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Mar 2022
Bereda GudisaCorresponding author
Department of Pharmacy, Negelle Health Science College, Guji, Ethiopia
Dolutegravir suppresses this integration enzyme, so human immune virus can’t create every greater copies of itself, thus ‘’integrase inhibitor.’’ Dolutegravir is hastily absorbed pursuing oral administration. The median maximum plasma concentration is reached 1.5–2.5 hours after oral uptake with a mean half-life of 12–15 hours, rendering feasible for once-daily dosing without the need for pharmacological boosting. The terminal half-life is about 14 hours. The apparent oral clearance is about 1 liter/hour. Fifty three percent of the total oral dose of dolutegravir is excreted unchanged in the feces, thirty two percent through urine as glucuronide (eighteen percent) or alkylated product (three point five percent), and other organic conjugated products sequencing from phase II liver metabolisms. Dolutegravir’s categorized as pregnancy category B (no confirmation of pitfall in humans) means either animal-reproduction inquests have not substantiated a fetal peril but there are no restrained inquests in pregnant women or animal-reproduction inquests have reveal an adverse effect (distinctive than a de-escalate in fertility) that was not inveterate in restrained inquests in women in the first trimester (and there is no confirmation of a pitfall in later trimesters) or there is survey in animal that revealed the medication is safe in pregnant animal, but there is no fetal pitfall confirmation in pregnant women.Antiviral Pregnancy Registry (APR) revealed that as of January 2017, pregnancy outcomes and birth defects were analyzed from 142 pregnancies with reported exposure to DTG during pregnancy. There were 128 live births reported (3 terminations, 11 miscarriages, no stillbirths). Only 4 (3.0%) reported birth defects, which is similar to the expected rate of birth defects in the general population. European Pregnancy and Paediatric HIV Cohort Collaboration (EPPIC) displayed that as of July 2017, 101 pregnancies with exposure to DTG had been identified with 84 birth outcomes. Rates of preterm delivery and “small for gestational age” were identical to outcomes reported from women on alternative regimens (standard of care in the United Kingdom of Great Britain and Northern Ireland).
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.
Jan 2017 DOI 10.14302/issn.2381-862X.jwrh-16-1292
Salim Bin Ghouth AbdullaCorresponding author
Professor, Department of Community medicine, Hadramout University, Yemen.
Objective: A cross-sectional study was designed to collect socio-demographic and obstetric data about female teenagers who have pregnancy and visiting primary health care centers for antenatal care. Subjects and methods: Data were collected by a trained 60 medical students of the 6th level in Hadramout University during their post in primary health care centers from 20 May – 10 June 2008. A convenience sample of 237 teenagers who were attending the 12 PHC centers for antenatal care checking constituted the study subjects. Results: Fifty-one out of 237 (21.5%) pregnant women were of age 17 years or less. Most of them were from rural areas with statistically significant difference in both age groups (p-value <0.002),they were housewives (232/237 97.8%) and their husband’s mostly had non-professional jobs with a significant difference between both age groups (p-value <0.005). A high prevalence of anemia in teenage pregnant women was reported (76.7% of them had Hb level less than 11 g/dl) but there were no significant difference between mean Hb level in those at age of 17 years or less (9.9 SD=1) and those at age >17-<20 years (10.1 SD=1.18) p-value >0.05 About one-third of pregnant teenagers were second or multigravida (81/237 pregnant women 34.2%) but only 66 of them were delivered before. The majority of second/multigravida were delivered normally (57/66 pregnant women 86.4%) while only 31 of them (47%) gets their births in a health facility where LSCS was done for 9 pregnant women. The outcome of the pregnancy in teenage multigravida are 67 children; three of them were stillbirth and other 6 babies died within the first week of their life indicating the total children died during the perinatal period as 9 children ; so the perinatal mortality rate was very high in teenagers (9/67*1000 = 134/1000 births). Conclusions: Teenage pregnancy is common and accepted in Hadramout in Yemen; the main consequences are a high prevalence of anemia and high perinatal mortality rate.