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BACKGROUND Anaemia is perceived to be a major public health problem especially among adolescent females .Findings from National Family Health Survey NFHS (2005-06) indicate that 56% of the adolescent girls in India are anaemic and, of these 17% suffer from moderate to severe anaemia. The prevalence of anaemia in female adolescent age group is still an understudied subject. The aims of this study were to evaluate the recently initiated WIFS program for government school girls with respect to implementation and impact on trends in prevalence of Anaemia among adolescent girls in a Bengaluru rural school. MATERIALS AND METHODS Cross-sectional, descriptive exploratory research study was used. The choice of the school was based on commitment to administration of weekly iron-folic acid supplements (WIFS) programme. All the girl students from class 6 th to 10th of Government High and Senior Secondary school (age group, 11-19 years) who were a part of WIFS were enrolled as study participants. Qualitative data on anaemia awareness and diet history, compliance, side effects were taken from these girls. General information on age, height, weight were collected and BMI calculated. Hb estimation was done by Haemocue method. Statistical Analysis-Analysis were prepared by IBM SPSS Statistics version 22. RESULTS Out of the 95girls in the school, there were 81 girls (85.26%) reported to consume one tablet of Iron folic acid (IFA) weekly in the past 1 year, with no major side effects. The girls had knowledge about symptoms of anaemia and iron-rich diet. Hb estimates indicated 79.01% non anaemic, prevalence of anaemia was 20.99%; none of the girls had severe anaemia, 1.2% had moderate anaemia and the remaining 19.8% belonged to mild anaemia category, indicating a significant decline. The mean BMI of the study sample was 17.53 kg/m 2 with 67.9% underweight and 6.2% overweight. CONCLUSION Overall, in this school, the WIFS program was found to be well implemented with good compliance. The study indicates a positive impact of WIFS programme with a decline in anaemia prevalence, compared to previous national estimates. WIFS seems to be an impactful strategy to prepare adolescents for the reproductive age group with adequate iron stores. However, the general nutritional status could be further improved to improve the BMI.

BACKGROUNDThe aim of the study is to determine the current practices in the medical college institutions pan India for testing for Hyperglycaemia in Pregnancy (HIP) to detect gestational diabetes and highlight areas that need additional attention in order to ensure adherence to current national guidelines. MATERIALS AND METHODSQuestionnaires were used to obtain information regarding the testing strategy for hyperglycaemia in pregnancy. The questionnaires were filled out by the teaching faculty of the OB/GYN departments of 47 medical college institutions in India. The perceptions regarding the prevalence of diabetes in pregnancy in India and the needs for capacity building were assessed. RESULTSForty seven respondents answered the questionnaires. The majority of respondents (95.83%) reported that all pregnant women were offered (universal) testing for hyperglycaemia in pregnancy and 37.5% reported that women were screened both in early and midtrimester of pregnancy. Most reported that testing for HIP took place once at booking, irrespective of the gestational age (39.58%). Thirty three (70.21%) respondents reported using the single-step nonfasting method to diagnose hyperglycaemia. Furthermore, 21.28% of respondents reported using a glucometer to determine the concentration of blood glucose in plasma, while 68.08% reported using a lab analyser. The instructions for the testing were offered by consultants and postgraduates in a vast majority of cases (87.5%). The staff communicated with the women in a significantly less number of cases (12.5%). 65.96% of respondents felt that all women readily agreed to follow this advice. The majority of respondents (89.35%) reported having noticed an increase in the number of women with hyperglycaemia. Furthermore, 91% of all the respondents felt there was a need to train medical personnel to test and manage hyperglycaemia. CONCLUSIONOur study confirms the continued wide variability in testing for HIP in India with respect to timing and frequency. It highlights the need for training initiatives to improve adherence to national guidelines. Clinical Significance-Increasing adherence to and awareness of national guidelines has the potential to result in earlier diagnosis and management of HIP. This would have an impact, which would improve pregnancy outcomes, maternal and neonatal health both in the short term as well as long term. Building the capacity of the available resource pool of healthcare providers including the staff nurses would empower them by for better communication. This would improve compliance for testing and follow up.

BACKGROUND The aim of the study is to determine the non-inferiority of a single dose of 500 mg Ferric Carboxymaltose (FCM) (Group 1) to a single dose of 1000 mg (Group 2) in treating women with postpartum anaemia. MATERIALS AND METHODS Women were recruited within 24 hours of delivery and randomised to one of the two study groups excluded were mothers with non-iron deficiency anaemia, iron intolerance and haematological disease. Haematological markers were measured at baseline and at 6 weeks after treatment. Main Outcome Measures-The primary outcome was an Hb increase ≥20 g/L. Secondary outcomes included the proportion of patients attaining Hb ≥120 g/L and the mean Hb change. Design-Open label, randomised, non-blinded, prospective study. Setting-Maternity units of four hospitals in Southern India. Population-Women ≥18 years old with haemoglobin of >60-<100 g/L. RESULTS There was no difference in the proportion of women achieving an Hb increase of >20 g/L between Groups 1 and 2 (91.4% versus 96.7%). Similar proportions of women in both groups became non-anaemic achieving an Hb of >120 g/L (57% versus 45.7%). The mean Hb change was comparable between the groups and both doses were well tolerated. CONCLUSION A single dose of 500 mg FCM (cost INR 2000.00) is non-inferior to a 1000 mg dose (cost INR 5000.00) in the treatment of postpartum anaemia. This has major implications for the scaling up of the eradication of iron-deficiency anaemia in India, since double the number of women who would otherwise have been treated with the 1000 mg dose can be treated with half the dose at less than half the cost with similar outcomes. Tweetable Abstract-A single dose of 500 mg FCM is a safe, efficacious and cost-effective treatment for PPA in India.

BACKGROUNDGestational Diabetes Mellitus (GDM) is a common complication of pregnancy that is associated with adverse pregnancy outcomes. Studies have shown that GDM responds to early and effective intervention, which improves maternal and neonatal outcomes and reduces long-term risk of Type 2 Diabetes Mellitus (T2DM) in mother and child. The guidelines of the Diabetes in Pregnancy Group in India (DIPSI) currently recommend GDM testing twice during pregnancy, i.e. at the first antenatal visit and at 24 -28 weeks' gestation; however, GDM has been shown to develop in the third trimester. MATERIALS AND METHODSPregnant women receiving antenatal care at Divakars Speciality Hospital, Bengaluru, India, took part in the study. The participants were recruited on their first antenatal visit, and informed consent was obtained. GDM testing was carried out at 12 weeks and 22 -24 weeks' gestation, in keeping with the DIPSI guidelines. GDM testing was also carried out at 32 weeks' gestation based on clinical findings and scan reports. GDM prevalence rates at each time point were obtained, and Pearson chisquare tests were used to determine whether a GDM diagnosis was associated with age, parity and BMI. RESULTSThe mean age of the participants was 29.06 ± 4.28 yrs., and their average BMI was 25.67 ± 4.52 kg/m 2 . The prevalence of GDM during the first trimester, second trimester and third trimester were 8.60%, 11.1% (universal testing) and 8.1% (selective testing) respectively. For each of the study points, i.e. 12 weeks' gestation (T1), 22 -24 weeks' gestation (T2) and 32 weeks' gestation (T3), significant differences were not found between the ages (P (T1) = 0.247; P (T2) = 0.953; and P (T3) = 0.252), BMIs (P (T1) = 0.917; P(T2) = 0.098; and P (T3) = 0.670), and parities (P (T1) = 0.172; P (T2) = 0.321; and P (T3) = 0.321) of women who were diagnosed with GDM and those who tested negative for GDM. CONCLUSIONOur study shows that additional testing of pregnant women in the third trimester would identify cases of late onset GDM that would have otherwise gone undetected; making a case for considering universal testing once in every trimester.