The impact of high maternal body mass index on obstetric and perinatal outcomes

Background: The incidence of obesity has increased to pandemic proportions over the last 20 years. Maternal obesity is associated with a wide array of adverse maternal pregnancy outcomes and increased risks in the offspring. The aim of the study was to find the effect of obesity on maternal and perinatal outcome in obese women in comparison to those of normal weight women.Methods: The study was designed as a case-control study. Antenatal women with first trimester body mass index (BMI) of more than 30 kg/m2 constituted the cases and those with BMI between 18 and 24.9 kg/m2 formed the controls.Results: There was increased incidence of antepartum complications in obese women. Obese women had a significant history of prior treatment for infertility (p<0.00001). The incidence of gestational diabetes (OR 4.76, 95%CI 1.267-17.72 p=0.014), gestational hypertension (OR 3.05, 95%CI 1.01-9.20 p=0.04), induction of labor (OR 2.5, 95%CI 1.0-6.28 p=0.04), preeclampsia (OR 2.38, 95%CI 1.0-5.64 p=0.04, Caesarean section (OR 1.98, 95%CI 1.24-3.14 p=0.003), postpartum haemorrhage (OR 8.57, 95%CI 1.07-76.15 p=0.04) and wound infection (OR 8.57, 95%CI 1.07-76.15 p=0.04) and adverse neonatal outcomes such as higher mean birth weight (p<0.0001) and requirement of NICU (OR 2.79, 95%CI 1.33 -5.84 p=0.006) was higher in obese women.Conclusions: Obesity is an independent risk factor for adverse pregnancy outcomes and hence, interventions directed towards weight loss and prevention of excessive weight gain must begin in the preconception period.

Narrowing the gap in careers in clinical research and academia for healthcare professionals: A scoping review on the role of major funding bodies in the UK

Differential attainment (DA) exists in research and academia, where individuals with protected characteristics face barriers to progression at different stages from selection in training or career pathways through to obtaining funding and getting research published. The causes of DA are multifactorial, however more barriers are associated with an individual’s gender, race, ethnicity, sexual orientation, disability or other social and economic factors rather than academic factors related to research. DA is seen across medicine and healthcare therefore it is likely a manifestation of wider inequalities experienced by these individuals within society. This scoping review takes a first step at exploring DA through the lens of equality, diversity and inclusion in research and academia, specific to healthcare professionals in medicine, in the UK. Given the paucity of published data, benchmarking and investigation of the causes of DA and access in this area, this review seeks to identify what published reports exploring this issue reveal. There has been mixed success in the area of gender equality with the Athena Swan benchmarking exercise; however differences in outcomes exist within gender when other protected characteristics, such as ethnicity, are also explored. The DA observed among women despite the Athena Swan programme demonstrates other factors such as allyship, apprenticeship, sponsorship and mentoring which may be accessible to some individuals, but not others. Furthermore, ethnicity appears to be a barrier to accessing this form of support, and non-Black and Minority Ethnic (BAME) women appear to be more privileged to receiving this type of support. Without more research into the lived experiences of individuals from non-traditional backgrounds at the micro-level, as well as data across the career progression pathway over time at the macro-level, the problem of DA is unlikely to improve. If anything, lack of openness and transparency around such data at an organisational level, may exacerbate the sense of injustice within research and academia among individuals with protected characteristics, especially given that the perceived sense of DA is very real for them. The purpose of this paper is to start the conversation with stakeholders within research and academia, about DA and commence the process of reducing the gap using equality, diversity and inclusion as fundamental concepts for achieving a level playing field for all. This type of accountability is essential for developing trust and in the system. Such open conversations need to happen across every organisation, that is a stakeholder of research and academia in the UK.Peer reviewe

IUPS Physiology Education Workshop series in India: organizational mechanics, outcomes, and lessons

Peer reviewe

Operations perspective to competency-based medical education: Experiences of IUPS-ICMR Physiology Education Workshop series (2018-2019) conducted in India

Peer reviewe

Low-dose versus standard-dose alteplase in acute ischemic stroke in Asian stroke registries: an individual patient data pooling study

10.1177/1747493019858777INTERNATIONAL JOURNAL OF STROKE147670-67

Palomar Gattini-IR: Survey overview, data processing system, on-sky performance and first results

Palomar Gattini-IR is a new wide-field, near-infrared (NIR) robotic time domain survey operating at Palomar Observatory. Using a 30 cm telescope mounted with a H2RG detector, Gattini-IR achieves a field of view (FOV) of 25 sq. deg. with a pixel scale of 8.”7 in J-band. Here, we describe the system design, survey operations, data processing system and on-sky performance of Palomar Gattini-IR. As a part of the nominal survey, Gattini-IR scans ≈7500 square degrees of the sky every night to a median 5σ depth of 15.7 AB mag outside the Galactic plane. The survey covers ≈15,000 square degrees of the sky visible from Palomar with a median cadence of 2 days. A real-time data processing system produces stacked science images from dithered raw images taken on sky, together with point-spread function (PSF)-fit source catalogs and transient candidates identified from subtractions within a median delay of ≈4 hr from the time of observation. The calibrated data products achieve an astrometric accuracy (rms) of ≈0.”7 with respect to Gaia DR2 for sources with signal-to-noise ratio > 10, and better than ≈0.”35 for sources brighter than ≈12 Vega mag. The photometric accuracy (rms) achieved in the PSF-fit source catalogs is better than ≈3% for sources brighter than ≈12 Vega mag and fainter than the saturation magnitude of ≈8.5 Vega mag, as calibrated against the Two Micron All Sky Survey catalog. The detection efficiency of transient candidates injected into the images is better than 90% for sources brighter than the 5σ limiting magnitude. The photometric recovery precision of injected sources is 3% for sources brighter than 13 mag, and the astrometric recovery rms is ≈0.”9. Reference images generated by stacking several field visits achieve depths of ≳16.5 AB mag over 60% of the sky, while it is limited by confusion in the Galactic plane. With a FOV ≈40× larger than any other existing NIR imaging instrument, Gattini-IR is probing the reddest and dustiest transients in the local universe such as dust obscured supernovae in nearby galaxies, novae behind large columns of extinction within the galaxy, reddened microlensing events in the Galactic plane and variability from cool and dust obscured stars. We present results from transients and variables identified since the start of the commissioning period