Fetal growth and its correlation with level of glycemic control in pregnancy with diabetes: an observational study in tertiary care centre of North India

Background: Diabetes in pregnancy is a known risk factor for macrosomia and intensive glycemic control is a well-known strategy to prevent this macrosomia. However, does this tight glycemic control is actually beneficial or is it one of the reasons for small for gestational age babies in these women? Is a clinical enigma. We planned this study to see effects of glycemic control on fetal weight and to answer if tight control is always better.Methods: This prospective observational study was conducted in the department of obstetrics and gynaecology in a tertiary care centre (King George medical university) over a period of one year (June 2017-June 2018). All pregnant women with GDM and pre-gestational diabetes with singleton pregnancy were registered in the study after proper consent, followed up for glycemic control, fetal weight. Antepartum risk factors and complications of diabetes were also noted in these women.Results: Total 88 patients included in the study. Five with pre-gestational diabetes, 83 with GDM. Small for gestational age neonates were seen in 54.1% cases, large for gestational age were seen in 2 cases and rest of neonates were appropriate for gestational age. 89.4% had good glycemic control, 7% had over-zealous glycemic control and 3.5% had under-controlled sugars.Conclusions: The results in the study strongly supported the efficacy of good glycemic control in prevention of LGA/macrosomia. However, optimal glycemic control in third trimester does not guarantee appropriate weight of fetus as incidence of SGA/FGR neonates was fairly high (53.9%) even in good glycemic control group

Assessment of Ecological Disturbance Caused by Flood and Fire in Assam Forests, India, Using MODIS Time Series Data of 2001-2011

The forest area of Assam State is known for its rich biodiversity. In the present study, the disturbance regime within the Assam forest area caused by periodic flood and forest fire, was assessed using the Moderate Resolution Imaging Spectroradiometer (MODIS) time-series (2001–2011) data. The MODIS Global Disturbance Index (MGDI) images were generated using MODIS derived Enhanced Vegetation Index (EVI) and Land Surface Temperature (LST) images. The temporal intensity of flood and forest fire in sixteen representative forests was analyzed to develop the MGDI based thresholds for detecting the disturbed area. The threshold for the non-instantaneous disturbance, i.e. flood, was found to be 107% whereas it was 111% for instantaneous disturbance, i.e. forest fire. The thresholds were applied on the MGDI images to delineate disturbed caused by flood and fire, separately for each year. The time-series disturbance areas were integrated over the years (2001–2011) to generate the classified disturbance prone maps

Strategies for identifying stable lentil cultivars (Lens culinaris Medik) for combating hidden hunger, malnourishment, and climate variability

Iron and zinc malnutrition is a global humanitarian concern that mostly affects newborns, children, and women in low- and middle-income countries where plant-based diets are regularly consumed. This kind of malnutrition has the potential to result in a number of immediate and long-term implications, including stunted growth, an elevated risk of infectious diseases, and poor development, all of which may ultimately cause children to not develop to the fullest extent possible. A determination of the contributions from genotype, environment, and genotype by environment interactions is necessary for the production of nutrient-dense lentil varieties that offer greater availability of iron and zinc with a high level of trait stability. Understanding the genotype and environmental parameters that affect G x E (Genotype x Environment) interactions is essential for plant breeding. We used GGE(Genotype, Genotype x Environment interactions) and AMMI (Additive Main effects and Multiplicative Interaction) models to study genetic stability and GE(Genotype x Environment interactions) for grain Fe, Zn, Al, and anti-nutritional factors like phytic acid content in sixteen commercially produced lentil cultivars over several different six geographical locations across India. Significant genetic variability was evident in the Fe and Zn levels of different genotypes of lentils. The amounts of grain iron, zinc, and phytic acid varied from 114.10 to 49.90 mg/kg, 74.62 to 21.90 mg/kg, and 0.76 to 2.84 g/100g (dw) respectively. The environment and GE (Genotype x Environment interactions) had an impact on the concentration of grain Fe, Zn, and phytic acid (PA). Heritability estimations ranged from low to high (53.18% to 99.48%). The study indicated strong correlation between the contents of Fe and Zn, a strategy for simultaneously increasing Fe and Zn in lentils may be recommended. In addition, our research revealed that the stable and ideal lentil varieties L4076 (Pusa Shivalik) for Fe concentration and L4717 (Pusa Ageti) for Zn content, which have lower phytic acid contents, will not only play an essential role as stable donors in the lentil bio-fortification but will also enable the expansion of the growing area of bio-fortified crops for the security of health and nutrition

Bronchiectasis in India:results from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) and Respiratory Research Network of India Registry

BACKGROUND: Bronchiectasis is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low-income and middle-income countries. We therefore aimed to describe the characteristics, severity of disease, microbiology, and treatment of patients with bronchiectasis in India. METHODS: The Indian bronchiectasis registry is a multicentre, prospective, observational cohort study. Adult patients ( 6518 years) with CT-confirmed bronchiectasis were enrolled from 31 centres across India. Patients with bronchiectasis due to cystic fibrosis or traction bronchiectasis associated with another respiratory disorder were excluded. Data were collected at baseline (recruitment) with follow-up visits taking place once per year. Comprehensive clinical data were collected through the European Multicentre Bronchiectasis Audit and Research Collaboration registry platform. Underlying aetiology of bronchiectasis, as well as treatment and risk factors for bronchiectasis were analysed in the Indian bronchiectasis registry. Comparisons of demographics were made with published European and US registries, and quality of care was benchmarked against the 2017 European Respiratory Society guidelines. FINDINGS: From June 1, 2015, to Sept 1, 2017, 2195 patients were enrolled. Marked differences were observed between India, Europe, and the USA. Patients in India were younger (median age 56 years [IQR 41-66] vs the European and US registries; p<0\ub70001]) and more likely to be men (1249 [56\ub79%] of 2195). Previous tuberculosis (780 [35\ub75%] of 2195) was the most frequent underlying cause of bronchiectasis and Pseudomonas aeruginosa was the most common organism in sputum culture (301 [13\ub77%]) in India. Risk factors for exacerbations included being of the male sex (adjusted incidence rate ratio 1\ub717, 95% CI 1\ub703-1\ub732; p=0\ub7015), P aeruginosa infection (1\ub729, 1\ub710-1\ub750; p=0\ub7001), a history of pulmonary tuberculosis (1\ub720, 1\ub707-1\ub734; p=0\ub7002), modified Medical Research Council Dyspnoea score (1\ub732, 1\ub725-1\ub739; p<0\ub70001), daily sputum production (1\ub716, 1\ub703-1\ub730; p=0\ub7013), and radiological severity of disease (1\ub703, 1\ub701-1\ub704; p<0\ub70001). Low adherence to guideline-recommended care was observed; only 388 patients were tested for allergic bronchopulmonary aspergillosis and 82 patients had been tested for immunoglobulins. INTERPRETATION: Patients with bronchiectasis in India have more severe disease and have distinct characteristics from those reported in other countries. This study provides a benchmark to improve quality of care for patients with bronchiectasis in India. FUNDING: EU/European Federation of Pharmaceutical Industries and Associations Innovative Medicines Initiative inhaled Antibiotics in Bronchiectasis and Cystic Fibrosis Consortium, European Respiratory Society, and the British Lung Foundation

Congenitally corrected TGA- A case diagnosed incidentally

Congenitally corrected transposition of the great arteries (CCTGA) is a rare congenital heart defect associated with multiple cardiac morphological abnormalities and conduction defects. Data from the Baltimore-Washington Infant Study supported the fact that congenitally corrected transposition is a rare disorder (1). As many as 40 infants per 100,000 live births are affected by congenitally corrected transposition of the great vessels; this is less than 1% of all congenital heart defects. The literature reports fewer than 1000 cases, however, the true prevalence of the malformation is not known. We report a case of a 25 year old female diagnosed incidentally post delivery with CCTGA

Effect of p53 codon 72 polymorphism on the survival outcome in advanced stage cervical cancer patients in India

Background & objectives: The Arg>Pro polymorphism in codon 72 of p53 gene is known to affect the susceptibility of cervical cancer differently in different population worldwide although information regarding its role in determining survival status and disease outcome in patients is lacking. The present study was conducted to determine the genotype frequency and prognostic role of p53 codon 72 Arg>Pro polymorphism in patients with advanced stage cervical cancer in India. Methods: The p53 codon 72 polymorphism was determined in tumour biopsies (n = 107) and matched blood samples (n = 19) in cervical cancer patients using polymerase chain reaction-restriction fragment length polymorphism method (PCR-RFLP). Effect of p53 genotype on the overall survival (OS) and recurrence-free survival (RFS) was analyzed. Individual Arg or Pro alleles were studied for their significance on survival as Pro carriers (Pro/Pro + Arg/Pro) versus Arg/Arg individuals or Arg carriers (Arg/Arg + Arg/Pro) versus Pro/Pro individuals. Results: The frequencies for Arg/Arg, Arg/Pro and Pro/Pro genotypes were 27.2, 49.5 and 23.3 per cent, respectively. There was no significant difference in the genotypes with respect to patients' OS or RFS. Interpretation & conclusions: The findings of our study indicated that p53 codon 72 polymorphism might not be an independent marker in predicting clinical outcome in advanced stage cervical cancer patients. Further studies need to be done in larger samples to confirm these findings