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  • 1.
    Brown, Nick
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Child Health and Nutrition. Lanssjukhuset Gavle Sandviken, Dept Paediat, Gavle, Sweden;Aga Khan Univ, Dept Child Hlth, Karachi, Pakistan.
    [Editor's note:] Clinical and cost-effectiveness of the Lightning Process in addition to specialist medical care for paediatric chronic fatigue syndrome: randomised controlled trial (vol 103, pg 155, 2018)2019In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 104, no 10, article id UNSP e3Article in journal (Other academic)
  • 2.
    Di Gravio, Chiara
    et al.
    Univ Southampton, MRC Lifecourse Epidemiol Unit, Southampton Gen Hosp, Tremona Rd, Southampton SO16 6YD, Hants, England.
    Lawande, Ashwin
    Dr Joshi Imaging Clin, Mumbai, Maharashtra, India.
    Potdar, Ramesh D.
    Ctr Study Social Change, Mumbai, Maharashtra, India.
    Sahariah, Sirazul A.
    Ctr Study Social Change, Mumbai, Maharashtra, India.
    Gandhi, Meera
    Ctr Study Social Change, Mumbai, Maharashtra, India.
    Brown, Nick
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Child Health and Nutrition.
    Chopra, Harsha
    Ctr Study Social Change, Mumbai, Maharashtra, India.
    Sane, Harshad
    Ctr Study Social Change, Mumbai, Maharashtra, India.
    Kehoe, Sarah H.
    Univ Southampton, MRC Lifecourse Epidemiol Unit, Southampton Gen Hosp, Tremona Rd, Southampton SO16 6YD, Hants, England.
    Marley-Zagar, Ella
    Univ Southampton, MRC Lifecourse Epidemiol Unit, Southampton Gen Hosp, Tremona Rd, Southampton SO16 6YD, Hants, England.
    Margetts, Barrie M.
    Univ Southampton, Publ Hlth Nutr, Southampton, Hants, England.
    Jackson, Alan A.
    NIHR Southampton Biomed Res Ctr, Southampton, Hants, England.
    Fall, Caroline H. D.
    Univ Southampton, MRC Lifecourse Epidemiol Unit, Southampton Gen Hosp, Tremona Rd, Southampton SO16 6YD, Hants, England.
    The Association of Maternal Age With Fetal Growth and Newborn Measures: The Mumbai Maternal Nutrition Project (MMNP)2019In: Reproductive Sciences, ISSN 1933-7191, E-ISSN 1933-7205, Vol. 26, no 7, p. 918-927Article in journal (Refereed)
    Abstract [en]

    Background: Young maternal age is associated with poorer birth outcomes, but the mechanisms are incompletely understood. Using data from a prospective cohort of pregnant women living in Mumbai slums, India, we tested whether lower maternal age was associated with adverse fetal growth.

    Methods: Fetal crown-rump length (CRL) was recorded at a median (interquartile range, IQR) of 10 weeks' gestation (9-10 weeks). Head circumference (HC), biparietal diameter (BPD), femur length (FL), and abdominal circumference (AC) were recorded at 19 (19-20) and 29 (28-30) weeks. Newborns were measured at a median (IQR) of 2 days (1-3 days) from delivery. Gestation was assessed using prospectively collected menstrual period dates.

    Results: The sample comprised 1653 singleton fetuses without major congenital abnormalities, of whom 1360 had newborn measurements. Fetuses of younger mothers had smaller CRL (0.01 standard deviation [SD] per year of maternal age; 95% confidence interval CI: 0.00-0.02(1); P = .04), and smaller HC, FL, and AC at subsequent visits. Fetal growth of HC (0.04 cm; 95% CI: 0.02-0.05; P < .001), BPD (0.01 cm; 95% CI: 0.00-0.01; P = .009), FL (0.04 cm; 95% CI: 0.02-0.06; P < .001), and AC (0.01 cm; 95% CI: 0.00-0.01; P = .003) up to the third trimester increased with maternal age. Skinfolds, head, and mid-upper arm circumferences were smaller in newborns of younger mothers. Adjusting for maternal prepregnancy socioeconomic status, body mass index, height, and parity attenuated the associations between maternal age and newborn size but did not change those with fetal biometry.

    Conclusion: Fetuses of younger mothers were smaller from the first trimester onward and grew slower, independently of known confounding factors.

  • 3.
    Jehan, Fyezah
    et al.
    Aga Khan Univ, Dept Paediat & Child Hlth, Stadium Rd,POB 3500, Karachi 74800, Pakistan.
    Nisar, Imran
    Aga Khan Univ, Dept Paediat & Child Hlth, Stadium Rd,POB 3500, Karachi 74800, Pakistan.
    Kerai, Salima
    Aga Khan Univ, Dept Paediat & Child Hlth, Stadium Rd,POB 3500, Karachi 74800, Pakistan.
    Brown, Nick
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Child Health and Nutrition. Aga Khan Univ, Dept Paediat & Child Hlth, Stadium Rd,POB 3500, Karachi 74800, Pakistan;Lanssjukhuset Gavle Sandviken, Dept Paediat, Gavle, Sweden.
    Ambler, Gwen
    PATH, Seattle, WA USA.
    Zaidi, Anita K. M.
    Aga Khan Univ, Dept Paediat & Child Hlth, Stadium Rd,POB 3500, Karachi 74800, Pakistan.
    Should fast breathing pneumonia cases be treated with antibiotics?: The scientific rationale for revisiting management in Low and Middle income countries2019In: International Journal of Infectious Diseases, ISSN 1201-9712, E-ISSN 1878-3511, Vol. 85, p. 64-66Article in journal (Refereed)
    Abstract [en]

    Background: Pneumonia is the largest single contributor to child mortality and the problem is more acute in low and middle income countries. The World Health Organization (WHO) currently recommends oral antibiotic treatment for all children with fast breathing pneumonia without danger signs. It is, however, widely acknowledged that most such infections are viral and self-limiting and that the evidence for the guidance is weak.

    Rationale: Overuse of antibiotics exposes children to adverse events, increases cost for families, burdens already stretched health care resources and may contribute to development of antibiotic resistance.

    Conclusion: There is equipoise regarding utility of antibiotic in case of fast breathing pneumonia and no high quality trial evidence exists. This paper provides further information behind the rationale for conducting non-inferiority trials to test the hypothesis that antibiotics may not be necessary for children with fast breathing as the sole symptomatology.

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