Comparison of Dubowitz scoring versus Ballard scoring for assessment of fetal maturation of newly born infants setting

Background: Different scoring systems based on neurological and physical examination are used in the neonatal units for assessment of gestational age. Assessment of gestational age is very much helpful in labelling the newborn to be preterm, term or post – term and to assess the further outcome of the newborn infants. Present study was performed to test the accuracy and reliability of the Ballard scoring system as compared to Dubowitz scoring system on 250 newborn infants and their correlation with the gestational age as calculated from first day of mother’s last menstrual period. In infants of 38 weeks onwards correlation of gestational age was done with the extension of plantar creases over sole.Methods: Infants studied were selected from infants born in Muzaffarnagar Medical College and Hospital Muzaffarnagar and those infants admitted to the neonatal intensive care unit. First of all methods of eliciting different criteria were experienced by examining several newborn infants and then Dubowitz and Ballard scoring system were performed separately and gestational age assessed. crease was measured, using metallic scale from base of great toe after stretching the sole.Results: Gestational ages estimated by Ballard scoring system and Dubowitz system strongly correlated with the gestational ages computed from the date of mother’s last menstrual period. The coefficient of correlation calculated between Ballard and Dubowitz scoring system showed perfect positive correlation on the regression line.  Association of gestational age with the length of sole crease was also very significant.Conclusions: The clinical test of maturation described by Ballard et al and which is evaluated in the present study, takes a balanced look at physical and neurological maturation and included those items found to be most useful regardless of the presence or absence of diseased state.

Correlation of efficacy of cerebro placental ratio with adverse perinatal outcome in clinically suspected IUGR pregnancies

Background: IUGR is a most common and complex problem in modern obstetrics. Most commonly use methods to assess fetal condition are BPP and NST which are not sensitive for predicting better perinatal outcome.  Present study was an effort to evaluate the role of ratio of pulsatility index (PI) of middle cerebral artery and umbilical artery which is called cerebro placental ratio as the most sensitive, specific and accurate predictor of adverse perinatal outcome in clinically suspected IUGR Pregnancies.Methods: 50 clinically suspected IUGR Pregnancies attending antenatal clinics Muzaffarnagar Medical College and Hospital, Muzaffarnagar were subjected to Doppler ultrasound evaluation Doppler velocity wave form of umbilical artery and fetal middle cerebral artery were obtained. Pulsatility index ratio of MCA and umbilical artery (cerebro placental ratio) was evaluated in each case. Abnormal ratio is defined as CPR<1.08 considered as cut of value. Ratio was coo related clinically with perinatal outcome.Results: Out of 50 antenatal cases, 63% neonates had birth weight <2.5 kg. There were 6 IUD’S and 44 live births, 9 neonates were admitted to NICU, 7 neonates had 5 min. APGAR score <7 and 13 neonates were born by emergency CS. Of the 6 IUDS, 4 cases had reversal of blood flow umbilical artery and 2 cases had absent diastolic flow. In all cases of reversal Diastolic flow, IUD occurred within 7 days of diagnosis. Conclusions: CPR is the most sensitive, specific and accurate parameter in prediction of adverse perinatal outcome and thus can help in decreasing perinatal mortality

The power of narrative persuasion: how an entertainment-education serial drama tackled open defecation and promoted contraceptive use in India

Television and radio serial dramas have been used as an effective entertainment-education (EE) strategy to address complex health and social issues around the world. In this article, we analyse India’s experience with the EE television serial, Main Kuch Bhi Kar Sakti HoonSeason 3 (I, A Woman, Can Achieve Anything, hereafter MKBKSH-3), broadcasted in 2019. Produced by Population Foundation of India, MKBKSH-3purposely employed principles of narrative persuasion to tackle open defecation, promote contraceptive use, and advocate for gender equality in a deeply entrenched patriarchal system. As part of a larger programme evaluation, we conducted data collection using two complementary methods: (1) field experiments in Uttar Pradesh’s Kanpur Dehat district with repeated measures among viewers and non-viewers; and (2) viewer surveys through the popular interactive voice response system with callers from across 28 states and union territories. Wherever possible, we kept questions consistent to help triangulate research findings. Our results indicate a significant increase in toilet ownership and decrease in open defecation among MKBKSH-3viewers. Further, MKBKSH-3’scharacters and storylines helped raise awareness of injectable contraceptives, and viewers—both male and female—displayed an increased likelihood of moving toward adopting contraceptives that were promoted. These empirical findings add to the growing literature on the value of entertainment-education serial dramas as enabling media for social and behaviour change.publishedVersio

Prevalence, Distribution and Functional Significance of the −237C to T Polymorphism in the IL-12Rβ2 Promoter in Indian Tuberculosis Patients

Cytokine/cytokine receptor gene polymorphisms related to structure/expression could impact immune response. Hence, the −237 polymorphic site in the 5′ promoter region of the IL-12Rβ2 (SNP ID: rs11810249) gene associated with the AP-4 transcription motif GAGCTG, was examined. Amplicons encompassing the polymorphism were generated from 46 pulmonary tuberculosis patients, 35 family contacts and 28 miscellaneous volunteers and sequenced. The C allele predominated among patients, (93.4%, 43/46), and in all volunteers and contacts screened, but the T allele was exclusively limited to patients, (6.5%, 3/46). The functional impact of this polymorphism on transcriptional activity was assessed by Luciferase-reporter and electrophoretic mobility shift assays (EMSA). Luciferase-reporter assays showed a significant reduction in transcriptional efficiency with T compared to C allele. The reduction in transcriptional efficiency with the T allele construct (pGIL-12Rb2-T), in U-87MG, THP-1 and Jurkat cell lines, were 53, 37.6, and 49.8% respectively, compared to the C allele construct (pGIL-12Rb2-C). Similarly, densitometric analysis of the EMSA assay showed reduced binding of the AP-4 transcription factor, to T compared to the C nucleotide probe. Reduced mRNA expression in all patients (3/3) harboring the T allele was seen, whereas individuals with the C allele exhibited high mRNA expression (17/25; 68%, p = 0.05). These observations were in agreement with the in vitro assessment of the promoter activity by Luciferase-reporter and EMSA assays. The reduced expression of IL-12Rβ2 transcripts in 8 patients despite having the C allele was attributed to the predominant over expression of the suppressors (IL-4 and GATA-3) and reduced expression of enhancers (IFN-α) of IL-12Rβ2 transcripts. The 17 high IL-12Rβ2 mRNA expressers had significantly elevated IFN-α mRNA levels compared to low expressers and volunteers. Notwithstanding the presence of high levels of IL-12Rβ2 mRNA in these patients elevated IFN-α expression could modulate their immune responses to Mycobacterium tuberculosis

Optimizing Internet Use during Adolescence: eHealth Solutions

Internet offers an immense opportunity as a resource for education, training, and health promotion. This narrative review summarizes the opportunities for health promotion among adolescents through use of the Internet and technology (defined as eHealth). The details of technology and use of Internet for adolescent-health related topics such as nutrition, fitness, sexual health, adventure, and violence were searched through PubMed. The review reports few digital solutions to address key challenges during adolescence like promotion of nutrition and sexual reproductive health, prevention of noncommunicable diseases, substance abuse, and mental health issues. eHealth was concluded as a potential solution for preventive and promotional health practices during adolescence. However, concerns of Internet addiction, safety, privacy, mental health disorders, and misinformation need to be addressed and monitored during adolescence

Correlation of efficacy of cerebro placental ratio with adverse perinatal outcome in clinically suspected IUGR pregnancies

Background: IUGR is a most common and complex problem in modern obstetrics. Most commonly use methods to assess fetal condition are BPP and NST which are not sensitive for predicting better perinatal outcome.  Present study was an effort to evaluate the role of ratio of pulsatility index (PI) of middle cerebral artery and umbilical artery which is called cerebro placental ratio as the most sensitive, specific and accurate predictor of adverse perinatal outcome in clinically suspected IUGR Pregnancies.Methods: 50 clinically suspected IUGR Pregnancies attending antenatal clinics Muzaffarnagar Medical College and Hospital, Muzaffarnagar were subjected to Doppler ultrasound evaluation Doppler velocity wave form of umbilical artery and fetal middle cerebral artery were obtained. Pulsatility index ratio of MCA and umbilical artery (cerebro placental ratio) was evaluated in each case. Abnormal ratio is defined as CPR&lt;1.08 considered as cut of value. Ratio was coo related clinically with perinatal outcome.Results: Out of 50 antenatal cases, 63% neonates had birth weight &lt;2.5 kg. There were 6 IUD’S and 44 live births, 9 neonates were admitted to NICU, 7 neonates had 5 min. APGAR score &lt;7 and 13 neonates were born by emergency CS. Of the 6 IUDS, 4 cases had reversal of blood flow umbilical artery and 2 cases had absent diastolic flow. In all cases of reversal Diastolic flow, IUD occurred within 7 days of diagnosis. Conclusions: CPR is the most sensitive, specific and accurate parameter in prediction of adverse perinatal outcome and thus can help in decreasing perinatal mortality

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

Polarographic & Cyclic Voltammetric Investigations on p-[(8-Hydroxyquinolyl)azo] benzenesulphonamides

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Phylogenetic associations with drug-resistant Mycobacterium tuberculosis isolates in a paediatric population

International audienceSETTING:Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India.OBJECTIVES:As paediatric tuberculosis (TB) is a surrogate marker for actively transmitted disease in a community, we investigated drug resistance patterns of 97 Mycobacterium tuberculosis complex strains isolated from children and explored their phylogenetic associations.DESIGN:A total of 111 paediatric patients who attended the out-patient department during the study period 2009-2011 and whose sputum samples were sent to the Microbiology Department for liquid culture and drug susceptibility testing (DST) were included in this study. DST and spoligotyping were performed on cultures positive for M. tuberculosis complex.RESULTS:DST against four first-line drugs showed that 31 of 97 (32%) strains were pan-susceptible, while 66/97 (68%) were resistant to at least one drug, including 55/97 (56.7%) that were resistant to at least isoniazid and rifampicin (i.e., multidrug-resistant). The majority of the isolates (n = 81/90, 90%) belonged to the principal genetic group 1 strains, the most predominant spoligotyping clusters being spoligotyping international type (SIT)1/Beijing (n = 28), SIT26/CAS1-Delhi (n = 27) and SIT53/T1 (n = 6).CONCLUSION:The involvement of Beijing and CAS1-Delhi clades in paediatric TB patients suggests that these two lineages play a major role in ongoing active transmission