Examine sermons of Dr Zakir Naik: Bangladesh tells India

Washington D.C., May 8: The prime time for brain development in a child's life is the first year, where the infant spends most of the time asleep. It is the time when neural connections form and sensory memories are encoded.

However, when sleep is disrupted, as occurs more often among children with autism, brain development may be affected, too.

New research led by the University of Washington finds that sleep problems in a baby's first 12 months may not only precede an autism diagnosis but also may be associated with altered growth trajectory in a key part of the brain, the hippocampus.

The study, which was published in the American Journal of Psychiatry, researchers report that in a sample of more than 400 taken of 6- to 12-month-old infants, those who were later diagnosed with autism were more likely to have had difficulty falling asleep.

It also states that this sleep difficulty was associated with altered growth trajectories in the hippocampus.

"The hippocampus is critical for learning and memory, and changes in the size of the hippocampus have been associated with poor sleep in adults and older children.

As many as 80 per cent of the children with autism spectrum disorder have sleep problems," said Annette Estes, director of the UW Autism Center and senior author of the study.

"In our clinical experience, parents have a lot of concerns about their children's sleep, and in our work on early autism intervention, we observed that sleep problems were holding children and families back," added Estes, who is also a UW professor of speech and hearing sciences.

"It could be that altered sleep is part-and-parcel of autism for some children. One clue is that behavioural interventions to improve sleep don't work for all children with autism, even when their parents are doing everything just right. This suggests that there may be a biological component to sleep problems for some children with autism," said Estes.

To consider links among sleep, brain development, and autism, researchers at the IBIS Network looked at MRI scans of 432 infants, surveyed parents about sleep patterns, and measured cognitive functioning using a standardized assessment.

At the outset of the study, infants were classified according to their risk for developing autism: Those who were at higher risk of developing autism -- about two-thirds of the study sample -- had an older sibling who had already been diagnosed.

Infant siblings of children with autism have a 20 per cent chance of developing autism spectrum disorder -- a much higher risk than children in the general population.

In the current study, 127 of the 432 infants were identified as "low risk" at the time the MRI scans were taken because they had no family history of autism.

They later evaluated all the participants at 24 months of age to determine whether they had developed autism. Of the roughly 300 children originally considered "high familial risk," 71 were diagnosed with autism spectrum disorder at that age.

Problems with sleep were more common among the infants later diagnosed with an autism spectrum disorder, as were larger hippocampi. No other subcortical brain structures were affected, including the amygdala, which is responsible for certain emotions and aspects of memory, or the thalamus, a signal transmitter from the spinal cord to the cerebral cortex.

The authors note that while parents reported more sleep difficulties among infants who developed autism compared to those who did not, the differences were very subtle and only observed when looking at group averages across hundreds of infants.

Sleep patterns in the first years of life change rapidly as infants transition from sleeping around the clock to a more adult-like sleep/wake cycle. Until further research is completed, Estes said, it is not possible to interpret challenges with sleep as an early sign of increased risk for autism.

Bengaluru, Jun 12: The Central government has identified Karnataka's Udupi and Yadgir among the "emerging districts of concern" for COVID-19 in the country. Confirming the development, a top official of the state health department said, "they (centre) had reviewed these two districts a few days back...there was a sudden spurt of cases due to Maharashtra returnees turning positive." Sources said union cabinet secretary Rajiv Gauba, during a recent video conference with state chief secretaries and health secretaries, had shared his thoughts on the issue.

According to the information shared, districts with more than 400 cases, half of which was reported post-May 18 lockdown relaxation, have been identified as "emerging districts of concern." They are concentrated in the seven states/union territories of Maharashtra, Rajasthan, Tamil Nadu, West Bengal, Karnataka, Jammu and Kashmir and Haryana. "Udupi and Yadgir from Karnataka, along with Gurugram in Haryana and Kolhapur in Maharashtra have 90 per cent of the cases recorded after May 18," they said.

As on June 11 evening, Udupi had a total of 969 positive cases, out of which 619 are active, while 735 positive cases have been reported in Yadgir, out of which 626 are active. The two districts had reported a total of only 11 cases each as on May 18. While Udupi till last evening had seen 349 discharges, it was 108 in Yadgir.

Both districts have reported one COVID related fatality so far. As of June 11 evening, cumulatively 6,245 COVID-19 positive cases were confirmed in the state, which included 72 deaths and 2,976 discharges.

Bengaluru, Jun 20: The Karnataka Health Department has issued guidelines on the admission of COVID-19 patients in private hospitals after clinical assessment, mandating that the district surveillance officer (DSO) should be first informed to initiate further procedures, an official said on Friday.

"A health team sent by the DSO should visit the home or hospital where the patient is staying. The team should conduct a rapid assessment of his or her health condition," said Karnataka's Additional Chief Secretary Jawaid Akhtar.

In the rapid health condition assessment, the team should first check the patient's body temperature, followed by SpO2 (oxygen saturation) level and confirm if there are any comorbidities such as hypertension, diabetes, tuberculosis, HIV, cancer, stroke etc.

Depending on the health condition of patients, Akhtar said, two categories have been made.

"Those who have body temperature greater than 37.5 degrees Celsius, SpO2 level below 94 percent, elderly (above 60 years) and suffering from known comorbid conditions should be taken to a dedicated Covid hospital (DCH)," he said.

"All other patients, even if older but not suffering from co-morbidities, those below 60 and suffering from co-morbidities and asymptomatic cases should be taken to a dedicated Covid health centre (DCHC) or a private hospital as opted by the patient," he added.

Private hospitals have been asked to pitch in due to the rising number of cases in Karnataka. Currently, there are 2943 active cases in the state after 337 cases were reported on Friday.

"The patients are assessed clinically and evaluated at DCHCs or private hospitals with appropriate diagnostic tests. After evaluation, if the patients are asymptomatic, they are shifted to a COVID Care Centre (CCC) for further management," said Akhtar.

CCCs are expected to be equipped with ventilated rooms, pulse oximeters, handheld thermal scanners and blood pressure apparatus.

A nurse has to be present round the clock for every 50 patients and should visit each patient twice a day for assessment whereas the medical officer has to visit the CCC once a day. He should also be available on call in case of an emergency.

Staff serving food and others should wear personal protective equipment and an N-95 mask. Explaining the procedures at DCHCs, Akhtar said general examinations for medical conditions like body temperature, BP, pulse, oxygen saturation and urine output should be in place.

Investigations such as complete blood count, fasting blood sugar, random blood sugar, liver function tests, renal function tests, ECG and chest X-ray facilities should be available.

"DCHCs should ensure that above examinations are over in an orderly timeline of 24 hours and depending on the examination, the patient is continued to be lodged at the DCHC or sent to DCH or CCC," said the senior officer.

Likewise, the discharge policy should be done as per the protocols issued by the Health Department from time to time.

The Karnataka government is yet to fix an upper limit on the cost of treating COVID-19 patients in private hospitals. While reports indicated that this could be capped at Rs 5200 per day, health officials are yet to specify this is the case. Private hospitals in the state have asked the government to take a collaborative approach in deciding the fixed cap on treatment cost.