Fetal alcohol syndrome: Diagnosis and management

With the increase in urbanization and socioeconomic status in Indian subcontinent, the incidence of alcoholism in women is rising alarmingly, so as its consumption in pregnancy. Alcoholism in pregnancy is associated with a wide spectrum of neurological manifestations covered under the umbrella of fetal alcohol syndrome (FAS). Hence, it is the need of the hour that the physicians should be aware of the condition and its phenotypic variations. In the absence of the availability of any definite treatment, supportive treatment and abstinence during pregnancy are the only available solution for preventing further progress and recurrence in future pregnancy

Which growth charts to use to classify neonates as small-for-gestational age at birth?

The use of correct growth chart at birth is crucial to identify small-for-gestational age (SGA) neonates since the burden of SGA is an indicator of national health status and hence has programmatic implications. With multitude of charts available globally and in context of recent introduction of newer standard charts (Intergrowth-21st), it is important to understand the merits and demerits of different types of neonatal charts in clinical application. The current review summarizes the available growth charts and discusses the advantages and disadvantages of each of them. We conclude that most of the available growth charts either overestimate or underestimate the neonatal growth, both of which are unacceptable. Hence, it is essential to devise region specific growth charts. In case of unavailability of the regional growth charts, the global charts should be used cautiously

Vaccination in preterm infants: An Indian prospective

Although available literature on vaccination in preterm infants supports timely vaccination without any correction for birth weight or gestation, a delay is still noted. Unfortunately, this group often suffers from various vaccine-preventable diseases with increased severity, especially in lower-middle-income countries. All this could be attributed to unavailability of robust evidence and clear guidelines related to vaccination. A current review article summarizes the available evidence on the use of these vaccines, their immune response, common myths and facts about vaccination in preterm infants in the Indian context. Authors conclude that the vaccines in preterm infants are equally safe, effective, and immunogenic as compared to full-term infants; hence, they should be vaccinated following the same schedule as of their counterparts who born full term. Only exception to this is hepatitis B vaccine, where additional doses should be administered to infants with weight <2000 g, apart from the birth dose

NationalConference on Construction, sustainable Infrastructure and Valorization of waste-2023

Gandhi Institute of Excellent Technocrats, Ghangapatna, BBSR is organizing a conference, “National Conference on Construction, sustainable Infrastructure and Valorization of waste-2023” on 6th& 7thOctober 2023, at GIET, Ghangapatna, BBSR. The conference provides a platform for deliberations on developing solutions that mitigate the impact of infrastructure on ecology and environment. Research and case studies on challenges, underlying opportunities and innovative ideas for the development of sustainable infrastructure will be presented and discussed.https://www.interscience.in/conf_proc_volumes/1089/thumbnail.jp

Comparison of Ultrasound-Guided Umbilical Venous Catheter Insertion with Blind Method: A Randomized Controlled Trial

Introduction: Ultrasonography (USG) can be used in neonates to manipulate and place the umbilical catheter in the correct position. Although chest radiograph (CXR) is the gold standard, a noninvasive method like USG without radiation exposure may be an alternative bedside armamentarium to the clinician. The purpose of the study was to evaluate whether USG-guided umbilical venous catheter (UVC) insertion is superior to the conventional method for the successful insertion of UVC. Method: The neonates born between 25 and 42 weeks of gestation requiring parenteral fluids and admission to neonatal intensive care unit (NICU) between September 2020 and November 2022 were randomized in two weight-based strata: ≤1,200 and >1,200 g. USG-guided UVC insertion was done in the intervention group and blind UVC insertion was done in the control group. Results: Out of 112 enrolled neonates, 58 were in the USG-guided group and 54 in the blind group. There was no significant difference in the failure rate between the intervention and control groups (20% versus 29% [RR: 0.69, 95% CI: 0.36–1.33]). The sensitivity and specificity of USG in locating tip position were 97 and 46.8%, respectively. The mean procedure time in USG and blind groups was 8.9 and 8.3 min, respectively (p value 0.56). Conclusion: USG does not reduce the failure rates during the insertion of umbilical catheters. However, being a safe, noninvasive procedure, it can be considered a rescue modality to CXR in NICUs equipped with portable USG for guiding UVC insertion

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Not AvailableThe effect of pre-harvest application of Methyl Jasmonate (MeJA) on berry quality, flavonoid content and antioxidant capacity in grapes (Vitis vinifera L.) cv. Pusa Navrang were studied under subtropical conditions of New Delhi. Different doses of MeJA (0, 5, 10, 15 mM) were applied at three different dates. There were no significant differences were recorded for bunch and berry weight. Grapes treated with MeJA had slightly higher soluble solid content, lower titratable acids than untreated berries. Methyl jasmonate significantly enhanced the content of total monomeric anthocyanins, total phenolics, flavonoids and the antioxidant capacities in the berries. These were found significantly different for dose of methyl jasmonate and time of application. In general, when MeJA(10 mM) applied at veraison stage was found most effective for improving the berry bioactive compounds and had significantly higher total monomeric anthocyanin (1434.43 C3GE mg/kg fresh berry weight), total phenolic content (504.58 mg/100 g),total flavonoid content and antioxidant activity measured in terms of DPPH.Not Availabl

Prices of combination medicines and single‐molecule antihypertensive medicines in India's private health care sector

Abstract More than half of patients with hypertension require two or more medicines to control blood pressure. Combinations of anti‐hypertensive medicines are available as Single Pill Combinations (SPCs) or Single Agent Pills (SAPs). SPCs of two or more anti‐hypertensive medicines facilitate simpler dosing schedules, decrease pill burden, increase adherence to medicine, and simplify procurement and distribution. Despite this, equivalent combinations of separate pills (SAPs) are often prescribed instead of SPCs under the assumption that SAPs are priced lower. This study compared prices of anti‐hypertensive SPCs and equivalent SAPs in the private health care sector of India. High sales volume anti‐hypertensive SPCs and SAPs were selected from 2018 private sector pharmaceutical sales data. SPCs and SAPs price information was collected from online pharmacy websites between November 2019 and January 2020. Anti‐hypertensive SPCs represent approximately 39.1% of India's private sector anti‐hypertensive drug market. Multiple manufacturers produce the same top‐selling SPCs, suggesting a viable and competitive market. A comparison of SPCs and SAPs across different manufacturers showed that the lowest prices of both SPCs and the sum of component SAPs were nearly identical across different manufacturers. An analysis of dual‐drug SPCs and SAPs by the same manufacturer showed that most manufacturers (five of six) had priced their SPCs higher than SAPs. These observations suggest that the price of SPCs could be lowered to match the combined price of the component SAPs, and manufacturing costs and market forces do not present a barrier to the implementation of anti‐hypertensive SPCs