scholarly journals Gestational route to healthy birth (GaRBH): protocol for an Indian prospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025395
Author(s):  
Vipin Gupta ◽  
Ruchi Saxena ◽  
Gagandeep Kaur Walia ◽  
Tripti Agarwal ◽  
Harsh Vats ◽  
...  

IntroductionPregnancy is characterised by a high rate of metabolic shifts from early to late phases of gestation in order to meet the raised physiological and metabolic needs. This change in levels of metabolites is influenced by gestational weight gain (GWG), which is an important characteristic of healthy pregnancy. Inadequate/excessive GWG has short-term and long-term implications on maternal and child health. Exploration of gestational metabolism is required for understanding the quantitative changes in metabolite levels during the course of pregnancy. Therefore, our aim is to study trimester-specific variation in levels of metabolites in relation to GWG and its influence on fetal growth and newborn anthropometric traits at birth.Methods and analysisA prospective longitudinal study is planned (start date: February 2018; end date: March 2023) on pregnant women that are being recruited in the first trimester and followed in subsequent trimesters and at the time of delivery (total 3 follow-ups). The study is being conducted in a hospital located in Bikaner district (66% rural population), Rajasthan, India. The estimated sample size is of 1000 mother-offspring pairs. Information on gynaecological and obstetric history, socioeconomic position, diet, physical activity, tobacco and alcohol consumption, depression, anthropometric measurements and blood samples is being collected for metabolic assays in each trimester using standardised methods. Mixed effects regression models will be used to assess the role of gestational weight in influencing metabolite levels in each trimester. The association of maternal levels of metabolites with fetal growth, offspring’s weight and body composition at birth will be investigated using regression modelling.Ethics and disseminationThe study has been approved by the ethics committees of the Department of Anthropology, University of Delhi and Sardar Patel Medical College, Rajasthan. We are taking written informed consent after discussing the various aspects of the study with the participants in the local language.

2013 ◽  
Vol 2 (2) ◽  
pp. 28-33
Author(s):  
Mohammad Athar Ansari ◽  
Iqbal Mohd Khan

The aim of the study is to assess the magnitude of the problem and certain epidemiological factors associated with malaria and examine the changing pattern of malaria through its parameters of measurement during 2009-2011. The study was carried out at the Rural Health Training Center (RHTC), under the J. N. Medical College, Aligarh Mus-lim University, Aligarh, (India) for three years from 1st January 2009 to 31st December 2011. Teams of doctors and paramedical staff regularly visited the villages. If any person was found to be suffering from fever, his/her blood was examined for the malaria parasite. Patients were given presumptive treatment and radical treatment if slides were positive. The findings of the study demonstrated that the number of malaria cases increased during the study period, but in the year 2010, a sudden upsurge was noticed. Out of 5594 patients, most of the patients seen were in the age group of 11-20 years (34.3%). P. vivax (96.2%) was the most common malaria infection in these areas. An increasing trend of malaria was seen from July to October. Most of the parameters of malaria measurement in-creased many folds in 2010 and showed a declining trend in 2011. The overall findings of the study indicated the high endemicity of malaria in the study area and demonstrated a changing pattern of malaria in the registered vil-lages as most of the parameters of malaria measurement increased. An integrated approach is needed which in-cludes mass survey or active surveillance, and appropriate drug therapy to tackle this public health problem. DOI: http://dx.doi.org/10.3329/seajph.v2i2.15940 South East Asia J Public Health | Jul-Dec 2012 | Vol 2 Issue 2 | 28-33


2015 ◽  
Vol 66 (4) ◽  
pp. 202-208 ◽  
Author(s):  
Sonja Entringer ◽  
Elissa S. Epel ◽  
Jue Lin ◽  
Elizabeth H. Blackburn ◽  
Claudia Buss ◽  
...  

Background/Aims: Telomere biology plays a fundamental role in genomic integrity and cell physiology. The newborn setting of telomere length (TL) likely has important implications for telomere dynamics over the lifespan; however, its determinants are poorly understood. Folate is essential for DNA integrity. The maternal compartment is the only source of folate for the developing fetus. We, therefore, tested the hypothesis that variation in maternal folate during pregnancy is associated with newborn TL. Methods: A prospective, longitudinal study was conducted in 119 mother-newborn dyads. Eligible mothers were enrolled at 9.5 (SD ±2.1) weeks gestation and followed through birth. Concentrations of maternal serum folate were measured in the first trimester of pregnancy. Newborn telomere length was measured in cord blood mononuclear cells (CBMC). Results: After accounting for the effects of other established determinants of newborn TL, each 10 ng/ml increase in maternal total folate was associated with a 5.8% increase in median TL (p = 0.03). The median TL in newborns of mother in the lowest quartile of total folate levels was approximately 10% shorter than that of newborns of mothers in the highest folate quartile. Conclusions: Our findings suggest that fetal TL exhibits developmental plasticity, and provide evidence that maternal nutrition may exert a ‘programming' effect on this system.


2017 ◽  
Vol 25 (1) ◽  
pp. 32-38
Author(s):  
Shireen Afroz ◽  
Tahmina Ferdaus ◽  
Rokeya Khanam ◽  
Maliha Alam Simi ◽  
Sanjida Sharmim ◽  
...  

The lifespan and outcome of End Stage Kidney Failure (ESKF) children have dramatically improved since the development of continuous ambulatory peritoneal dialysis (CAPD), it offers several advantages over hemodialysis. This study was done to evaluate the efficacy, outcome and to find out the complication profile of CAPD. This prospective longitudinal study was carried out in the department of Pediatric Nephrology, Dhaka Medical College Hospital (DMCH), Bangladesh, over a period of 3 year. A total of 8 children with ESKF were included. (Age 5-14 year, M:F=1:1), All underwent CAPD. Average duration of CAPD 40.6 months with a total of 185 patient months of CAPD. The rate of complications was recorded. Common complications being observed were peritonitis 1 episode per 13.9 patient months, catheter obstruction by omental capture was in 4. Catheter tip dislocation was found in 3 children and all needed laparotomy and omentectomy. Satisfactory level of improvement of mean weight, mean serum albumin and declining of serum creatinine has been found after CAPD in all 8 study children. At the end of the study, 3 out of 8 are still on CAPD, 2 transferred to haemodialysis and 3 expired due to uncontrolled hypertension with congestive heart failure and sepsis. So, CAPD is an effective modality of renal replacement therapy for children. Early detection of complications and prompt therapy is essential for a favourable outcome. Placement of catheter by surgical method with elective omentectomy will reduce catheter related complications.J Dhaka Medical College, Vol. 25, No.1, April, 2016, Page 32-38


PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10164
Author(s):  
Ilango Saraswathi ◽  
Jayakumar Saikarthik ◽  
K. Senthil Kumar ◽  
Kumar Madhan Srinivasan ◽  
M. Ardhanaari ◽  
...  

Background The COVID-19 pandemic is found to affect the mental health of the population. Undergraduate medical students are especially prone to mental health disorders and hence could be more vulnerable to the impact of the pandemic. Methods A prospective longitudinal study was conducted on 217 undergraduate medical students in a medical college at Chennai, India. Depression, anxiety, and stress levels were recorded using Depression Anxiety Stress Scale 21 Items (DASS21) before and during the COVID-19 outbreak in India in December 2019 and June 2020, respectively. In the follow-up survey, in addition to DASS21, the Pittsburgh Sleep Quality Index to assess sleep quality and a self-administered questionnaire to assess the impact of COVID-19 related stressors were used. The self-administered questionnaire assessed the status of COVID-19 testing, interactions with COVID-19 patients, self-perceived levels of concerns and worries related to academics (COVID-19-AA (academic apprehensions)) and those pertaining to the self and family/friends (COVID-19-GA (general apprehensions)). Cross-sectional and longitudinal comparison of overall scores of depression, anxiety, and stress and scores stratified by gender, year of study, place of residence and monthly family income were performed. Predictors for depression, anxiety, and stress during COVID-19 were investigated using adjusted binary logistic regression analysis and results were expressed as adjusted odds ratio with 95% confidence interval (CI). A P value < 0.05 was considered statistically significant. Results The average scores of depression, anxiety, and stress during the baseline survey were 7.55 ± 7.86, 4.6 ± 6.19 and 7.31 ± 7.34 with the prevalence (95% Cl) of 33.2% [27–39.9%], 21.2% [16–27.2%] and 20.7% [15.5–26.7%]; in follow-up survey, the mean scores were 8.16 ± 8.9, 6.11 ± 7.13 and 9.31 ± 8.18 with the prevalence being 35.5% [29.1–42.2%], 33.2% [27–39.9%] and 24.9% [19.3–31.2%] for depression, anxiety, and stress respectively. There was a significant increase in both the prevalence and levels of anxiety and stress (P < 0.001), with depression remaining unchanged during COVID-19, irrespective of gender, year of study, place of residence and family’s monthly income. Poor sleep quality, higher levels of baseline depression, anxiety, and stress, higher COVID-19-GA, COVID-19 patients in family/friends and direct interactions with COVID-19 patients were found to be significant predictors of negative mental health in undergraduate medical students. COVID-19-AA was not significantly associated with depression, anxiety, and stress. Conclusion The COVID-19 pandemic appears to negatively affect the mental health of the undergraduate medical students with the prevalence and levels of anxiety and stress being increased, and depression symptoms remaining unaltered. Addressing and mitigating the negative effect of COVID-19 on the mental health of this population is crucial.


2021 ◽  
pp. 39-41
Author(s):  
Adrita Bose ◽  
Gobinda Chandra Das ◽  
Debasish Dey ◽  
Dipak Singh

Introduction:In spite of an improved understanding of its pathogenesis , perinatal asphyxia and resulting hypoxic ischemic encephalopathy (HIE) is one of the most dreaded neurological disease of the newborn. Published data show that 25-60% of the babies who survive, suffer from permanent neuro developmental handicaps including cerebral palsy, seizures, mental retardation, and learning disabilities. Aims & Objectives: To correlate Magnetic Resonance Imaging (MRI) Brain with neurological outcome at 12 months in term (more than or equal to 37 weeks gestational age) neonates with Hypoxic Ischemic Encephalopathy. Materials And Methods: Sick Newborn Care Unit (SNCU) and Neonatal Intensive Care Unit (NICU) of R G Kar Medical College & Hospital, Kolkata(2) Department of Radiology of R.G.Kar Medical College & Hospital, Kolkata. From February 1st, 2019 to July 31st 2020. Aprospective observational study in longitudinal design. Results:All the babies with fetal bradycardia(N=19) had abnormal cardiotocographical ndings, out of them 16 babies had suspicious suspicious ndings and 3 had pathological cardiotocographical ndings. Most of the cases with abnormal CTS (N=19) i.e. Suspicious(N1=16)+ Pathological(N2=3) were delivered by LSCS(18) followed by breech vaginal (1). About 45.5 % of the study population had MSL (meconium stained liquor), followed by clear liquor(27.3%), blood stained (21.21%). Only 6.1% showed features of chorioamionitis with foul smelling liquor. Summary & Conclusion:Though normal MRI babies can later be normal or may have minor disabilities in future. But MRIs showing moderate to severe grade of injuries always resulted in severe neuromotor disabilities like cerebral palsies. Further large population studies in other regions of India are to be conducted to emphasize the role of a validated MRI Scoring system to determine the possible clinical outcomes. This will help to initiate early interventions and thus can improve outcomes.


2020 ◽  
Vol 56 (S1) ◽  
pp. 216-217
Author(s):  
H. Schreiber ◽  
T. Weissbach ◽  
H. Toledano ◽  
E. Kassif ◽  
T. Biron‐Shental ◽  
...  

2021 ◽  
Vol 9 ◽  
Author(s):  
Susanne C. Diesner-Treiber ◽  
Peter Voitl ◽  
Julian J. M. Voitl ◽  
Klara Langer ◽  
Ulrike Kuzio ◽  
...  

Background: The Covid-19 pandemic compelled the implementation of measures to curb the SARS CoV-2 spread, such as social distancing, wearing FFP2 masks, and frequent hand hygiene. One anticipated ramification of these measures was the containment of other pathogens. This prospective, longitudinal study aimed to investigate the spread of 22 common seasonal non-SARS-CoV-2 pathogens, such as RSV and influenza, among children with an acute respiratory infection during a pandemic.Methods: Three hundred ninety children (0-24 months) admitted to Vienna's largest pediatric center with acute respiratory infection (November 2020-April 2021) were included in this study. The researchers tested nasal swabs for 22 respiratory pathogens by Multiplex PCR, documented clinical features and treatment, and evaluated data for a potential connection with the lockdown measures then in force.Results: The 448 smears revealed the most common pathogens to be rhino-/enterovirus (41.4%), adenovirus (2.2%), and coronavirus NL63 (13.6%). While the first two were active throughout the entire season, coronaviruses peaked in the first trimester of 2021 in conjunction with the lift of the lockdown period (OR 4.371, 95%CI 2.34-8.136, P &lt; 0.001). RSV, metapneumovirus, and influenza were absent.Conclusion: This prospective, longitudinal study shows that Covid-19 measures suppressed the seasonal activity of influenza, RSV, and metapneumovirus among very young children, but not of rhino-/enterovirus and adenovirus. The 0-24 month-olds are considered the lowest risk group and were only indirectly affected by the public health measures. Lockdowns were negatively associated with coronaviruses infections.


2018 ◽  
Vol 5 (5) ◽  
pp. 1805
Author(s):  
Ashok Kumar ◽  
Rupa Dalmia Singh ◽  
Shashank Suryavanshi ◽  
Kriti Mohan

Background: Nucleated red blood cells (NRBCs) can be easily found in cord blood and its >20/100 WBCs has been distinguished as a marker of perinatal asphyxia at birth. Authors conducted this study to find out if there exists a relation between NRBCs at birth and its effects on long term neurological outcome in patients of perinatal asphyxia.Methods: This was a prospective longitudinal study conducted in the Department of Pediatrics in collaboration with Department of Obstetrics and Gynaecology, G.S.V.M. Medical College, Kanpur from December 2014 to September 2016.Results: On assessing the long term neurodevelopmental outcome in newborns with HIE at birth, Authors found that cord blood NRBCs had no direct influence on the final neurodevelopmental outcome at 1 year of life as did HIE staging.Conclusions: Authors propose that cord blood NRBC counts of > 20/100 WBCs is a good predictor of asphyxia at birth but is definitely not an indicator of forth coming developmental delay.


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