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Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4329
Adejoh Attah TimothyCorresponding author
National Space Research and Development Agency, Obasanjo Space Centre, Umaru Musa Ydar'adua express way, P.M.B. 437, Lugbe, Abuja
Introduction Malaria in pregnancy is a serious public health concern that could result in detrimental health outcomes for pregnant women and their foetuses. In Nigeria, there is still a significant risk of the disease epidemic and adverse effects especially in pregnancy. The aim of this study is to assess the socio-demographic factors associated with Intermittent Preventive Treatment and health seeking behaviours for malaria in pregnancy among women of reproductive ages in Nigeria Methods Using the National Demographic Survey (NDHS) 2018 data, a cross sectional study was conducted to assess socio-demographic factors associated with Intermittent Preventive Treatment (IPT) for Malaria among Nigerian women of reproductive ages. Result Majority were between ages 30-39 years (39.5%), married/cohabiting (91.8%), Muslims (59.5%), from the north (68.9%), uneducated ( 49.9%), poor (47.5%), and grand parous (65.7%). 63.4% of the women had taken fansidar for malaria in pregnancy while only 6.1% had received healthcare for malaria from informal sources. Except for marital status, all socio-demographic variables (regions, highest educational level, wealth index, age group, religion and parity) were significantly associated with intake of IPT. Additionally, region, education, wealth index, age group, marital status and religion were associated with health seeking behaviour for malaria in pregnancy (P<.05). After control for other variables, wealth index, highest educational level, married/cohabiting marital status and religion was significantly associated with intake of IPT while region, primary and secondary education, poorer and richest wealth index, widowed/separation influenced health seeking for malaria in pregnancy (P<.05). Conclusion The National Malaria Elimination programme should evaluate existing policies that develop interventions that are centred on high risk population in order to prevent malaria in pregnancy while improving health seeking behaviours of women of reproductive ages.
Mar 2019 DOI 10.14302/issn.2639-3166.jar-19-2691
Masoero GiorgioCorresponding author
Accademia di Agricoltura di Torino, Italy
In precision agriculture (PA) fertilizing, based on soil testing, production maps and crop nitrogen (N) demand, is the key to maximizing yields and tempering fertilizer costs. A trend study has considered the output / input relationships performed on a farm that has progressively adapted to PA procedures over two decades. The evolutions of the variability parameters of yield, comprising the repeatability coefficient of repeated plots, the vegetative vigour (NDRE) at the panicle initiation (pi) stage, and the nitrogen utilization efficiency (NUE) were monitored and compared by means of mixed linear models over a six-year period, after the variable nitrogen (N) fertilization rate (VNFR) had been enlarged to the whole 230 ha of one farm. At pi key fertilization stage, a corrective dose was applied by tacking the correlation between Npi and the measured NDRE in strong negative mode. The evolution of the yield, for the 2012-2017 interval, based on 1165 ha-1 parcel-data, showed a significant yearly increase of 2.3% more than the regional trend (+0.5%). The variability parameters of the yield, that is, the standard deviation (+7.3%), range (+7.1%), coefficient of variation (+5.4%) and maximum (+2.1%) were enhanced over the years, but the minimum remained stable. The repeatability of the parcel yield generally appeared low (r = +0.31), but it tended to increase by 8.3% year-1 (P = 0.018). At the same time, the vegetational vigour also showed significant increases of the NDRE means (+3.0%) as well as of the maximum (+0.8%), but also large oscillations in the standard deviation and in the coefficient of variation. No significant regression of the NDRE on the coefficient of variation of the yield was established. The favorable increase in yield was found to be independent of the distributed N-total. A strong negative correlation (imposed) between N-pi and NDRE (-0.90) and a negative correlation with production were observed for a sample field (but in the area of maximum production). It is recommended that a partial correlation between Yield and N-tot should be considered in the I /O features for a parity of NDRE, which apparently decreases the negativity of the relationship. In short: with the same total input of N, the PA increased the yield, but also its variability – and it did not reduce the variability as predicted by the theory - by strengthening the repeatability. This is an evidence that in many of the parcels with minimum yield the limiting factors cannot be referred to the N availability.
Jan 2018 DOI 10.14302/issn.2474-3585.jpmc-17-1836
Róbert PókaCorresponding author
University of Debrecen, Faculty of Medicine, Department of Obstetrics and Gynecology.
Objective: Demographic analysis of intrauterine deaths in North-Eastern Hungary with national and international comparison. Materials and Methods: The authors collected data from the National Bureau of Statistics’ 1996-2014 database to assess frequency, gestational age, maternal age and education for six counties of the region. 722 individual cases were analyzed. A regional survey was initiated to collect more detailed data on living environment in the region between 2010 and 2014 through community midwifery services records. Results: Data over 20 years showed most intrauterine deaths (Perinatal mortality, Late fetal death, Stillbirth] occurred between 24th and 36th weeks of which 35% occurred in the North-Eastern region of Hungary. The causes of intrauterine deaths were placental abruption, cord accident, placental insufficiency, malformations and intrauterine infection. Detailed analysis regarding attendance at either the Obstetricians or the community midwifery services, the patient’s medical history and the patients’ compliance were reported, compliance in 1% completely lacked. Gravidity and multiparity were associated risk factors. A significant proportion was associated with teenage pregnancy, low maternal education, smoking risks, unemployment, dependence on social support, unhygienic environment and smaller accommodations. Lack of cooperation during antenatal care was significant. Conclusion: Frequency and distribution of intrauterine deaths in North-Eastern Hungary show a similar picture as those of socio-economic indices. The unfavorable trend came to an end in 2015, however the national statistics did not show any improvement. The solution to the problem seems to be independent of the service provision, therefore, socio-economic development of affected counties is warranted, and financial incentives and/or government aid provided during pregnancy may improve future perinatal outcomes.
Oct 2017 DOI 10.14302/issn.2381-862X.jwrh-17-1758
U MazumderCorresponding author
Department of Obstetrics and Gynaecology, Dhaka Medical College, Dhaka , Bangladesh,
Background: The nature of placenta previa can be unpredictable and harsh on the mother and baby. These complications are often unpredictable, unpreventable and often leave the labour ward team in a dilemma. This Obstetricians' nightmare is fortunately a rare complication. The frequency of placenta previa at the time of delivery average 1/200 births i.e. 0.5%. Placenta previa is still an important cause of maternal and fetal death in our country. The risk factors are Advanced Maternal age, Multi parity, Previous Cesarean Section, Multiple gestation, Previous Abortions, Previous intrauterine surgery, placenta previa in previous pregnancy, Smoking. Objective: Identification of risk factors, the feto-maternal outcome and complications of patients having placenta previa with previous caesarean section. Methodology: This cross sectional study was conducted from July 2012 to June 2015 in Obstetrics and Gynaecology department, Dhaka Medical College hospital. 100 patients of placenta previa were included in this study. Non-probability purposive sampling method was used for selection of patients. Results: In this study, Socio-demographic profiles, Identification of risk factors, the feto-maternal outcome and complications of patients having placenta previa were assessed. The frequency of placenta previa associated with previous cesarean section was 61%. In demographic profiles of the patients in this study - with a history of previous caesarean section, 78.7% patients were in the age group 26-35. Multiparity was predominant on scarred uterus group (63.9%). Here, demonstrated that > 2 previous history of caesarean section was associated with 80.3% of placenta previa. Regarding maternal outcome, complications like massive haemorrhage, ureteral injury, bladder injury, wound infection, DIC, maternal and perinatal mortality were more in the scarred patients than in the unscarred patients. In our study, 29.5% of morbid adhesion of placenta observed in scarred uterus. Conclusions: There is significant association of placenta previa with previous cesarean delivery. So, Careful monitoring of high risk pregnancies is of utmost importance. Avoidance of unnecessary caesarean sections and early week’s pregnancy terminations can minimize the Obstetricians' nightmare.
Jul 2016 DOI 10.14302/issn.2576-2818.jfb-16-1035
Sugimoto MayumiCorresponding author
National Livestock Breeding Center, Nishigo, Fukushima, Japan,
Female fertility is an economically important trait in the dairy industry, and the fertility selection index has been developed as a method of including female fertility in the breeding goals of this industry. This index considers a combination of factors, including days open, number of inseminations per lactation, success after first insemination, and pregnancy within 70 d, 90 d, and 110 d after parity. Based on a genome-wide association study of the fertility selection index using 442 Holsteins, we found that the index is influenced by a variation in the thioredoxin fold region of the family with the sequence similarity 213, member A (FAM213A) protein. FAM213A is a CXXC motif-containing peroxiredoxin 2-like protein that regulates cellular redox status. A replacement of isoleucine with valine in FAM213A was associated with poor fertility in cows. The overexpression of FAM213AVal in bovine endometrial epithelial cells reduced reactive oxygen species to a lesser extent relative to the overexpression of FAM213AIle and caused a decrease in cyclooxygenase-2 expression. Downregulation of cyclooxygenase-2 led to a decline in prostaglandin E2, which is critical for implantation because it protects the conceptus from the maternal immune system. Cows with FAM213AVal showed lower levels of prostaglandin E2 than did cows with FAM213AIle, suggesting that cows with FAM213AVal are less fertile than cows with FAM213AIle because of their reduced uterine environment. Thus, the present study found that FAM213A unexpectedly modulates female fertility in cattle.
Mar 2016 DOI 10.14302/issn.2374-9431.jbd-16-939
Nusrat-SultanaCorresponding author
Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU)
Objective: To observe association of risk factors with gestational diabetes mellitus (GDM) in a tertiary care hospital of Bangladesh. Materials and Methods: Risk factors of GDM were evaluated in pregnant subjects (n=385; age: 26.4±4.9 yrs; body mass index, BMI: 25.3±4.3 kg/m2; mean ± SD) screened by 75 gram oral glucose tolerance test (OGTT) following WHO 1999 criterion irrespective of gestational age in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU). BMI, maternal age, parity, trimester and family history of diabetes were considered as risk factors. Plasma glucose was measured by glucose-oxidase method on the same day. Results: GDM and normal glucose tolerance (NGT) showed significant difference for age (28.2±4.9 vs. 25.3±4.6 yrs, p<0.001), BMI (26.7±4.4 vs. 24.4±3.9 kg/m2, p˂0.001), family history of DM (55.5% vs. 43.0%, p=0.017) and number of gravida (p=0.048). There was no significant difference of frequencies of GDM among various trimesters (39.4% vs. 42.5% vs. 38.2%; χ2=0.653, p=0.721). OGTT performed before 24 weeks revealed GDM in about 44% (88/202). Multiple regression revealed age (p<0.001), BMI (p=0.007) and family history of DM (p=0.048) as independent predictors for GDM. Conclusion: It is concluded that age of mother, increased BMI, family history of diabetes as well as multigravidae are important predictors for GDM.
Feb 2016 DOI 10.14302/issn.2381-862X.jwrh-15-672
Panda SunitaCorresponding author
Clinical Midwife Manager, Delivery Suite, Coombe Women and Infants University Hospital, Dublin-8. Ireland.
The study was conducted in four selected hospitals in the Southern part of India with an aim to determine the support needs of women in early labour as perceived by women. A descriptive design was used to determine the support needs of women in early labour. Following ethical approval, sixty women between 29-40 weeks of gestation with singleton pregnancy were interviewed in early labour, using a validated Labour Support Need Assessment Tool to gather data on background information and perception of women related to need and support needs (physical, emotional and informational support). Results indicated that women perceived all types of support such as physical, emotional and informational as significant factors in their care during labour, regardless of their parity and gestation. The major findings of the study suggested that there was a slightly higher need for support among women for informational (90.33%) and emotional support (88.78%) compared to physical support (80.19%). For primigravid women, and multiparous women who were experiencing labour for the first time (previous birth by caesarean section), the ‘need for support’ was greater than for women who had previous experience of labour. Early labour is the time when most women use their own coping skills and seek support. Determining the quantity and quality of support women need at this phase of labour can help care providers to provide the best comprehensive care to women in early labour. The findings of the study provide a guide on what women feel is helpful in early labour.
Oct 2015 DOI 10.14302/issn.2329-9487.jhc-15-677
Kolhe RavindraCorresponding author
Department of Pathology, Georgia Regents University, Augusta, GA
The aim of this review is to compile our understanding of microRNA (miRNA) and its significance in Hypertension (HTN) pathophysiology. The wide spectrum of health disparity is one of the reasons for the dominance of HTN in humans for decades. We are striving hard to understand these variations, and we know to some extent that genetic susceptibilities do exist in HTN. Understanding miRNA will add to the current understanding of the disease process. In later parts, we discussed possible clinical implications of miRNAs in HTN as a biomarker of disease expression and its potential in prognostic and therapeutic applications in HTN.
Feb 2015 DOI 10.14302/issn.2381-862X.jwrh-14-532
Elie NKWABONGCorresponding author
Department of Obstetrics & Gynecology; University Teaching Hospital/ Faculty of Medicine and Biomedical Sciences, Yaoundé (Cameroon).
Objective: To identify risk factors for ≥4500 g macrosomic babies given that maternal and neonatal complications of macrosomia increase with birth weight. Design: Cross sectional analytical study. Setting: The Yaoundé University Teaching Hospital and Central Maternity, Cameroon from October 1st, 2012 to June 30th, 2013. Population: 42 women who delivered ≥4500 g babies and 126 women who delivered babies of 4000 to <4500 g were recruited. Methods: Data were analysed using SPSS 18.0. Analyses included the student t-test and the Fisher exact test. The level of significance was P<0.05. Main outcome measures: Fetal sex and birth weight, gestational age at delivery, maternal age at delivery, parity, mother's pre-gestational body mass index (BMI), weight gain during pregnancy, father's BMI and past history of ≥4000 g macrosomia. Results: Main risk factors for ≥4500 g macrosomic babies were maternal weight gain of ≥16 kg (OR 4.2, 95%CI 2.0-8.9), maternal age ≥30 (OR 3.8, 95%CI 1.8-8.2), post term (OR 2.3, 95%CI 0.9-5.6), past history of ≥4000 g macrosomia (OR 1.9, 95%CI 0.9-4.1) and male sex (OR 1.3, 95%CI 0.6-2.8). Conclusion: To reduce the risk of ≥4500 g macrosomic babies, women at risk should make efforts to gain less than 16 kg bodyweight during pregnancies. Moreover, post term pregnancies should be avoided.