Early diagnosis, treatment of diabetes in pregnant women benefit infants, finds study

Early diagnosis and treatment of gestational diabetes mellitus results in additional protection for babies and mothers from pregnancy complications, as per the results of a multi-centric, randomised controlled trial published recently

• Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy.
• GDM not only influences immediate maternal (preeclampsia, stillbirths, macrosomia, and need for cesarean section) and neonatal outcomes (hypoglycemia, respiratory distress), but also increases the risk of future Type 2 diabetes in mother as well as the baby.
• Prevention at the earliest stage of development of the foetus is essential to prevent children from becoming predisposed to diabetes or other non-communicable diseases (NCD) in future.
  • Higher glucose transfer to the foetus, when the mother has high blood sugar, stimulates the foetal pancreatic cells to start secreting insulin earlier and in higher quantities. Once initiated, it becomes self perpetuating.
  • In addition, when the maternal glucose reading is high (over 110 mg/dl), the amniotic fluid becomes glucose enriched, and after 20 weeks, when the foetus begins to swallow the amniotic fluid, which further stimulates production of insulin.

Gestational Diabetes in India

• India has an estimated 62 million people with Type 2 diabetes mellitus (DM); this number is expected to go up to 79.4 million by 2025.
• In parallel with the increase in diabetes prevalence, there seems to be an increasing prevalence of gestational DM (GDM), that is, diabetes diagnosed during pregnancy.
• India has a very high prevalence of GDM by global standards. Conversion rates to Type 2 diabetes are also very high.
• Healthcare resources are insufficient. There is inadequate awareness among public. This results in a large population being hesitant to access healthcare system for diseases with not so “obvious” implications like GDM.
• Interventions during and immediately after pregnancy provide important opportunities to improve the lives of mothers and children today and reducing diabetes in future generations.
• Screening and appropriate management of diabetes during pregnancy provides a unique opportunity to prevent Type 2 diabetes in two generations.
• Lack of awareness in society is one of the reasons that GDM is given low priority in public health delivery system in India.
• Therefore, the Ministry of Health has developed national guidelines for testing, diagnosis and management of hyperglycaemia in pregnancy, and they recommend early testing at the time of contact (during the first trimester) and if the test is negative, yet another test should be done between 24-28 weeks.

Pakistan and China vow to press ahead with CPEC

A day after India criticised the China-Pakistan Economic Corridor (CPEC), the Foreign Ministers of Pakistan and China on Saturday expressed their firm commitment to continue their cooperation on the multi-billion dollar infrastructure projects. This came at the 4th edition of the Pakistan-China Strategic Dialogue

• CPEC is a 3,000-km long route of infrastructure projects connecting China’s northwest Xinjiang Uygur Autonomous Region and the Gwadar Port in the western province of Balochistan in Pakistan.
• It is a bilateral project between Pakistan and China, intended to promote connectivity across Pakistan with a network of highways, railways, and pipelines accompanied by energy, industrial, and other infrastructure development projects.
• It will pave the way for China to access the Middle East and Africa from Gwadar Port, enabling China to access the Indian Ocean and in return China will support development projects in Pakistan to overcome the latter’s energy crises and stabilising its faltering economy.
• CPEC is a part of the Belt and Road Initiative.
  • The BRI, launched in 2013, aims to link Southeast Asia, Central Asia, the Gulf region, Africa and Europe with a network of land and sea routes.

CPEC’s Implications for India

• India’s Sovereignty: India has continuously opposed the project since it passes through the Pakistan-occupied Kashmir territory of Gilgit-Baltistan – a claim opposed by Pakistan.
  • The corridor is also perceived to be an alternative economic road link for the Kashmir Valley lying on the Indian side of the border.
  • Most key players in the Indian state of Jammu and Kashmir, have expressed optimism about the project.
  • There have been calls by local business and political leaders to declare Kashmir on both sides of the Line of Control (LoC) a ‘Special Economic Zone’.
  • However, a well-connected Gilgit-Baltistan that attracts industrial development and foreign investment**, if CPEC proves a success, will further consolidate the region’s perception as internationally recognised Pakistani territory**, diminishing India’s claim over the 73,000 sq km piece of land which is home to more than 1.8 million people.
• Chinese Control Over Trade Via Sea: Major US ports on the East Coast depend on the Panama Canal to trade with China.
  • Once CPEC becomes fully functional, China will be in a position to offer a ‘shorter and more economical’ trade route (avoiding travel through the entire Western Hemisphere) to most North and Latin American enterprises.
  • This will give China the power to dictate the terms by which the international movement of goods will take place between the Atlantic and the Pacific oceans.
• Chinese String of Pearls: China has been increasing its presence in the Indian Ocean with the ‘String of Pearls’ ambition: A term coined by the Americans and often used by Indian defence analysts to refer to a Chinese game-plan of encircling India through a network of airfields and ports.
  • With an existing presence in Chittagong port (Bangladesh), Hambantota port (Sri Lanka), Port Sudan (Sudan), Maldives, Somalia and Seychelles, a control of Gwadar port establishes complete dominance of the Indian ocean by the Communist nation.
• Emergence of Pakistan as an Outsourcing Destination: It is poised to speed up Pakistan’s economic progress.
  • Pakistani exports, mainly in the textile and construction material industry, compete directly with those of India in the US and UAE – two of the top three trading partners of both countries.
  • With the supply of raw material from China becoming easier, Pakistan will be suitably placed to become a regional market leader in these sectors – mainly at the cost of Indian export volumes.
• Stronger BRI and Chinese Dominance in Trade Leadership: China’s BRI project that focuses on the trade connectivity between China and the rest of Eurasia through a network of ports, roads and railways has been often seen as China’s plan to dominate the region politically. CPEC is one giant step in the same direction.
  • A China that is more accepted and integrated with the rest of the global economy will have a better say in the United Nations and with individual nations, which may prove to be bad news for an India aspiring to acquire a permanent seat at the UN Security Council.

FDA approves first vaccine for respiratory syncytial virus

Food and Drug Administration (FDA) approved the first vaccine — Arexvy — for respiratory syncytial virus (RSV) to lower respiratory tract disease in people older than 60 years. This is the first RSV vaccine to be approved anywhere in the world.

The trail showed that a single dose of the vaccine reduced the risk of people, older than 60 years, developing lower respiratory tract disease caused by the RSV virus by 82.6% and reduced the risk of developing severe disease by 94.1%.

• Respiratory Syncytial Virus is a common respiratory virus. It is characterized by its highly contagious nature i.e., it has a high potential to infect people.
• It exacerbated the seasonal lung infection. It commonly infects children especially under 2 to 6 years of age.
• In most of the cases it has symptoms like the common cold but in advanced stages it converts into phenumonia and bronchiolitis.
• Findings
  • In the year 2019, over 45000 infant fatalities under the age of six were reported.
  • One child out of every five RSV infected children died in the entire world.
  • Children six months and younger are most vulnerable to this virus.
  • According to the research, the annual incidence rate in India is 53 per 1,000 children (5.3%), with an estimated 61,86,500 cases of RSV associated with acute lower respiratory infection in children under the age of five.
    • RSV killed 97 percent of children under the age of five in low- and middle-income nations.

Cure

• There is no reliable cure available for RSV infection.
• Scientists, Government and concerning authority are promoting research and development in this domain to find out appropriate medicine and vaccination to save the life of infants and children.

Pheromone deters migratory locusts from cannibalism

• Swarming migratory locusts — which threaten food security across the globe — avoid being eaten by other locusts by producing a smelly Pheromone called phenylacetonitrile (PAN), according to a new study (Science).
• The discovery of an anti-cannibalistic signalling pathway in locusts could provide a target for locust management strategies. Among species of locusts, cannibalism is common, and cannibalistic interactions have been implicated in the formation of damaging swarms.