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OBJECTIVES: Electronic fetal monitoring (EFM) is used to identify early signs of fetal deterioration. However, caution is advised when interpreting cardiotocographic parameters. A promising alternative is umbilical cord blood sampling. The analysis of blood gases and lactate levels in the cord within the initial minutes of life is a recommended approach. STUDY DESIGN: This prospective cohort study, conducted over eighteen months from June 2021 to December 2022, enrolled 70 patients with non-reactive and 70 with reactive cardiotocograph (CTG) patterns. APGAR scores were recorded at 1 and 5-minute intervals. 1 ml of umbilical artery blood was assessed in an arterial blood gas machine and fetal acidosis was defined as pH <7.0 and a lactate concentration exceeding 4 mmol/L. RESULTS: In the non-reactive CTG group, 35.7% had early decelerations, 37.1% had variable decelerations, and 17.1% had late decelerations (p<0.001). The mean cord blood lactate was 5.220±1.970 mmol/L in the non-reactive CTG group and 3.400±0.228 mmol/L in the reactive CTG group. Similarly, the mean cord blood pH was 7.030±0.007 in the non-reactive CTG group and 7.170±0.076 in the reactive CTG group (p<0.001). 14.3% of cases in the non-reactive CTG group had a 5-minute APGAR <7, with a higher APGAR score in the reactive group. CONCLUSION: The study suggests that abnormal or indeterminate CTG readings are linked to a higher risk of intrapartum fetal acidosis. Non-reactive CTG results were associated with higher mean cord blood lactate and pH levels and more number of Neonatal Intensive Care Unit (NICU) admissions. There is a definite correlation between abnormal CTG patterns and poorer neonatal outcomes. [ABSTRACT FROM AUTHOR]

Although a preference for sons is reportedly a universal phenomenon, in some Asian societies daughters are considered financial and cultural liabilities. Increasing availability of ultrasonography and amniocentesis has led to widespread gender screening and selective abortion of normal female foetuses in many countries, including India. Feminists have taken widely divergent positions on the morality of this practice. Feminists from India have strongly opposed it, considering it as a further disenfranchisement of females in their patriarchal society, and have agitated successfully for legislative prohibitions. Libertarian feminists on the other hand, primarily from the United States, have argued that any prohibition of the use of this technology is a curtailment of a woman's reproductive choices and a violation of her right to make autonomous decisions regarding procreation. Using India as an illustrative case, this paper argues that in the context of what prevails in some societies, an ethical argument that hinges on the principle of autonomy as understood in the West can be problematic. Furthermore, a liberal theoretical assumption that it is always better to have more rather than fewer choices may not hold up well against the realities of life for such women. Although feminists have little disagreement concerning substantive matters, it is in the area of strategy that differences of opinion have arisen, their moral reasoning and responses shaped by the culture, ethnicity, class and race to which they belong. A view that a single ‘orthodox’ feminism of any variety can embody the aspiration of all women reverts to the problematic issues in the evolution of the rationalistic, individualistic, ‘male’ ethics against which women have consistently raised objections. [ABSTRACT FROM AUTHOR]

This article aims to trace and describe the bioethical threads in medical practice and the understanding of medicine among Tibetan refugees living in India. Taking up such a task results mainly from the fact that only traces of bioethical reflection are visible in Tibetan society, but without the awareness that it requires systematic reflection on its essence and changes that accompany modern medicine. I define the state of the discussion on Tibetan bioethics as preparadigmatic, i.e., one that precedes the recognition of the importance of bioethics and the elaboration of its basic concepts. In this paper, I will show how the Tibetan refugees today, in an unconscious way, approach bioethics, using the example of life-related topics, namely beginning and death. To this end, I chose topics such as abortion, fetal sex reassignment, euthanasia, and suicide. On this basis, I will indicate the main reasons that hinder the emergence of bioethics and those that may contribute to systematic discussions in the future. An introduction to Tibetan medicine will precede these considerations. I will show how medical traditions, especially the Rgyud bzhi text, are related to Tibetan Buddhism and opinions of the 14th Dalai Lama. [ABSTRACT FROM AUTHOR]

The 2021 census does not show a very good picture of the sex ratio in India. The missing female feotues are a great challenge for society and administration. Though we have PC and PNDT Act for prevention of female foeticide, there are various issues of interpretation which have been addressed by the judiciary. This article aims at evaluation of the issues and their interpretation so that through constructive implementation we are able to pave our way to a better gender balance in our society. The article begins with the proportion of the challenge of missing female foetus The judicial stance has been tilted towards complete prohibition of sex determination even in case of surrogacy and test tube babies. Similarly public interest seems to be the thread running around the judicial precedents. Nevertheless, effectiveness of these judicial precedent lies in a change of attitude towards girl child. [ABSTRACT FROM AUTHOR]

Background: Aplasia cutis congenita is regarded as congenital focal absence of skin in the newborn, and occurrence of more than three similar skin defects is rare. The etiology is thought to be multifactorial, and precise etiopathogenesis is unknown.Case Presentation: A 13-day-old newborn Sri Lankan Tamil girl was referred to the dermatologic clinic with multiple skin defects at birth. There were six lesions on the body, and two of them had healed during intrauterine period, leaving scars. This was a second twin of her pregnancy. Her first twin fetus had demised before 19 weeks of pregnancy and was confirmed to be fetus papyraceous based on ultrasound-guided fetal assessment. The said child was thoroughly investigated and found to have no other congenital abnormalities. Chromosomal studies yielded normal findings. She was treated with tropical antibacterial ointment, and all lesions resolved spontaneously within 4 weeks, leaving scars. Physiotherapy was commenced to prevent contracture formation, and follow-up was arranged in collaboration with the plastic surgical team.Conclusions: Aplasia cutis congenita is a rare condition of uncertain etiology, but consanguinity may play a role. This report described a newborn with type V cutis aplasia congenita in whom the diagnosis was confirmed based on clinical features and revision of antenatal history. The management depends on the pattern, extent, location, severity, underlying causes, and associated anomalies. [ABSTRACT FROM AUTHOR]

India's Integrated Child Development Services (ICDS) provides daily supplementary nutrition and other public health services to women and children. We estimated associations between exposure to early‐childhood ICDS nutrition and adult reproductive outcomes. During 1987–1990, a balanced protein–calorie supplement called "upma"—made from locally available corn–soya ingredients—was rolled out by subdistricts near Hyderabad and offered to pregnant women and children under age 6 years. In a controlled trial, 15 villages received the supplement and 14 did not. We used data from a 2010–2012 resurvey of adults born during the trial (n = 715 in intervention and n = 645 in control arms). We used propensity score matching methods to estimate the associations between birth in an intervention village and menarcheal age, age at first pregnancy, and fertility of adults. We found that women born in the intervention group during the trial, as compared with the control group, had menarche 0.45 (95% confidence interval [CI: 0.22, 0.68]; p <.001) years later and first pregnancy 0.53 (95% CI [0.04, 1.02]; p <.05) years later. Married women from the intervention group had menarche 0.36 (95% CI [0.09, 0.64]; p <.01) years later, first cohabitation with partner 0.8 (95% CI [0.27, 1.33]; p <.01) years later, and first pregnancy 0.53 (95% CI [0.04, 1.02]; p <.05) years later than married women in the control group. There was no significant difference between intervention and control group women regarding whether they had at least one childbirth or the total number of children born. The findings were similar when we employed inverse propensity score weighted regression models. [ABSTRACT FROM AUTHOR]