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Introduction: Extrauterine growth restriction (EUGR) is a universal problem but its prevalence using recent reference growth charts and morbidities associated with it are lacking. The study aims at estimating EUGR prevalence in very low birth weight (VLBW) neonates and its associated morbidities. Methods: All VLBW neonates admitted to NICU between Jan 2018 to June 2019 were analysed. Neonatal anthropometries were recorded on Intergrowth 21st gender based postnatal growth chart. EUGR was defined by weight below 10th percentile at discharge. Demographic profile and neonatal morbidities were compared between EUGR and non-EUGR by using unpaired t test and Chi-square test. Regression was used for identification of the risk factors. Results: Out of 148 VLBW neonates, 92 (62.1%) were male, 26 (17.56%) were below 1000 gm, 102 (68%) were EUGR at discharge. Mean (SD) birth weight and gestational age were 1202 (221) gms and 30.89 (2.77) wks respectively. Caesarean delivery, higher gestational age, lower birth weight, SGA at birth and prolonged duration to achieve full enteral feeding were significantly associated with EUGR (P < 0.05). Sepsis was significantly associated with EUGR (36.28% vs. 17.4%; P 0.022). EUGR babies needed longer hospital duration (24.56% vs. 16.78%; P 0.005) with a higher mean PMA at discharge (38.07 wks vs. 35.11 wks; P < 0.001). In regression model SGA at birth and delay in achieving full feeding were independent predictor of EUGR. Conclusions: In VLBW neonate, prevalence of EUGR at discharge was 68%. Sepsis was significantly associated with EUGR. SGA and delay in achieving full feeding were independent predictors of EUGR.

Background: COVID-19 pneumonia is complicated with residual lung fibrosis, as evidenced by imaging and postmortem pathological findings. In addition to steroids, we compared the efficacy of nintedanib and pirfenidone in the management of COVID-19 lung fibrosis measured by CT severity score (CTSS). Methods: All cases of COVID-19 pneumonia diagnosed as COVID-19 positive by RT-PCR having SpO2 ⩽ 96% and CTSS ⩾ 10 even after 15 days were included in the study. The patients were divided into three groups. All three groups received steroids at a dose of 1 mg/kg body weight of prednisolone or equivalent. The first group received steroids alone, the second group received pirfenidone with steroids and the third group received nintedanib with steroids. All patients were followed up at 6 and 12 weeks. The primary endpoint of our study was to find out any improvement in CTSS. Results: Out of 90 patients, 56 patients completed the study. Among three groups, 19 (33.9%) patients received steroids (control) only, 16 (28.6%) patients received steroids with pirfenidone and 21 (37.5%) patients received steroids with nintedanib. The study population had a mean (±SD) age of 52.5 ± 10.1 years, mean (±SD) C-reactive protein of 97.1 ± 102.2 mg/L (normal Conclusion: Along with steroids in the treatment of COVID-19 lung fibrosis, there was a significant improvement in lung CTSS with nintedanib compared to pirfenidone.

Outcomes of pregnancy in COVID 19-infected mothers are worse than in the general population. Due to immunological changes, antenatal women are more vulnerable to severe complications. The India has experienced two waves of the disease. We analysed whether the second wave of the disease had affected pregnancy outcomes differently by comparing pregnancy outcomes with those of the first wave.The study population included all the women delivered in the same tertiary centre during both the waves. Maternal outcome parameters include maternal oxygen requirement, maternal ICU admission and maternal death. Foetal outcome parameters include APGAR scores, preterm deliveries and NICU admissions, maternal and foetal outcome parameters between the first and the second waves were compared.Demographic parameters were similar in both the waves of COVID 19. No significant differences were found in pre-pregnancy comorbidities, high-risk pregnancies and mode of deliveries between the two waves. Maternal oxygen requirement increased in the second wave [first wave 6(4.7%) vs second wave 25(40.3%) (Mothers had more severe diseases during the second wave. But this did not translate into significant increase in maternal mortality and poor neonatal outcomes, possibly due to better preparedness.

There is an uncertainty regarding the effect of the SARS-CoV-2 infection on patients with chronic rheumatic diseases who are on immunosuppressive drugs. We did a multicentric cross sectional seroprevalence study were conducted in five different cities of India prior to COVID-19 immunization. Patients with a diagnosis of rheumatic disease and on DMARDs were included. Relatives of the patients, preferably staying in the same household with no known rheumatic diseases served as controls (subjects without disease). Serum IgG antibodies to SARS-CoV-2 Receptor Binding Domain (RBD) of the spike protein and nucleoprotein (NP) was assayed. Eight hundred eighty-nine sera (subjects with disease = 379 and in subjects without disease = 510) were assayed. IgG antibodies to either RBD and/or NP were positive in 135 (36%) subjects with disease as compared to 196 (38%) in subjects without disease. The seroprevalence to RBD and NP varied between different cities but was not significantly different between subjects with and without disease in Mumbai, Ahmedabad, Bengaluru and Bhubaneswar. However, the occurrence of IgG antibodies to RBD was significantly (p

The study aimed at examining the prevalence of pregnancy terminationbyAbortion, Miscarriage,and Stillbirths (AMS) and its determinants in the state of Odisha, India. The NFHS-IV data have been used for this analysis. GIS mapping has been used forthe spatial distribution of outcome variables at the district level. Univariate analysis (chi-square)and a multivariable logistic model havebeen used to identifythe potential factors associated with AMS. Out of 8,484 pregnancy cases registered, 969 (11.4%) caseshadmet with pregnancy termination byAMS. Jagatsinghpur, Jajapur, Subarnapur, Kendrapara, Nayagarh,and Puri have been identified as high prevalent districts. The age group of 30-34 yearsismore likely of pregnancy termination thanthe age group 15-19 years (OR=1.254). Women who have completed secondary education have 1.568 times higher oddsof pregnancy termination byAMSthan those whoareilliterate. Pregnancy complicationsshow significantly higher odds (OR=1.091) of pregnancy termination.Among the trio of reasons for pregnancy termination, miscarriage cases are the mostprevalent,followed by abortion and stillbirths. Potential factors like age, education, wealth index, place of delivery, and anemiaare significant for AMS(pvalue

Introduction Suicide is a major social and health issue in India. Yearly statistics show a concerning increasing pattern of suicidal deaths in India which is higher in comparison to the global trend. There is limited evidence regarding historical analysis of suicide or any forecasting for suicide in India towards predicting the possible risks of death due to suicide. Methods This paper examines the trend of suicide rate and characteristics of suicide victims in India, based on the longitudinal time series data over the last 50 years—collected from the National Crime Record Bureau Reports (1969 to 2018) of the Government of India. In our analysis, we have used the time series model to forecast the suicide rates in India for the next decade. ARIMA (4,1,0) model is found to be the best fit model for forecasting the data. Findings There has been an observable and rising trend of suicide rates in India over the last five decades. The forecast indicates a continuance of rising suicide cases for an upcoming couple of years in India with a limited decline in the following years. The prediction model indicates a future relatively consistent pattern of suicide in India which does not seem to be a very encouraging trend. As we have not included the period staring the year 2020 onwards affected by Covid-19 and which has several disruptions in personal and family spaces, the projected suicide trend during the period of next two to three years (2020–22) may rise far high and then it may show a declining path. Along with this, there is a shift in means of suicide in the last couple of decades. Constituting the second-highest number of cases, Illness associated suicide was visibly a serious concern. Conclusion The present analysis finds that there is no visible substantial relief for suicide deaths during the coming years in India. On the other hand, more extensive exploration of sample cases may provide important information for suicide prevention. Availability of detailed and more inclusive data will be highly useful for analysis and suicide preventive policies. Investment in public health care and other welfare activities like education and employment generation will yield visible positive results in suicide control.

Context: Overweight and obesity has become a major contributor to global burden of chronic diseases and disability. Obesity among rural India is emerging as a major health problem because of change in lifestyle and food habits, thereby increases the risk of multiple morbid conditions among rural population. Aims: This study aims to find out the association of overweight/obesity with different socio-demographic factors and explore the co-morbidities among overweight and obese in a rural setting. Settings and Design: A cross-sectional study was done in a randomly selected primary health centre of Khurda district, Odisha for 4 months. Materials and Methods: This study was done among 183 patients aged >20 years with BMI >25 kg/m2 after taking their consent. Anthropometric measurements were done and data were collected using a semi-structured questionnaire. Statistical Analysis Used: Descriptive statistics such as proportion, mean and standard deviation were calculated and inferential statistics such as Chi-square test, univariate and multivariate regression was done using the SPSS version 20.0. Results: Mean age of participants was 45.7 (±13.8) years. About 93.4% were Grade II obese while 51.9% were at risk according to their waist–hip ratio. Around 53.6% of participants had multi-morbidity. Age, occupation and number of children were significantly associated with obesity. Morbidity was significantly associated with age, occupation, marital status and number of children. Increased grade in obesity the more is the probability of having morbidity. Conclusions: There is an urgent need to screen for obesity at rural health facility and early management for prevention from co-morbidities.

Context: Partograph is a simple, effective and low-cost intrapartum monitoring tool that helps in early identification of complications if any and helps in prompt intervention to save the life of the mother and the newborn. There is limited study about its usage and challenges in plotting from India particularly Odisha. Aim: To determine the usage of partograph and explore the issues/challenges in its plotting at various levels of health facilities Settings and Design: A cross-sectional study was carried out from April to June 2018 in ten different public health facilities from two tribal districts of Odisha, India. Materials and Methods: Quantitative information from 1552 mothers using pre-tested epi-info questionnaire tool and qualitative information through 22 in-depth interviews among health care providers. Statistical Analysis Used: Quantitative data using Ms Excel 10 and IBM SPSS ver. 22 and qualitative data using the inductive content analysis method. Results: Partograph plotting was found in 48.7% (adherence) while its completeness was only 1.03%. Partograph plotting was significantly better at CHCs compared to DHH and SDH (P = 0.000). No significant association of partograph adherence was observed with the birth outcome, complications, referral status and type of delivery. Though majority health care providers knew the importance of the partograph, hardly they use it. The main reasons were increased workload, shortage of staff, cases arriving at a later stage and lack of monitoring from a higher level. Conclusions: On job training on partograph, regular monitoring and strict policy will improve the adherence and completeness in partograph plotting.

Lysozyme activity in buffalo milk in relation to the period of lactation, parity of animal, weather conditions and udder infections was studied. Effect of storage and heat processing of milk on lysozyme activity was determined. Lysozyme activity was higher in buffalo milk than in cow milk. Buffalo colostrum showed lysozyme activity 5 times of that in mature milk. Lysozyme activity in buffalo milk was not influenced by the parity of animal and the stage of lactation, however, it increased during extreme whether conditions (winter and summer). Lysozyme in both cow and buffalo milk exhibited maximum activity at pH 7.4. Buffalo milk lysozyme was fully stable while the cow milk lysozyme was partly inactivated by pasteurization (low temperature-long time as well as high temperature-short time treatments). Lysozyme in buffalo milk was more stable than in cow milk during storage and heat treatment. A 10 to 50-fold increase in milk lysozyme activity was observed in mastitic cows. An assay of lysozyme activity in milk can be used to diagnose mastitis in cattle but not in buffaloes. Some buffaloes exhibited 1000 fold greater lysozyme activity and moderately raised somatic cell count in milk, but there was no sign of mastitis in these animals. A possible role of milk lysozyme in prevention of mastitis in buffaloes is discussed.

The primary form of therapy for prostate cancer is androgen ablation resulting in apoptosis and expression of apoptotic genes (i.e. par-4). Prostate cancer cells that survive androgen ablation therapy express pro-survival genes (i.e. bcl-2) permitting these androgen independent (AI) cells to overcome apoptotic signals and proliferate in the absence of normal growth signals. To disrupt tumor growth and progression to AI, we expressed the tumor suppressor gene, WT1 in LNCaP prostate tumor cells. The WT1 transcription factor modulates expression and activity of several prostate growth control genes (i.e. par-4, bcl-2 and AR) in vitro. To provide insight into potential mechanisms of prostate cancer growth suppression both the transcriptionally active form of wild-type WT1 (D) and an inactive WT1 (D) R394W mutant form were stably transfected in LNCaP cells. Surprisingly both transfected lines underwent apoptosis and were growth suppressed in nude mice. A 3-fold reduction in overall tumor incidence and volume was associated with increased apoptosis, as evidenced by DNA fragmentation and par-4 expression, and was reduced or absent in early forming LNCaP tumors. After several months the indolent WT1-LNCaP cells became proliferative forming small tumors lacking par-4 protein. Although bcl-2 protein was present in all LNCaP tumors at this late-stage, it was detected in only a minority of WT1-LNCaP tumors, suggesting that pro-survival signals continued to be reduced in WT1-suppressed tumor cells. While the mechanisms of WT1-mediated growth suppression and apoptosis in LNCaP tumor cells are unknown, our results argue against simple transcriptional regulation since the mutant WT1 (D) R394W suppressed tumor formation similarly to wild-type WT1. This suggests that the mechanism of WT1-mediated growth suppression does not rely upon DNA binding at known WT1 recognition sites.

Lysozyme, a low-molecular weight basic protein, is an important component of the antibacterial system in milk. Lysozyme activity is higher in buffalo milk (60±3·9×10−3 units/ml) than in bovine milk (29·1±1·5×10−3 units/ml). Buffalo colostrum contains five-times more lysozyme activity than mature milk (Priyadarshini & Kansal, 2002a). Lysozyme activity in buffalo milk is not influenced by the parity of animal or stage of lactation, but it increases during extreme weather (winter and summer). Lysozyme in buffalo milk is more stable than in cow milk during storage and heat treatment. A sharp increase in milk lysozyme has been observed in buffaloes with sub-clinical mastitis (Priyadarshini & Kansal, 2002a).

Lysozyme from buffalo milk was purified to homogeneity and its N-terminal amino acid sequence, biochemical properties and antibacterial spectrum were determined. The purification procedure, comprising ion-exchange chromatography using CM-cellulose and size-exclusion chromatography using Sephadex G-50, conferred 8622-fold purification and 39·3% recovery of lysozyme. The purified enzyme migrated as a single band on sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and native PAGE. Immunological purity of lysozyme preparation was confirmed by immuno-electrophoresis. Molecular weight of buffalo-milk lysozyme as determined by SDS-PAGE was 16 kDa and its amino acid composition was determined by reverse phase high performance liquid chromatography (HPLC). The sequence of 23 amino acid residues at the N-terminal end showed 56·5% homology with bovine milk lysozyme and 30·4% with equine milk lysozyme. The specific activity of buffalo milk lysozyme was ten-times that of bovine milk lysozyme. Buffalo-milk lysozyme was active over a wide range of pH and its activity was strongly influenced by molarity of the medium. Antibacterial activity of buffalo-milk lysozyme was determined against 11 species of bacteria; out of seven Gram-positive bacteria tested, four were inhibited, while Gram-negative bacteria were resistant.