERIAL AND METHODS: This Prospective comparative study was done to assess the efficacy and clinical profile of two a2 adrenergic agonists - clonidine and dexmedetomidine administered epidurally in combination with intrathecal 0.5%levobupivacaine. 60 adult patients ASA Class I and II undergoing lower abdomen and lower limb surgery were randomly assigned into two groups, to receive either epidural dexmedetomidine (1.5μg/kg) or clonidine (2 μg/kg) with 0.5% isobaric levobupivacaine. RESULTS: Based on the VAS score of the patients and time taken for rescue analgesia, it was found that better post-operative analgesia was provided for longer duration by dexmedetomidine than clonidine. Though no significant differences have been observed based on the hemodynamic parameters between both the groups of the patients, dexmedetomidine has shown beteer hemodynamic stability as compared to clonidine. CONCLUSION: It can be concluded that in patients undergoing lower abdominal and lower limb surgeries, administration of epidural anaesthesia with 0.5% of Levobupivacaine with dexmedetomidine provided better and longer post-operative analgesia as compared to clonidine. [ABSTRACT FROM AUTHOR]

Background: Sub-arachnoid block is most commonly used technique in regional anaesthesia to conduct lower limb surgeries [1]. Wide variety of adjuvants have been used intrathecally to prolong post-operative analgesia. The aim of this study is to evaluate and compare the intra-operative block characteristics and duration of postoperative analgesia by using intrathecal dexmedetomidine (5μg) or nalbuphine(1mg) as an adjuvant to hyperbaric bupivacaine (12.5mg) in lower limb orthopedic surgeries. Aims and objectives: This study is used to compare the effects of dexmedetomedine and nalbuphine when given as an adjuvant to hyperbaric bupivacaine in sub-arachnoid block. Material and methods: This study was prospective, randomized, double-blind study. After obtaining ethical committees' clearance and informed consent, sixty patients of either sex, and ASA physical status I and II scheduled for sub-arachnoid block were included and categorized into two groups(n=30). Result: Addition of dexmedetomedine with hyperbaric bupivacaine intrathecally when compared with nalbuphine result in faster onset of both motor and sensory blockade, with statistically significant longer duration of post-operative analgesia. Conclusion: Both dexmedetomidine and nalbuphine can be used as adjuvant to hyperbaric bupivacaine in spinal anaesthesia but dexmedetomidine along with bupivacaine provide better quality of anaesthesia, and excellent post-operative analgesia when compared with nalbuphine. [ABSTRACT FROM AUTHOR]

• The present research decodes the ties between consanguineous marriages and childhood stunting in India using the latest round of National Family Health Survey. • Findings hint a significant association between consanguineous marriages and childhood stunting in India. • Study highlights poor nutritional outcomes among progeny of consanguineous couples in India. The present research aims to decode the ties between marriages within blood relation (consanguineous marriages) and childhood stunting in India using the latest round of National Family Health Survey, conducted during 2015–16. The present study utilizes data on 192,357 ever-married women age 15–49 years and 14,707 children under age five years from National Family Health Survey, India, 2015–16. To draw inferences from the data, bivariate and multivariable logistic regression has been utilized. A Propensity Score Matching technique has been used to understand the causal linkages between consanguineous marriages and childhood stunting. The prevalence of childhood stunting was higher among male child (40%) compared to the female child (38%) among women who have married their blood relatives. The findings hint's a significant association between consanguineous marriages and childhood stunting. Multivariable regression and propensity score matching results also show that childhood stunting was significantly higher in consanguineous marriages compared to non-consanguineous marriages in the country. Thus, to reduce childhood stunting among children born to women married to their blood relatives, measures like premarital and pre-conception counselling need to be taken for the individuals opting for consanguineous marriages. [ABSTRACT FROM AUTHOR]