First Three-Parent Baby in the World Born

Use of DNA from three parents in the embryo, a controversial novel technique, has yielded the first baby in the world. Born to Jordanian parents in Mexico five months ago, the baby is reported to be healthy as per a report in the New Scientist magazine. The three parent fertility method was approved due to frequent history of miscarriage of the mother in addition to the mother hosting Leigh Syndrome. Spindle nuclear transfer was taken up using the patient’s nuclear DNA in combination with an egg donor’s mitochondria. The egg was then thereafter fertilized with the father’s sperm.t The three parent method has not been approved in the United states, hence the birth was undertaken in Mexico.

Administering Additional Antibiotic Prior to C-Section Reduces Infection Rates by Half

BIRMINGHAM, Ala -- September 28, 2016 -- Administering the antibiotic azithromycin alongside the standard recommended antibiotic regimen, cefazolin, reduces infection rates by 50% for women who have a non-elective caesarean section (C-section) delivery, according to a study published in the New England Journal of Medicine (NEJM).

Adding azithromycin 500 mg during a C-section also significantly decreased the use of healthcare resources, including readmissions, emergency room visits, and clinic visits.

“Infection during pregnancy and during the postpregnancy period is a major health problem for both mom and baby, and a common underlying cause of death,” said Alan T. N. Tita, MD, Center for Women’s Reproductive Health, University of Alabama at Birmingham (UAB), Birmingham, Alabama. “Women who have a C-section are at significantly increased risk for infection compared with those who deliver vaginally. A major national goal is to reduce the risk of infection after surgery, and this finding is the culmination of investigative work over decades.”

“When our group first developed the idea that a second antibiotic could help reduce infections for these women, we found reassurance in the fact that some patients who have preterm premature rupture of the membranes receive 2 antibiotics to help reduce infection and prolong pregnancy,” he explained.

The current study was conducted across 14 hospitals in the United States with 2,013 women who were more than 24 weeks’ gestation and undergoing a C-section during labour or after membrane rupture. A randomized group of patients received either the standard antibiotic regimen to prevent infection or a modified regimen with the additional azithromycin.

“These results are extremely important, given that the maternal death rate has increased in the United States and there is an urgent need for therapies to decrease serious complications that can lead to maternal deaths,” said Uma Reddy, MD, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), part of the National Institutes of Health (NIH), Bethesda, Maryland.

The UAB Department of Biostatistics analysed data gathered from 14 participating hospitals to reveal that the frequency of endometritis. Infection of the caesarean wound was decreased by 50% in the women who received the adjunctive azithromycin compared with women who received the standard single antibiotic.

The babies who were delivered with the additional azithromycin did not have an increased risk of adverse events.

“Further analyses indicate that the benefits associated with adjunctive azithromycin are consistent across several subgroups of patients,” said Jeff Szychowski, PhD, UAB School of Public Health Department f Biostatistics. “Thanks to the dedication of research staff across the consortium of 14 centres to successfully execute a clinical trial of this magnitude, we are poised to perform multiple follow-up investigations and to understand the ramifications of these results more completely.”

Hospital readmission rates and unscheduled visits to a clinic or to the emergency room were also reduced.

“There are significant costs associated with infections,” said Dr. Tita. “The reduction in readmissions, visits, fevers and overall antibiotic use due to the intervention was higher than we expected, and translates to reduced healthcare costs.”

SOURCE: University of Alabama at Birmingham

DENGUE AND PLATELET TRANSFUSION

New Delhi, September 22, 2016: Dengue cases are at an all-time high causing immense panic and chaos in the city. Every family member of patients diagnosed with dengue is found to be worrying about how to arrange the necessary platelets for transfusion. “It is crucial that the public is educated about the fact that platelet transfusion is not the only solution and is not required in most of the dengue cases”, said Padma Shri Awardee Dr KK Aggarwal - President Heart Care Foundation of India (HCFI) & President Elect IMA at a webcast held today. “What most people are not aware of is that most dengue cases are preventable and manageable. The risk of complications is less than 1% of dengue cases and if the public knows warning signals, all deaths from dengue can be avoided. One must however always remember it is a myth that all dengue patients require platelet transfusion,” he added. Addressing the webcast, Dr NK Bhatia Medical Director Mission Jan Jagruti Blood Bank said, “Unnecessary transfusion causes more harm and puts the patient at risk of complications such as sepsis, transfusion-related acute lung injury (TRALI), transfusion associated circulatory overload (TACO), alloimmunization and allergic and anaphylactic transfusion reactions. Transfusion must only be done if a person’s platelet count is less than 10,000, and he has active bleeding”. It is also important to remember that platelet counts acquired by machine readings is not reliable, and a discrepancy of up to 40,000 can be found. Instead, the doctor must opt for a haematocrit test. Most dengue cases can be managed without testing by only measuring the difference between the upper and lower blood pressure. The pulse pressure should be kept over 40 mm Hg. The public must not pressurise the doctors to hospitalise patients whose illness can be managed at home. The beds should be made available for severe dengue patients instead. The typical symptoms of dengue are fever, vomiting, headache, nausea, pain behind the eyes and severe joint and muscle pain. Most dengue virus infections in adults are symptomatic (86%) and in children under the age of 15 years are asymptomatic or minimally symptomatic. Classic dengue fever is an acute febrile illness accompanied by a headache, retro-orbital pain, and marked muscle and joint pains. Symptoms typically develop between 4 and seven days after the bite of an infected mosquito. The incubation period may range from 3 to 14 days. Fever typically lasts for five to seven days. The febrile period may also be followed by a period of marked fatigue that can last for days to weeks, especially in adults. Joint pain, body aches, and rash are more common in females. Because a virus causes dengue fever, there is no specific medicine or antibiotic to treat it. For typical dengue fever, the treatment is directed toward relief of the symptoms. The acute phase of the illness with fever and myalgia lasts about one to two weeks. In dengue, most complications occur within two days of the fever subsiding and most people are casual during this period. Dengue complications during this period are due to a shift of blood volume and patients require a rapid infusion of oral or intravenous fluids in large quantities during this time. In dengue, most complications occur within two days of the fever subsiding and most people are casual during this period. Dengue complications during this period are due to a shift of blood volume and patients require a rapid infusion of oral or intravenous fluids in large quantities during this time. 

Myths and facts about platelet transfusion 

 • Right now there exists a platelet mania with the public demanding a platelet transfusion even when it is not required. People have a fear and they want to increase their platelet count either by unproved therapies or through transfusion. Both can cause more harm than good and awareness must be raised against this. 

• Platelet deficiency leads to thinning of blood, a condition that is not harmful as blood thinning is routine therapy for heart patients. 

 • Risk of platelet shortage is when the blood becomes thick and that is a condition that needs to be managed by the treating doctor 

• Unnecessary transfusion may cause a resistance in the body and make a person’s platelets ineffective in a time of need, a situation called platelet refractoriness 

• Platelet transfusion is known to cause acute severe allergic reactions – a condition called anaphylaxis because of plasma proteins 

• Unnecessary transfusion can also cause platelet transfusion linked acute lung injury and confuse the doctor about whether lung involvement is due to platelets or dengue 

 • When indicated, platelet transfusion (single donor) increases platelets by only 50,000 and they last in the body only for about 4-5 days 

• There are people whose baseline platelet counts may be permanently low and the panic may cause them to get an unnecessary platelet transfusion

Magic of breast milk – shielding infants with genetic predisposition for asthma

 

According to a study presented at European Respiratory Society's International Congress, breast feeding reduces the later risks of asthma in infants born with a defective chromosome (17q21). The researchers conducted the study with an aim to find out whether breast feeding have a modifying effect on this specific gene related to asthma. The study reported that, in breast-fed infants born with defective gene there was 27 % decrease in the relative risk of developing respiratory symptoms in than those who were not breastfed. “The study sheds light on how this interaction can be modified by breastfeeding. This is the first time that we were able to show the effect of the 17q21 variants on respiratory symptoms during the 1st year of life, depending on breastfeeding status”, commented Dr Gorlanova from the University Children's Hospital Basel (UKBB), and the University of Basel, Basel, Switzerland.