Acute viral Hepatitis E in antenatal women: a multicenter prospective study

Background: Hepatitis E has poor prognosis in pregnancy and leads to 20-30% mortality in term cases. The Aim of the study was to observe the trend of maternal and perinatal outcome in acute viral hepatitis E.Methods: A prospective study conducted in two high risk obstetric center of Jabalpur district in January 2015 to December 2017. The inclusion criteria were all antenatal women diagnosed with acute viral Hepatitis E entering to the Intensive care unit of any gestational age who later delivered in the same center. Other than acute hepatitis E all acute hepatitis cases and women missed in follow up in delivery were excluded from the study. The data collected on demographic, clinical and biochemical variables in excel sheet and descriptive analysis done by SPSS system.Results: There were 72 antenatal women enrolled with mentioned criteria in study duration. Out of these only 67 were in follow up and alive till their delivery in the same set ups. Out of these 70.14% were Primigravida of median age 27 year. The mean gestational age at detection of hepatitis E was 30.3week. The maternal mortality observed was 17.9% (12/67) in the total study population. The high grade of mortality was significantly associated with high grade of disease. There were 19.4% (13/67) perinatal (mortality seen which included intrauterine (14.9%) and neonatal (4.4%).Conclusions: The severity of Hepatitis and high grade of hepatic encephalopathy following poor primary care in the beginning of disease results in poor perinatal and maternal outcome

Electrocardiographic changes in Emphysema

Chronic obstructive lung disease (COPD), predominantly emphysema, causes several thoracic anatomical and hemodynamic changes which may cause changes in various electrocardiographic parameters. A 12-lead electrocardiogram (ECG), which is often a part of routine evaluation in most clinical settings, may serve as a useful screening modality for diagnosis of COPD or emphysema. Our current article aims to provide a comprehensive review of the electrocardiographic changes encountered in COPD/emphysema utilizing published PubMed and Medline literature database. Several important ECG changes are present in COPD/emphysema and may serve as a good diagnostic tool. Verticalization of Pvector, changes in QRS duration, pattern recognition of precordial R-wave progression and axial shifts can be considered some of the most valuable markers among other changes. In conclusion, 12-lead surface electrocardiogram can serve as a valuable tool for the diagnosis of COPD and/or emphysema. An appropriate knowledge of these ECG changes can not only help in the diagnosis but can also immensely help in an appropriate clinical management of these patients

Study of proteolytic enzymes for their application in food industry

Peptides are the important molecules in food protein that play a significant role in enhancing its flavor and taste. By controlling the generation of peptides, the flavor of food can be rebalanced to fit specific applications. Enzymatic hydrolysis of food proteins is a way to achieve the desired control on peptides, but it requires a careful selection of proteases and a controlled hydrolysis to maximize its potential.The main aim of this master thesis is to study S53 protease family for its applications in food sector. A previous study done in our lab suggested that this family consists of proteases with broad specificity (studied with synthetic substrates). Therefore, we hypothesized that they may not just degrade plant proteins but could also provide us with a diverse range of peptides (with varied sequences), where each peptide will have its own unique application in the food industry. To work on this hypothesis, firstly, we conducted gel electrophoresis experiments using the ten proteases (which could be expressed efficiently) of this family to investigate their proteolytic action towards four different proteins sources (chickpea, pea, sunflower, pumpkin). This initial study included various stages, starting from the identification of the dominant storage protein (in all the substrates) using SDS-PAGE followed by their digestion to produce hydrolysates. These hydrolysates were further studied by gel electrophoresis. Once, the proteases were tested for their activity, a bi-protease treatment was given to the protein sources with an aim to enhance the peptide generation. A total of 45 combinations were considered and an increase in peptide production in the resulting hydrolysates was studied using a florescence assay. A difference in relative fluorescent unit (RFU) values (obtained from the assay) was linearly related to the increase in peptide production from multi-protease treatment. SDS-PAGE results of protein sources showed various storage proteins in the range 15 to 75 kDa. All the S53 proteases were able to digest plant proteins, however with different proteolysis degree, signaling that different amount and composition of peptides were produced. Results from the florescence assay showed some protease combinations with RFU values greater than that of single-protease treatment. These findings helped us in screening some of the best protease blends for producing peptides which could be further studied to support new strategies for controlling the flavor of food proteins

Can placental shear wave elastography predict preeclampsia in high-risk pregnant women during second trimester? Insights from a prospective cohort study

Abstract Background Preeclampsia, a condition very frequently linked to maternal and fetal deaths worldwide, remains a pressing concern due to delays in recognition and response. Effective screening tests for early detection of high-risk cases and appropriate preventive measures are currently lacking. Well planned prenatal care, timely detection, monitoring, and appropriate management are vital to prevent preeclampsia-related fatalities. Methods This prospective study evaluated the use of shear wave elastography (SWE) in identifying placental structural issues caused by preeclampsia in high-risk pregnancies. A total of 143 high-risk pregnant women with singleton pregnancies and an anterior placental position were included in the study. Results Women with preeclampsia exhibited significantly elevated SWE values in both center (27.98 ± 16.12 vs. 4.57 ± 6.57 kPa) and peripheral areas of the placenta (29.14 ± 16.12 vs. 4.80 ± 7.70 kPa) when compared to non-preeclampsia women (p = 0.000). Cutoff values of 8.70 kPa and 8.15 kPa at the Center and edge of the placenta respectively, accurately predicted preeclampsia in second-trimester pregnancies, with 84.62% sensitivity and 94% specificity. However no significant difference was observed between elastography values obtained from the center and edge of the placenta. Conclusions In conclusion, shear wave elastography can help diagnose preeclampsia early by assessing placental stiffness

Predictors of quality of life in people living with type-1 and type-2 diabetes: an Indian perspective study and systematic review

Background: This study evaluated predictors of good quality of life (QOL) in people with type-1 diabetes (T1DM) and type-2 diabetes (T2DM) using validated general health questionnaire [World Health Organization’s (WHO)-QOL-Brief (BREF) questionnaire] and diabetes specific questionnaire [Multidimensional Diabetes Questionnaire (MDQ)]. Methods: Consecutive people > 18 years age, having T1DM or T2DM of > 6 months duration, without any severe co-morbid states or hospital admission in last 3 months, attending endocrinology-clinics of 3 different centres in Delhi, between August 2014 to September 2019, underwent QOL assessment. PubMed and Medline search for articles published to till November 2019 on QOL in diabetes was done for systematic review. Result: Data from 2067 patients was analysed. WHO-QOL-BREF aggregate score was significantly better in T2DM compared to T1DM (3.39±0.46 vs 3.11±0.63; P < 0.001). T1DM did significantly better than T2DM patients only with regards to physical health. T1DM patients’ QOL scores were worse for psychological, social relationship and environmental domains. Analysis based on quartiles of WHO-QOL-BREF aggregate score revealed people in Quartile-4 were significantly older, had lowest hypoglycaemia, nephropathy, retinopathy, neuropathy, CAD and peripheral artery disease. Patients with lowest QOL (Quartile-1) had highest blood glucose and HbA1c. Step-wise linear regression revealed age, sex, diabetes type, duration, HbA1c, hypoglycemia, nephropathy, neuropathy and coronary artery disease to be independent predictors of QOL. Every percent increase in HbA1c was associated with 2.1% reduction in aggregate QOL score. Hypoglycemia, presence of nephropathy and neuropathy were associated with 9.1%, 11.4% and 7.8% reduction in QOL aggregate score. Conclusion: Younger age, female sex, T1DM, disease duration, glycaemic control, hypoglycaemia end organ damage are important predictors of poor QOL in Indians. Insulin use and number of medications have no impact on QOL

Systematic review of efficacy and safety of shorter regimens for drug-resistant tuberculosis (DR-TB) in children

Introduction: Recent years have witnessed the emergence of antimicrobial-resistant strains of Mycobacterium tuberculosis, resulting in drug-resistant tuberculosis (DR-TB). DR-TB is difficult to treat, necessitating prolonged therapy with multiple medications. However, attempts have been made to shorten the therapeutic regimen in DR-TB. Objective: This systematic review was undertaken to investigate the efficacy and safety of short-term regimens (STRs) for the treatment of DR-TB in children. Methods: We conducted a comprehensive literature search across PubMed, EMBASE, Scopus, CINHAL, Web of Science, Cochrane Library, major trial registries, and grey literature. We searched for randomized controlled trials, and observational studies, comparing World Health Organization (WHO) approved treatment regimens of ≤12 months duration (shorter regimens) versus >12 months duration (longer regimens), in children (<18 years) diagnosed with DR-TB. Data on cure rate, mortality rate, and adverse events were analyzed. Results: From 44,532 records, step-wise screening of titles and abstract identified 90 potentially relevant publications. Full-text screening eliminated 13 (being reviews, reports, oral presentations, or abstracts). Among the remaining 77 (17 RCTs and 60 observational studies), in 21 studies the population did not match the review question, in 33, the intervention was different, and in 23 studies, data on children could not be extracted separately from adults. Thus this systematic review did not identify any RCT or observational study meeting the inclusion criteria. Conclusion: This systematic review did not identify any RCT or observational study on the efficacy and safety of STRs in children with DR-TB. This necessitates urgent generation of robust evidence in this population

Association of Child Growth Failure Indicators With Household Sanitation Practices in India (1998-2021): Spatiotemporal Observational Study

BackgroundUndernutrition among children younger than 5 years is a subtle indicator of a country’s health and economic status. Despite substantial macroeconomic progress in India, undernutrition remains a significant burden with geographical variations, compounded by poor access to water, sanitation, and hygiene services. ObjectiveThis study aimed to explore the spatial trends of child growth failure (CGF) indicators and their association with household sanitation practices in India. MethodsWe used data from the Indian Demographic and Health Surveys spanning 1998-2021. District-level CGF indicators (stunting, wasting, and underweight) were cross-referenced with sanitation and sociodemographic characteristics. Global Moran I and Local Indicator of Spatial Association were used to detect spatial clustering of the indicators. Spatial regression models were used to evaluate the significant determinants of CGF indicators. ResultsOur study showed a decreasing trend in stunting (44.9%-38.4%) and underweight (46.7%-35.7%) but an increasing prevalence of wasting (15.7%-21.0%) over 15 years. The positive values of Moran I between 1998 and 2021 indicate the presence of spatial autocorrelation. Geographic clustering was consistently observed in the states of Madhya Pradesh, Jharkhand, Odisha, Uttar Pradesh, Chhattisgarh, West Bengal, Rajasthan, Bihar, and Gujarat. Improved sanitation facilities, a higher wealth index, and advanced maternal education status showed a significant association in reducing stunting. Relative risk maps identified hotspots of CGF health outcomes, which could be targeted for future interventions. ConclusionsDespite numerous policies and programs, malnutrition remains a concern. Its multifaceted causes demand coordinated and sustained interventions that go above and beyond the usual. Identifying hotspot locations will aid in developing control methods for achieving objectives in target areas