Coverage of antenatal iron-folic acid and calcium distribution during pregnancy and their contextual determinants in the northeastern region of India

Iron-folic acid (IFA) and calcium supplementation are nutritional interventions recommended prophylactically (against maternal anemia and preeclampsia, respectively) to all antenatal mothers in India under basic antenatal care (ANC) services. Using Health Management Information System data (reporting period: 2018–19 to 2020–21), we mapped the coverage of antenatal IFA and calcium distribution across the remote northeastern region of India relative to the number of pregnant women (PW) who registered for ANC, disaggregated by states and districts. Variations in coverage were also investigated by subgroups based on contextual attributes, viz., physiography (hilly/ plateau/ plain), socioeconomic development (“aspirational”/ “non-aspirational”) and proportion of early ANC visits (low/ medium/ high). Full course of antenatal IFA and calcium supplements were received by 79.36 (95% CI: 79.31–79.40) and 61.26 (95% CI: 61.21–61.32) PW per 100 ANC registered women, respectively. There was widespread heterogeneity in outreach, with calcium coverage generally trailing behind IFA coverage. Among states, coverage of the two interventions (per 100 ANC registered women) was highest in Assam (97.06 and 78.11 PW, respectively) and lowest in Nagaland (24.87 and 16.77 PW, respectively). At the district-level, the two interventions failed to reach even 50 PW per 100 ANC registered women in 32 (out of 115) districts. The coverage tended to be inferior in districts that were hilly, “non-aspirational” and had low proportion of early ANC visits. The granular information provided by our findings will facilitate monitoring, root cause analyses, microplanning, informed resource allocation and tailoring of locally appropriate solutions to achieve targeted coverage improvements

A single-center retrospective study of Vitamin D status and acute left ventricular heart failure from a super specialty tertiary care hospital in Northeast India

Introduction: Heart failure (HF) is a progressive clinical condition and is a major cause of mortality and morbidity. Various studies have shown the association of Vitamin D deficiency with HF. The present study aimed to investigate the Vitamin D status among acute left ventricular failure (LVF) patients admitted to our hospital. Materials and Methods: Medical records of 55 acute LVF patients were retrospectively assessed. Patients were categorized according to their Vitamin D status. Demographics, risk factors, clinical presentations, and biochemical data of the patients were analyzed and documented. Results: Patients were grouped based on their Vitamin D status as deficient (40%; n = 22), insufficient (32.7%; n = 18), optimal (23.6%; n = 13), and toxic (3.6%; n = 2). The overall cohort included 67.3% (n = 37) of males with a male/female ratio of 2.1:1. Ages ranged from 22 to 86 years with a mean age of 64.8 years ± 2.3. Rural/Urban was 1:0.9. Hypertension (63.6%; n = 35) was the predominant risk factor across all groups. Mortality was the highest in the Vitamin D deficient group (36.4%; n = 8). The most common symptom observed was dyspnea (76.4%; n = 42). A high incidence of HF with reduced ejection fraction (58.1%; n = 32) was seen in the entire cohort with the highest prevalence in the Vitamin D-deficient group (27.3%; n = 15). Conclusions: Our study revealed a high occurrence of Vitamin D deficiency and insufficiency among HF patients. Routine screening of Vitamin D levels should be done in patients with unexplained cardiac problems. Serious adverse events, including HF, can be prevented and/or reduced on early diagnosis and treatment of Vitamin D deficiency/insufficiency

Orbital lipoma: A rare case report from India with review of literature

Orbital lipomas are uncommon benign tumors with only a few reported cases in literature.  They are usually asymptomatic and exhibit gradual growth.  We rendered such a rare case of primary lipoma in the orbital region with interpreted symptoms of ocular pain, reduced vision, and mild proptosis.  Right fronto-orbital craniotomy with gross total excision of the tumor was done.  Histological examination suggested a final diagnosis of lipoma.  Post-operatively, the patient developed mild ptosis.  During follow-up, ptosis completely subsided and significant improvement in vision was noted

Clinical characteristics, risk factors, and thyroid profile of patients admitted with acute left ventricular heart failure from a tertiary hospital in Northeast India: A single-center retrospective cohort study

Introduction: Heart failure (HF) is a progressive chronic clinical syndrome. Thyroid dysfunction in HF patients has been reported in the literature. We aimed to explore the prevalence of thyroid dysfunction among acute left ventricular failure (LVF) patients admitted to our hospital. Materials and Methods: A retrospective study involving 78 patients diagnosed with acute LVF was conducted. Baseline information that included demographics, risk factors, clinical presentations, and biochemical data was recorded. A comparison of acute LVF patients with thyroid dysfunction to those with normal thyroid function was analyzed and documented. Results: About 29.5% (n = 23; 63.8 ± 11.4 years) of patients had normal thyroid function and 70.5% (n = 55; 65.3 ± 6 years) had thyroid dysfunction (P = 0.0003). The mean age of the cohort was 64.7 ± 12.4 years and 68% (n = 53) were men. Hypertension was the most common risk factor among both groups (56.5%, n = 13 vs. 67.3%, n = 37; P = 0.0006). Around 13% (n = 3) of patients with normal thyroid function and 20% (n = 11) of patients with thyroid dysfunction expired (P = 0.0325). The most common symptom seen in both groups was shortness of breath (28%, n = 16 vs. 72%, n = 41; P = 0009). There was a high prevalence of HF with reduced ejection fraction (60.8%, n = 14 vs. 65.5%, n = 36; P = 0.0018). Electrocardiography abnormalities were noted in 70.5% (n = 55) of patients of the cohort (65.2%, n = 15 vs. 72.7%, n = 40; P = 0.007). Irregularities in two-dimensional echocardiography and Doppler were seen in 76.5% (n = 59) of patients (69.6%, n = 16 vs. 78.2%, n = 43; P = 0.0004). Conclusions: Thyroid dysfunction can cause significant adverse effects on the heart. Early diagnosis and treatment of thyroid abnormalities can reduce and/or prevent the development of serious cardiac problems including HF

Orbital lipoma

Orbital lipomas are uncommon benign tumors with only a few reported cases in literature.  They are usually asymptomatic and exhibit gradual growth.  We rendered such a rare case of primary lipoma in the orbital region with interpreted symptoms of ocular pain, reduced vision, and mild proptosis.  Right fronto-orbital craniotomy with gross total excision of the tumor was done.  Histological examination suggested a final diagnosis of lipoma.  Post-operatively, the patient developed mild ptosis.  During follow-up, ptosis completely subsided and significant improvement in vision was noted

Prolactin and thyroid stimulating hormone affecting the pattern of LH/FSH secretion in patients with polycystic ovary syndrome: A hospital-based study from North East India

Introduction: Polycystic ovary syndrome (PCOS) is one of the most important endocrinal diseases in reproductive age group, clinically manifested by hyperandrogenism and anovulation and different other metabolic disturbances that may have important implications for long-term health. Aim and Objective: The aim of this study was to determine the incidence of abnormal luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratio in women with polycystic ovary and to assess the influence of prolactin and thyroid-stimulating hormone (TSH) in the elevated LH/FSH ratio. Study Design: Retrospective observational study. Materials and Methods: Eighty-five women in reproductive age diagnosed with PCOS between June 2012 to June 2014 at the Department of Obstetrics and Gynecology in a tertiary care hospital were selected for the study. Serum LH and FSH levels were determined and LH/FHS ratio (normal range ≤2) calculated in the study subjects. They underwent a detailed clinical, hormonal, and metabolic evaluation, which was performed between the second and third days of a natural or induced menstrual period. Results: Elevated LH/FSH ratio was found in 60 women (70.58%). Normal gonadotropin ratio was detected in 25 women (29.41%). Statistically significant differences in serum TSH levels were noted between groups with normal and elevated LH/FSH ratio. However, no statistically significant difference was noted in other endocrine parameters. Further analysis revealed a slight negative correlation of TSH with prolactin in the study subjects of PCOS with an 'r' value of − 0.3. Conclusions: LH/FSH ratio is one of the characteristic attribute of PCOS women. In the present study, this abnormality was detected in 70% of patients. Hypothyroidism was a common endocrinal abnormality and prolactin was inversely correlated to TSH levels in PCOS patients

Association of serum uric acid with left ventricular ejection fraction: A retrospective insight from a tertiary care hospital of North East India

Context: Cardiometabolic risk factors play crucial roles in left ventricular dysfunctions (left ventricular failure): a defining feature of heart failure (HF) with preserved ejection fractions (HFpEF). Among the many, serum uric acid (SUA) is a controversial risk factor that needs to be investigated globally. Aim: We aim to elucidate a correlation of SUA with ejection fraction percentage (EF%) in patients with chronic HF supporting the probable notion of hyperuricemia being a prognostic biomarker. Settings and Design: This retrospective, cohort study was performed on patients who visited from January 2022 to June 2022 in the Department of Cardiology at a tertiary care hospital in Northeastern India. Methods: A series of 81 selected patients with known congestive HF were documented with various baseline, clinical, and biochemical parameters. Patients were divided into three groups based on EF% and their relation with SUA, along with other parameters was analyzed. Statistical Analysis: Data were presented as mean ± standard deviation and frequencies for continuous variables and categorical variables, respectively. ANOVA one-way tests were conducted for continuous variables and Chi-square tests for categorical variables. P < 0.05 was considered as statistically significant. Results: A significant correlation was established between levels of SUA and EF (P = 0.021). Hence, hyperuricemia is directly related to an increased risk of lower EF. Conclusion: Even when asymptomatic, SUA can be used as a prognostic biomarker in the assessment of HF diseases

Assessment of the relationship between serum xanthine oxidase levels and type 2 diabetes: a cross-sectional study

Abstract Xanthine oxidase (XO) is an enzyme associated with purine metabolism. The relationship between XO levels and type 2 diabetes (T2D) is not clear yet or little is known so far. Therefore, we conducted a cross-sectional study to determine the association of XO levels with T2D in a Bangladeshi adult cohort. A total of 325 participants (234 males and 91 females) were enrolled in the study. The participants were divided into three groups; diabetic (n = 173), prediabetic (n = 35), and non-diabetic control (n = 117). Serum levels of XO were measured by enzyme-linked immunosorbent assay (ELISA) and other biochemical parameters including fasting blood glucose (FBG), serum uric acid (SUA), and lipid profile markers measured by colorimetric methods. Participants with T2D were confirmed according to the definition of the American Diabetic Association. The association between serum XO levels and T2D was determined by logistic regression models. The mean level of serum XO was significantly higher in females (6.0 ± 3.7 U/L) compared to male (4.0 ± 2.8 U/L) participants (p < 0.001). In contrast, males had a higher mean level of SUA (6.1 ± 1.9 mg/dL) than female (4.4 ± 1.9 mg/dL) participants (p < 0.001). The mean level of XO was significantly higher in the diabetic group (5.8 ± 3.6 U/L) compared to the prediabetic (3.7 ± 1.9 U/L) and control (2.9 ± 1.8 U/L) groups (p < 0.001). On the other hand, the mean SUA concentration was significantly lower in the diabetic group than in the other two groups (p < 0.001). A significant increasing trend was observed for FBG levels across the XO quartiles (p < 0.001). A decreasing trend was found for SUA levels in the XO quartiles (p < 0.001). Serum levels of XO and SUA showed a positive and negative correlation with FBG, respectively. In regression analysis, serum XO levels showed an independent association with T2D. In conclusion, this study reports a positive and independent association between XO levels and T2D in Bangladeshi adults. Monitoring serum levels of XO may be useful in reducing the risk of T2D. Further research is needed to determine the underlying mechanisms of the association between elevated XO levels and T2D

Unravelling oxygen driven α to β phase transformation in tungsten

International audienceThin films of β-W are the most interesting for manipulating magnetic moments using spin–orbit torques, and a clear understanding of α to β phase transition in W by doping impurity, especially oxygen, is needed. Here we present a combined experimental and theoretical study using grazing incidence X-ray diffraction, photoelectron spectroscopy, electron microscopy, and ab initio calculations to explore atomic structure, bonding, and oxygen content for understanding the formation of β-W. It is found that the W films on SiO2/Si have 13–22 at.% oxygen in A15 β structure. Ab initio calculations show higher solution energy of oxygen in β-W, and a tendency to transform locally from α to β phase with increasing oxygen concentration. X-ray absorption spectroscopy also revealed local geometry of oxygen in β-W, in agreement with the simulated one. These results offer an opportunity for a fundamental understanding of the structural transition in α-W and further development of β-W phase for device applications