Study of placental location and pregnancy outcome

Background: Placental location can be estimated easily using ultrasonogram by 16 weeks. It can be classified based on its location into central and lateral. Central can be anterior or posterior. Lateral can be left lateral or right lateral. Placental location has been attributed to both normal and abnormal pregnancy and neonatal outcomes.Methods: This is a prospective cohort study conducted in the department of Obstetrics and Gynecology which comprised of 450 singleton gestations between 18 and 24 weeks. The primary objective is to determine the association between placental location and pregnancy outcome and secondary objective is to find out the association between placental location and neonatal outcome. The study population was divided into two groups – central and lateral. Results were analyzed using SPSS version 20, Chi square test and independent two sample t-test.Results: The frequency of central placenta was 377 (83.8%) and lateral placenta in 73 (16.2%). Central placentation had an abnormal outcome in 182(48.3%), lateral placentas with abnormal outcome were 44(60.3%). Abnormal maternal outcomes like hypertensive disorders (33.3%), Intra Uterine Growth Restriction (10.2%), Antepartum haemorrhage (25%), Preterm birth (16.3%) were more in lateral placentation. The number of central placentas having NICU admissions were 62(16.4%) and lateral placenta with NICU admissions were 19(26%).Conclusions: There is a significant association between lateral placentation and abnormal pregnancy and neonatal outcomes. Second trimester ultrasound can be used as non-invasive predictor of adverse pregnancy and neonatal outcomes.

Reduction of hand transmitted and whole body vibrations experienced by tractor operators by using piezo crystal material

 A study was proposed to investigate the effects of vibration on tractor operator’s health attempting a biodynamic and physiological approach.  The source vibration levels at steering wheel and seat for the hand transmitted and whole body vibration during different tractor operations were measured.  Two isolators, one commercially available, made of styrene butadiene rubber (SBR) and the other custom designed, made of piezo-electric material embedded in SBR were tested for attenuation of vibration.  It was observed that an average 40% reduction in vibration intensity was experienced with installation of custom-designed isolator underneath the tractor operator’s seat.  The measured values of vertical vibration at operator’s seat were found to be within 8 h fatigue decreased proficiency boundary limit.  Incorporation of custom-designed isolator reduced the muscle load to a maximum of 44.37% in erector spinae muscle during first tilling operation, while flexor carpi radialis in transport attained 23.03% reduction.   Keywords: Piezo crystal, vibration, transmissibility, accelerometer, isolators

Psychosocial, behavioral and clinical correlates of children with overweight and obesity

Background Psychological and behavioral correlates are considered important in the development and persistence of obesity in both adults and youth. This study aimed to identify such features in youth with severe obesity (BMI ≥ 120% of 95thpercentile of sex-specific BMI-for-age) compared to those with overweight or non-severe obesity. Methods Youth with BMI ≥ 85th percentile were invited to participate in a prospective research registry where data was collected on attributes such as family characteristics, eating behaviors, dietary intake, physical activity, perception of health and mental well-being, and cardiometabolic parameters. Results In a racially/ethnically diverse cohort of 105 youth (65% female, median age 16.1 years, range 4.62–25.5), 51% had severe obesity. The body fat percent increased with the higher levels of obesity. There were no differences in the self-reported frequency of intake of sugar sweetened beverages or fresh produce across the weight categories. However, the participants with severe obesity reported higher levels of emotional eating and eating when bored (p = 0.022), levels of stress (p = 0.013), engaged in fewer sports or organized activities (p = 0.044), and had suboptimal perception of health (p = 0.053). Asthma, depression and obstructive sleep apnea were more frequently reported in youth with severe obesity. The presence of abnormal HDL-C, HOMA-IR, hs-CRP and multiple cardiometabolic risk factors were more common among youth with severe obesity. Conclusions Youth with severe obesity have identifiable differences in psychosocial and behavioral attributes that can be used to develop targeted intervention strategies to improve their health

Psychosocial, behavioral and clinical correlates of children with overweight and obesity

Abstract Background Psychological and behavioral correlates are considered important in the development and persistence of obesity in both adults and youth. This study aimed to identify such features in youth with severe obesity (BMI ≥ 120% of 95thpercentile of sex-specific BMI-for-age) compared to those with overweight or non-severe obesity. Methods Youth with BMI ≥ 85th percentile were invited to participate in a prospective research registry where data was collected on attributes such as family characteristics, eating behaviors, dietary intake, physical activity, perception of health and mental well-being, and cardiometabolic parameters. Results In a racially/ethnically diverse cohort of 105 youth (65% female, median age 16.1 years, range 4.62–25.5), 51% had severe obesity. The body fat percent increased with the higher levels of obesity. There were no differences in the self-reported frequency of intake of sugar sweetened beverages or fresh produce across the weight categories. However, the participants with severe obesity reported higher levels of emotional eating and eating when bored (p = 0.022), levels of stress (p = 0.013), engaged in fewer sports or organized activities (p = 0.044), and had suboptimal perception of health (p = 0.053). Asthma, depression and obstructive sleep apnea were more frequently reported in youth with severe obesity. The presence of abnormal HDL-C, HOMA-IR, hs-CRP and multiple cardiometabolic risk factors were more common among youth with severe obesity. Conclusions Youth with severe obesity have identifiable differences in psychosocial and behavioral attributes that can be used to develop targeted intervention strategies to improve their health.http://deepblue.lib.umich.edu/bitstream/2027.42/173638/1/12887_2020_Article_2145.pd

Suboptimal Clinical Documentation in Young Children with Severe Obesity at Tertiary Care Centers

Background and Objectives. The prevalence of severe obesity in children has doubled in the past decade. The objective of this study is to identify the clinical documentation of obesity in young children with a BMI ≥ 99th percentile at two large tertiary care pediatric hospitals. Methods. We used a standardized algorithm utilizing data from electronic health records to identify children with severe early onset obesity (BMI ≥ 99th percentile at age <6 years). We extracted descriptive terms and ICD-9 codes to evaluate documentation of obesity at Boston Children's Hospital and Cincinnati Children's Hospital and Medical Center between 2007 and 2014. Results. A total of 9887 visit records of 2588 children with severe early onset obesity were identified. Based on predefined criteria for documentation of obesity, 21.5% of children (13.5% of visits) had positive documentation, which varied by institution. Documentation in children first seen under 2 years of age was lower than in older children (15% versus 26%). Documentation was significantly higher in girls (29% versus 17%, p < 0.001), African American children (27% versus 19% in whites, p < 0.001), and the obesity focused specialty clinics (70% versus 15% in primary care and 9% in other subspecialty clinics, p < 0.001). Conclusions. There is significant opportunity for improvement in documentation of obesity in young children, even years after the 2007 AAP guidelines for management of obesity