A clinical study of fetal outcome following early and delayed cord clamping in births associated with anemia in pregnancy.

Background: As there is a risk for infant anaemia, early cord clamping which is usually performed at 10-15 seconds of delivery was changed to delayed cord clamping for at least for 30 seconds Delayed cord clamping (DCC) increases the blood volume and haemoglobin levels in newborns and reduces risk of iron deficiency anaemia in both term and preterm infants.Early clamping allows cord blood collection in benefit for transplantation of stem cells. Research Objective: To compare levels of haemoglobin, hematocrit and serum ferritin at birth and 4 weeks of age in babies as well as neonatal outcome following early and delayed cord clamping in births associated with anaemia in pregnancy. Study Design: An observational study. Participants: Anaemic pregnant women with period of gestation 32-40 weeks admitted in labour room for delivery were enrolled. Intervention: Grouping of the patients was done according to the timing of the umbilical cord clamping. 1. Early cord clamping (< 60 seconds) 2. Delayed cord clamping (1 - 3 minutes) Of which 58 subjects were in ECC (early cord clamping)and 62 were in DCC (delayed cord clamping)group. Results: There was no significance of ECC or DCC in developing polycythemia, IVH or hyperbilirubinemia or increased need of blood transfusion. The levels of haemoglobin, hematocrit and ferritin levels were showing significant increased among DCC as compared to ECC. Conclusion: Delayed cord clamping significantly increases the levels of haemoglobin, Serum ferritin and hematocrit at 4 weeks of age. It should be recommended in routine practice where it is not contraindicated especially in resource- poor settings.

Components of IGF-axis in growth disorders: a systematic review and patent landscape report.

PURPOSE: In this review, epi/genetic mutations of IGF-axis components associated with growth disorders have been summarized alongwith assessment of relevant diagnostic and therapeutic technology through patent literature. METHODOLOGY: PROSPERO protocol registration CRD42021279468. For scientific literature search Literature databases (PubMed, EMBASE, ScienceDirect, and Google Scholar) were queried using the appropriate syntax. Various filters were applied based on inclusion and exclusion criteria. Search results were further refined by two authors for finalizing studies to be included in this synthesis. For patent documents search Patent databases (Patentscope and Espacenet) were queried using keywords: IGF or IGFBP. Filters were applied according to International Patent Classification (IPC) and Cooperative Patent Classification (CPC). Search results were reviewed by two authors for inclusion in the patent landscape report. RESULTS: For scientific literature analysis, out of 545 search results, 196 were selected for review based on the inclusion criteria. For Patent literature search, out of 485 results, 37 were selected for this synthesis. CONCLUSION: Dysregulation of IGF-axis components leads to various abnormalities and their key role in growth and development suggests epi/mutations or structural defects among IGF-axis genes can be associated with growth disorders and may explain some of the idiopathic short stature cases. Trend of patent filings indicate advent of recombinant technology for therapeutics.

Gene-editing, immunological and iPSCs based therapeutics for muscular dystrophy.

Muscular dystrophy is a well-known genetically heterogeneous group of rare muscle disorders. This progressive disease causes the breakdown of skeletal muscles over time and leads to grave weakness. This breakdown is caused by a diverse pattern of mutations in dystrophin and dystrophin associated protein complex. These mutations lead to the production of altered proteins in response to which, the body stimulates production of various cytokines and immune cells, particularly reactive oxygen species and NFκB. Immune cells display/exhibit a dual role by inducing muscle damage and muscle repair. Various anti-oxidants, anti-inflammatory and glucocorticoid drugs serve as potent therapeutics for muscular dystrophy. Along with the above mentioned therapeutics, induced pluripotent stem cells also serve as a novel approach paving a way for personalized treatment. These pluripotent stem cells allow regeneration of large numbers of regenerative myogenic progenitors that can be administered in muscular dystrophy patients which assist in the recovery of lost muscle fibers. In this review, we have summarized gene-editing, immunological and induced pluripotent stem cell based therapeutics for muscular dystrophy treatment.

Non-variceal gastrointestinal bleed in children: surgical experience with emphasis on management challenges.

PURPOSE: This exclusively surgical series on pediatric non-variceal gastrointestinal bleed (NVGIB) defines three levels of bleed site and describes etiology, bleed severity, diagnostic algorithm, and surgical management for each bleed site. Management challenges are detailed. METHODS: Patients aged ≤ 18 years treated surgically for NVGIB were analysed. RESULTS: Bleed site (n = 87) was classified as: upper gastrointestinal bleed (UGIB; n = 11); small bowel bleed (SBB: n = 52); and lower GIB (n = 24). Four etiology-based groups were identified: lesions with ectopic gastric mucosa (EGM; n = 33), tumours (n = 23), ulcers (n = 21), and vascular pathology (n = 8). Bleed severity spectrum was: acute severe bleed (n = 12); subacute overt bleed (n = 59); and occult GIB (n = 16). Preoperative diagnosis was obtained in all UGIB and LGIB lesions. Eighty-two percent of surgical SB lesions were diagnosed preoperatively on Tc99m pertechnetate scan, computed tomography enterography-angiography, and capsule endoscopy; remaining 18% were diagnosed at laparotomy with intra-operative enteroscopy (IOE). Surgical management was tailored to bleed site, severity, and etiology. Indications of IOE and approach to management challenges are detailed. CONCLUSIONS: The commonest site-specific bleed etiologies were duodenal ulcers for UGIB, EGM lesions for SBB, and tumours for LGIB. SBB presented diagnostic challenge. Diagnostic algorithm was tailored to bleed site, age-specific etiology, bleed severity, and associated abdominal/systemic symptoms. Management challenges were acute severe bleed, occult GIB, SBB, obscure GIB, and rare etiologies. IOE has a useful role in SBB management.