Perinatal Transmission and Outcomes of SARS-CoV-2 Infection.

Maternal SARS-CoV-2 infection can adversely affect the birth and neonatal outcomes. The authors prospectively enrolled 196 neonates born to 193 SARS-CoV-2-positive mothers to determine the rate of mother-to-baby transmission of SARS-CoV-2 and its effect on short-term neonatal outcomes in Indian population. Nineteen babies turned out to be RT-PCR-positive for SARS-CoV-2, carrying a perinatal transmission rate of 9.8%. Rates of prematurity and low birth weight were 12.8% and 18.9% in the neonatal group, respectively. On comparing SARS-CoV-2-positive (n = 19) and negative (n = 177) neonatal groups, rate of prematurity, hospital admission rate, and death rate were higher in the former group. The placental positivity rate for SARS-CoV-2 was 8.1%, but no relation was found between placental and neonatal infection.

Towards a sustainable organic waste supply chain: A comparison of centralized and decentralized systems.

Proper disposal of Municipal Solid (MSW) waste is an important issue as it causes land, air, and water pollution. Organic MSW provides a habitat environment to insects and often it spreads dangerous diseases. Major reasons identified behind this as the non-separation of MSW at the source and lack of facilities (bins) in the appropriate place for collection of wastes. The present study has proposed an integrated three-stage model to provide a solution to the problem of (i) allocation of the bin for waste collection, (ii) allocation and comparison of centralized and decentralized composting plants, and finally, (iii) vehicle routing for waste collection. The proposed generic model is applied to an Indian city, Bilaspur located in the state of Chhattisgarh. From the results, it is observed that the first stage model provides an optimal number of bins required and allocation of it at minimum cost. Taking it as input for the second stage model, it identifies the best locations for centralized and decentralized composting plants. The result also reveals that decentralized composting plants are more economical than centralized plants. Finally, the third stage of the model identifies the vehicle routing for the waste collection considering both centralized and decentralized plants to minimize the cost. Further, sensitivity analysis is carried out on collection rate and participation percentage parameters to draw additional insights for better management of MSW.

Modeling and identification of suitable motivational mechanism in the collection system of municipal solid waste supply chain.

Many studies have identified that incentive, subsidy, and reward-penalty mechanisms improve the collection rate of recyclables and end of life products. But there is a lack of studies mathematical models and analysis of these mechanisms in the context of municipal solid waste supply chain. Therefore, in this study, models have been formulated for municipal solid waste supply chain (profit) considering government and collectors' profit under incentive, subsidy, and reward-penalty mechanisms. The study has analysed the models against the non-separation and separation scenario of waste. A numerical analysis is performed and observed that: (i) separation of waste at source along with incentive, subsidy, and reward-penalty mechanisms scenario improve the collection rate by 17%, 23%, 30%, and 45% compared to non-separated MSW. (ii) Incentive, subsidy, and reward-penalty mechanisms increases the total supply chain profit by around 9%, -36% and 18%. (iii) reward-penalty mechanism performs better than incentive and subsidy mechanism by providing the high supply chain profit (18% and 85%) and collection rate (22% and 15%) comparatively. Further, sensitivity analysis carried out to understand the behaviour of the models against the key parameters. The study also develops interesting propositions and proved for a better understanding of the models. From results, some key managerial insights have been drawn and a few future scopes of the study are presented.

Comparison of the efficacy and safety of indomethacin, ibuprofen, and paracetamol in the closure of patent ductus arteriosus in preterm neonates - A randomized controlled trial.

INTRODUCTION: In this prospective study, we compared the efficacy and safety of ibuprofen, indomethacin, and paracetamol in the closure of patent ductus arteriosus (PDA) in preterm neonates. MATERIALS AND METHODS: This randomized prospective study was conducted in the Division of Pediatric Cardiology, M. D. M and Umaid Hospital, Jodhpur. A total of 105 preterm neonates with gestational age <37 weeks and hemodynamically significant PDA (hs-PDA) diagnosed clinically and confirmed by echocardiography were enrolled. All neonates were randomly assigned in a ratio of 1:1:1 to oral indomethacin (Group A, 3 doses at an interval of 12 h with a starting dose of 0.2 mg/kg), oral ibuprofen (Group B, 10 mg/kg ibuprofen followed by 5 mg/kg/day for 2 days), or IV paracetamol (Group C, 15 mg/kg every 6 hourly for 3 consecutive days). After the completion of the first course, neonates were assessed clinically as well as by echocardiography to confirm PDA closure. If PDA remained open, the second course of the same drug was given and repeat assessment was done within 24 h of the last dose. In addition to an echocardiographic examination, complete blood counts, renal and liver function tests were performed. RESULTS: Our study shows that there was no significant difference observed in PDA closure among all the three treatment groups after the completion of two courses of treatment. The cumulative rate of PDA closure was 68% in the indomethacin group, 77.14% in the ibuprofen group, and 71.43% in the paracetamol group (P = 0.716). There were no significant changes found in Hb, platelet, blood urea nitrogen (BUN), creatinine, and liver enzymes after treatment in the paracetamol group (P > 0.05). BUN and serum creatinine levels were significantly increased after treatment in indomethacin and ibuprofen groups (P < 0.0001 and P < 0.05, respectively). CONCLUSION: Our study shows that IV paracetamol is as effective as indomethacin and ibuprofen in promoting the closure of hs-PDA in premature infants with a better safety profile.

Relationship between T2* magnetic resonance imaging-derived liver and heart iron content and serum ferritin levels in transfusion-dependent thalassemic children.

CONTEXT: T2* magnetic resonance imaging (MRI) is being increasingly used for the assessment of organ iron content in thalassemics, but cost is a major prohibitive factor for repeated measurements. If serum ferritin correlates well with the T2* MRI liver and heart, it will be economical and more simple tool to assess organ iron deposition. AIMS: The aim of this study was to find out the relationship between serum ferritin level and T2* MRI-derived liver and heart iron content in transfusion-dependent thalassemic children. SETTINGS: Thalassemia day-care center of a teaching hospital. DESIGN: This was a cross-sectional study. SUBJECTS AND METHODS: Seventy-three transfusion-dependent beta thalassemic children belonging to 2-18 years of age were subjected to T2* MRI of heart and liver to assess their iron content. Values obtained here were related to serum ferritin. STATISTICAL ANALYSIS USED: Keeping the correlation between serum ferritin and T2* MRI as primary outcome, spearman's correlation coefficient was calculated. RESULTS: We found poor (negative) correlation between serum ferritin level and T2* MRI liver (r = -0.448, P = 0.000) but no correlation between serum ferritin and T2*MRI heart (r = -0.221, P = 0.060). CONCLUSIONS: Serum ferritin cannot reliably predict the liver and heart iron content in Indian children with ß thalassemia.