Determinants of Breastfeeding Practices and Its Association With Infant Anthropometry: Results From a Prospective Cohort Study in South India.

Introduction: Despite national efforts for promoting exclusive breastfeeding (EBF) during the first 6 months of the infants' life, breastfeeding rates are low in India. Evidence on the interference of supplementary food on optimal nourishment and growth of the infant has also been well-established. Our study was undertaken to assess the effect of breastfeeding practices on infant anthropometry and determine the various factors affecting breastfeeding practices. Methods: A prospective cohort study - Maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI) was conducted at a tertiary care public hospital in Bengaluru, South India. From the consenting women, data such as obstetric history, infant feeding practices, anthropometry of mother and child, the psychosocial status of the women using the Edinburgh Postnatal Depression Scale (EPDS), was collected at baseline and subsequent follow-up: post-delivery and 14 weeks after birth. In this study, we analyzed data collected from April 2016 to April 2018, with descriptive statistics presented in mean and standard deviation, and logistic regression adjusting for confounders. Results: Among the 240 women enrolled in the study, 33% (n= 80) were using supplementary food for their infants at 14 weeks of infants age. Infants who received supplementary feeding at age 14 weeks had nearly 2.5 times higher odds of being wasted (OR: 2.449, p-value: 0.002) as compared to exclusively breastfed infants. Conclusion: Infants between 14 to 16 weeks of age who received supplementary feeding were at risk of wasting as compared to exclusively breastfed infants. Despite strong evidence in support of the benefits of exclusive breastfeeding, awareness in urban women in India is low. Increased focus on promoting exclusive breastfeeding is necessary to ensure proper nutritional intake and healthy growth of infants.

Small for gestational age babies and depressive symptoms of mothers during pregnancy: Results from a birth cohort in India.

Background: Annually, more than a million low birthweight (LBW) is born in India, often afflicting disadvantaged families. Several studies have undertaken the association of poverty, nutritional status, and obstetric factors with LBW. Through our study, we aimed to examine the possibility of any relation between the Edinburgh Postnatal Depression Scale (EPDS) score measured during pregnancy with the incidence of babies born Small for Gestational Age (SGA). Methods: Pregnant women attending the antenatal clinic at a public hospital between 14 to 32 weeks were recruited from April 2016 to Oct 2017. The EPDS was administered to assess depression through face-to-face interviews. Newborn anthropometry was performed post-delivery. For analysis, birth weight <10 percentile was classified as SGA. Results: Prevalence of depressive symptoms (EPDS score >11) was 16.5% (n=108/654) in antenatal mothers. These women delivered a higher proportion of SGA babies (21.3 v/s 15.8) compared to women with no symptoms. The odds of women giving birth to a child with SGA were twice as high for women with EPDS scores >11 (adjusted OR = 2.03; 95% CI = 1.12 - 3.70) compared to the women with EPDS scores of ≤11, The EPDS 12 (Adjusted OR = 1.96; 95% CI = 1.04 - 3.69) and EPDS 13 (Adjusted OR = 2.42; 95% CI = 1.24 - 4.70) cut-off categories also proved to be a risk factor for SGA with significant p-value (0.0006 and 0.0003) and the individuals with more than 13 EPDS score is found to have the highest odds of SGA. Conclusions: We found a strong association of antenatal depressive symptoms during pregnancy with SGA measured by EPDS. Thus, we recommend the implementation of timely and effective screening, diagnostic services, and evidence-based antenatal mental health services to combat SGA and further associated-metabolic syndromes.

Ethyl 3-amino-5-bromo-1-benzo-furan-2-carboxyl-ate.

The title compound, C11H10BrNO3, is close to planar with the benzo-furan unit and the ester group subtending a dihedral angle of 5.25 (2)°. The mol-ecular structure features an intra-molecular N-H⋯O inter-action. In the crystal, N-H⋯O hydrogen bonds involving carboxyl O-atom acceptors generate a chain extending along [201].

Ethyl 5-bromo-3-eth-oxy-carbonyl-amino-1-benzofuran-2-carboxyl-ate.

In the title compound, C14H14BrNO5, the ester group is disordered [occupancy ratio 0.52 (2):0.48 (2)]. The major component is nearly coplanar with the benzofuran plane, subtending a dihedral angle of 7.84 (2)°, while the amide group is twisted out of the benzofuran plane making a dihedral angle of 39.69 (2)°. An intra-molecular N-H⋯O hydrogen bond occurs. In the crystal, pairs of weak C-H⋯O hydrogen bonds link the mol-ecules into inversion dimers, which are further linked via strong N-H⋯O hydrogen bonds, generating a zigzag chain extending along [100].

Glutathione S-transferase and metallothionein levels in the freshwater prawn Macrobrachium malcolmsonhi exposed to mercury.

Healthy juveniles of M. malcolmsoniiwere exposed to 24.1 microg l(-1) of mercury (96 hr LC50: 145 microg l(-1) Hg) for a period of 21 days. The hepatopancreas and gills of the prawns were sampled on 8th, 15th and 22nd day of exposure. Accumulation and elimination of Hg, activity of glutathione S-transferase (GST), content of glutathione (GSH) and metallothionein (MT) level were studied. Mercury accumulation was found to be higher in the hepatopancreas (88.60 microg g(-1)) and lower in the gills (67.8 microg g(-1)). However, Hg elimination was found to be faster in the gills (62%) and slower in the hepatopancreas (58%). Therefore, the rate of Hg elimination did not match the rate of its uptake. The activity of GST was found to be higher in tissues of test prawns (5.94-9.13 nmol mg(-1) protein min(-1)) on all sampling days when compared with controls (3.454.23 nmol mg(-1) protein min(-1)). Similarly, the content of GSH was found to be higher in tissues of test prawns (0.80-1.43 micromol g(-1) protein) on all sampling days when compared with controls (0.55-1.00 micromol g(-1) protein). These results indicate the formation of glutathione conjugate in test prawns to eliminate Hg. The induction of MT level was also found to be higher in tissues of test prawns (57.50-75.76 nmol g(-1) protein) on all sampling days when compared with control (20.24-45.22 nmol g(-1) protein). This indicates the fact that sequestration of Hg has occurred for its easy elimination. Thus, induction of GST-GSH and MT ensured protection and adaptation of test prawns to thrive in Hg contaminated environment.

Ultrastructural observations in gills and hepatopancreas of prawn Macrobrachium malcolmsonii exposed to mercury.

The juveniles of M. malcolmsonii were exposed to 24.1 microg l(-1) of Hg fora period of 21 days. The gills and hepatopancreas of test prawns were sampled and processed for electron microscopic observations. Mitochondria are the organelle most affected in the gills of test prawns. The number of mitochondria and the electron-density of the matrix were found to be less in test prawns. The in-folding of cell membrane associated with mitochondria was absent in test prawns. This suggests that operation of the mitochondrial pumps was affected in the gills of test prawns. Vacuoles with crystalline granular inclusions were noted in the gills of test prawns. These are suggestive of metal-rich inorganic deposits or granules representing detoxified dumps of Hg. In the hepatopancreas of test prawns, the tubules exhibit vacuoles with granular inclusion and the cell cytoplasm contains electron-dense granules, which indicate a storage detoxification of Hg. The mitochondria were shrunken in the hepatopancreas of test prawns. This suggests attenuation of its function. The rough endoplasmic reticulum appeared vesiculated and dilated. These reactions denote the hyperactivity of the rough endoplasmic reticulum. Membranous whorl-like structures with myelin fibers and residual bodies were seen in the hepatopancreas of test prawns. Such structures indicate the involvement of lysosomal breakdown in detoxification process. The ultrastructural alterations are suggestive of the operation of compensatory mechanisms within the test prawns to enable it to tolerate Hg toxicity. However these alterations would have an impact on the cellular integrity of the gills and hepatopancreas and such alterations can be taken as 'biomarkers' for assessing Hg pollution in the aquatic environment.

Population based study of quality of diabetes care in southern India.

OBJECTIVES: To analyse and compare the clinical profile and glycaemic outcome in known diabetic cases in South Indian urban and periurban populations. MATERIAL AND METHODS: Details of known type 2 diabetic cases identified in a population survey of diabetes in Chennai city, Kanchipuram town and Periurban Villages (PUV) of Panruti in Tamil Nadu were analyzed (n=524, M:F, 256:268). Glycaemic outcome, prevalence of hypertension, dyslipidaemia and obesity, and treatment details were studied and compared between the areas. RESULTS: Mean age at diagnosis was 45.3 +/- 10.1 years, prevalence of hypertension was 57.4% (32% known), 48% were obese and a larger percentage (63.3%) had abdominal obesity Dyslipidaemia was present in nearly 50%. Abnormalities were more in urban areas than in PUV. Glycaemic target (post prandial glucose < or =160 mg/dl) was met by 28.8% only; better results were seen in PUV. In PUV 46% were not taking any diabetic treatment. As expected, majority of patients in all areas were treated with oral drugs. CONCLUSIONS: This population-based data indicated that the clinical outcome in known diabetic cases was far from satisfactory even in the city, where specialized diabetes care was available.

High prevalence of cardiometabolic risk factors among young physicians in India.

AIM: To assess the health status of young Indian doctors engaged in clinical practice compared with the general population. MATERIALS AND METHODS: During a continuing medical education programme on diabetes, data from 2499 doctors from urban and semiurban areas, (mean age 39.0 + 9.0 yrs), were collected and was compared with 3278 subjects from general population (mean age 37.0 +/- 8.0 yrs). Prevalence of diabetes, hypertension, obesity, dyslipidaemia, metabolic syndrome, smoking and alcohol consumption were analysed. RESULTS: Doctors had significantly higher (p<0.001) prevalence of all abnormalities except diabetes, compared with the general population (diabetes 13.3 Vs 14.8%, impaired glucose tolerance 10.7 Vs 7.4%, hypertension 35.6% Vs 27.0%, obesity 55.5% Vs 35.8%, metabolic syndrome 29.0% Vs 24.8%). Undetected cases of diabetes and hypertension were similar in both groups. Use of alcohol was more common among doctors. Other illness was less common among doctors (13.2% Vs 21.8%, p < 0.001). CONCLUSIONS: In India, doctors had high prevalence of metabolic disorders showing that they had not taken good care of their health. Doctors need to be motivated to practise good healthcare habits that they advocate to their clients.

Stress and undetected hyperglycemia in southern Indian coastal population affected by tsunami.

AIM: Natural calamities are known to result in higher stress conditions and also result in adverse health outcomes including development of non-communicable diseases. The impact of tsunami on mental stress and prevalence of hyperglycemic conditions was assessed in a population affected by the calamity in coastal populations of southern India. METHODS: Two populations similar in demography and physical characteristics, but, one affected by tsunami were selected for a comparative study. Subjects aged 20 years or above were randomly selected (control population n = 1176; tsunami population n = 1184). Details of stress were assessed using Harvard trauma questionnaire and scores were assigned. Glucose tolerance was assessed using 2h capillary blood glucose (75gms glucose load) and diagnosis was made using WHO criteria. RESULTS: Stress score was significantly higher in tsunami population. Although the total prevalence of diabetes was similar (control - 10.0 %; tsunami population - 10.5 %) prevalence of undetected diabetes (5.7 % vs. 3.8 %; Z = 9.54, P < 0.001) and impaired glucose tolerance (9.8 % vs. 8.3 %; Z = 12.83, P < 0.001) higher in the tsunami area. Stress score was higher in women and in the young in the tsunami area. CONCLUSION: Population affected by tsunami was under high stress and also showed a high prevalence of undetected diabetes and impaired glucose tolerance.

Enhanced catalytic and conformational stability of Atlantic cod trypsin upon neoglycosylation.

The applicability of psychrophilic enzymes is limited because of their lower thermodynamic stability in spite of their higher catalytic rate. In this study, we have shown that the thermodynamic stability of the psychrophilic Atlantic cod trypsin could be enhanced appreciably by covalent chemical modification with oxidized sucrose polymer without affecting its hydrolytic activity. The acquired stability of cod trypsin was found to be on par with the mesophilic porcine trypsin.

Effects of Hg and Cu on hemocytes-mediated functions in the prawn, Macrobrachium malcolmsonii.

Sublethal effects of Hg (9.6, 14.5 and 24.1 microg/l) and Cu (60.5, 90.8 and 150.5 microg/l) on the hemocytes-mediated functions in the juveniles of the economically important freshwater prawns, Macrobrachium malcolmsonii were investigated. The population of total hemocytes, percentile phagocytosis and superoxide anion production were found to be increased in test prawns exposed to the lowest sublethal concentration of these two metals in comparison to controls. This indicates the fact that a mechanism of host-defence was in an active state to encounter metal toxicity. The total hemocytes population, percentile phagocytosis and superoxide anion production were found to be decreased in test prawns exposed to intermediate as well as the highest sublethal concentrations of Hg and Cu when compared with controls. This suggests that high concentrations of both Hg and Cu have inhibitory effects on the immune functions of the hemocytes in the prawn, M. malcolmsonii.

Expression of heat shock protein 70 in freshwater prawn Macrobrachium malcolmsonii (H. Milne Edwards) following exposure to Hg and Cu.

Juveniles of freshwater prawn M. malcolmsonii were exposed to 1/6th concentration of LC50 of Hg and Cu for 48 hr. Sampling was done at 1 8, 12, 16, 24, 30, 36, 42 and 48 hr of exposure. Gill and hepatopancreas were dissected and subjected to one-dimensional electrophoresis. Western blotting was employed to determine the relative concentration of heat shock protein, hsp 70 (stress-70) in each sample. In the gill tissue of the prawn that had been exposed to Hg (0.024 mgHg 1(-1)), stress-70 was detected from the 1st hr till the 16th hr of exposure. But in the gills of Cu exposed prawn, synthesis of stress-70 appeared from the 1st hr till the 24th hr. Synthesis of hsp70 was not recorded after the 24th hr in the gills of exposed prawns. Synthesis of stress-70 was also found to be tissue-specific for both metals in this prawn. When the antibody probe raised against stress-70 was used, synthesis of stress-70 was not observed in hepatopancreas of prawns exposed to Hg or Cu, during the entire period of exposure of 48 hr. The expression of stress-70 in M. malcolmsonii following exposure to Hg and Cu is apparently only transient, and also a differential expression of stress-70 between gill and hepatopancreas was observed for both the metals.