Pregnancy outcome in women with gestational diabetes mellitus – a study from Eastern India

Introduction: Hyperglycemia first detected in pregnancy during screening test (often between 24-28 weeks) which does not meet the criteria for overt diabetes is called gestational diabetes mellitus (GDM). The International Association of Diabetes in Pregnancy Study group (IADPSG) recommended a new diagnostic criteria and protocol. Objective: To find out the prevalence, the need for insulin therapy, any short term maternal or fetal adverse effect of metformin therapy and maternal and fetal outcome of gestational diabetes mellitus in eastern part of India.  Methods: This observational study was conducted in a tertiary care semi urban private hospital from October 2018 to September 2019 for a period of twelve months. All women with normal fasting blood sugar at booking underwent oral glucose tolerance test between 24-28 weeks using 75 grams glucose drink. All GDM cases were managed by a multidisciplinary team. Pregnancies complicated with known type 1 or type 2 DM, preexisting hypertension and multiple pregnancies, were excluded from this study. Results: Out of 581 total deliveries 70 cases was GDM (12%). All cases received dietary modifications; metformin was needed in 62 (88.5%) and insulin required in 8 (11.5%) cases. 7 cases (10%) detected to have growth between 50 th and 90 th centile, interestingly 3(4.2%) cases growth was between 5th and 50th centile. 4 patients (5.7. %) delivered between 32 to 34 weeks and 15 (21.4%) between 34-36 weeks. 67 (95.7%) were delivered by caesarean section. There was no perinatal loss. Conclusion: This study indicates that majority of the patients with GDM can be managed without insulin. Metformin use has reduced the need for insulin therapy. Universal screening and proper vigilance can result in optimal outcom

Thermal and photochemical reactions ofbis(diamine)(sulfito)cobalt(III) complexes: effect ofchelate-ring size

The kinetics of formation of cis-[Co(tn)2(OH2)(OSO2-O )]+ (tn = 1,3-diaminopropane), its acid-catalysed aquation to the parent diaqua complex, anation of trans-[Co(tn)2(OH2)(SO3−S)]+ by N−, NCS−, SO32−–HSO3− , anation of trans-[Co(tn)2(OH)(SO3-S )] by SO32− and acid-catalysed aquation of trans-[Co(tn)2(SO3-S)2]- to the corresponding (aqua)(sulfito-S) complex were investigated and the results compared with analogous data for the corresponding 1,2-diaminoethane (en) complexes. Expanding the chelate-ring size from five to six had virtually no effect on the rate of formation of the sulfito-O complex, but retarded its acid-catalysed aquation. The latter effect was attributed to a pK perturbation; intramolecular hydrogen bonding between the co-ordinated H2O and sulfite in cis-[Co(tn)2(OH2)(OSO2-O )]+ hindered the protonation pre-equilibrium of the sulfito-O complex involved in the acid-catalysed aquation. This is further supported by the fact that there was no ring-size effect on the acid-catalysed aquation of trans-[Co(L–L)2(OH2)(OSO2) ]+ (L–L = tn or en). The strong labilising action due to chelate-ring expansion is remarkably attenuated by the trans effect of S-bonded sulfite as observed in the anation of trans-[Co(L–L)2(OH2/OH)(SO3 -S)]+/0. However, trans-[Co(tn)2(OH2)(SO3- S)]+ was found to be prone to intramolecular electron transfer between CoIIIand SIV under thermal conditions unlike its en analogue, further reflecting the ring-size effect. Flash photolysis of trans-[Co(L–L)2(OH2)(SO3 -S)]+ (L–L = en or tn) generated the transient trans-[Co(L–L)2(OH2)(OSO2 )]+. The photochemical ligand isomerisation of both complexes (CoIII–SO3+ → CoIII–OSO2+) also occurred at comparable rates [kiso = (4.1 ±0.8) × 104 and (3.2 ±1.3) × 104 s−1 at 25 °C for the en and tn complexes respectively]. Steady-state photolysis at 254 nm indicated that trans–[Co(en)2(OH2)(SO3-S )]+ underwent photoaquation and photoreduction. Strikingly photoreduction could not be detected for this complex at pH > 8

A Multi-centre Study to Evaluate the Long-Term Efficacy and Safety of Biosimilar Infliximab (Infimab™) in Ankylosing Spondylitis in Real-world Clinical Settings - A perspective from Eastern India

Introduction: Owing to dearth of data on infliximab biosimilars in Indian patients, a pan-India case database-based study with infliximab biosimilar BOW015 (Infimab™) was carried out to capture its efficacy and safety in real world clinical settings in India. Here, we assessed its efficacy and safety in ankylosing spondylitis (AS) among patients in the East India cohort. Materials and methods: Data were collected from multiple centers across the eastern region of India. Patients diagnosed with AS, within the preceding 4-6 months during the preceding one year were included in the study. Patients who were given BOW015 for other indications, prior innovator infliximab or other biologics were excluded from the study. Primary variable was Ankylosing Spondylitis Disease Activity Scale (ASDAS) response defined as change of > 2 in the ASDAS score from the baseline by 4-6 months of follow up. Results: The cohort consisted of 149 patients, predominantly male (69.8%), with mean (±SD) age of 36.75 (±11.11) years and mean (±SD) body weight of 58.26 (±15.4) kgs. Of the treated patients, 91 (61.1%) patients were administered four doses, 10 (6.7%) patients were administered three doses, 37 (24.8%) patients were administered two doses and 11 (7.4%) patients were administered only a single dose of BOW015. In the final analysis set, 81 patients had data at baseline and 4th visit. Among the 81 patients, 74 (91%) patients achieved major improvement, 5 (6%) patients achieved clinically important improvement and 2 (3%) were non-responders at 4th visit. Secondarily, cross categorization of the cohort into disease activity categories by number of infusions administered from baseline to 4th visit and assessment of trends in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores were also carried out and these too confirmed the efficacy of BOW015. Conclusion: Infimab™ (BOW015) showed significant improvement in ASDAS and BASDAI in patients with AS at the end of 4-6 months of follow up with its clinical benefits being apparent as early as first dose of BOW015

Using morphometric and analytical techniques to characterize elephant ivory

There is a need to characterize Asian elephant ivory and compare with African ivory for controlling illegal trade and implementation of national and international laws. In this paper, we characterize ivory of Asian and African elephants using Schreger angle measurements, elemental analysis $\{$ X-ray fluorescence (XRF), inductively coupled plasma-atomic emission spectroscopy (ICP-AES), and inductively coupled plasma-mass spectroscopy (ICP-MS)\} and isotopic analysis. We recorded Schreger angle characteristics of elephant ivory at three different zones in ivory samples of African (n = 12) and Asian (n = 28) elephants. The Schreger angle ranged from $32^o$ to $145^o$ and $30^o$ to $153^o$ in Asian and African ivory, respectively. Elemental analysis (for Asian and African ivory) by XRF, ICP-AES and ICP-MS provided preliminary data. We attempted to ascertain source of origin of Asian elephant ivory similarly as in African ivory based on isotopes of carbon, nitrogen and strontium. We determined isotopic ratios of carbon (n = 31) and nitrogen (n = 31) corresponding to diet and rainfall, respectively. Reference ivory samples from five areas within India were analyzed using collagen and powder sample and the latter was found more suitable for forensic analysis. During our preliminary analysis, the range of $\delta^{13}C$ values (-13.6\pm 0.15%o and –25.6\pm 0.15%o) and $\delta^{15}N$ values (10.2\pm 0.15%o and 3.5\pm 0.15%o) were noted