Accuracy of pulse oximetry screening for detecting critical congenital heart disease in the newborns in rural hospital of Central India

Congenital cardiovascular malformations are the most common category of birth defects and responsible for mortality in the first twelve months of life. Critical congenital heart disease (CCHD) will be present in approximately one quarter of these children, which requires catheter or surgery intervention in the first year of life. The aim is to determine the accuracy of pulse oximetry for detecting clinically unrecognized CCHD in the newborns. This article reports the following methods : Pulse oximetry was performed on clinically normal newborns within first 4 hours of life. If screening oxygen saturation (SpO2) was below 90%, echocardiography was then performed. Inclusion criteria: All newborns who were admitted in postnatal ward & NICU. Exclusion criteria: Out born babies and babies with a prenatal diagnosis of duct dependent circulation.peer-reviewe

Hartley-Ross Type Unbiased Estimators Using Ranked Set Sampling and Stratified Ranked Set Sampling

This paper proposes several Hartley-Ross (HR) type unbiased estimators of the finite population mean using information on known population parameters of the auxiliary variable in ranked set sampling (RSS) and stratified ranked set sampling (StRSS). The variances of the proposed HR unbiased ratio-type estimators are obtained to first degree of approximation. In simulation study the proposed estimators are more efficient as compared to all other competitor estimators

Phosphate Glass Microspheres as Cell Microcarrier Substrates for Bone Tissue Engineering Applications

Phosphate glasses have demonstrated a high degree of suitability for use as biomaterials in a wide range of biomedical applications involving both hard and soft tissue regeneration. This study focused on the use of these glasses as substrate microcarrier materials for three-dimensional bone tissue formation. For this purpose, the successful production of phosphate glass microspheres in the ~10–200 μm size range was demonstrated using a simple, inexpensive and industrially scalable process. Microspheres made out of two different series of phosphate glass compositions were investigated: (a) iron phosphate glasses 0.5P2O5–0.4CaO–(0.1 – x)Na2O–xFe2O3 where x = 0.00, 0.01, 0.03 and 0.05 mole fraction and (b) titanium phosphate glasses 0.5P2O5–0.4CaO–(0.1 – x)Na2O–xTiO2 where x = 0.00, 0.01, 0.03, 0.05 and 0.07 mole fraction. Investigations of the microsphere physicochemical properties revealed the densification of the glass structure with increased metal oxide incorporation in the glass. Glass structural characterisation studies provided valuable information relating the physicochemical properties to glass structural arrangements at the glass phase and atomic levels. Cell culture studies involving culture of the microspheres with MG63 osteosarcoma cells and human mesenchymal stem cells indicated that microspheres made of glasses containing 3–7 mol% metal oxides, and particularly those containing 5 mol% TiO2, showed favourable characteristics in terms of cell attachment, viability, proliferation and release of proteins related to cell differentiation and metabolism under both static conditions in culture well plates and dynamic conditions in spinner flask bioreactors. Taken together, the results provide evidence of the potential of the investigated glass microspheres to function as effective microcarrier substrates for bone tissue engineering application

An Ecient Class of Estimators of Population Mean in Two-Phase Sampling Using Two Auxiliary Variables

<p>This study is devoted to obtain an ecient estima-tor for population mean in two-phase sampling using two auxiliary variables following Vishwakarma and Kumar (2014). Expressions for bias and mean squared error(MSE) are obtained to rst or-der of approximation. The new proposed estimator is compared with some competitor estimators both theoretically and numeri-cally using eight dierent data sets. It has been shown that the new proposed estimator gives more ecient results as compared to its competitor estimators.</p

A study to assess the factors associated with developmental delay and nutritional status among the children with cleft lip and/or cleft palate

Background: Cleft lip with or without cleft palate is one of the most common congenital anomalies. Development is often affected in these children. It may be due to other associated defects, syndromic status, or malnutrition. Objective: The objective of this study was to assess the factors associated with developmental delay and nutritional status among the children with cleft lip and/or cleft palate. Materials and Methods: A cross-sectional study was conducted at the Department of Pediatrics of a Medical College in Sawangi (Meghe), Wardha, for 2 years from August 2010 to March 2012. All children below 15 years with cleft lip and/or palate admitted in the pediatric ward, the neonatal intensive care unit, or postnatal ward were included in the study. A total of 200 children were included in the study and were analyzed for developmental delay and growth lag. Results: Cleft clip was seen in 51 (25.5%) of the children, 25 (12.5%) had cleft palate, and 124 (62%) had both cleft lip and palate. Developmental delay was more common in cleft palate category; however, it was not statistically significant (χ2=0.90, p=0.34). Unilateral form of defects had more number of delays as compared to bilateral defects, and it was statistically significant (χ2=7.32, p=0.006). Delay was more common when both the defects were present together as compared to isolated defects; however, it was not statistically significant. Gross motor and language delay were the most common type followed by global and personal social. 12.5% of children were syndromic. Most of the syndromic children (64%) had global developmental delay (χ2=7.84, significant). 69.6% of children below the age group of 5 years were malnourished (χ2=16, significant). Faulty feeding (73.5%), recurrent respiratory infections (21.4%), and repeated hospitalization (17.1%) were the statistically significant factors for poor growth. Conclusion: Global developmental delay was more common in syndromic children. Overall, delay was more commonly seen in children with unilateral defect. Factors, which contributed to growth lag, were faulty feeding, recurrent respiratory infections, and repeated hospitalization

Incidental finding of cleidocranial dysplasia in an adolescent with head trauma

Cleidocranial dysplasia (CCD) is a rare autosomal dominant skeletal disease. It is characterized by partial or completeabsence of clavicles, late closure of fontanels, presence of open skull sutures and multiple wormian bones and variouscraniofacial and dental abnormalities. The majority of craniofacial abnormalities become obvious during adolescence.Early diagnosis with preventive measures for various associated complications helps improve the quality-of-life of thepatient. We hereby report an incidental finding of CCD in a 16-year-old young adolescent male with blunt head trauma andreview the clinical and radiological features and associated orthopedic, dental and ENT complications of this rare disorder

Titanium phosphate glass microcarriers induce enhanced osteogenic cell proliferation and human mesenchymal stem cell protein expression.

In this study, we have developed 50- to 100-µm-sized titanium phosphate glass microcarriers (denoted as Ti5) that show enhanced proliferation of human mesenchymal stem cells and MG63 osteosarcoma cells, as well as enhanced human mesenchymal stem cell expression of bone differentiation markers, in comparison with commercially available glass microspheres at all time points. We also demonstrate that these microcarriers provide superior human mesenchymal stem cell proliferation with conventional Dulbecco's Modified Eagle medium than with a specially developed commercial stem cell medium. The microcarrier proliferative capacity is revealed by a 24-fold increase in MG63 cell numbers in spinner flask bioreactor studies performed over a 7-day period, versus only a 6-fold increase in control microspheres under the same conditions; the corresponding values of Ti5 and control microspheres under static culture are 8-fold and 7-fold, respectively. The capability of guided osteogenic differentiation is confirmed by ELISAs for bone morphogenetic protein-2 and osteopontin, which reveal significantly greater expression of these markers, especially osteopontin, by human mesenchymal stem cells on the Ti5 microspheres than on the control. Scanning electron microscopy and confocal laser scanning microscopy images reveal favorable MG63 and human mesenchymal stem cell adhesion on the Ti5 microsphere surfaces. Thus, the results demonstrate the suitability of the developed microspheres for use as microcarriers in bone tissue engineering applications

TiO₂-doped phosphate glass microcarriers:a stable bioactive substrate for expansion of adherent mammalian cells

Scalable expansion of cells for regenerative cell therapy or to produce large quantities for high-throughput screening remains a challenge for bioprocess engineers. Laboratory scale cell expansion using t-flasks requires frequent passaging that exposes cells to many poorly defined bioprocess forces that can cause damage or alter their phenotype. Microcarriers offer a potential solution to scalable production, lending themselves to cell culture processes more akin to fermentation, removing the need for frequent passaging throughout the expansion period. One main problem with microcarrier expansion, however, is the difficulty in harvesting cells at the end of the process. Therefore, therapies that rely on cell delivery using biomaterial scaffolds could benefit from a microcarrier expansion system whereby the cells and microcarriers are transplanted together. In the current study, we used bioactive glass microcarriers doped with 5% TiO₂ that display a controlled rate of degradation and conducted experiments to assess biocompatibility and growth of primary fibroblast cells as a model for cell therapy products. We found that the microcarriers are highly biocompatible and facilitate cell growth in a gradual controlled manner. Therefore, even without additional biofunctionalization methods, Ti-doped bioactive glass microcarriers offer potential as a cell expansion platform

Cyp2c44 Gene Disruption Exacerbated Pulmonary Hypertension and Heart Failure in Female but Not Male Mice

Epoxyeicosatrienoicacids (EETs), synthesized from arachidonic acid by epoxygenases of the CYP2C and CYP2J gene subfamilies, contribute to hypoxic pulmonary vasoconstriction (HPV) in mice. Despite their roles in HPV, it is controversial whether EETs mediate or ameliorate pulmonary hypertension (PH). A recent study showed that deficiency of Cyp2j did not protect male and female mice from hypoxia-induced PH. Since CYP2C44 is a functionally important epoxygenase, we hypothesized that knockout of the Cyp2c44 gene would protect both sexes of mice from hypoxia-induced PH. We tested this hypothesis in wild-type (WT) and Cyp2c44 knockout (Cyp2c44 (-/-)) mice exposed to normoxia (room air) and hypoxia (10% O2) for 5 weeks. Exposure of WT and Cyp2c44 (-/-) mice to hypoxia resulted in pulmonary vascular remodeling, increased pulmonary artery resistance, and decreased cardiac function in both sexes. However, in female Cyp2c44 (-/-) mice, compared with WT mice, (1) pulmonary artery resistance and right ventricular hypertrophy were greater, (2) cardiac index was lower, (3) left ventricular and arterial stiffness were higher, and (4) plasma aldosterone levels were higher, but (5) there was no difference in levels of EET in lungs and heart. Paradoxically and unexpectedly, we found that Cyp2c44 disruption exacerbated hypoxia-induced PH in female but not male mice. We attribute exacerbated PH in female Cyp2c44 (-/-) mice to elevated aldosterone and as-yet-unknown systemic factors. Therefore, we suggest a role for the human CYP2C genes in protecting women from severe PH and that this could be one of the underlying causes for a better 5-year survival rate in women than in men