A randomized controlled trial of vaginal misoprostol tablet and intracervical dinoprostone gel in labor induction of women with prolonged pregnancies

Background: Objective of the study was to compare the efficacy of vaginal misoprostol and intracervical dinoprostone gel for induction of labor in women with unfavorable cervix beyond 41 weeks (287 days) of gestation.Methods: This randomized controlled trial was performed at a teaching hospital between January 2011 and December 2012. 192 women with singleton uncomplicated pregnancy with no previous uterine scar not going into spontaneous labor at 288th days of gestation .Misoprostol(25 mcg tablet)in the posterior vaginal fornix, four hourly, maximum six doses or Dinoprostone (0.5 mg gel) intracervical instillation ,six hourly, maximum three doses were given.Oxytocin was administered if needed. Primary outcome: Induction delivery interval (IDI) with incidence of delivery within 12 hours and 24 hours; mode of delivery: vaginal or caesarean section. Secondary outcome: maternal side effects, neonatal outcome. For statistical analysis chi-square test, student t- test and P-value determination were done.Results: The mean IDI was shorter in the misoprostol group compared to the dinoprostone group (p0.05). Adverse neonatal outcome (5-minutes Apgar score0.05).Conclusions: Vaginal misoprostol tablet is a safe and more effective method of induction of labour when compared with intracervical dinoprostone gel in prolonged pregnancies.

Usage Pattern of Glimepiride/Metformin Fixed-dose Combination in Type 2 Diabetes Patients with CVD or at Risk of CVD: An Experience in Indian Setting

Background: Diabetes is associated with almost twofold increased risk of cardiovascular diseases (CVD). The present case-based questionnaire survey evaluated the treatment pattern and clinical experience of healthcare professionals in prescribing glimepiride/metformin fixed-dose combination (FDC) to type 2 diabetes mellitus (T2DM) patients with CVD or those patients who are at risk of CVD in the Indian settings. Material and methods: A retrospective, multicenter, observational, case-based questionnaire survey was conducted in Indian healthcare centers using medical records of patients having T2DM, with CVD or are at risk of CVD, who were prescribed any strength of glimepiride/metformin FDC. Data was collected from the patients’ medical records and was analyzed using statistical tests. Results: A total of 680 patients with T2DM with CVD or at risk of CVD were included in this study. Mean duration of diabetes in the patients was 5.7 ± 4.8 years. About 68.5% patients had hypertension, 47.9% had dyslipidemia, 25.4% had coronary artery disease (CAD), 3.6% had transient ischemic attack (TIA), 4.8% had peripheral arterial disease (PAD) and 2.9% had heart failure. Around 18.1% patients had CVD after diabetes was diagnosed, while 81.9% presented with cardiovascular (CV) issues at the time of diabetes diagnosis. All patients received glimepiride/metformin FDC as first-line therapy. About 68.2% patients on glimepiride/metformin FDC had blood pressure within optimal limits. A large proportion of patients had improvement in glycemic parameters. Weight change was noted in 18.4% of the patients overall. Of these, 59.2% had reduction in weight. There were no major adverse events and treatment efficacy and tolerability were reported as good to excellent for 94.6% and 92.9% patients, respectively. Conclusion: This case-based questionnaire survey demonstrates the usage pattern of various strengths of glimepiride/metformin FDC and the clinicians’ practice approach regarding early initiation of this combination in Indian patients with diabetes who have or are at risk of CVD

Amino Acid Compositions of 27 Food Fishes and Their Importance in Clinical Nutrition

Proteins and amino acids are important biomolecules which regulate key metabolic pathways and serve as precursors for synthesis of biologically important substances; moreover, amino acids are building blocks of proteins. Fish is an important dietary source of quality animal proteins and amino acids and play important role in human nutrition. In the present investigation, crude protein content and amino acid compositions of important food fishes from different habitats have been studied. Crude protein content was determined by Kjeldahl method and amino acid composition was analyzed by high performance liquid chromatography and information on 27 food fishes was generated. The analysis showed that the cold water species are rich in lysine and aspartic acid, marine fishes in leucine, small indigenous fishes in histidine, and the carps and catfishes in glutamic acid and glycine. The enriched nutrition knowledge base would enhance the utility of fish as a source of quality animal proteins and amino acids and aid in their inclusion in dietary counseling and patient guidance for specific nutritional needs

Apolipoproteins AI/B/E gene polymorphism and their plasma levels in patients with coronary artery disease in a tertiary care-center of Eastern India

Aim: The present study was designed to investigate whether the three-apolipoprotein (AI, B, E) gene polymorphisms were related to alter their plasma protein levels and hence associated to coronary artery disease (CAD). Methods: We determined distribution of MspI apo AI, EcoRI apo B, HhaI apo E gene polymorphisms, plasma apolipoproteins and lipids levels among 150 patients having CAD admitted to the Department of Cardiology, N.R.S. Medical College & Hospital, Kolkata, India during June 2010–June 2012 and 150 age sex matched healthy controls. Results: We found that ApoAI concentration of studied population was significantly different in each genotypes of −75 G/A apo AI (p < 0.0001) gene polymorphism. A significant association was found in multivariate analysis for the genotypes with apo E4 allele [odds ratio (OR): 3.639; 95% confidence interval (CI): 1.019–12.995, p = 0.040] with four conventional risk factors (i.e. smoking, low-density lipoprotein, ApoAI and ApoB) with CAD. In contrast E2 allele has reverse effect, but the genotypes with apo E2 allele was no longer significant in the multivariate model (OR: 1.788; 95% CI: 0.400–8.001, p = 0.447) where as being significant in univariate analysis (OR: 0.219; 95% CI: 0.087–0.552, p = 0.001). Conclusions: Our findings suggest that the polymorphisms apo AI MspI and apo B EcoRI do not seem to affect CAD. But the genotype with E4 allele of apo E gene independent of other risk factors is associated with this disease

Association of common genetic polymorphisms with plasma lipid and coronary artery disease in West Bengal population

529-535Both apolipoprotein B (APOB) and low-density lipoprotein receptor (LDL-R) play crucial role in LDL uptake by cells. The association of apob MspI polymorphism and ldl-r AvaII polymorphism with coronary artery disease (CAD) has already been reported in other populations. Genetic variations in these two gene locus is associated with CAD in West Bengal population was investigated here. Blood samples were collected from angiographically proven 254 CAD patients and age matched 246 healthy people (controls) from different districts of West Bengal, India. Serum lipids including total cholesterol (TC), triglycerides (TG), high density lipid-cholesterol (HDL-C), low density lipid-cholesterol (LDL-C) and very low density lipid-cholesterol (VLDL-C) were evaluated in all the subjects. Genotyping was performed by PCR-RFLP combined with gel electrophoresis. The lipid-profile analysis revealed that TC, TG, LDL-C and VLDL-C were significantly high (p ) in patients than controls. Genotyping study showed that homozygous A+A+ genotype was significantly more prevalent (22% vs 10%, p = 0.0011) among patient group in this population than control. This genotype was also associated with higher LDL-C and TC levels. But there was no significant association of genotypes with serum lipid concentration was evident in APOB gene. The A+A+ genotype could be a genetic marker for CAD

A randomized controlled trial of vaginal misoprostol tablet and intracervical dinoprostone gel in labor induction of women with prolonged pregnancies

Background: Objective of the study was to compare the efficacy of vaginal misoprostol and intracervical dinoprostone gel for induction of labor in women with unfavorable cervix beyond 41 weeks (287 days) of gestation.Methods: This randomized controlled trial was performed at a teaching hospital between January 2011 and December 2012. 192 women with singleton uncomplicated pregnancy with no previous uterine scar not going into spontaneous labor at 288th days of gestation .Misoprostol(25 mcg tablet)in the posterior vaginal fornix, four hourly, maximum six doses or Dinoprostone (0.5 mg gel) intracervical instillation ,six hourly, maximum three doses were given.Oxytocin was administered if needed. Primary outcome: Induction delivery interval (IDI) with incidence of delivery within 12 hours and 24 hours; mode of delivery: vaginal or caesarean section. Secondary outcome: maternal side effects, neonatal outcome. For statistical analysis chi-square test, student t- test and P-value determination were done.Results: The mean IDI was shorter in the misoprostol group compared to the dinoprostone group (p&lt;0.001) with more delivery within &lt;12 hours (p&lt;0.001) and within &lt;24 hours (p&lt;0.05). Caesarean section rate was lower in misoprostol group compared to dinoprostone group (12.76% versus 23.07%) but this difference was not statistically significant (p&gt;0.05). Adverse neonatal outcome (5-minutes Apgar score&lt;7) with NICU admission was more in misoprostol group compared to dinoprostone group (0.04%versus0.01%) but this difference was also not statistically significant(p&gt;0.05).Conclusions: Vaginal misoprostol tablet is a safe and more effective method of induction of labour when compared with intracervical dinoprostone gel in prolonged pregnancies.

Maternal Fish Consumption and Prevention of Low Birth Weight in the Developing World

Low birth weight (LBW) is characterized by less than 2,500 g of body weight at birth. It represents about 15.5 % of total births worldwide and is a major cause of neonatal death. Most notably, 95.6 % of all LBWinfants are born in the developing countries. It is primarily resulted from either preterm birth (before 37 weeks of gestation) or intrauterine growth restriction (IUGR). Infants with LBW are about 20 times at higher risk of neonatal mortality and are believed to be more susceptible to cardiovascular complications, inhibition of growth and cognitive development and chronic diseases later in life. Despite its high incidence worldwide and clinical implications, there is still no clear understanding of its causes and consequently, no specific treatments exist. Maternal nutrition before and during pregnancy plays a major role in determining the pregnancy outcome and health of the new born. Fish is a cheap source of quality animal proteins and micronutrients, and fish oil is rich in omega-3 polyunsaturated fatty acids (PUFAs), EPA and DHA. Although the beneficial effects of fish oil on human health is known since 1930s, its protective effects against various pregnancy complications, including IUGR and LBW, have been increasingly recognized during the last two decades. Despite the poor outcome of clinical trials on therapeutic use of fish oil for various pregnancy complications inWestern countries, our preliminary epidemiological findings, and numerous observational and experimental studies in developing countries highlight the beneficial effects of fish consumption on pregnancy outcome, particularly in reducing the incidence of LBW. The present paper summarizes various evidences on effects of maternal fish consumption on birth weight, growth and development of infants and young children in the developing world, and emphasizes future research for better understanding of the effects of maternal fish consumption on pregnancy outcome in low socioeconomic settings

Not Available

Not AvailableLow birth weight (LBW) is characterized by less than 2,500 g of body weight at birth. It represents about 15.5 % of total births worldwide and is a major cause of neonatal death. Most notably, 95.6 % of all LBWinfants are born in the developing countries. It is primarily resulted from either preterm birth (before 37 weeks of gestation) or intrauterine growth restriction (IUGR). Infants with LBW are about 20 times at higher risk of neonatal mortality and are believed to be more susceptible to cardiovascular complications, inhibition of growth and cognitive development and chronic diseases later in life. Despite its high incidence worldwide and clinical implications, there is still no clear understanding of its causes and consequently, no specific treatments exist. Maternal nutrition before and during pregnancy plays a major role in determining the pregnancy outcome and health of the new born. Fish is a cheap source of quality animal proteins and micronutrients, and fish oil is rich in omega-3 polyunsaturated fatty acids (PUFAs), EPA and DHA. Although the beneficial effects of fish oil on human health is known since 1930s, its protective effects against various pregnancy complications, including IUGR and LBW, have been increasingly recognized during the last two decades. Despite the poor outcome of clinical trials on therapeutic use of fish oil for various pregnancy complications inWestern countries, our preliminary epidemiological findings, and numerous observational and experimental studies in developing countries highlight the beneficial effects of fish consumption on pregnancy outcome, particularly in reducing the incidence of LBW. The present paper summarizes various evidences on effects of maternal fish consumption on birth weight, growth and development of infants and young children in the developing world, and emphasizes future research for better understanding of the effects of maternal fish consumption on pregnancy outcome in low socioeconomic settings.Not Availabl

Patients' preference for integrating homeopathy (PPIH) within the standard therapy settings in West Bengal, India: The part 1 (PPIH-1) study

There is lack of studies assessing the preference of Indian patients for integration of homeopathy into standard therapy settings. The objectives of this study were to examine the knowledge, attitudes, and practice of homeopathy among Indian patients already availing homeopathy treatment and its integration into mainstream healthcare. A cross-sectional survey was conducted among adult patients attending the out-patients of the four government homeopathic hospitals in West Bengal, India. A self-administered 24-items questionnaire in local vernacular Bengali was developed and administered to the patients. A total of 1352 patients' responses were included in the current analysis. 40% patients thought that homeopathic medicines can be used along with standard therapy. 32.5% thought that homeopathic medicines might cause side effects, while only 13.3% believed that those might interact with other medications. Patients' knowledge ranged between 25.1 and 76.5% regarding regulations of practicing and safety of homeopathic medicine in India and abroad; while positive attitude towards the same ranged between 25.4 and 88.5%. 88.6% of the patients had favorable attitude toward integrated services. 68.2% of the patients used homeopathic medicines in any acute or chronic illness for themselves and 76.6% for their children. Preference for integrated services was significantly associated with better knowledge (P = 0.002), positive attitudes toward safety and regulations (P < 0.0001), and integration (P < 0.0001), but not with the level of practice (P = 0.515). A favorable attitude toward integrating homeopathy into conventional healthcare settings was obtained among the patients attending the homeopathic hospitals in West Bengal, India

Exercise and eating habits among urban adolescents: a cross-sectional study in Kolkata, India

Abstract Background Unhealthy eating and lack of exercise during adolescence culminated into earlier onset and increasing burden of atherosclerotic cardiovascular diseases (CVDs) worldwide. Among urban Indian adolescents, prevalence of these risk factors of CVD seemed to be high, but data regarding their pattern and predictors was limited. To address this dearth of information, a survey was conducted among urban adolescent school-students in Kolkata, a highly populated metro city in eastern India. Methods During January–June, 2014, 1755 students of 9th-grade were recruited through cluster (schools) random sampling. Informed consents from parents and assents from adolescents were collected. Information on socio-demographics, CVD-related knowledge and perception along with eating and exercise patterns were collected with an internally validated structured questionnaire. Descriptive and regression analyses were performed in SAS-9.3.2. Results Among 1652 participants (response rate = 94.1%), about 44% had poor overall knowledge about CVD, 24% perceived themselves as overweight and 60% considered their general health as good. Only 18% perceived their future CVD-risk and 29% were engaged in regular moderate-to-vigorous exercise. While 55% skipped meals regularly, 90% frequently consumed street-foods and 54% demonstrated overall poor eating habits. Males were more likely to engage in moderate-to-vigorous exercise [adjusted odds ratio (AOR) = 3.40(95% confidence interval = 2.55–4.54)] while students of higher SES were less likely [AOR = 0.59(0.37–0.94)]. Males and those having good CVD-related knowledge were more likely to exercise at least 1 h/day [AOR = 7.77(4.61–13.07) and 2.90(1.46–5.78) respectively]. Those who perceived their future CVD-risk, skipped meals more [2.04(1.28–3.25)] while Males skipped them less [AOR = 0.62(0.42–0.93)]. Subjects from middle class ate street-foods less frequently [AOR = 0.45(0.24–0.85)]. Relatively older students and those belonging to higher SES were less likely to demonstrate good eating habits [AOR = 0.70(0.56–0.89) and 0.23(0.11–0.47) respectively]. A large knowledge-practice gap was evident as students with good CVD-related knowledge were less likely to have good eating habits [AOR = 0.55(0.32–0.94)]. Conclusions CVD-related knowledge as well as eating and exercise habits were quite poor among adolescent school-students of Kolkata. Additionally, there was a large knowledge-practice gap. Multi-component educational interventions targeting behavioral betterment seemed necessary for these adolescents to improve their CVD-related knowledge, along with appropriate translation of knowledge into exercise and eating practices to minimize future risk of CVDs