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Background and Objective: The noninvasive hemoglobin (NHb) devices are recently evaluated as an alternative to laboratory hemoglobin (LHb) in neonates. This systematic review explores the diagnostic accuracy of NHb devices for neonatal hemoglobin measurement. Methods: Literature related to the comparison of NHb device with LHb in neonates was searched from Medline, PubMed Central, PubMed, Web of Science, Google Scholar, and Scopus databases after PROSPERO registration. The quality of included publications was assessed by QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). The pooled correlation coefficient and bias (precision) in Bland-Altman difference plots were used for summary statistics using MetaXL 5.0 software. Results: A total of 1,477 paired NHb-LHb observations were analyzed from 1,047 neonates in 10 studies. Massimo radical-pulse co-oximetry (8 studies) and Mediscan-2000 (2 studies) were used for NHb estimation. The pooled correlation coefficient between NHb and LHb was r = 0.94 (95% CI: 0.83–0.98, p < 0.001), and the pooled bias (precision) was −0.013 (1.4) gm/dL between NHb and LHb measurements in Bland-Altman analysis. NHb device had better precision in stable neonates (0.91gm/dL) over sick neonates (1.66 gm/dL). Conclusions: Hemoglobin measurement by NHb is excellently correlated with LHb measurement with a minimal average difference. It may be used as a screening tool for hemoglobin measurement in neonates to avoid frequent phlebotomy.

Introduction: Extrauterine growth restriction (EUGR) is a universal problem but its prevalence using recent reference growth charts and morbidities associated with it are lacking. The study aims at estimating EUGR prevalence in very low birth weight (VLBW) neonates and its associated morbidities. Methods: All VLBW neonates admitted to NICU between Jan 2018 to June 2019 were analysed. Neonatal anthropometries were recorded on Intergrowth 21st gender based postnatal growth chart. EUGR was defined by weight below 10th percentile at discharge. Demographic profile and neonatal morbidities were compared between EUGR and non-EUGR by using unpaired t test and Chi-square test. Regression was used for identification of the risk factors. Results: Out of 148 VLBW neonates, 92 (62.1%) were male, 26 (17.56%) were below 1000 gm, 102 (68%) were EUGR at discharge. Mean (SD) birth weight and gestational age were 1202 (221) gms and 30.89 (2.77) wks respectively. Caesarean delivery, higher gestational age, lower birth weight, SGA at birth and prolonged duration to achieve full enteral feeding were significantly associated with EUGR (P < 0.05). Sepsis was significantly associated with EUGR (36.28% vs. 17.4%; P 0.022). EUGR babies needed longer hospital duration (24.56% vs. 16.78%; P 0.005) with a higher mean PMA at discharge (38.07 wks vs. 35.11 wks; P < 0.001). In regression model SGA at birth and delay in achieving full feeding were independent predictor of EUGR. Conclusions: In VLBW neonate, prevalence of EUGR at discharge was 68%. Sepsis was significantly associated with EUGR. SGA and delay in achieving full feeding were independent predictors of EUGR.

To compare breast milk volume between manual method and breast pump expression in mothers of preterm infants at different time point of first week.Randomized controlled trial.Postpartum ward of Obstetrics department and tertiary level neonatal intensive care unit (NICU) in a single institution in Orissa between October, 2020 and May, 2021.Mothers who delivered before 34 completed weeks of gestation.Manual breastmilk expression (ME) group using Marmet technique and breast pump milk expression (PE) group using pigeon manual breast pump, initiated milk expression within one hour of delivery.Expressed breast milk (EBM) volume in mothers of preterm infants at different time point of first week, and cumulative milk volume.Out of 170 mothers (83 PE and 87 ME group), 7-days milk volume data was available for 137 (71 ME and 66 PE) mothers. In per protocol analysis for 126 mothers (63 in each group), the median (IQR) EBM volume on day 2 and day 7 of ME and PE groups were similar [10 (5,20) vs 12 (5,28), P=0.10] and [280 (220-356) vs 280 (220-360), P=0.66]. The median (IQR) cumulative EBM volume over first 7 days in ME group was not significantly different from PE group [733 (593-995) vs 848.5 (571-1009)] P=0.55). A similar number of mothers in the PE and ME group [56 (88.9%) vs 58 (92%); P=0.14] provided exclusive breast milk for their neonates during the first week. Similar results were found on intention to treat analysis.EBM volume expressed was comparable between mothers expressing manually or with breast pump.

The toxic metalloid arsenic is known to cause liver and kidney injury in many humans and animals. The goal of this paper was to exemplify the antagonism of ginger against arsenic (As)-induced hepato-renal toxicity. In addition, the pathways Nrf2/Keap1 and NF/κB were studied to reveal the molecular mechanism of the stress. One hundred twenty 7-day-old White Pekin ducks were randomly allocated into five groups, having 24 birds in each. Each group contained three replicates having 8 birds in each replicate and maintained for 90 days. The groups were as follows: T-1 [control-basal diet with normal water], T-2 [T1 + As at 28 ppm/L of water], T-3 [T2 + ginger powder at 100 mg/kg feed], T-4 [T2 + ginger powder at 300 mg/kg feed], and T-5 [T2 + ginger powder at 1 g/kg feed]. It was observed that there was a significant increase in oxidative parameters whereas a significant decrease in antioxidant parameters in hepato-renal tissues in T-2. The exposure to As not only decreased the mRNA expression of antioxidant parameters like Nrf2, SOD-1, CAT, GPX, and HO-1and anti-inflammatory markers like IL-4 and IL-10 but also increased the m-RNA expression of NF-κB, Keap-1 and pro-inflammatory markers like IL-2, Il-6, IL-18, IL-1β, and TNF-α. There was also an accumulation of As in hepatic and renal tissue, confirmed by residual analysis of these tissues. By correlating the above parameters, As at 28 ppm showed significant toxic effects, and ginger powder at 1 g/kg feed effectively counteracted the toxic effects of As in ducks.

Objective- To evaluate the clinical characteristics of hypoglycemic brain injury (HBI) in unanticipated term neonates, confirmed by neuroimaging. Methodology- We reviewed Magnetic resonance imaging (MRI) of brain of term neonatal encephalopathy cases, from January 2018 to November 2020. Neonates with MRI topography suggestive HBI and documented hypoglycemia from case records were enrolled in study. Perinatal data, clinical characteristics and management of cases was recorded. Descriptive statistics was used to analyse the data. Result-Total 13 term neonates had brain MRI suggestive of HBI conducted at median postnatal age of 7 days. The mean birth weight of HBI neonates was 2582 ± 285 gram, mean gestational age 38.15± 0.48 weeks and five (38.4%) babies were low birth weight. Eight (61.5%) babies were delivered by caesarean section, eleven (84.6%) were first born, twelve (92.3%) were male and nine (69.2%) were on exclusive breastfeeding. Out of thirteen neonates twelve (92.3%) were outborn, mean age of symptom noticed was 2.83±0.53 days and mean age of admission was 3.84± 0.82 days. Mean blood glucose at admission was 28.84±3.23 mg/dl and four (30.7%) were diagnosed with hypoglycemia at referral hospital.

An orifice meter is one of the flow measuring devices which are more popular among all the instruments because of its simple design, less cost, and easy manufacturing to determine the discharge in single and multi-phase flow. In a multiphase flow problem such as oil and gas industry, chemical and processing industry wellhead chokes are used to control the production of oil and control, which create more fluctuation in the downstream flow due to back pressure on the reservoir and create significantly error in the measurement. To avoid the above problem orifice is an alternative device. The review paper gives an idea about single orifice consider for various applications, which will be helpful for betterment of orifice design and analysis. The review papers also produce the numerical and experimental studies on orifice to determine the pressure drop and coefficient of discharge on the variation of geometrical and flow parameters.

Preterm neonates perceive multiple painful procedures during Neonatal Intensive Care Unit (NICU) stay, having long term neurobehavioral effects. This study aims to compare the analgesic efficacy of oral melatonin with 24% sucrose in neonates during retinopathy of prematurity (ROP) screening.A prospective, non-blinded, randomized controlled trial was conducted in a tertiary care NICU. All preterm neonates with gestational age (GA)34 weeks or birth weight (BW)2000 grams eligible for ROP screening were randomized into oral melatonin (4 mg/kg) and oral 24% sucrose (0.5 ml) groups. Both groups received standard non-pharmacological measures and topical proparacaine. The intensity of pain was measured by Premature Infant Pain Profile (PIPP) score during the procedure, at 1st and 5th minutes following the procedure and compared between the two groups by Mann-Whitney U test with p value0.05 considered as significant.A total of 60 preterm neonates were randomized with 30 neonates in the melatonin (median [interquartile range] GA: 30.86 [3.78] weeks, BW: 1160 [430] grams) and 30 neonates in the 24% sucrose (median [IQR] GA: 29.29 [4.68] weeks, BW: 1070 [315] grams) group. The median PIPP score during the procedure in the melatonin and sucrose groups were 17 and 16, respectively (p=0.64). The median (Q1-Q3) PIPP score at the 1st minute was significantly lower among the melatonin group (7 [5.25-10]) vs 24% sucrose group (9.5 [7.25-11]) (p=0.02); and at the 5th minute, the median (Q1-Q3) PIPP scores in the melatonin group (5 [4-6]) was comparable to the 24% sucrose group (5.5 [3.25-7]) (p= 0.52).Oral melatonin is not inferior to oral 24% sucrose for pain management during ROP screening.

Identifying hyperglycaemia during postoperative period is essential for neonates. The objective of the study was to analyse the accuracy and reliability of continuous glucose monitoring (CGM) device for detecting hyperglycaemia during postoperative period in neonates. In this prospective study, hourly glucose recordings by CGM device and six hourly by glucometer glucose (GG-reference test for patient management) were collected in ten surgical neonates during first three postoperative days. Mean absolute relative difference (MARD) and proportion of CGM values within ± 15%/15 mg/dL, ± 20%/20 mg/dL, and ± 30%/30 mg/dL of GG, were analysed from matched pair CGM and GG recordings. The diagnostic performance of CGM for neonatal hyperglycaemia (150 mg/dL) was expressed as sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV); and the clinical reliability was assessed in Clarke Error Grid Analysis. A total of 720 CGM glucose readings, 120 matched -paired glucose readings by CGM --GG, and 37 episodes were hyperglycaemia by GG. The MARD was 10.76 %; the percentages of glucose readings within 15%/15 mg/dL, 20%/20 mg/dL, and 30%/30 mg/dL were 94.6%, 97.3% and 100% during the hyperglycaemia period. The sensitivity, specificity, PPV and NPV to detect hyperglycaaemia by CGM device were 100%, 93.9%, 88% and 100 % respectively. In Clarke Error Grid Analysis, 97.3 % points were in zone A and B during the hyperglycaemia period.CGM device can be a clinically reliable tool for hyperglycaemia management during postoperative period in neonates.• Neonates are vulnerable for hyperglycaemia during post-operative period and bed side glucometers are used for frequent glucose monitoring in them. • Continuous glucose monitor(CGM) devices are used for the glucose monitoring in adult and paediatric diabetes care.• For the first time, this study analysed the accuracy and clinical reliability of FreeStyle Libre (CGM device) for identifying hyperglycaemia during post-operative period in neonates. • CGM device has very good accuracy for detecting hyperglycaemia in neonates, it may help the clinician for better glucose stability during post-operative period.

Efforts are made to perform simulations to describe the gaseous entrainment dynamics in a viscous liquid pool due to the combined influence of asymmetric converging rotational field and continuous freestream flow of air. A pair of counter-rotating and equal sized rollers is placed inside the pool along a horizontal line. Gerris is an open-source solver, which is employed to carry out the present computational study. Complex interfacial configurations are illustrated with the influence of relevant input parameters, such as rotation of rollers 1 and 2 (measured by Capillary number, Ca1=Rω1μl/σ and Ca2=Rω2μl/σ, where R=D/2 is roller radius), submersion depth (b*), the gap between the rollers (2a*), and strength of air stream flow (measured by Reynolds number, Reflow=ρgUD/μg). It has been observed that the depth of steady entrainment is reduced at Reflow≠0 compared to Reflow=0 because the hydrodynamic force acts as an opposing force to viscous pumping and rotating inertia. A complete understanding of disintegration of and subsequent accumulation of gaseous bubbles from the cusp tip is characterized in detail. In addition, the influence of viscous drag (specified by Morton number, Mo=gμl4(ρl−ρg)/(ρl2σ3)) and gravitational pull (estimated by Archimedes number, Ar=gD3ρl2/μ2) on the phase contours are also reported. Finally, an analytical formulation is proposed to analyze the structure of entrainment, and this model reports an excellent match with the numerical findings.

The present investigation elucidates the interfacial characterization caused by the simultaneous effect of a symmetric converging rotational field and continuous air stream flow above the free surface. The converging rotational field is developed by a couple of counter and equal rotating rollers fully immersed inside the viscous liquid medium and their centers are aligned along a horizontal line. Such phenomenon is abundantly encountered in various engineering devices, where the interactions and transfer of mass, momentum, and energy are quite important through gas–liquid interfaces. Behavior of entrainment profile is observed due to the influence of various relevant pertinent parameters, namely, rotational of speed (measured by Ca), submersion depth (b*), the gap between the rollers (2a*), and strength of air stream flow (measured by Reflow). An upper rounded structured interfacial configuration is obtained for all cases of Ca when the rollers are located very close to each other. The length of the entrainment of cusp decreases with the rise of Reflow for the same value of Ca. The value of Cac increases continuously with the increase of Reflow for a particular of 2a* and b*. Bubble ejection from filament tip and subsequent accumulation increases significantly with the rise of Ca for a particular case of Reflow. The cusp tip progressively traverses in upward direction with the continuous increase of gravitational pull for a particular value of Ca and Reflow. Entrainment length progressively grows with the continuous rise of viscous drag for a particular value of Ca and Reflow. Finally, an analytical formulation is proposed to analyze the structure of entrainment and this model reports an excellent match with the numerical findings.

To compare the continuous real time blood glucose (CG) measurement with venous laboratory blood glucose (LG) level in neonates during perioperative period.Glucose levels were measured simultaneously by CG, glucometer glucose (GG) and LG at 40 time points in ten neonates during perioperative period. Intraclass correlation coefficient (ICC) and Bland Altman analysis were used for comparison.Correlation between CG and LG was excellent (ICC= 0.953; P0.001), and average difference was 23.8 (95%CI 52.9 to -5.3) mg/dL, showed better reliability than at hyperglycemic state (ICC=0.653; P=0.006). The GG-LG showed excellent reliability with ICC = 0.985; P0.001 and average difference of 15.4 (95% CI 30.7 to 0.1) mg/dL. CG at euglycemic state (ICC= 0.880; P0.001).CG measurement is reliable for blood sugar estimation in neonates; but has lower reliability for hyperglycemia. The continuous trend of glucose measurement by CG is helpful for timely diagnosis of hyperglycemia during perioperative period in neonates.

Colorectal cancer (CRC) is a type that develops in the colon to anus segment of the elementary canal. Is painful; acutely debilitating & fatality becausing. Age; diet, lifestyle habits; occupational stress; agrometeorology; bacteriums; virus have been adduced as risk factors and a small percentage being attributed to genetics etc.,. CRC is now a global threat. However, physiologically the protein TNIK (TRAF2 And NCK Interacting Kinase) is found to be widely associated with CRC and is also over expressed. Glycyrrhizaglabra is an herbal plant with lots of known medicinal properties. Glycyrrhizaglabra has 45 known phyto-compounds (PCs). In the present investigation all the 45 PCs have been put to in silico processes including docking and DFT (Density Functional Theory) analysis to find out the PCs that best stop over-expression of the TNIK protein in colorectal cancer. Glabroiso-flavanone B and Glabridin are found to be champion molecules of this plant against CRCs. Phytos are natural source hence are peerless in drug discovery; functional food and in synergistic therapeutics.

The objective of this study was to explore the availability of expressed breast milk (EBM) volume for the premature neonates born from mothers in different gestational age groups during neonatal intensive care unit (NICU) stay. All preterm infants (extreme-preterm infant [EPTI

The purpose of the study is to evaluate the antidiabetic and hyperlipidemic potential of stem bark extract of

Overcoming multi drug resistance is one of the crucial challenges to control enteric typhoid fever caused by