Timing of administration of antenatal magnesium sulphate and correlation with umbilical cord blood magnesium levels in preterm babies.

BACKGROUND: The effectiveness of MgSO4 for foetal neuroprotection is acknowledged, but the best time to provide it in relation to birth is a conundrum, and dose schedule is yet unknown. Understanding the determinants of the magnesium levels in cord blood aids in determining the appropriate timing and length of administration. AIM AND OBJECTIVE: To assess the cord blood magnesium concentration in relation to the timing of MgSO4 and delivery. To achieve ROC in relation to optimum level of cord blood magnesium concentration in relation to neonatal outcome variables. STUDY DESIGN: A prospective observational study conducted in a tertiary care hospital over 2 years in women having preterm delivery from 26 weeks to 33 + 6 weeks, who received Neuroprophylaxis. Cord blood was collected for magnesium level estimation. Baby followed 24 h after delivery. ROC analysis performed for predicting an optimal cut-off for a continuous predictor predicting binary outcome. RESULTS: 85 recruited cases divided into bolus group, bolus + infusion group. The mean cord blood magnesium (n = 85) was 3.8 mg/dl. The AUROC for Gestational Age at Administration predicting Baby Outcome: 0.699, It was statistically significant (p = 0.034). The AUROC for Cord Blood Mg predicting Baby Outcome: 0.606, It was not statistically significant (p = 0.262). CONCLUSION: Mean cord blood magnesium levels served as a tool to determine the timing and duration of Neuroprophylaxis. Mean cord blood magnesium of 3.8 mg/dl should be achieved to serve the purpose of Neuroprotection. To achieve this, Bolus followed by Infusion should be administered for at-least 6 h prior to delivery.

Protein profile pattern analysis: A multifarious, in vitro diagnosis technique for universal screening.

Universal health care is attracting increased attention nowadays, because of the large increase in population all over the world, and a similar increase in life expectancy, leading to an increase in the incidence of non-communicable (various cancers, coronary diseases, neurological and old-age-related diseases) and communicable diseases/pandemics like SARS-COVID 19. This has led to an immediate need for a healthcare technology that should be cost-effective and accessible to all. A technology being considered as a possible one at present is liquid biopsy, which looks for markers in readily available samples like body fluids which can be accessed non- or minimally- invasive manner. Two approaches are being tried now towards this objective. The first involves the identification of suitable, specific markers for each condition, using established methods like various Mass Spectroscopy techniques (Surface-Enhanced Laser Desorption/Ionization Mass Spectroscopy (SELDI-MS), Matrix-Assisted Laser Desorption/Ionization (MALDI-MS), etc., immunoassays (Enzyme-Linked Immunoassay (ELISA), Proximity Extension Assays, etc.) and separation methods like 2-Dimensional Polyacrylamide Gel Electrophoresis (2-D PAGE), Sodium Dodecyl-Sulfate Polyacrylamide Gel Electrophoresis (SDS-PAGE), Capillary Electrophoresis (CE), etc. In the second approach, no attempt is made the identification of specific markers; rather an efficient separation method like High-Performance Liquid Chromatography/ Ultra-High-Performance Liquid Chromatography (HPLC/UPLC) is used to separate the protein markers, and a profile of the protein pattern is recorded, which is analysed by Artificial Intelligence (AI)/Machine Learning (MI) methods to derive characteristic patterns and use them for identifying the disease condition. The present report gives a summary of the current status of these two approaches and compares the two in the use of their suitability for universal healthcare.

Elucidating the Effect of Antenatal Corticosteroids in the Late Preterm Period.

Aim and Objective: To determine the efficacy of antenatal corticosteroids given in the late preterm period. Methodology: We conducted a retrospective case-control study on patients with singleton pregnancies who were at a risk of delivering in the late preterm period (34 weeks to 36 weeks 6 days). A total of 126 patients who had received antenatal corticosteroids (prenatal administration of either betamethasone or dexamethasone, minimum one dose) during the late preterm period were taken as cases, and 135 patients who had not received steroids antenatally due to various reasons, for example, who were clinically unstable, presented with active bleeding, non-reassuring foetal status that obligated an imminent delivery and those in active labour were included as controls. The various neonatal outcomes like APGAR score at one and five minutes, incidence of admission and duration of stay in neonatal intensive care unit (NICU), respiratory morbidity, requirement of assisted ventilation, intraventricular haemorrhage (IVH) necrotizing enterocolitis, transient tachypnea of the newborn, respiratory distress syndrome, use of surfactant, neonatal hypoglycaemia, hyperbilirubinemia requiring phototherapy, sepsis and neonatal mortality were compared between the two groups. Results: The baseline characteristics of both groups were comparable. There was a lower incidence of admissions to neonatal intensive care unit (NICU) (15% vs. 26%, p = 0.05), respiratory distress syndrome (5% vs. 13%, p = 0.04), requirement of invasive ventilation (0% vs. 4%, p = 0.04) and hyperbilirubinemia requiring phototherapy (24% vs. 39%, p = 0.02) in the babies of the group that received steroids compared to the control group. The rate of overall respiratory morbidity in the neonates was lowered after giving steroids (16% vs. 28%, p = 0.04). The incidence of neonatal necrotizing enterocolitis, hypoglycaemia, IVH, TTN, sepsis and mortality between the two groups was not significant (p > 0.05). Conclusion: Antenatal corticosteroids administered to patients between 34 and 36 weeks 6 days of gestation reduce respiratory morbidity, requirement of invasive ventilation, respiratory distress syndrome, hyperbilirubinemia requiring phototherapy and the incidence of NICU admissions in the newborns. Supplementary Information: The online version contains supplementary material available at 10.1007/s13224-022-01664-5.

In vivo spectroscopy: optical fiber probes for clinical applications.

INTRODUCTION: Fiber optic probe-based in vivo spectroscopy techniques are fast and highly objective methods for intraoperative diagnoses and minimally invasive surgical interventions for all procedures where endoscopic observations are carried out for cancers of different types. The Raman spectral features provide molecular fingerprint-type information and can reveal the subjects' pathological state in label-free manner, making endoscopy multiplexed fiber optic probe-based devices with the potential for translation from bench to bedside for routine applications. AREAS COVERED: This review provides a general overview of different fiber-optic probes for in vivo measurements with emphasis on Raman spectroscopy for biomedical application. Various aspects such as fiber-optic probe, radiation source, detector, and spectrometer for extracting optimum spectral features have also been discussed. EXPERT OPINION: Optical spectroscopy-based fiber probe systems with 'Chip-on-Tip' technology, combined with machine learning, can in the near future, become a complementary diagnostic tool to magnetic resonance imaging (MRI), computed tomography (CT) scan, ultrasound, etc. Hyperspectral imaging and fluorescence-based devices are in the advanced stage of technology readiness level (TRL), and with advances in lasers and miniature spectroscopy systems, probe-based Raman devices are also coming up.

A micro-Raman spectroscopy study of inflammatory condition of human cervix: Probing of tissues and blood plasma samples.

The present study explores the application of the micro-Raman spectroscopy technique to discriminate normal and cervicitis condition from cervical malignancy by analyzing the Raman signatures of tissues and plasma samples of the same subjects. The Raman peaks from tissue samples at 1026 cm-1,1298 cm-1 and 1243 cm-1 are attributed to glycogen, fatty acids and collagen and are found to be reliable signatures capable of identifying cervicitis and normal condition from cervical cancer. The Raman signatures from plasma samples belonging to carbohydrates (578 cm-1), lipids (1059 cm-1) and nucleic acids (1077 cm-1,1341 cm-1 and 1357 cm-1) are quite useful to classify various pathological conditions of cervix at par with tissue based diagnosis. The PCA-SVM based classification of the spectral data indicates the potential of Raman spectroscopy based liquid biopsy to rule out false diagnosis of cervicitis as cervical malignancy.

KAP Study on HIV/AIDS Among Antenatal Women Attending Central Referral Hospital of North East India.

BACKGROUND: This study was conducted to determine whether antenatal mothers in Sikkim have adequate knowledge about awareness, attitude, and preventive practices regarding HIV infection. METHODS: Cross-sectional study using structured questionnaire. 220 Antenatal mothers attending the outpatient department of Central Referral Hospital of Sikkim were taken for the study for a period of 1 year from April 2011 to April 2012. Questionnaire form filled by pregnant women during their first antenatal visit was the source of data for this study. Systematic sampling technique was used where every alternate pregnant women registering for ANC visit were voluntarily recruited into the study. RESULTS: 2.27 % (5) women had not heard about HIV. 84 % (38) women had the knowledge that HIV was related to STI, while 50 % (110) did not. Television was the best method of increasing the knowledge (48 %). 68 % (150) of the women were aware about mother-to-child transmission (MTCT) of HIV during antenatal period. Only 2.66 % (6) women knew that HIV can be transmitted to child through breast milk. 90 % (198) knew that HIV is spread by having unsafe sex, 48 % (106) women knew using condoms would protect against it. 69.4 % (153) women wanted partner testing, and 84 % (185) of women consented that all pregnant women should be tested for HIV. CONCLUSIONS: The current study revealed high levels of knowledge, positive attitude, and preventive practices regarding HIV; however, this population lacked knowledge about MTCT and its prevention.