Attitudes of First-Time Fathers in South India Toward Their Role in Their Wives' Prenatal Period.

OBJECTIVE: To assess the attitudes of first-time fathers toward their role during their wives' prenatal period. DESIGN: Cross-sectional study. SETTING: Tertiary care hospital in South India. PARTICIPANTS: First-time fathers accompanying their pregnant wives to an antenatal clinic. METHODS: Participants were surveyed to collect information on their attitudes toward their role during the prenatal period. The survey captured attitudes about fathers' role in pregnancy care; role as financial provider; and need to provide physical, emotional, moral, and social support. RESULTS: Two hundred fathers were included in the sample. Approximately 17.5% (n = 35) had a positive attitude toward their role in the prenatal period, whereas 40% (n = 80) had a negative attitude. Having a joint family (i.e., husband, wife, children, and husband's parents) was found to be negatively associated with fathers' attitudes toward their role during the prenatal period (p < .05). CONCLUSION: The findings revealed that the presence of a joint family structure was associated with a more negative attitude among fathers toward their role in their wives' pregnancies. Antenatal care should include education programs aimed at enhancing husbands' knowledge, awareness, and active participation during the prenatal period.

The CryoPop study: Screening for high-grade cervical dysplasia in Karnataka, India.

OBJECTIVE: To describe our experience of screening with visual inspection with acetic acid (VIA) and colposcopy to identify women with high-grade precancerous cervical lesions who were candidates for cryotherapy. Women were screened to determine eligibility for a clinical trial testing the safety and efficacy of a new, simple and inexpensive cryotherapy device (CryoPop®) targeted for use in low and middle-income countries (LMICs). DESIGN: Prospective cohort study. SETTING: Primary and urban health centres in Belagavi, Hubballi and Vijayapur, India. POPULATION: Women in the age-group 30-49 years, premenopausal, with no prior hysterectomy and no known HIV infection were eligible for screening. METHODS: Visual inspection with acetic acid was performed on eligible women following informed consent. VIA-positive women were referred for colposcopy and biopsy. Biopsies were read by two pathologists independently, with a third pathologist acting as tie-breaker if needed. MAIN OUTCOME MEASURES: The primary outcome measures were the number/proportion of women screening positive by VIA and the number/proportion of those women screening VIA-positive found to have high-grade cervical lesions on biopsy (cervical intraepithelial neoplasia 2/3 [CIN 2/3]). Demographic variables were compared between women who screened VIA-positive and those who screened VIA-negative; a separate comparison of demographic and limited reproductive variables was performed between women who had CIN 2/3 on biopsy and those without CIN 2/3 on biopsy. Chi-square or Fisher's exact tests for categorical data and t-tests or analysis of variance for numeric data were used with all tests two-sided and performed at an alpha 0.05 level of statistical significance. RESULTS: A total of 9130 women were screened with VIA between 4 July 2020 and 31 March 2021. The mean age of all women screened was 37 years (standard deviation = 5.6 years) with 6073 of the women (66.5%) in the 30-39 year range. Only 1% of women reported prior cervical cancer screening. A total of 501 women (5.5%) were VIA-positive; of these, 401 women underwent colposcopy. Of those who had colposcopy, 17 (4.2%) had high-grade lesions on biopsy, an additional 164 (40.9%) had low-grade cervical lesions on biopsy or endocervical curettage and one woman (0.2%) was found to have invasive cancer. VIA-positive women were younger and had higher levels of education and income; however, women who were VIA-positive and found to have CIN 2/3 were older, were more likely to be housewives and had higher household income than those without CIN 2/3. CONCLUSION: Despite the COVID-19 pandemic, over 9100 women were screened with VIA for precancerous lesions. However, only 17 (4.2%) were found to have biopsy-proven high-grade cervical lesions, underscoring the subjective performance of VIA as a screening method. Given that this is significantly lower than rates reported in the literature, it is possible that the prevalence of high-grade lesions in this population was impacted by screening a younger and more rural population. This study demonstrates that screening is feasible in an organised fashion and can be scaled up rapidly. However, while inexpensive and allowing for same-day treatment, VIA may be too subjective and have insufficient accuracy clearly to identify lesions requiring treatment, particularly in low-prevalence and low-risk populations, calling into question its overall cost-effectiveness.

Co-infection of bluetongue virus serotypes 12 and 16 in sheep from Haryana, India.

World Organization for Animal Health has listed bluetongue (BT) under notifiable diseases. The BT is an arboviral infectious disease of domestic and wild ruminants caused by the bluetongue virus (BTV). Southern states of India had remained the point of attention for BT since first presence in 1964 in Maharashtra. Recently, northern states of India have also been reported positive for BTV in small ruminants. The present study reported the dual infection of BTV serotypes, BTV-12 and -16 in sheep population from Sirsa district of Haryana in the year 2016. After detection and serotyping with Seg-2 specific real time polymerase chain reaction (PCR), the Seg-2 and Seg-6 of BTV were PCR amplified and sequenced. On phylogenetic analysis it was detected to be clustered in nucleotype G and nucleotype B specific for BTV-12 and BTV-16, respectively. This was the first report of BTV-16 from Haryana. The results signified the co-infection of two different serotypes in an animal from a single outbreak.

Maternal Anemia and BMI as Determinants of Pregnancy Outcomes: A Hospital-Based Study.

BACKGROUND: Malnutrition is a serious underlying cause of child and maternal deaths around the world. The objective of this study evaluates maternal anemia and body mass index as determinants of pregnancy outcomes. Undernourishment during pregnancy can occurs Intra Uterine Growth Retardation. Contributing to about 80,0000 new-borns, 40,0000 infant deaths and 20% under 2 years children have stunted, 20% of maternal deaths during labor and early postpartum. METHODS: This study Hospital-based cross-sectional study. The study comprised laboring women admitted for delivery in selected tertiary care hospital in South India from 10th November 2021 to 20th January 2022. Structured interview schedule for demographic information, patient's case sheet for information about the 'Body Mass Index as a determinants of pregnancy outcomes' and anthropometric measurement for body mass index (weight and height). All registered deliveries in the study period have been included, comprising of 101 sample size Bivariate logistic regressions were used to determine the factors associated with outcome variables. A significant level of 5% was used to decide the significance of statistical tests. RESULTS: Body Mass Index in the 1st antenatal visit of the women who came for delivery in tertiary care hospital, underweight 36.6%, normal body mass index 52.5%, and overweight 10.9%. During 1st antenatal visit 58.4% had anemia, while 53.5% had mild anemia during the last antenatal visit. Respectively 39.6% of antenatal women had normal Hb% during 1st antenatal care visit, whereas 46.5% had normal Hb%, during their last antenatal visit. The mode of delivery; spontaneous vaginal delivery 45.5%, vacuum delivery 3.0%, emergency caesarean section delivery 50.5%. Preterm delivery was statistically significant among whose first antenatal care visit was after 11th weeks of gestation. Whereas, emergency caesarean section delivery was statistically significant among underweight. Increasing maternal weight body mass index was associated with maternal and neonatal health outcomes. Which was risk of pregnancy induced hypertension, preeclampsia, eclampsia, gestational diabetes mellitus and caesarean section delivery. CONCLUSIONS: Every 2nd women was anemic, every 3rd pregnant women was underweight (BMI >18.5), every 2nd baby was born with caesarean section delivery. Preterm delivery was statically significant of weeks of gestation during first antenatal care visit with more than 11th weeks of gestation. Whereas, emergency cesarean section was significant with low body mass index.

Safety and efficacy of the new CryoPop® cryotherapy device for cervical dysplasia in low- and middle-income countries: study protocol for a multicenter open-label non-inferiority clinical trial with historical controls.

BACKGROUND: Cervical cancer is the fourth most common cancer in the world, affecting mainly women residing in low- and middle-income countries. Progression from a pre-invasive phase to that of an invasive phase generally takes years and provides a window of opportunity to screen for and treat precancerous lesions. METHODS: This study is being conducted at four sites in north Karnataka, India. Community sensitization activities have been organized in the study areas to create awareness among stakeholders, including elected representatives, physicians, health care workers, and potential participants. Organized community based as well as hospital-based screening is being conducted using visual inspection with acetic acid (VIA). Screen positive women are referred to respective study hospitals for colposcopy and directed biopsy. Participants with confirmed high-grade cervical dysplasia (high-grade squamous intraepithelial lesions or HSIL) who fit all other eligibility criteria will be recruited to the study and will receive cryotherapy using CryoPop®, an innovative new cryotherapy device. DISCUSSION: There is a need to develop an inexpensive, simple, and effective cryotherapy device for use by frontline health care providers at locations where screening and timely treatment can be given, accelerating access to cervical cancer prevention services and minimizing loss to follow-up of women with precancerous lesions who need treatment. TRIAL REGISTRATION: Clinical Trial Registry - India CTRI/2019/01/017289 ClinicalTrials.Gov number NCT04154644 . Registered on November 6, 2019.

Association of Stillbirths with Maternal and Fetal Risk Factors in a Tertiary Care Hospital in South India.

BACKGROUND: Birth of a fetus with no signs of life after a predefined age of viability is a nightmare for the obstetrician. Stillbirth is a sensitive indicator of maternal care during the antepartum and intrapartum period. Though there has been a renewed global focus on stillbirth as a public health concern, the decline in stillbirth rate (SBR) has not been satisfactory across the nations, with a large number of stillbirths occurring in the low- to middle-income countries (LMICs). Hence, the study was carried out to analyze maternal and fetal risk factors and their association with stillbirths in a tertiary care center in South India. METHODS: This observational prospective study included pregnant women with stillbirth beyond 20 weeks of gestation or fetal weight more than 500 grams. Stillbirths were classified according to the simplified causes of death and associated conditions (CODAC) classification. Association between the risk factor and stillbirths was calculated with chi-square test and odds ratio with 95% confidence interval. RESULTS: There were 171 stillbirths (2.97%) among total 5755 births. The SBR was 29.71/1000 births. Risk factors such as preterm delivery (OR: 22.33, 95% CI: 15.35-32.50), anemia (OR: 21.87, 95% CI: 15.69-30.48), congenital malformation (OR: 11.24, 95% CI: 6.99-18.06), abruption (OR: 10.14, 95% CI: 6.43-15.97), oligohydramnios (OR: 4.88, 95% CI: 3.23-7.39), and hypertensive disorder (OR: 3.01, 95% CI: 2.03-4.46) were significantly associated with stillbirths. The proportion of intrapartum stillbirths was found to be 5 (3%) among the study population. CONCLUSION: Highest prevalent risk factors associated with stillbirth are anemia and prematurity. Intrapartum stillbirths can be reduced significantly through evidence-based clinical interventions and practices in resource-poor settings. There is a need to provide and assure access to specialized quality antenatal care to pregnant women to control the risk factors associated with stillbirths.

Detection methods for influenza A H1N1 virus with special reference to biosensors: a review.

H1N1 (Swine flu) is caused by influenza A virus, which is a member of Orthomyxoviridae family. Transmission of H1N1 occurs from human to human through air or sometimes from pigs to humans. The influenza virus has different RNA segments, which can reassert to make new virus strain with the possibility to create an outbreak in unimmunized people. Gene reassortment is a process through which new strains are emerging in pigs, as it has specific receptors for both human influenza and avian influenza viruses. H1N1 binds specifically with an α-2,6 glycosidic bond, which is present in human respiratory tract cells as well as in pigs. Considering the fact of fast multiplication of viruses inside the living cells, rapid detection methods need an hour. Currently, WHO recommended methods for the detection of swine flu include real-time PCR in specific testing centres that take 3-4 h. More recently, a number of methods such as Antigen-Antibody or RT-LAMP and DNA biosensors have also been developed that are rapid and more sensitive. This review describes the various challenges in the diagnosis of H1N1, and merits and demerits of conventional vis-à-vis latest methods with special emphasis on biosensors.

Isolation, cloning and expression of CCA1 gene in transgenic progeny plants of Japonica rice exhibiting altered morphological traits.

Circadian clock genes holds tremendous potential for breeding crops better adapted to environmental fluctuations inherent to climate change. Endogenous TOC1 promoter and CCA1 gene from rice were isolated, cloned and mobilized into pCAMBIA1300 vectors and RNAi constructs A, B and C. Embryogenic calli of varying ages derived from mature seeds of Taipei 309 were employed for Agrobacterium-mediated genetic transformation generating T0, T1 and T2 independent transgenic lines were analyzed for over-expression and repression of CCA1 gene along with various morphological traits. Six hundred and thirty two T0 transgenic plants were generated from rice calli using constructs A, B and C. T0 progeny plants derived from constructs A, B and C did not show any considerable difference in morphological traits. T1and T2 progeny plants derived from construct A exhibited over-expression of CCA1 gene, on the contrary, progeny plants derived from RNAi constructs B and C exhibited repression of CCA1 gene in qRT-PCR analysis at different time points and showed rhythmicity peaking at dawn (6:00 AM) and lowest expression at 12:00 Noon. T1 and T2 progeny plants derived from construct A, namely, A-17 and A-45 exhibited reduced number of tillers/panicles (6-8), reduced thousand seed weight (10.1-16.6g), decreased seed length (4.98 to 6.58mm), decreased seed width (1.1-1.8mm) as compared to wild type plants. T1 and T2 progeny plants of construct B and C showed increased number of tillers/panicles (8-19), better seed yield (4.98-28.9g), increased thousand seed weight (15.6-29.03g), slightly increased seed length (5.7-7.43mm) and slightly increased seed width (1.7-2.98mm) as compared to wild type plants. Chlorophyll content in T1 and T2 progeny plants did not show any significant difference among the three constructs, however, rhythmicity was observed over the period of time in conjunction to CCA1 gene expression. Evidence has been presented which demonstrates that endogenous repression of CCA1 gene resulted in improved morphological traits: increased number of tillers/panicle, thousand seed weight, seed size; whereas, over-expression leads to diminution in morphological traits: decreased number of tillers/panicle, thousand seed weight, seed size as compared to the wild type in T1 and T2 progeny plants. This is first report of successful regulation of endogenous CCA1 gene under control of TOC1 promoter and its effect on improved growth vigor in Japonica rice.

Inverse spatially-offset Raman spectroscopy using optical fibers: An axicon lens-free approach.

Inverse spatially offset Raman spectroscopy (I-SORS) seeks to interrogate deep inside a Raman-active, layered, diffusely scattering sample. It makes a collimated laser beam incident onto the sample surface in the form of concentric illumination rings (of varying radii) from whose center the back-scattered Raman signal is collected for detection. Since formation of illumination rings of different sizes requires an axicon to be moved along the axis of the collimated laser beam and axicons below a certain minimum size (~1 inch) are not readily available, this classical configuration incorporating an axicon cannot be used for designing a compact I-SORS probe of narrower diameter. We report a novel scheme of implementing I-SORS which overcomes this limitation by implementing ring illumination and point collection using two multi-mode optical fibers. An important advantage of the proposed scheme is that unlike the previously reported inverse SORS configurations, it does not require physical movement of any of the optical components for generating spatial offsets needed for probing sub-surface depths. Another advantage is its fiber-optic configuration which is ideally suited for designing a compact and pencil-sized I-SORS probe, often desired in many practical situations for carrying out depth-sensitive Raman measurements in situ from a layered turbid sample.

An aptasensor for rapid and sensitive detection of estrogen receptor alpha in human breast cancer.

The analysis of estrogen receptor (ER) expression in breast carcinomas plays a crucial role in determining the endocrine responsiveness of tumors for systemic adjuvant therapy. Conventionally, the ER levels in breast carcinomas had been detected using the dextran-coated charcoal assay and radioimmunoassay, which are now substituted with safer and economic antibody-based assays such as immunohistochemistry (IHC) and enzyme-linked immunosorbent assay (ELISA). Despite a gold (Au) standard method, the IHC has been criticized for factors such as tissue fixation, antibody selection, and threshold staining for result interpretation that could falsify test accuracy and reproducibility. The quest for alternative methods of ER quantification in tissue samples paved the way for aptamer-based diagnostics. Previously, we have isolated a DNA aptamer against human ER alpha (ERα) using an in vitro evolution system. In this study, we developed an electrochemical sensor using the 76-nucleotide DNA ERα- aptamer for rapid, precise, and cost-effective detection of ERα expression in human breast cancer patients. The aptasensor was constructed by covalently immobilizing the thiolated ERα- aptamer onto a screen-printed Au electrode. Construction of aptasensors was confirmed through atomic force microscopy and differential pulse voltammetry measurements. A detection limit of 0.001 ng/ml was calculated for full-length ERα (66.2 kDa) in a detection time of 10 min. Analysis of the cancerous breast tissue samples using the ELISA and aptasensor methods enabled distinctive classification of samples into the categories of ER -ve, weak ER +ve, and strong ER +ve samples. The current change of this aptasensor lies within 5% after a storage of 60 days at 4°C. Further studies on a reasonably large sample size are required to realize the clinical potential of the sensor.

Molecular analysis of genome segment-3 of bluetongue virus serotype 12 isolates from Haryana.

AIM: The present study was designed to characterize the genome segment 3 (Seg-3) of bluetongue virus (BTV) serotype 12 isolates from different outbreaks of Bluetongue disease in Haryana, India. MATERIALS AND METHODS: Blood and swab samples were collected from goat and sheep suspected to be suffering of BT from different outbreaks from Gurugram, Sirsa, Hisar, and Karnal districts of Haryana. The samples were grown in insect and mammalian cell lines. After preliminary identification, serotyping was done using BTV type-specific quantitative reverse transcription-polymerase chain reaction (qRT-PCR) assays. Sequencing was performed using terminal and walking internal primers specific for Seg-3 on ABI Capillary Sequencer 3130 using a "BigDye cycle sequencing kit." The obtained sequence data were analyzed with various bioinformatic tools. RESULTS: Real-time PCR results confirmed the samples to be positive for BTV-12. The Seg-3 of Indian isolates was most closely related to that of a south Indian isolate of BTV-12 from Andhra Pradesh (KC662614) with 97% nucleotide identity. CONCLUSIONS: The study confirmed the circulation of BTV-12 in Haryana, India. The variations shown in genome Seg-3 of BTV-12 isolates may have some significance and need to be further explored.

Harlequin ichthyosis: A rare case.

Harlequin ichthyosis is a very rare condition that affects the skin of newborns. It is associated with poor barrier function of the skin leading to dehydration and leaves newborns prone to infections. It is due to mutations in adenosine triphosphate binding cassette A12 gene transmitted as an autosomal recessive disorder. The prognosis is very poor in these cases. Here, we report one such rare case.

A comprehensive study on seroprevalence of bluetongue virus in Haryana state of India.

AIM: The aim of present study was to determine seroprevalence of bluetongue virus (BTV) in Haryana state of India. MATERIALS AND METHODS: A total of 803 serum samples, 408 of cattle and 395 of buffalo origin, respectively, were collected from different villages of Haryana. Sampling was done randomly to obtain unbiased results. The samples were evaluated by a competitive enzyme-linked immunosorbent assay for the presence of BTV antibodies. RESULTS: Overall seroprevalence of BTV antibody in cattle and buffaloes for all 21 districts of Haryana state was found to be 75.49% and 92.91%, respectively. The prevalence of BTV in different agroclimatic zones ranged between 72-77% and 90-94% for cattle and buffalo, respectively. In buffaloes, the BTV seroprevalence was comparatively higher than in cattle. CONCLUSION: The study showed that BTV is circulating in cattle and buffalo populations in the Northern part of India.

Full-Genome Sequence Analysis of a Reassortant Strain of Bluetongue virus Serotype 16 from Southern India.

The complete genome sequence of a reassortant field strain (IND2014/01) of Bluetongue virus (BTV) serotype 16, isolated from sheep from southern India in 2014, was sequenced. The total genome size was 19,186 bp. Sequence comparisons of all genome segments, except segment 5 (Seg-5), showed that IND2014/01 belonged to the major eastern topotype of BTV.

Cervical cancer screening by visual inspection with acetic acid--interobserver variability between nurse and physician.

OBJECTIVES: The objective of the study was to evaluate and compare the test performance of visual inspection with acetic acid (VIA) by a physician and nurse so as to evaluate the feasibility and efficacy of training a nurse in interpreting VIA. METHODS: It was a cross sectional study conducted in the colposcopy clinic at the University teaching hospital. 406 women who fulfilled the selection criteria underwent VIA done by both physician and nurse and the findings were interpreted independently. This was followed by colposcopy done by a gynecologist blinded to the results of VIA and directed biopsy was taken if indicated. The diagnostic efficacy was calculated separately for physician and nurse using threshold of cervical intraepithelial neoplasia (CIN) 2 and above and concordance of results between the physician and nurse was determined by kappa statistics. RESULTS: VIA by physician had a higher sensitivity (88.89% versus 80%) and a higher specificity (69.81% versus 54.85%) with disease threshold of CIN 2 and above. The concordance of results showed moderate agreement (kappa=0.366). CONCLUSION: Trained nurses can be an effective alternative human resource for cervical cancer screening using VIA as a preliminary screening method. Intensive training and periodic reinforcement sessions are needed so as to reduce the false positive results.

Cervical cancer screening by visual inspection with acetic acid - interobserver variability between nurse and physician.

OBJECTIVES: The objective of the study was to evaluate and compare the test performance of visual inspection with acetic acid (VIA) by a physician and nurse so as to evaluate the feasibility and efficacy of training nurses in interpreting VIA. METHODS: This cross sectional study was conducted in the colposcopy clinic at the University teaching hospital. A total of 406 women who fulfilled the selection criteria underwent VIA done by both physician and nurse and the findings were interpreted independently. This was followed by colposcopy carried out by a gynecologist blinded to the results of VIA and a directed biopsy was taken if indicated. The diagnostic efficacy was calculated separately for physician and nurse using threshold of cervical intraepithelial neoplasia (CIN) 2 and above and concordance of results between the physician and nurse was determined by kappa statistics. RESULTS: VIA by physician had a higher sensitivity (88.9% versus 80.0%) and a higher specificity (69.8% versus 54.9%) with a disease threshold of CIN 2 and above. The concordance of results showed moderate agreement (kappa=0.366). CONCLUSION: Trained nurses can be an effective alternative human resource for cervical cancer screening using VIA as a preliminary screening method. Intensive training and periodic reinforcement sessions are needed so as to reduce false positive results.

Correlation of colposcopy using Reid colposcopic index with histopathology- a prospective study.

OBJECTIVE: To estimate the diagnostic efficacy of colposcopy & determine the strength of correlation between colposcopic impression using the Reid Colposcopic Index (RCI) and histopathology. MATERIAL AND METHODS: This was a prospective cross sectional study carried out in the colposcopy clinic at KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belgaum from January 2008 to June 2009. A total of 268 women who fulfilled the selection criteria were included in the study. All women underwent colposcopy and a diagnosis was made based on RCI. Colposcopy directed biopsy was obtained from the abnormal areas. In cases where colposcopy did not reveal any lesion, a four quadrant biopsy from the squamocolumnar junction was taken, which served as a gold standard. RESULTS: Three women who had an unsatisfactory colposcopy & eleven women with the diagnosis of cervical cancer were excluded from the analysis. The sensitivity, specificity, positive predictive value & negative predictive value of colposcopy with CIN 1 as a disease threshold was 88.5%, 86.2%, 77% & 93.5% respectively. With CIN 2 as a disease threshold the sensitivity, specificity, positive predictive value & negative predictive value of colposcopy were 85.2%, 99.6%, 95.8% & 98.3% respectively. The degree of correlation between colposcopic impression using RCI & histopathology was high (k=0.73). CONCLUSION: Colposcopy is an indispensable tool in the diagnosis of precancerous lesions & the good correlation between colposcopic impression using RCI & histopathology makes it a reproducible technique which is easy to implement in colposcopy clinics.