Background: Anaemia is a cause of serious concern and contributes to a significantly higher maternal mortality. Rate Pressure Product (RPP) is a major determinant of myocardial oxygen consumption and blood flow. There is an increase in oxygen demand in anemia. Thus, in the present study, we have compared the difference in RPP between a normal pregnant women and pregnant women with anemia.Methods: A total of 180 pregnant women (normal pregnant woman - 90 and pregnant woman with anaemia - 90) belonging to different trimesters of pregnancy were included in the study. Age, height, and weight were recorded, and their body mass index was calculated. The systolic blood pressure, diastolic blood pressure, heart rate was recorded and RPP was calculated.Results: There was a significant increase in RPP in pregnant woman with anaemia in all three trimesters of pregnancy, but the significant increase was more in the third trimester.Conclusions: The present study shows that there is an increase in RPP in pregnant woman with anaemia and they are more prone to hemodynamic stress and cardiovascular risks, especially in their third trimester of pregnancy. This hemodynamic change may be taken into account to prevent the cardiovascular complications associated with anemia in pregnancy. Thus, RPP can be used as a sensitive non-invasive simple marker for early diagnosis of cardiovascular disease in pregnant woman.
Background: Sleep disturbances are common during pregnancy. The risk of sleep disturbances is estimated to be two times higher in the later part of pregnancy compared to the early trimester. Thus, the present study was planned to assess the sleep quality in different trimesters of South Indian pregnant women.Methods: This was a descriptive cross-sectional questionnaire-based study. A total of 90 healthy pregnant women with a mean age of 25 years were recruited and sleep quality was assessed using a standardized PSQI questionnaire. Mean global PSQI score of ≥5 is suggestive of poor sleep quality. A p value <0.05 was considered statistically significant.Results: Subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medications and daytime medication were found to be significantly higher in the second and third trimester (p<0.0001) pregnant women. Mean global PSQI score was ≥5 in the third trimester pregnant women.Conclusions: The present study shows that the sleep quality is disturbed during pregnancy and it is more in the third trimester of pregnancy. Pregnant women should be aware of the effects of sleep deprivation and adverse outcomes related to it. Thus, proper identification of sleep disturbances and a good awareness on the cumulative effects of the risk factors associated with sleep deprivation during pregnancy will help the physicians to manage and prevent the adverse maternal and fetal outcomes.
Objectives Carbamazepine (CBZ) is a first-line antiseizure drug used for focal onset seizures. It exhibits inter-individual variability in plasma carbamazepine levels and there are both genetic and non-genetic factors having a role in the requirement of CBZ maintenance dose. The aim was to study the influence of EPHX1 c.337 T>C and UGT2B7*2 genetic polymorphisms on CBZ maintenance dose requirement in persons with epilepsy. Methods Persons with epilepsy (PWE) of both gender of age 15–65 years on carbamazepine monotherapy who had been taking same maintenance dose for one year were eligible. Five milliliter of venous blood was collected in 10% EDTA under aseptic precautions. After centrifugation, the cellular component was used for DNA extraction and genotyping. For three genotypes of EPHX1 c.337 T>C and UGT2B7*2, the differences in mean carbamazepine dose were analyzed using Analysis of Variance (ANOVA). An unpaired t-test was used to draw a comparison between the genotypes and CBZ maintenance dose requirement for dominant and recessive models of EPHX1 c.337 T>C and UGT2B7*2. A value of p<0.05 was considered to be statistically significant. Results For UGT2B7*2 (rs 7439366), CT required a higher dose (CT 626 mg/day and TT 523 mg/day) but not found to be significant (p-value 0.167). PWE carrying CT genotype of EPHX1 c.337 T>C had 62 mg higher dose when compared to homozygous mutant CC (590 mg/day for CT and 528 mg/day for CC) but p-value was not found to be significant (p-value 0.835). Conclusions The results of our study done in 115 PWE showed there was a lack of association between SNPs of EPHX1 c.337 T>C, UGT2B7*2 and CBZ maintenance dose requirement in Southern part of India and this finding has to be confirmed in a larger sample size.
The “National Guidelines for Gene Therapy Product (GTP) Development and Clinical Trials” prepared by the Indian Council of Medical Research and Department of Biotechnology in 2019 came as a welcome step in the process of regulation of gene therapy research, as there was a lack of Indian guidelines earlier specific to gene therapy. Indian researchers have taken their step in setting the path of gene therapy research, and this guideline serves to provide the standards starting from its development up to translation to new drug including the ethical, scientific, and regulatory requirements to be followed during the conduct of trial. The Indian guidelines were framed with reference to United States-Food and Drug Administration and European Union guidelines on gene therapy. It is the responsibility of all the stakeholders involved in the development of GTP to adhere to the national guidelines. This review provides an outline of the Indian regulatory guidelines on GTP.
Background: The occurrence of metabolic abnormalities in schizophrenic patients has been increased with the rampant use of second-generation antipsychotics. The aim and objective of this study is to compare the metabolic derangements induced by a typical antipsychotic: haloperidol and an atypical antipsychotic, risperidone in patients with newly diagnosed schizophrenia in a tertiary care hospital.Methods: Out of 60 newly diagnosed schizophrenic patients, 30 patients received tablet haloperidol and the remaining 30 patients received tablet risperidone orally. The anthropometric measurements like height, weight, waist circumference was measured and blood investigations like fasting blood glucose level and fasting lipid profile were taken at baseline and at the end of 3 and 6 months of drug therapy. The metabolic derangements induced by the two antipsychotics were compared and analyzed at end of 3rd and 6th month using SPSS software version 16.Results: At the end of 6th month statistically significant differences (p<0.05) were observed in weight, waist circumference, fasting blood sugar, fasting triglyceride and high-density lipoprotein level between the haloperidol and risperidone group on following the International Diabetic Federation (IDF) criteria of metabolic syndrome. Risperidone caused metabolic abnormalities in 13.3%, 4 patients whereas none of the patients in haloperidol group developed metabolic syndrome.Conclusions: Hence it is concluded that the atypical antipsychotic risperidone has been associated with an increased risk of causing metabolic abnormalities than the typical antipsychotic haloperidol. Regular and periodic monitoring of the anthropometric and metabolic parameters in schizophrenic patients on antipsychotics especially the atypical antipsychotics is mandatory to prevent further complications.
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