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Introduction: Optimal human milk (HM) B-vitamin concentrations remain undefined, especially in areas where undernutrition is prevalent. The impact of supplementation pre-conception through pregnancy on HM B-vitamin composition remains unknown. Methods: Human milk (HM) was collected at 2-weeks postpartum from 200 women in Guatemala, India, and Pakistan (the Women First Trial). The women were randomized to start a lipid-based nutrient supplement before conception, at end of the first trimester, or not at all; intervention continued until delivery. HM concentrations of eight B-vitamins and choline were assessed via ultra-performance liquid chromatography-tandem mass spectrometry. Maternal diet was assessed in early pregnancy, and infant growth followed through 6 months post-delivery. Results: Despite supplement exposure averaging 15.7 (pre-conception arm) and 6.0 months (prenatal arm), HM B-vitamins did not differ between arms, but site differences were evident. Guatemala had higher HM concentrations of vitamin B3 than Pakistan and India. Pakistan had higher HM concentrations of thiamin and vitamin B6 than India and Guatemala. Cohort average HM vitamin B2 (162 ± 79 μg/L) and B6 (31.8 ± 24.6 μg/L) fell below values defined as deficient in 81.5 and 85.5% of samples, potentially reflecting sampling procedures and timing. Maternal dietary intakes of only vitamin B6 and choline were associated with the corresponding concentrations in HM (p < 0.005). No HM B-vitamin concentrations were associated with infant growth. Conclusion: Prenatal supplementation for at least 6 months had no impact on HM B-vitamin concentrations at 2-weeks postpartum. Results suggest that the adequacy of HM composition was generally maintained, with potential exceptions of vitamin B2 and B6.

INTRODUCTION: Naadi pariksha is a historical diagnostic skill of physicians to examine the state of dosha (dosha avasta) in patients. Although this is a commonly used examination, there is still a need for standardization in the collection of data and reliability of the diagnostic technique. Considerable researchers have been conducted on the pulse classification based on its characters but this study was conducted to analyze the repeatability of arterial pulse-based diagnosis (Naadi pariksha) by test-retest method in a single group. AIM: The study aims to test and retest the repeatability of the arterial pulse-based diagnosis. The naadi parameters such as pulse wavelength and pulse character were tested for repeatability in the gap period of 9-18 min in a controlled environment. MATERIALS AND METHODS: This was an observational study conducted in Belagavi. An Ayurveda physician examined the pulse of 30 healthy volunteers twice, within an interval of 9-18 min. A random sampling of volunteers was adopted (to avoid bias), and the data were recorded graphically as per the study protocol. This study was conducted for 6 days with five participants per day for examination. The Naadi pariksha was done to examine the pulse wavelength and pulse character. The data obtained from the test and retest of Naadi pariksha were statistically analyzed using paired t-test to study the difference between both the test-retest methods. RESULTS: All the data collected from the naadi examination were statistically analyzed using IBM SPSS Statistics 26. The mean difference in pulse wavelength was 0.004 mm (standard deviation [SD]: 0.2067 mm, degree of freedom (df): 29, and t: 0.106). There was no statistically significant difference between the two variables: test and retest pulse wavelength (P > 0.05). The mean difference in pulse character was 0.333 mm (SD: 1.64177 mm, df: 29, and t value: 1.112). There was no statistically significant difference between the two variables: test and retest pulse wavelength (P > 0.05). CONCLUSION: The reliability and repeatability of pulse-based diagnosis depend on the adaptation of standardized techniques in arterial pulse data collection along with the training, maintaining the controlled environment, and experience of a physician in naadi pariksha. Quantification of the physiological signals has become more important to create evidence and research documentation. The results of this study suggest that an identical report may be obtained on repetition of the test within 9-18 min. This demonstrates the repeatability of arterial pulse-based diagnosis (naadi pariksha). [ABSTRACT FROM AUTHOR]

Background: The fundamental principle of ayurveda is the tridosha theory (three doshas). These dosha are the causative and governing bio-energies responsible for the formation of body constitution. The vata dosha dominant personality have classical features like a small body frame when compared to kapha with large body built and broad anatomical structures. Pittaja body constitution has medium body built with reddish colouration and sharp features. Aim: This study aimed to correlate the radial artery intima-media thickness (IMT) and luminal diameter (LD) and further study its association with different body constitution (prakriti) and check the difference between the groups of prakriti. Methods: This observational cross-sectional study was done between May 2021 and June 2021 in the Department of Radiology, KLE Prabhakar Kore Charitable Hospital, Belagavi. Non-randomly selected volunteers ≥23 ±5years (n = 35) were divided into body constitution (prakriti) groups and evaluated for the IMT, LD (luminal diameter) of the radial artery using B-mode ultrasonography. Pearson's co-relation was used to test the corelation between the luminal diameter and intimae media thickness of distal radial artery. Chi-square test of independence was used to check the association between luminal diameter and intimae media thickness of distal radial artery with body constitution. One-way ANOVA was used to study the difference between the groups of prakriti. Results: The mean luminal diameter (LD) in vataja body constitution (5%) was 1.450 ± 0.495 mm, pittaja body constitution (11%) was 1.750±0.10 mm, kaphaja constitution (11%) was 1.70± 0.30 mm, vatapittaja body constitution (11%) was 4.15±0.47 mm, vatakaphaja body constitution (26%) was 1.64±0.83 mm, pittakaphaja constitution (23%) as 2.3±0.15 mm and samadhatuja constitution (11%) had 1.8±0.189 mm. The mean intima media thickness (IMT) in vataja body constitution (5%) was 0.05± 0 mm, pittaja body constitution (11%) was 0.03±0 mm, kaphaja constitution (11%) was 0.05± 0.014 mm, vatapittaja body constitution (11%) was 0.107±0.09 mm, vatakaphaja body constitution (26%) was 0.83±0.07 mm, pittakaphaja constitution (23%) was 0.313±0.006 mm and samadhatuja constitution (11%) had 0.350 ± 0.012 mm. As per the analysis a low positive Pearson's correlation was found between IMT and LD (r = 0.254) between the luminal diameter (LD) and intima medial thickness (IMT) of distal radial artery. Chi square test of independence has shown significant association between DRA dimensions (IMT, LD) and body constitution (prakriti), palpatory blood vessel consistency. Among the observed values the vatakaphaja body constitution (0.83±0.07 mm) had increased intima media thickness (IMT). Among all the observed values the vatapittaja body constitution had broadest DRA luminal diameter (LD) of 4.15±0.47mm. One way ANOVA showed no significant difference between the groups of prakiti and IMT, LD of distal radial artery. Conclusion: As per the observations of the present study different body constitution (prakriti) did not show any significant impact on distal radial artery dimensions (IMT and LD) as there are various factors like hormones, neural, blood volume regulators involved in vascular constriction and dilation. The prakriti assessment is a strong marker for prediction and the early diagnosis of diseases. This body constitution (prakriti) of an individual is the basic constituent on which the pulse wave variability of distal radial artery (DRA) acts. [ABSTRACT FROM AUTHOR]

Introduction: Cadmium is one of the most dangerous and toxic occupational heavy metal. Exposure of cadmium is one of the risk factor for diabetes. This study aimed to assess the simultaneous effects of Black Tea Extract (BTE) on cadmium chloride induced alterations in oral glucose tolerance. Methods: In this study, BTE on cadmium chloride induced alterations in oral glucose tolerance test (OGTT) and pancreas histology were assessed. Adult rats were divided into four groups (n=6/group), group I (normal saline), group II (CdCl2, 1.0 mg/kg body weight; intraperitoneal), group III (black tea extract, 2.5 gm tea leaf/dl of water that is 2.5% of aqueous BTE) and group IV (cadmium chloride + BTE). Results: The study revealed cadmium chloride intoxicated rats showed significant impaired glucose tolerance and changes in normal architecture of pancreas compare to control group. Oral administration of black tea extracts with cadmium chloride significantly improved glucose tolerance and pancreas architecture as compared to the cadmium chloride group. Conclusion: The results indicate that BTE is beneficial in preventing cadmium-induced impaired glucose tolerance with pancreatic cellular damage. [ABSTRACT FROM AUTHOR]

Infants need to receive care in environments that limit their exposure to pathogens. Inadequate water, sanitation, and hygiene (WASH) environments and suboptimal infection prevention and control practices in healthcare settings contribute to the burden of healthcare-associated infections, which are particularly high in low-income settings. Specific research is needed to understand infant feeding preparation in healthcare settings, a task involving multiple behaviors that can introduce pathogens and negatively impact health. To understand feeding preparation practices and potential risks, and to inform strategies for improvement, we assessed facility WASH environments and observed infant feeding preparation practices across 12 facilities in India, Malawi, and Tanzania serving newborn infants. Research was embedded within the Low Birthweight Infant Feeding Exploration (LIFE) observational cohort study, which documented feeding practices and growth patterns to inform feeding interventions. We assessed WASH-related environments and feeding policies of all 12 facilities involved in the LIFE study. Additionally, we used a guidance-informed tool to carry out 27 feeding preparation observations across 9 facilities, enabling assessment of 270 total behaviors. All facilities had 'improved' water and sanitation services. Only 50% had written procedures for preparing expressed breastmilk; 50% had written procedures for cleaning, drying, and storage of infant feeding implements; and 33% had written procedures for preparing infant formula. Among 270 behaviors assessed across the 27 feeding preparation observations, 46 (17.0%) practices were carried out sub-optimally, including preparers not handwashing prior to preparation, and cleaning, drying, and storing of feeding implements in ways that do not effectively prevent contamination. While further research is needed to improve assessment tools and to identify specific microbial risks of the suboptimal behaviors identified, the evidence generated is sufficient to justify investment in developing guidance and programing to strengthen infant feeding preparation practices to ensure optimal newborn health., Competing Interests: The authors have read the journal’s policy and have the following competing interests: BAC, KM, KEAS, KF, LV, DET, and CRS report funding from the Bill & Melinda Gates Foundation outside the submitted work. BAC reports funding from the National Institutes of Health outside the submitted work. CPD reports editorial duties with American Society for Nutrition and royalties from People’s Medical Publishing House (PMPH USA, Ltd.) outside the submitted work. CPD reports royalties from Wolters Kluwer Health (UpToDate, Inc.) outside the submitted work. This does not alter our adherence to PLOS policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare., (Copyright: © 2023 Caruso et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Globally, increasing rates of facility-based childbirth enable early intervention for small vulnerable newborns. We describe health system-level inputs, current feeding, and discharge practices for moderately low birthweight (MLBW) infants (1500-<2500g) in resource-constrained settings. The Low Birthweight Infant Feeding Exploration study is a mixed methods observational study in 12 secondary- and tertiary-level facilities in India, Malawi, and Tanzania. We analyzed data from baseline facility assessments and a prospective cohort of 148 MLBW infants from birth to discharge. Anthropometric measuring equipment (e.g., head circumference tapes, length boards), key medications (e.g., surfactant, parenteral nutrition), milk expression tools, and human milk alternatives (e.g., donor milk, formula) were not universally available. MLBW infants were preterm appropriate-for-gestational age (38.5%), preterm large-for-gestational age (3.4%), preterm small-for-gestational age (SGA) (11.5%), and term SGA (46.6%). The median length of stay was 3.1 days (IQR: 1.5, 5.7); 32.4% of infants were NICU-admitted and 67.6% were separated from mothers at least once. Exclusive breastfeeding was high (93.2%). Generalized group lactation support was provided; 81.8% of mother-infant dyads received at least one session and 56.1% had 2+ sessions. At the time of discharge, 5.1% of infants weighed >10% less than their birthweight; 18.8% of infants were discharged with weights below facility-specific policy [1800g in India, 1500g in Malawi, and 2000g in Tanzania]. Based on descriptive analysis, we found constraints in health system inputs which have the potential to hinder high quality care for MLBW infants. Targeted LBW-specific lactation support, discharge at appropriate weight, and access to feeding alternatives would position MLBW for successful feeding and growth post-discharge., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Semrau et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)