Background: Obesity in pregnancy is of great concern in Kerala. According to the National Family Health Survey-3, Kerala holds second position next to Punjab, with a 34% prevalence of overweight and obesity. Based on consensus guidelines, the BMI categories for Asian Indians have been revised and categorized overweight as a BMI of 23.0 -24.9 kg/m2 and obesity as a BMI >25 kg/m2. This study aims to determine the pregnancy outcome among overweight and obese women and compare the pregnancy outcomes among overweight and obese with normal BMI women. Materials and Methods: A retrospective observational study was conducted at Travancore Medical College Kollam Kerala for six months. The revised consensus guidelines for Asian Indians were considered for BMI categorization. Results: 63.9% of pregnant women were either overweight or obese of the total 399 pregnant women. Gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH) were the common antenatal complications significantly associated with overweight and obese women. Preterm labor was also significantly increased in overweight and obese women. Conclusion:Obesity is a rising public health concern in Kerala reflected in pregnancy, with an increase in adverse pregnancy outcomes. Obesity is a modifiable risk factor that health care providers need to address during preconception, antepartum, intrapartum, and postpartum periods, thereby preventing obesity complications.

Aim: A peripheral inflammatory response can drive neuroinflammation in a number of infections including human immunodeficiency virus (HIV). Monocyte/macrophage (M/Mφ) activation is a hallmark of acute HIV infection and a source of chronic inflammation in a subset of HIV-infected individuals. We sought to decrease peripheral inflammation and M/Mφ transmigration after HIV infection by engineering extracellular vesicles (EV) to antagonize a microRNA (miR) associated with inflammation. We hypothesized that induced pluripotent stem cell (iPSC)-derived monocyte EVs (mEVs), engineered to contain an antagomir to miR-155 (αmiR mEV) would target monocyte inflammation and influence neuroinflammation in an HIV-infected humanized mice. Methods: mEVs were characterized by tetraspanins, nanoparticle tracking analysis, electron microscopy, and their preferential entry into circulating monocytes as well as testing for endogenous selected miRNAs. HIV-infected humanized mice were treated with control or antagomir155 mEVs. Plasma viral load was measured plus activation markers on lymphocytes and monocytes and the number of macrophages in the brain was quantified. Results: mEVs preferentially entered peripheral monocytes. HIV infection increased C-C chemokine receptor type 5 (CCR5) and major histocompatibility complex, class II, DR (HLA-DR) expression on T cells and monocytes. Treatments with mEVs did not decrease plasma HIV viral load; however, mEVs alone resulted in a decrease in %CCR5+ and %HLA-DR+ on T cells and an increase in %CCR5+ monocytes. αmiR mEVs decreased %CCR5 on M/Mφ. The mEV-treated HIV-infected mice did not show an increase in macrophage transmigration to the brain. Conclusion: mEVs alone caused an unexpected decrease in lymphocyte activation and increase in monocyte %CCR5; however, this did not translate to an increase in macrophage transmigration to the brain.

The rapid rise in CS has become a grievous public health issue and have found increasing since the routine use of better facilities. This study assesses the common indications of LSCS and improve quality of obstetric care by taking steps to reduce unnecessary cesarean sections. Methods: This retrospective study was conducted among 381 women who delivered by cesarean section in a duration of 1 year at Travancore Medical College, Kerala. Variables including age, parity, gestational age, CS timing (elective or emergency), indications for LSCS were collected from their case records and entered in the proforma. Descriptive statistics used for the analysis. Results: The prevalence of LSCS was 45.84%. Out of the 381 LSCS performed, 44% were emergency cases and 56% were elective. Previous LSCS was the most common indication (153 cases, 42.5%), followed by failure of induction of labor (92 cases, 24.13%). Conclusion: Indications for LSCS are common in most institutions globally. The most common indication in the audit was previous LSCS, followed by failed induction of labor. Efforts should be made to focus on reducing the primary LSCS rates thereby reducing common indication of previous LSCS in subsequent pregnancies.

Background: Birth weight of <2.5 kg at birth is considered low birth weight and impacts the individual's health during their adult life. Babies are born with low birth weight, both in term and preterm deliveries. This study aims to find the incidence of term low birth weight babies (TLBW) and the maternal risk factors associated with the same.Methods: This case-control study was conducted on 166 pregnant women who had term live births during the study period July 2019 to December 2020. Inclusion criteria: Women with a live singleton TLBW (<2.5 kg) - cases (63) and normal birth weight babies - controls (103). Control group selection was 1:2 proportion as per the cases. Exclusion criteria consisted of women with multiple gestations. Binary and categorical variables were presented using counts and percentages. Independent sample t-test was used to compare two continuous variables, and the chi-square test/Fisher's exact test was used to find the association of categorical variables.Results: 1344 live births were reported during the study period, of which 63 cases were TLBW babies with an incidence of 4.68%. Among the baseline parameters, significant difference was observed only in body mass index (BMI). After assessing the common risk factors like anemia, urinary tract infection (UTI), genital tract infection, gestational diabetes mellitus (GDM), and gestational hypertension, only hypothyroidism showed significant association with TLBW (OR: 2.240, 95% CI:0.98-5.13, p=0.006).Conclusions: The incidence of TLBW babies was 4.68%, which is low compared with other studies. Hypothyroidism shows significant association with TLBW in this study which was not observed in previous literature.

Background: Overweight or obesity is a major risk factor for maternal complications. Most western countries adhere to WHO guidelines for classifying obesity. In India, revised consensus Body Mass Indices (BMI) for Asian Indians are used for BMI classification. The present study aims to compare WHO and revised consensus BMI criteria for Asian Indians on the maternal outcome in overweight and obese women. Methodology: This was a retrospective study done in 399 women with singleton deliveries during a period of six months in a tertiary care center in South India. Data were gathered from medical records in accordance with the inclusion and exclusion criteria. Two proportion Z-test and Independent t test were used for the comparison between the WHO and revised consensus BMI for Asian Indian criteria. Results: Overweight/obesity prevalence was 40.60% as per WHO criteria and 63.91% as per Asian Indian criteria. Proportionate difference was significant for the parameters GDM, PIH, and preterm labor between obese and nonobese women in Asian Indian criteria. WHO criteria showed significant difference in GDM and PIH only (p <0.05). Preterm labor was found to be insignificant between both criteria among non-obese women (p>0.05). Conclusion: The study could not find statistically significant differences between the two criteria. As the body fat distribution in Asian Indians differs considerably from other ethnic groups, we recommend the use of revised consensus BMI for Asian Indians for BMI classification to prevent maternal morbidity and mortality.