Prevalence of gestational diabetes mellitus and its feto-maternal outcome in Kamla Nehru state hospital for mother and child, IGMC, Shimla, India

Background: Gestational Diabetes Mellitus (GDM) is defined as carbohydrate intolerance of variable severity with the onset or first recognition during pregnancy. It is a disease entity that adversely affects maternal as well as fetal outcome. DIPSI guideline having suggested one-time plasma glucose level has emerged as a simple, practical and cheap method to detect GDM. This study was done to evaluate the prevalence of gestational diabetes using Diabetes in Pregnancy Study Group India (DIPSI) criteria and further assess its feto maternal outcome in Kamla Nehru State Hospital for Mother and Child, IGMC, Shimla.Methods: This study was conducted in 500 patients between 24 and 28 weeks of gestation, attending the antenatal OPD. These patients were given 75g oral glucose irrespective of last meal and their plasma glucose was estimated at 2h. Patients with plasma glucose ≥140mg/dl were diagnosed as GDM and the rest as control or the non GDM group. The GDM patients were followed up and treated with medical nutrition therapy (MNT) and/or insulin therapy till delivery and maternal and fetal outcomes were then noted.Results: The prevalence of GDM in this study was 6%. Maternal and fetal complications were more in the GDM patients. Vaginal candidiasis and PROM were the common maternal complications, while hypoglycemia and hyperbilirubinemia were common in the fetuses.Conclusions: GDM adversely affects the mother as well as fetus. DIPSI guideline having suggested a single plasma glucose level test has emerged as a practical and economical method to detect GDM

A Wearable Platform for Research in Augmented Hearing.

We have previously reported a realtime, open-source speech-processing platform (OSP) for hearing aids (HAs) research. In this contribution, we describe a wearable version of this platform to facilitate audiological studies in the lab and in the field. The system is based on smartphone chipsets to leverage power efficiency in terms of FLOPS/watt and economies of scale. We present the system architecture and discuss salient design elements in support of HA research. The ear-level assemblies support up to 4 microphones on each ear, with 96 kHz, 24 bit codecs. The wearable unit runs OSP Release 2018c on top of 64-bit Debian Linux for binaural HA with an overall latency of 5.6 ms. The wearable unit also hosts an embedded web server (EWS) to monitor and control the HA state in realtime. We describe three example web apps in support of typical audiological studies they enable. Finally, we describe a baseline speech enhancement module included with Release 2018c, and describe extensions to the algorithms as future work

Cost-effectiveness of therapeutic use of safety-engineered syringes in healthcare facilities in India

Background: Globally, 16 billion injections are administered each year of which 95% are for curative care. India contributes 25–30% of the global injection load. Over 63% of these injections are reportedly unsafe or deemed unnecessary. Objectives: To assess the incremental cost per quality-adjusted life-year (QALY) gained with the introduction of safety-engineered syringes (SES) as compared to disposable syringes for therapeutic care in India. Methods: A decision tree was used to compute the volume of needle-stick injuries (NSIs) and reuse episodes among healthcare professionals and the patient population. Subsequently, three separate Markov models were used to compute lifetime costs and QALYs for individuals infected with hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Three SES were evaluated—reuse prevention syringe (RUP), sharp injury prevention (SIP) syringe, and syringes with features of both RUP and SIP. A lifetime study horizon starting from a base year of 2017 was considered appropriate to cover all costs and consequences comprehensively. A systematic review was undertaken to assess the SES effects in terms of reduction in NSIs and reuse episodes. These were then modelled in terms of reduction in transmission of blood-borne infections, life-years and QALYs gained. Future costs and consequences were discounted at the rate of 3%. Incremental cost per QALY gained was computed to assess the cost-effectiveness. A probabilistic sensitivity analysis was undertaken to account for parameter uncertainties. Results: The introduction of RUP, SIP and RUP + SIP syringes in India is estimated to incur an incremental cost of Indian National Rupee (INR) 61,028 (US$939), INR 7,768,215 (US$119,511) and INR 196,135 (US$3017) per QALY gained, respectively. A total of 96,296 HBV, 44,082 HCV and 5632 HIV deaths are estimated to be averted due to RUP in 20 years. RUP has an 84% probability to be cost-effective at a threshold of per capita gross domestic product (GDP). The RUP syringe can become cost saving at a unit price of INR 1.9. Similarly, SIP and RUP + SIP syringes can be cost-effective at a unit price of less than INR 1.2 and INR 5.9, respectively. Conclusion: RUP syringes are estimated to be cost-effective in the Indian context. SIP and RUP + SIP syringes are not cost-effective at the current unit prices. Efforts should be made to bring down the price of SES to improve its cost-effectiveness

Exploring the global landscape of work-life balance research: A bibliometric and thematic analysis

The research on work-life balance (WLB) published in journals with a Scopus index between 2011 and 2022 is carefully examined in this work. Our research attempts to clarify the evolution and trends in WLB research and the importance of publications that Scopus indexes. After analyzing 2717 research articles, we found that WLB publications have a significant annual growth rate of 14.71 %, which suggests that the trend continues to grow. Significant changes are seen, with 1888 papers produced between 2017 and 2022 highlighting a notable increase in interest in the field. With 1608 papers, social sciences account for the majority of WLB research. With 54 publications, Griffith University (Australia) is the most affiliated institution. With 30 papers, the “Economic and Social Research Council of the United Kingdom” became the primary source of financing. The most prolific author, with nine publications, is Lingard H. At the same time, co-citation analysis reveals 168 co-cited authors. The United States (USA), the United Kingdom (U.K.), and Australia (A.U.) are the top three producing nations. A thematic analysis reveals ten major WLB themes, from work stress to difficulties with human resource management. This study provides crucial insights for policymakers and leaders to address work-life balance issues effectively. Using tools like Gephi or CiteSpace, we could deepen our understanding through advanced analysis methods such as page rank and network visualization

A Realtime, Open-Source Speech-Processing Platform for Research in Hearing Loss Compensation

We are developing a realtime, wearable, open-source speech-processing platform (OSP) that can be configured at compile and run times by audiologists and hearing aid (HA) researchers to investigate advanced HA algorithms in lab and field studies. The goals of this contribution are to present the current system and propose areas for enhancements and extensions. We identify (i) basic and (ii) advanced features in commercial HAs and describe current signal processing libraries and reference designs to build a functional HA. We present performance of this system and compare with commercial HAs using "Specification of Hearing Aid Characteristics," the ANSI 3.22 standard. We then describe a wireless protocol stack for remote control of the HA parameters and uploading media and HA status for offline research. The proposed architecture enables advanced research to compensate for hearing loss by offloading processing from ear-level-assemblies, thereby eliminating the bottlenecks of CPU and communication between left and right HAs

Study protocol: UK 2022 Comparative Audit of Acute Upper Gastrointestinal Bleeding (AUGIB) and the use of Blood

Introduction: The last UK-wide audit of the management of acute upper gastrointestinal bleeding (AUGIB) was conducted in 2007. Re-evaluation of current practice is needed, because since then, there have been several initiatives to improve the management of AUGIB including new guidelines, innovative endoscopic therapy, service delivery improvements and expansion of endoscopy provision. Methods and analysis: Consecutive, unselected presentations with AUGIB across all UK NHS hospitals were prospectively enrolled over a 2-month period between May and July 2022. Data will be collected on patient characteristics, comorbidities, use of anticoagulant drugs, transfusion, timing and type of diagnostic and therapeutic procedure, length of stay and mortality. Clinical practice will be audited against predefined minimum standards of care for AUGIB and compared to the results of the 2007 UK-wide audit. Data will be collected on the availability and organisation of care as well as the provision of training for specialist registrars in endoscopic management of AUGIB. Ethics and dissemination: This audit will be conducted as part of the National Comparative Audit of Blood Transfusion through collaboration with specialists in gastroenterology, haematology, surgery, and interventional radiology. Individual site reports will be provided alongside a UK-wide report disseminated through specialist societies and publications in peer-reviewed journals. The study has been funded by National Health Services Blood and Transplant and the British Society of Gastroenterology and endorsed by the Royal Colleges of Physicians, the British Association for the Study of the Liver, the Association of Upper GI Surgeons, and the British Society of Interventional Radiology