Rahul Gajbhiye

• MBBS, PhD
• Head of the Department at ICMR-National Institute for Research in Reproductive and Child Health

In brief The transition from histones to protamines during spermiogenesis is critical for male genome integrity and influences fertilisation and early embryogenesis. This study reveals that specific 5′ UTR single nucleotide polymorphisms (SNPs) and promoter methylation of the H2BC1 gene may regulate TSH2B expression in sperm, contributing new insig...

Endometriosis and adenomyosis are major gynaecological conditions affecting women of reproductive age-group, particularly in low- and middle-income countries. This Health Policy outlined research priorities for India and Sri Lanka, derived from a structured debate during the ‘Future Directions in Endometriosis and Adenomyosis Research’ workshop. Re...

Background: Snakebite envenomation (SBE), a neglected tropical disease is a significant cause of mortality and disability in India. Despite which comprehensive epidemiological data remains scarce. This study aimed to estimate the incidence, mortality, clinical outcomes, treatment-seeking behavior, and socio-economic burden of SBE across India. Meth...

India accounts for one-half of global snakebite-related deaths. The recently launched National Action Plan for the Prevention and Control of Snakebite Envenoming in India is a comprehensive initiative designed to address this burden. It aims to ensure universal access to antivenom, strengthen healthcare systems, train healthcare professionals and e...

Syphilis is a major public health concern particularly in vulnerable populations. Maternal syphilis mainly causes congenital syphilis, which contributes to the high risk of stillbirth. Data on the prevalence and trends of maternal syphilis in the Indian population are very limited. This narrative review assesses current trends, geographic distribut...

Background & objectives Snakebite envenoming (SBE) is a major public health concern, with India bearing the highest global burden of SBE-related deaths. SBE is concentrated in rural and tribal regions of India, where the knowledge, attitude and behaviour of the dwelling communities largely influence mortality and morbidity. Understanding these fact...

Endometriosis, affecting approximately 10% of reproductive-aged women globally, poses significant challenges, including chronic pelvic pain, dysmenorrhea, and infertility. In low- and middle-income countries like India, accessibility to affordable infertility care remains a concern. This multicenter prospective cohort study, conducted across six te...

The International Day of the World’s Indigenous Peoples and the Tribal Pride Day hold significant importance in India, home to 106 million indigenous individuals. There are 705 recognized Scheduled Tribes (STs) in India that enrich the nation’s cultural fabric but experience disproportionately high morbidity and mortality. Historical injustice, geo...

Snakebite envenoming (SBE) is a global health challenge, predominantly affecting economically disadvantaged regions. India contributes significantly to global snakebite mortality. Since 2013, the Indian Council of Medical Research (ICMR) has spearheaded efforts to combat SBE. A multi-sectoral engagement in the snakebite research projects and inputs...

The article highlights the disparities in global health and the challenges LMIC researchers face in global health. We suggested feasible alternatives to address these issues. It is now time for the well-intentioned global health agencies to hand over meaningful roles to emerging leaders from LMICs and squash tokenism.

Synopsis The adverse outcomes of COVID‐19 among pregnant women have been pronounced in the low‐income countries compared with low‐ and middle‐income countries.

National programme for prevention & control of snakebite in India: Key challenges & recommendations

Objective To estimate incidence, risk of early and late-onset preeclampsia (PE) and understand their relationship with severity of COVID-19. Methods Pregnant women with COVID-19 (n = 1929) were enrolled from 1 April 2020 to 24 February 2022. Primary outcome measure was incidence and risk of early onset PE in women with COVID-19. Results The incid...

Background Pregnancy outcome is an important health indicator of the quality of maternal health. Adverse pregnancy outcomes is a major public health problem, which can lead to poor maternal and neonatal outcomes. This study investigates the trends in pregnancy outcomes prevalent during 2015–2021 in Indian women. Methods The study analysed the data...

Background Snakebite envenoming (SBE) is an acute, life-threatening emergency in tropical and subtropical countries. It is an occupational hazard and a major socioeconomic determinant. Limited awareness, superstitions, lack of trained health providers, poor utilization of anti-venom results in high mortality and morbidity. India is the snakebite ca...

More than 533 million Coronavirus Disease 2019 (COVID-19) cases and associated 6 million fatalities were reported globally whereas 43 million cases and 0.5 million deaths in India were reported till June 2022. Maharashtra state alone reported about one-third of the total cases of COVID-19 in India in the early period of COVID-19 pandemic. The lack...

Background: Snakebite envenoming (SBE) is an acute, life-threatening emergency in tropical and subtropical countries. It is an occupational hazard and a major socioeconomic determinant. Limited awareness, superstitions, lack of trained health providers, poor utilization of anti-venom results in high mortality and morbidity. India is the snakebite c...

Objective To study clinical presentation, disease severity, pregnancy complications, and maternal outcomes in women affected with coronavirus disease 2019 (COVID‐19) during the third wave compared with the first and second waves of COVID‐19. Methods A retrospective, observational cohort study was conducted among 2058 pregnant and postpartum women...

COVID-19 pandemic has affected all age groups globally including pregnant women and their neonates. The aim of the study was to understand outcomes in neonates of mothers with COVID-19 during the first and second waves of COVID-19 pandemic. A retrospective analysis of 2524 neonates born to SARS-CoV-2-infected mothers was conducted during the first...

Objective Investigate Testis specific Histone 2B (TSH2B) and its gene anomalies in infertile men Design Case- control study Subjects Fertile and infertile men Intervention Not applicable Main outcome measures Histone and protamine status of sperm was studied by Aniline blue and Chromomycin A3 (CMA3) staining, respectively. TSH2B, total H2B and...

Background There are conflicting data on the mother-to-child transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and few studies have described the clinical course of neonates infected with SARS-CoV-2. Objectives This study investigates the mother-to-child transmission rate and clinical profile of SARS-CoV-2-infected newbor...

Endometriosis is a public health disorder affecting ∼ 247 million women globally and ∼ 42 million women in India. Women with endometriosis suffer from dysmenorrhea, chronic pelvic pain, dyspareunia, dyschezia, fatigue, depression, and infertility leading to significant socioeconomic impact and morbidity. The etiology of endometriosis is not underst...

Problem: Surfactant protein D (SP-D), a multimeric collectin expressed by testicular mucosal epithelia and is positively regulated by testosterone. It exerts antimicrobial effects, modulates inflammation and rescued spermatogenesis in a murine model. Various cytokines and chemokines, including MCP-1, play a key role in regulating the inflammation...

Introduction Pregnant women are at increased risk of contracting COVID-19 due to several factors and therefore require special attention. However, the consequences of the COVID-19 pandemic on pregnant women and their newborns remain uncharted. The PregCovid registry aims to document the impact of SARS-CoV-2 infection on pregnant, postpartum women a...

Objective To study clinical, surgical characteristics and the relationship between endometriosis lesion types and conception rate after surgery in infertile women with endometriosis. Methods A prospective, multicenter cohort of 204 women (age 20–35 years) with endometriosis was followed up post‐surgery between November 2017 and February 2020 at th...

Recent data suggest that the DNA damage response (DDR) is altered in the eutopic endometrium (EE) of women with endometriosis and this probably ensues in response to higher DNA damage encountered by the EE in endometriosis. DDR operates in a tissue-specific manner and involves different pathways depending on the type of DNA lesions. Among these pat...

Importance: Following the outbreak of SARS-CoV-2 infection, it is unclear whether there is any difference in clinical presentation, disease severity, pregnancy complications, and maternal outcomes in pregnant and postpartum women during the third wave of COVID-19 as compared to the earlier two waves of COVID-19. Objective: To assess the clinical p...

Background Biological relevance of the major testis specific histone H2B variant (TH2B) in sperm is not fully understood. Studies in TH2A/TH2B double knockout male mice indicate its role in chromatin compaction and male fertility. Additionally, the presence of TH2B and TH2A reportedly generates more dynamic nucleosomes, leading to an open chromatin...

Aim: Although two-wave pattern of the coronavirus disease-2019 (COVID-19) pandemic was observed in many countries, there is limited information on the impact of both the waves on clinical presentations of ectopic pregnancy (EP) with COVID-19. Therefore, we aimed to understand the impact of the first wave and second wave of COVID-19 pandemic on wome...

Objective To compare spontaneous preterm birth (SPTB) and iatrogenic preterm birth (IPTB) rates during both waves of the coronavirus disease 2019 (COVID‐19) pandemic. Methods Retrospective analysis of the PregCovid registry of pregnant women with COVID‐19 was performed at a dedicated COVID‐19 hospital in Mumbai, India. The data of 1630 women were...

Background & objectives: The PregCovid registry was established to document the clinical presentations, pregnancy outcomes and mortality of pregnant and post-partum women with COVID-19. Methods: The PregCovid registry prospectively collects information in near-real time on pregnant and post-partum women with a laboratory- confirmed diagnosis of SAR...

Background: Limited information is available on the aetiology and semen profiles of male infertility in Indian population. Aim: The aim of this study is to study the clinical and semen characteristics of men attending the infertility clinic and also to understand the impact of World Health Organization (WHO) 2010 reference values on the diagnosi...

Lack of reliable data on the risk of spontaneous abortions (SABs) due to COVID-19 is leading to concern in patients, and obstetricians. The SAB rate (per 1,000 births) was significantly higher during the second wave as compared to the first wave of the COVID-19 pandemic (82.6 vs 26.7; p<0.001) as well as the prepandemic period (OR 1.7, 95%; CI 1.16...

• Stillbirth rate among COVID-19 pregnant women was higher in second wave (p=0.038) • Preeclampsia was reported higher during the second wave among stillbirths (p=0.590) • More stillbirths occurred at <34 weeks gestation during the second wave (p=0.214) • Moderate-severe COVID-19 was observed only during the second wave among stillbirths • Reducing...

For combating the SARS-CoV-2 infection, health-care workers (HCWs) have been on the forefront making them vulnerable for a higher risk of contagious SARS-CoV-2 infection. Identification of risk factors for increased susceptibility for COVID-19 in healthcare workers is urgently required especially during the devastating second wave to reduce the mo...

Introduction India has remarkably the highest number of snakebite cases contributing to nearly 50% of the global snakebite deaths. Despite this fact, there is limited knowledge and awareness regarding the management practices for snakebite in the Indian population. The study aimed to explore the knowledge, awareness, and perception of snakes and sn...

Introduction Endometriosis is one of the common, gynaecological disorders associated with chronic pelvic pain and subfertility affecting ~10% of reproductive age women. The clinical presentation, etiopathogenesis of endometriosis subtypes and associated risk factors are largely unknown. Genome-Wide Association (GWA) Studies (GWAS) provide strong ev...

Protocol for a prospective, hospital-based registry of pregnant women with SARS-CoV-2 infection in India: PregCovid Registry study. https://pregcovid.com

Background SARS‐CoV‐2 has infected a large number of pregnant women. Objective To compare clinical, perinatal outcomes of women with COVID‐19 from high‐income countries (HICs) and low‐ to middle‐income countries (LMICs). Search strategy Online databases were searched. Selection criteria Original studies on pregnant women with COVID‐19 were inclu...

Rates of severe coronavirus disease 2019 (COVID-19), intensive care unit admission, and maternal mortality increased among pregnant and postpartum women admitted for COVID-19 in the second wave compared with the first wave in India.

Infertility affects 8%–12% of couples worldwide with a male factor contributing to nearly 50% of couples either as a primary or contributing cause. Several genetic factors that include single-gene and multiple-gene defects associated with male infertility were reported in the past two decades. However, the etiology remains ambiguous in a majority o...

Introduction: We describe the clinical characteristics, management, and short-term outcomes of SARS-CoV-2 neonates born to mothers with COVID-19 in a tertiary care hospital in Mumbai, India. Methods: The study is a retrospective analysis of 524 neonates born to mothers with COVID-19 admitted from 14th April 2020 to 31st July 2020. Results: SAR...

Neurological complications of COVID-19 affecting both the central and peripheral nervous system and skeletal muscles are being increasingly reported. However, to our knowledge, acute neurological complications of COVID-19 are not reported to date. We report a rare case of GBS in a pregnant woman with COVID-19 who suffered from spontaneous abortion...

Background There is growing evidence of Multisystem Inflammatory Syndrome in Children (MIS-C) resembling Kawasaki disease in children infected with SARS-CoV-2. The review was undertaken to evaluate the case definition, the spectrum of clinical presentations and current management practices in children with COVID-19 presenting with or without MIS-C....

Pregnant women with symptomatic COVID‐19 should also be tested for TB in countries with a high burden of TB. The infrastructure of the TB Program can be utilized for the control of COVID‐19, and vice versa.

We observed that, little is still known about the impact of the SARS-CoV-2 infection on pregnant women with heart disease (HD). Aim of our study was to investigate the impact of COVID-19 on pregnancy and neonate retrospectively at BYL Nair Charitable Hospital (NH), a dedicated COVID-19 hospital in women with HD in Mumbai, India. In the initial phas...

Background: Reinfection/reactivation of SARS-CoV-2 has been a matter of great interest from the immunological and vaccine perspective. However, little is known about the clinical presentation of such reinfection/reactivation. We report a case series of 9 COVID-19 patients having experienced two clinically- and/or virologically-confirmed episodes of...

Background Healthcare workers (HCWs) are at higher risk of contracting SARS‐CoV‐2 infection. Information regarding co‐infection of SARS‐CoV‐2 with vector‐borne diseases (malaria and dengue) is crucial especially for the countries wherein malaria and dengue are endemic. The objective was to study the prevalence, demographic, clinical presentations a...

PTMs and microtubule-associated proteins (MAPs) are known to regulate microtubule dynamicity in somatic cells. Reported literature on modulation of α-tubulin acetyl transferase (αTAT1) and histone deacetylase 6 (HDAC6) in animal models and cell lines illustrate disparity in correlating tubulin acetylation status with stability of MT. Our earlier st...

Coronavirus disease 2019 (COVID-19) is caused by infection of the respiratory tract by SARS-CoV-2 which survives in the tissues during the clinical course of infection but there is limited evidence on placental infection and vertical transmission of SARS-CoV-2. The impact of COVID-19 in first trimester pregnancy remains poorly understood. Moreover,...

Objective To assess clinical presentations, pregnancy complications, and maternal and neonatal outcomes among women with multiple gestation pregnancy (MGP) and confirmed SARS‐CoV‐2 (COVID‐19) infection and to compare the data with a pre‐pandemic period. Methods A retrospective study at a dedicated COVID‐19 Hospital in Mumbai, India. Data were obta...

Pregnant woman with delirium and COVID-19 is extremely challenging to manage especially in low income and middle income countries (LMICs). we recommend the training of healthcare workers on early recognition and appropriate treatment of psychiatric emergencies in pregnancy and post-partum period. There is a need for creating specialist mental healt...

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is rapidly spreading in India and across the world. Healthcare workers (HCWs) are at increased risk of contracting COVID-19 due to direct or indirect exposure to COVID-19 patients, and require special attention. Limited information is available about its effect in...

Background & objectives: Due to limited information available on the frequency and spectrum of cystic fibrosis (CF) transmembrane conductance regulator (CFTR) gene mutations in congenital bilateral absence of vas deferens (CBAVD) in Indian population, it is difficult to provide accurate genetic counselling to couples. The present study was underta...

STUDY QUESTION Is the DNA damage response (DDR) dysregulated in the eutopic endometrium of women with endometriosis? SUMMARY ANSWER Endometrial expression of genes involved in DDR is modulated in women with endometriosis, compared to those without the disease. WHAT IS KNOWN ALREADY Ectopic endometriotic lesions are reported to harbour somatic mut...

Physicians and obstetricians should be vigilant so that they can swiftly identify co‐infections of malaria and dengue in pregnant women with COVID‐19.

This data on undocumented or “steady state” infections in pregnant women is useful for ensuring safe obstetric and neonatal services and assessing the burden of COVID-19 in the region to plan strategies on strengthening or relaxing mass social distancing measures. We strongly recommend that the strategy of universal testing of pregnant women admitt...

Coronaviruses infect the respiratory tract and are known to survive in these tissues during the clinical course of infection. However, how long can SARS-CoV-2 survive in the tissues is hitherto unknown. Herein, we report a case where the virus is detected in the first trimester placental cytotrophoblast and syncytiotrophoblasts five weeks after the...

It might be possible that altered immune mechanisms in patients with SARS-CoV-2 infection may be a risk factor for developing psychiatric illness. Neuropsychiatric sequalae can also be due to a direct neurotoxic effect of the virus or the host’s immune response towards it. Having comorbid COVID-19 infection or the fact that these women had to deliv...

Objective: The aim of this systematic review was to examine published and preprint reports for maternal and fetal outcomes in pregnant women with COVID-19 and also assess the incidence of maternal-fetal transmission of SARS CO-V-2 infection. Design : Systematic review Data sources:We searched PUMBED. Medline, Embase, MedRxiv and bioRxiv databases u...

Congenital bilateral absence of the vas deferens (CBAVD) involves a complete or partial defect of the Wolffian duct derivatives and is a common cause of obstructive azoospermia. There are different subphenotypes of CAVD such as congenital bilateral absence of vas deferens (CBAVD), congenital unilateral absence of vas deferens (CUAVD), and CBAVD/CUA...

Congenital bilateral absence of vas deferens (CBAVD) is responsible for 2-6 % of male infertility cases and use of Assisted Reproductive Techniques (ART) especially testicular or epididymal sperm aspiration and Intracytoplasmic Sperm Injection (ICSI) is the treatment of choice to achieve biological fatherhood in men having CBAVD. There is a risk of...

Snakebite is a major public health problem in rural India contributing to half of the global cases of snakebites (2.8 million) with approximately 50,000 deaths per year. Snakebite mostly affects mainly poor, agricultural and migrant workers, tribes, hunters, often take away the life or disable of earning member of their families. In majority of cas...

This study was undertaken to know the incidence and management practices of snakebite envenomation at the First Referral Unit - Sub-District Hospital, Dahanu, Maharashtra, India. Retrospective analysis of snakebite case records (n=145) was carried out for one-year period (January to December 2014). The annual incidence of snakebite was 36 per 100,0...

Variation in reproductive lifespan and female fertility have implications for health, population size and ageing. Fertility declines well before general signs of menopause and is also adversely affected by common reproductive diseases, including polycystic ovarian syndrome (PCOS) and endometriosis. Understanding the factors that regulate the timing...

Endometriosis is characterized by the growth of epithelial and stromal cells outside the uterine cavity. It has a complex etiology and affects ∼10% of reproductive age women. It is accompanied by a chronic inflammatory response with substantial evidence to indicate genetic susceptibility. The causal genes and their pathways leading to endometriosis...

Background: Preterm births are an enormous global problem on families, medical system and economy. The rates of preterm birth are increasing and one of the contributors is growing use of Assisted Reproduction Techniques (ART) leading to multifetal gestations. Some risk factors for preterm birth are specific to women who conceive by ART. Since there...

The aim of the study was to detect the frequency of the CFTR gene variants poly-T, TG repeats and c.1408A>G p.Met470Val (M470V) in Indian men with congenital bilateral absence of the vas deferens (CBAVD). Men diagnosed with CBAVD (n = 76), their female partners (n = 76) and healthy men from general population (n = 50) were recruited. Genomic DNA wa...

An abnormality of cystic fibrosis transmembrane conductance regulator (CFTR) gene is known to be one of the etiologies of male infertility. CFTR gene mutations are associated with cystic fibrosis (CF-severe phenotype) to congenital bilateral absence of the vas deferens (CBAVD-mild phenotype). CF is the most common autosomal recessive disorders in t...

Endometriosis, characterized by the presence of endometrial-like tissue at extrauterine sites, is a common, chronic, estrogen-dependent, inflammatory condition associated with pelvic pain, subfertility, dysmenorrhea, and dyspareunia, affecting about 10% of reproductive-age women in any population. The diagnosis of endometriosis is usually delayed o...

Background & objectives: The role of cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations in congenital bilateral absence of vas deferens and unilateral renal agenesis (CBAVD-URA) has been controversial. Here, we report the cases of five Indian males with CBAVD-URA. The objective was to evaluate the presence or absence of CFTR...

The unmet need for contraception in India (NFHS-3, 2005-06) is about 13 per cent of which 6.2 per cent for spacing and 6.6 per cent for limiting the family. Introducing a modern method of contraception increases the prevalence by 3 per cent and reduces the unmet need by 1.6 per cent. The aim of this study was to explore the acceptability of Female...

GRP78, a resident endoplasmic reticulum (ER) chaperone involved in protein transport, folding and assembly, has been reported in sperm. It is shown to be localized in the neck region of human sperm. We have previously reported GRP78 to be less phosphorylated in asthenozoosperm.The present study aimed to determine whether sperm GRP78 undergoes phosp...

Optimization assays for GRP78 phosphodetection in sperm. (DOCX)

Effect of Urea on the GRP78 profile in rat testicular- and caudal sperm. A representative isoelectropherogram of overlaid profiles of GRP78 for testicular sperm (A) and Caudal sperm (B) using 20ng of protein lysate made in lysis buffer containing No Urea (blue), 6M (red), and 9M (green) of Urea. Three peaks were observed for testicular- and four pe...

Effect of Phosphatase Inhibitors present in NP40 lysis buffer on the outcome of λ-PP treatment of rat sperm lysates. This was studied by using testicular- or caudal sperm lysates prepared in NP40 lysis buffer containing phosphatase inhibitor cocktail or devoid of it, and incubating 100 μg of these lysates without or with 300U of λ-PP at 30°C for 2...

NIA profile of GRP78 in rat sperm using Premix of pI range 5–6. A) A representative isoelectropherogram of GRP78 profile in testicular sperm (red). Three peaks GP4.94, GP4.96 and GP5.43 were consistently observed for testicular sperm. In caudal epididymal sperm (blue), four peaks GP4.85, GP4.94, GP4.96 and GP5.43 were consistently observed. ‘GP’ re...

Effect of different concentrations of λ-PP on GRP78 peak profile in rat testicular- and cauda epididymal sperm. Representative isoelectropherogram depicting overlaid images of NIA profiles for testicular- (A) and caudal sperm (B) treated without or with 100–500 U λ-PP. 100 μg of testicular- or caudal sperm protein was incubated without (red) or wit...

Background/Purpose of Study: Endometriosis, a common, chronic, gynecological condition, has a burden of around 176 million women globally and ~26 million women alone in India. It is associated with chronic pelvic pain, subfertility, dysmenorrhea and dyspareunia. Information about clinical phenotype of endometriosis is lacking in India. Additionally...

Endometriosis is an estrogen-regulated chronic inflammatory disease, characterized by the presence and growth of endometrium-like tissue in extrauterine locations. Its prevalence is 6 to 10% of women in the general population, and 35 to 40% of women with pain and/or infertility. Endometriosis is manifested in different forms, of which peritoneal en...

One of the major goals of the National Population Policy, 2000 is to address the unmet need for contraception. The unmet need for contraception in India (NFHS-3, 2005 - 06) is about 13% of which 6.3% for spacing and 6.8% for limiting the family. Introducing a new modern method of contraception increases the prevalence by 3% and reduces the unmet ne...