Publications by authors named "Dharamveer Tatwavedi"

5 Publications

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Neonatal and infant mortality associated with spina bifida: A systematic review and meta-analysis.

PLoS One 2021 12;16(5):e0250098. Epub 2021 May 12.

National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.

Objectives: A systematic review was conducted in high-income country settings to analyse: (i) spina bifida neonatal and IMRs over time, and (ii) clinical and socio-demographic factors associated with mortality in the first year after birth in infants affected by spina bifida.

Data Sources: PubMed, Embase, Ovid, Web of Science, CINAHL, Scopus and the Cochrane Library were searched from 1st January, 1990 to 31st August, 2020 to review evidence.

Study Selection: Population-based studies that provided data for spina bifida infant mortality and case fatality according to clinical and socio-demographical characteristics were included. Studies were excluded if they were conducted solely in tertiary centres. Spina bifida occulta or syndromal spina bifida were excluded where possible.

Data Extraction And Synthesis: Independent reviewers extracted data and assessed their quality using MOOSE guideline. Pooled mortality estimates were calculated using random-effects (+/- fixed effects) models meta-analyses. Heterogeneity between studies was assessed using the Cochrane Q test and I2 statistics. Meta-regression was performed to examine the impact of year of birth cohort on spina bifida infant mortality.

Results: Twenty studies met the full inclusion criteria with a total study population of over 30 million liveborn infants and approximately 12,000 spina bifida-affected infants. Significant declines in spina bifida associated infant and neonatal mortality rates (e.g. 4.76% decrease in IMR per 100, 000 live births per year) and case fatality (e.g. 2.70% decrease in infant case fatality per year) were consistently observed over time. Preterm birth (RR 4.45; 2.30-8.60) and low birthweight (RR 4.77; 2.67-8.55) are the strongest risk factors associated with increased spina bifida infant case fatality.

Significance: Significant declines in spina bifida associated infant/neonatal mortality and case fatality were consistently observed, advances in treatment and mandatory folic acid food fortification both likely play an important role. Particular attention is warranted from clinicians caring for preterm and low birthweight babies affected by spina bifida.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0250098PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8115829PMC
May 2021

Application of induced pluripotent stem cell technology for the investigation of hematological disorders.

Adv Biol Regul 2019 01 10;71:19-33. Epub 2018 Oct 10.

Bloodwise Molecular Haematology Unit, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, and Oxford BRC Haematology Theme, Oxford, UK. Electronic address:

Induced pluripotent stem cells (iPSCs) were first described over a decade ago and are currently used in various basic biology and clinical research fields. Recent advances in the field of human iPSCs have opened the way to a better understanding of the biology of human diseases. Disease-specific iPSCs provide an unparalleled opportunity to establish novel human cell-based disease models, with the potential to enhance our understanding of the molecular mechanisms underlying human malignancies, and to accelerate the identification of effective new drugs. When combined with genome editing technologies, iPSCs represent a new approach to study single or multiple disease-causing mutations and model specific diseases in vitro. In addition, genetically corrected patient-specific iPSCs could potentially be used for stem cell based therapy. Furthermore, the reprogrammed cells share patient-specific genetic background, offering a new platform to develop personalized therapy/medicine for patients. In this review we discuss the recent advances in iPSC research technology and their potential applications in hematological diseases. Somatic cell reprogramming has presented new routes for generating patient-derived iPSCs, which can be differentiated to hematopoietic stem cells and the various downstream hematopoietic lineages. iPSC technology shows promise in the modeling of both inherited and acquired hematological disorders. A direct reprogramming and differentiation strategy is able to recapitulate hematological disorder progression and capture the earliest molecular alterations that underlie the initiation of hematological malignancies.
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http://dx.doi.org/10.1016/j.jbior.2018.10.001DOI Listing
January 2019

Efficacy of modified Tochen's formula for optimum endotracheal tube placement in low birth weight neonates: an RCT.

J Perinatol 2018 05 6;38(5):512-516. Epub 2018 Feb 6.

Department of Neonatology, St. Johns Medical College Hospital, Bangalore, 560034, India.

Objective: To assess the efficacy of modified Tochen's formula (birth weight + 5 cm) when compared to Tochen's formula for optimum placement of endotracheal tubes (ET) in low birth weight (LBW) neonates.

Study Design: In the NICU of a tertiary care hospital, LBW babies requiring intubation were randomized to Tochen's formula or modified Tochen's formula. The incidence of inadequate placement and optimum length of ET insertion were estimated. Analysis was done by the Chi square and 't'-tests.

Results: Sixty-seven babies were included: 34 in Tochen's group and 33 in modified Tochen's group. Baseline characteristics were similar. Modified Tochen's formula was significantly (p = 0.006) closer to the optimum position when compared to Tochen's formula. The percentages of optimum and adequate placements of the ET tube was higher in the modified Tochen's group, though not statistically significant.

Conclusion: Modified Tochen's formula in LBW babies may enable more optimum placement of ETs.
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http://dx.doi.org/10.1038/s41372-018-0044-8DOI Listing
May 2018

Evaluation of body parameters for estimation of endotracheal tube length in Indian neonates.

Eur J Pediatr 2015 Feb 3;174(2):245-9. Epub 2014 Aug 3.

St. John's Medical College, Bangalore, India,

Unlabelled: The objectives were to estimate the incidence of inadequate placement of the endotracheal tube (ET) using Tochen's formula (6 + birth weight) and to correlate optimum ET length with anthropometric measurements in neonates. A cross-sectional analytical study was conducted in 50 neonates. Neonates requiring intubation for ventilation, with a confirmatory chest radiograph, were intubated using Tochen's formula, after which tube placement was verified by auscultation. The incidence of inadequate placement and optimum length of ET insertion were estimated from chest radiographs. Anthropometric parameters were measured and correlated with the optimum length and regression equations generated. The incidence of inadequate placement of the ET was 40 % (20 of 50). The incidence of inadequate placement was higher (5 of 6, 83 %) in extremely low birth weight (ELBW) infants, and in extreme preterm infants (5 of 5, 100 %). It was found that all the anthropometric parameters correlated well (r between 0.71 and 0.84) with the optimum ET length.

Conclusion: The incidence of inadequate placement was high, especially in the ELBWs' and extreme preterm infants. Birth weight, sternal length, and shoulder umbilical length correlated significantly with optimum ET length and may guide optimal ET placement.
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http://dx.doi.org/10.1007/s00431-014-2388-1DOI Listing
February 2015