Biomedical subjects
I Bhargava
Publications and source records attributed to I Bhargava.
Undergraduate pediatric education in India.
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The expanded programme on immunization: a decade of progress in India.
The Expanded Programme on Immunization (EPI) was initiated in India in 1978 with the objective to reduce morbidity and mortality from diphtheria, pertussis, tetanus, poliomyelitis and childhood tuberculosis by providing immunization services to all eligible children and pregnant women by 1990. Measles vaccine was included when the EPI was accelerated by launching the Universal Immunization Programme (UIP) in 1985-6. Approximately half of all infants now receive complete primary immunization with diphtheria, polio and tetanus (DPT), oral polio vaccine (OPV) and BCG vaccine. Forty-six per cent of pregnant women currently receive a second or booster dose of tetanus toxoid (TT). Surveillance reports from selected areas have documented impact through reduction of disease incidence. Although vaccination coverage levels are increasing, continued acceleration is needed to achieve the universal levels targeted for 1990.
Role of consanguinity in chromosomal syndromes.
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Anthropometry of the newborn and its relation to maternal factors.
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Blood vessels of the twin placenta in relation to zygosity.
The anatomical characteristics of the arteries, veins and arteriovenous relationships, velamentous vessels, and vascular communications in 148 placentae from multiple pregnancies were studied. All features were found to show discordance of varying degrees, irrespective of the twins' zygosity. Singular involvement of one component of the twin placenta by hydramnios or congenital defects, incidence of vascular communications and the anatomical characteristics of the vessels in conjoined twins, acardiac monsters and triplets, and a chromosomal discordance in a MZ pair, lend additional support to the initial surmise of anatomical characteristics of fetal blood vessels of the placenta being determined by functional demands. It is suggested that the inequalities of prenatal environment be assessed by an examination of the fetal blood vessels of the placenta before drawing homologies in the twin concordance studies.
Vascular anastomoses in twin placentae and their recognition.
166 placentae from multiple pregnancies (including three triplets and 17 monochorral) have been studied by injection corrosion technique, using cellulose acetate buterite in acetone, under continuous pressure within physiological limits. It has been shown that vascular anastomoses in twin placentae are usually multiple. The direct type is frequently found in monochorial twin placentae and is mostly arterial or venous in nature. The indirect type is observed more commonly in dichorial twin placentae and is mostly arteriovenous in nature. Both types are almost universally found in monochorial monoamniotic placentae. The presence of direct anastomotic channels has a highly significant association with the incidence of marginal vessels and an exaggeration of parameters of stress to an abnormal quantum--both singly and in combinations of three or more-, and is independent of the pattern of branching. In the ontogenetic time-sequence perspective, direct anastomoses, marginal vessels and parameters of stress in a twin placenta can be regarded as different phases of the sequelae of an altered vascular relationship caused by disturbances in the vicinity of the 12th week of gestation. It has been further shown that direct vascular anastomoses are a greater risk to the twins than indirect ones. The importance of early and timely recognition of such channels, by an examination of twin placentae for the presence of marginal vessels, is stressed.