Biofortification of Millets: A Way to Ensure Nutritional Security

Malnutrition poses significant socioeconomic challenges worldwide, with its most acute impact felt in developing and impoverished nations. This issue is exacerbated by the reliance on cereal-based diets, which often lack essential micronutrients, as the world’s population continues to grow. Millets and whole grains emerge as promising solutions to this dilemma. Although millets have historically served as a primary energy source in regions like Asia, Africa, and other semi-arid tropical areas, their nutritional value has been underrated. Beyond their carbohydrate content, millets are rich sources of vitamins, minerals, and crucial amino acids. Biofortification, the practice of enhancing the nutrient content of staple crops, offers a cost-effective approach to address micronutrient deficiencies. Initiatives like Harvest Plus in India have introduced biofortified millets to combat widespread deficiency disorders. The global distribution of biofortified millets is supported by non-governmental organisations, the business sector, and government regulatory bodies. This book chapter delves into these critical efforts, emphasising their role in ensuring nutritional security and effectively tackling malnutrition on a global scale

Prevalence & perinatal outcome of GDM : a tertiary teaching hospital based study

Can we do something to improve outcomes of GDM?Much needs to be done to deal with epidemic of GDM in India as it affects both mother and fetus adversely.This study was aimed to find out the data pertaining to GDM.Using notional sampling frame 200 pregnant women  were offered  75 gm oral glucose tolerance test between 24 to 28 weeks of gestation,irrespective of the fasting status as recommended by DIPSI.Patients having values ≥140 mg/dl ,2 hrs after administration of 75 gm oral glucose were labelled as GDM.Whole cohort was followed during antenatal period and upto 7 days after delivery for fetomaternal outcome. Prevalence of GDM was 8% in our study. Statistically significant  increased rates of gestational hypertension,chronic hypertension, preeclampsia,UTI,preterm delivery,rate of caesarean section and polyhydramnios were found  in GDM patients.Statistically significant higher rates of metabolic complications,respiratory distress,admission to neonatal unit and macrosomia were found in neonates of GDM mothers.Hence there is a need for studying outcomes as well as cost effectiveness of different diagnostic criteria while simultaneously creating social awareness, training manpower, and sensitizing policymakers to make GDM testing and management mandatory during pregnancy at all levels

Ultrasound-detected venous changes associated with peripheral intravenous placement in children

© 2020 MA Healthcare Ltd Background: Peripheral intravenous catheters (PIVs) are routinely used for venous access in hospitalized pediatric patients to administer fluids and medications and to aspirate blood. Unfortunately, PIVs do not remain functional for the entire duration of intravascular need. We hypothesized that PIV malfunction may be related to venous changes that can be visualized with ultrasound (US) imaging. The purpose of this study was to describe and document such changes in pediatric patients. Methods: This Institutional Review Board-approved study was performed at a tertiary pediatric medical center. Patients underwent US scans of their PIV-containing veins, documenting venous characteristics such as depth, diameter, wall thickness, blood flow, valves, branch points, and presence of thrombus. Patient demographics and PIV characteristics were also recorded. Results: Data from 30 patients including 12 males and 18 females with a mean age of 11 years were analyzed. Mean venous depth and diameter were 2.07±0.13 and 2.02±0.18 mm, respectively. Mean PIV dwell time at time of evaluation was 3.3 days. PIV-associated venous changes were seen in 73% of accessed veins and included lumen narrowing (47%), wall thickening (33%), presence of thrombus (20%), and absence of blood flow around the PIV tip (40%). Conclusion: PIV-associated venous changes are seen with US in the majority of pediatric patients with indwelling PIVs but are not necessarily appreciated on physical exam. These changes may help explain the high rate of pediatric PIV device failure. Given the small sample size, further investigation is needed to better characterize PIV-associated venous changes in children

Ultrasound-detected venous changes associated with peripheral intravenous placement in children.

© 2020 MA Healthcare Ltd Background: Peripheral intravenous catheters (PIVs) are routinely used for venous access in hospitalized pediatric patients to administer fluids and medications and to aspirate blood. Unfortunately, PIVs do not remain functional for the entire duration of intravascular need. We hypothesized that PIV malfunction may be related to venous changes that can be visualized with ultrasound (US) imaging. The purpose of this study was to describe and document such changes in pediatric patients. Methods: This Institutional Review Board-approved study was performed at a tertiary pediatric medical center. Patients underwent US scans of their PIV-containing veins, documenting venous characteristics such as depth, diameter, wall thickness, blood flow, valves, branch points, and presence of thrombus. Patient demographics and PIV characteristics were also recorded. Results: Data from 30 patients including 12 males and 18 females with a mean age of 11 years were analyzed. Mean venous depth and diameter were 2.07±0.13 and 2.02±0.18 mm, respectively. Mean PIV dwell time at time of evaluation was 3.3 days. PIV-associated venous changes were seen in 73% of accessed veins and included lumen narrowing (47%), wall thickening (33%), presence of thrombus (20%), and absence of blood flow around the PIV tip (40%). Conclusion: PIV-associated venous changes are seen with US in the majority of pediatric patients with indwelling PIVs but are not necessarily appreciated on physical exam. These changes may help explain the high rate of pediatric PIV device failure. Given the small sample size, further investigation is needed to better characterize PIV-associated venous changes in children

Improving neonatal health with family-centered, early postnatal care: A quasi-experimental study in India.

Despite the global decline, neonatal mortality rates (NMR) remain high in India. Family members are often responsible for the postpartum care of neonates and mothers. Yet, low health literacy and varied beliefs can lead to poor health outcomes. Postpartum education for family caregivers, may improve the adoption of evidence-based neonatal care and health outcomes. The Care Companion Program (CCP) is a hospital-based, pre-discharge health training session where nurses teach key healthy behaviors to mothers and family members, including skills and an opportunity to practice them in the hospital. We conducted a quasi-experimental study to assess the effect of the CCP sessions on mortality outcomes among families seeking care in 28 public tertiary facilities across 4 Indian states. Neonatal mortality outcomes were reported post-discharge, collected via phone surveys at four weeks postpartum, between October 2018 to February 2020. Risk ratios (RR), adjusting for hospital-level clustering, were calculated by comparing mortality rates before and after CCP implementation. A total of 46,428 families participated in the pre-intervention group and 87,305 in the post-intervention group; 76% of families completed the phone survey. Among the 33,599 newborns born before the CCP implementation, there were 1386 deaths (NMR: 41.3 deaths per 1000 live births). After the intervention began, there were 2021 deaths out of 60,078 newborns born (crude NMR: 33.6 deaths per 1000 live births, RR = 0.82, 95% CI: 0.76, 0.87; cluster-adjusted RR = 0.82, 95% CI: 0.71, 0.94). There may be a substantial benefit to family-centered education in the early postnatal period to reduce neonatal mortality