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OBJECTIVES To assess effects of enteral “low” dose (daily doses of ≤10 000 international unit) vitamin A supplementation compared with no vitamin A supplementation in human milk-fed preterm and low birth weight (LBW) infants. DATA SOURCES Cochrane Central Register of Controlled Trials; Medline, Embase, Scopus, Web of Science, CINAHL from inception to 16 March 2021. STUDY SELECTION Randomized trials were screened. Primary outcomes were mortality, morbidity, growth, neurodevelopment. Secondary outcomes were feed intolerance and duration of hospitalization. We also assessed the dose and timing of vitamin A supplementation. Data were extracted and pooled with fixed and random-effects models. RESULTS Four trials including 800 very LBW LIMITATIONS Heterogeneity and small sample size in the included studies. CONCLUSIONS Low-dose vitamin A increased serum retinol concentration among very LBW and very preterm infants but had no effect on other outcomes. More trials are needed to assess effects on clinical outcomes and to assess effects in infants 1.5 to 2.4 kg or 32 to 26 weeks’ gestation.

The burden of geriatric mental health in India is showing a silent epidemic trend, but the knowledge on spectrum of their mental well-being dwelling in slums is very trivial. This mixed-method study aimed to estimate the proportion of depression among elderly and to find out the gender-specific circumstances, leading to depression. A total of 209 subjects selected through multistage sampling from an urban slum in a city of Maharashtra were interviewed for estimating depression, and six focus group discussions (FGDs) were conducted to explore the circumstances. Overall, 42.1% of elderly people had depression with 2.8% severe depression. Major themes highlighted after FGDs were self-esteem, social role, dependence, negative experience, and disgrace among males, and among females, main themes were justifiable reason, managing mood, suppression, undesirable events, and stigma. Depression is a significant public health problem, and a diverse approach is required to understand the perception of elderlies which will highlight the core issues related to depression.

Intrauterine growth restriction (IUGR) may predispose metabolic diseases in later life. Changes in fat-free mass (FFM) and fat mass (FM) may explain this metabolic risk. This review studied the effect of IUGR on body composition in early infancy. Five databases and included studies from all countries published from 2000 until August 2021 were searched. Participants were IUGR or small-for-gestational age (SGA) infants, and the primary outcomes were FFM and FM. Eighteen studies met the inclusion criteria, of which seven were included in the meta-analysis of primary outcomes. Overall, intrauterine growth-restricted and SGA infants were lighter and shorter than normal intrauterine growth and appropriate-for-gestational age infants, respectively, from birth to the latest follow up. They had lower FFM [mean difference -429.19 (p = 0.02)] and FM [mean difference -282.9 (p < 0.001)]. The issue of whether lower FFM and FM as reasons for future metabolic risk in IUGR infants is intriguing which could be explored in further research with longer follow-up. This review, the first of its kind can be useful for developing nutrition targeted interventions for IUGR infants in future. info:eu-repo/semantics/publishedVersion

BACKGROUND AND OBJECTIVES Iron is needed for growth and development of infants globally, but preterm and low birth weight (LBW) infants are at risk for severe iron deficiencies. To assess the effect of enteral iron supplementation on mortality, morbidity, growth, and neurodevelopment outcomes in preterm or LBW infants fed human milk. Secondary objectives were to assess the effect on biomarkers and dose and timing. METHODS Data sources include PubMed, Embase and Cochrane Library databases to March 16, 2021. Study Selection includes controlled or quasi experimental study designs. Two reviewers independently extracted data. RESULTS Eight trials (eleven reports; 1093 participants, 7 countries) were included. No trials reported mortality. At latest follow-up, there was little effect on infection (very low certainty evidence, 4 studies, 401 participants, relative risk [RR] 0.98, 95% confidence interval [95% CI] 0.56 to 1.73, I2 = 0.00%) and necrotising enterocolitis (3 studies, 375 participants, RR 1.47, 95% CI 0.68 to 3.20, I2 = 0.00%). There was an increase in linear growth (length) (moderate certainty evidence, 3 studies, 384 participants, mean difference 0.69 cm, 95% CI 0.01 to 1.37, I2 = 0%) but little effect on weight, head circumference, or cognitive development. There was an improvement in anemia (moderate certainty evidence, 2 studies, 381 participants, RR 0.25, 95% CI 0.10 to 0.62, I2 = 0.00%) but no effect on serum ferritin. Limitations include heterogeneity in the included studies. CONCLUSIONS There are important benefits for human milk-fed preterm and LBW infants from enteral iron supplementation. However, more randomized control trials are required to improve the certainty of evidence.

BACKGROUND: India is a lower middle-income country with one of the fastest growing economies in the world. Despite improvements in its economy, it has a high child mortality rate, with significant differences in child mortality both between and within different states. In this research, we tend to explore factors as to how a particular child's growth is optimal. With this aim, we utilized positive deviance inquiry to study the factors influencing under five child's health. MATERIALS AND METHODS: This qualitative study was carried out in Naigoan, an urban health setting of metropolitan city with 37 sample size between July 2020 and September 2020. It consisted of total 16 in-depth interviews (IDIs), 3 focus group Discussion (FGDs), and 7 key informant interviews (KIIs) which were performed by predesigned guides. RESULTS: Various themes evolved with the interviews; however, triangulation of the concept (from FGDs, IDIs, and KIIs) occurred with the following themes: satisfaction among mothers for health-care services, community participation, family support, and new interventions. CONCLUSION: Mothers' satisfaction to health-care services, community participation, family support, and innovations by the health-care providers are the influencing factors in promoting child's health. Further research can be conducted to understand the in-depth understanding of each factor.

As the pandemic of COVID-19 intensifies there is a huge burden on the health care system of each country. As predicted by epidemic model, India with 1.3 billion population and only 0.76 doctors per thousand people will have 1 million people affected by COVID-19 needing ventilatory support. This situation focusses on the substantial thrust on health care workers in India while dealing with the pandemic and protection of the health care workers from COVID-19 infection is significant as they are the key-groups in health system to procure win-battle status against COVID-19. Henceforth, after meticulously comparing various countries’ strategies to protect their HCWs this brief study is being prepared and few recommendations has been suggested which may enable the protection of HCWs in India. Un-interrupted supply of appropriate PPE, phenomenon of presenteeism among HCWs, burn-outs among HCWs, front-line department protocol for protection of HCWs, need of constant psycho-analysis among HCWs, stigma in society for HCWs, prophylaxis for HCWs against COVID-19 and HCWs’ family concerns are some of the issues which are being highlighted in this paper.

Background: Annually in the world 1,200,000 cases of envenomation and 3,250 deaths by scorpion stings ensue. Alarming statistics are also seen for snake bites globally i.e. 421,000 envenoming and 20,000 deaths. India is the country with the highest annual number of envenoming (81,000) and deaths (nearly 11,000).Methods: A retrospective cross-sectional study based on hospital record to assess the trend of diverse cases of scorpion sting and snake bite reporting to a rural primary health care center from January 2017 to December 2017. A pre-designed case record proforma was utilized to estimate the percentages of diverse cases of scorpion and snake bites attending the center and assess the demographic profile of the bite cases along with the evaluation of management protocol of these bite cases.Results: 190 cases of envenomation visited the health care center in a year where 165 were scorpion stings and 25 were snake bites. Referral to higher centres for management was established to be more in children and adolescent age groups but the mean age of envenomation was evaluated to be 33.8 years. Remarkable seasonal variation in the envenomation cases was spotted. Anti-snake venom was used for treatment of snake bites but anti-venom was not utilized for scorpion bites.Conclusions: Envenomation cases were common in adults but complications were higher in children and adolescents. We observed gender based risk and a seasonal incidence of envenomation. Most patients of envenomation were successfully managed in rural hospital with limited facilities.