Spousal violence remains a critical public health and human rights issue in India and limited evidence exists on its relationship with short birth intervals (SBI). This study investigates the effect of spousal violence on SBI among Indian women using data from the latest National Family Health Survey. This cross-sectional study utilized a nationally representative sample of 394,571 ever-married women aged 15 to 49 years with at least two live births. The primary outcome variable was SBI, defined as <33 months between two successive live births. The key exposure variable was experience of spousal violence (emotional, physical, or sexual). Multivariable logistic regression, Propensity Score Matching (PSM), and Fairlie decomposition analyses were performed to assess the impact of spousal violence on SBI, adjusting for key socio-demographic and reproductive health covariates. Approximately 26.7% of women reported experiencing spousal violence, and 50.7% had a SBI. Logistic regression revealed that women who experienced spousal violence had 11% higher odds of SBI (OR = 1.11, p < .001) than those who did not. PSM results indicated a 2.2 percentage point higher risk of SBI among women exposed to violence (Average Treatment Effect = 0.022, p < .001). Fairlie decomposition showed that 27% of the SBI gap between exposed and unexposed groups was explained by observed covariates, with women's low education and rural residence being the largest contributors. This study highlights spousal violence as a significant correlate of SBI in India, emphasizing the urgent need for targeted policy interventions that integrate reproductive health services with domestic violence prevention. Strengthening legal enforcement, raising awareness through digital platforms, and promoting women's education and autonomy are critical strategies to reduce adverse reproductive outcomes linked to intimate partner violence.
Unroofed coronary sinus (CS) with CS orifice atresia and persistent left superior vena cava (PLSVC) is an exceptionally rare congenital anomaly that may coexist with acquired valvular disease, as illustrated in this case of severe rheumatic mitral stenosis. Multimodality imaging including echocardiography and cardiac CT was essential for precise anatomical delineation, guiding safe surgical intervention. Recognition of this complex anatomy is critical to avoid catastrophic complications such as inadvertent PLSVC ligation without ensuring adequate CS drainage. This case highlights the importance of comprehensive preoperative imaging in managing combined congenital and acquired cardiac pathologies.
Viral hepatitis is one of the infectious diseases with an overall increasing mortality rate. The global burden of acute viral hepatitis remains substantial, with hepatitis A, B, C, D, and E responsible for millions of new cases annually and significant morbidity, especially in resource-limited settings and among travelers to endemic regions. People living with chronic viral hepatitis, especially with advanced liver disease, may face specific health risks and management challenges during travel, which makes preparing for travel especially important. Travel-related gastroenteritis or febrile syndromes can lead to more severe clinical outcomes due to limited hepatic reserve. Newly acquired hepatitis A and E significantly increase the risk of liver failure and mortality in patients with chronic liver disease. This review emphasizes the critical importance of checking the immunization status of patients with chronic viral hepatitis before travel, managing antiviral medications, assessing risk of complications, evaluating the health infrastructure of the destination country, and applying food and water safety precautions. Safe travel for patients with chronic viral hepatitis can be facilitated through an appropriate risk assessment and a personalized travel plan.
