Deficiency In Women Research Articles

Математическое прогнозирование рисков железодефицитных состояний у женщин

Purpose. Based on the study of medico-social, medico-biological and psychological factors, to assess the risks of iron deficiency in women. The results obtained will be used to develop a relevant program for the prevention of iron deficiency anemia and latent iron deficiency in primary health care. Materials and methods. The medical and social study was conducted on the basis of the city polyclinics of Kazan, the samples included two groups of women: 394 patients with laboratory-confirmed iron deficiency, including its clinical manifestations, and 373 women with a confirmed absence of iron deficiency and without probable complaints. The following methods were used in the study: bibliographic, socio-hygienic, psychological testing, sociological, information-analytical, mathematical-statistical, organizational experiment. Results. New data have been established on the factors affecting the volume of tissue iron stores in women: statistically significant associations of serum ferritin with sleep quality parameters and carbohydrate intake. The risks of iron deficiency anemia and latent iron deficiency were assessed, and subranges for individual risk groups were calculated. Findings. Statistically significant associations were found in the ferritin-total protein model with late bedtime (p <0,001), discrete sleep patterns (p <0,001), situational anxiety (p <0,001), and daily sugar intake (p = 0,021). According to mathematical forecasting, the greatest influence on the development of IDA in women is “going to bed” (R=2,1). Women who go to bed after midnight and from 23.00 to midnight are at risk of iron deficiency anemia, the risk of which is 2 times higher than in women who fall asleep before 23.00. The probability of latent iron deficiency in women with a high level of personal and situational anxiety is 28–29 times higher than in women with a low level of anxiety (R=29,254 and R=28, respectively).

Влияние физических упражнений на мышцы тазового дна и промежности. Основные гипотезы и утверждения

Pelvic floor dysfunction is one of the key issues in modern medicine. Symptoms associated with insufficiency of the pelvic floor support apparatus, such as pelvic organ prolapse, urinary and fecal incontinence are increasingly observed in young women, and after giving birth to a third child, their frequency reaches 80%. Women who are professionally engaged in sports are of particular interest to modern medicine. Many of them, highly motivated to achieve results, do not give importance and do not focus on the problem of pelvic floor dysfunction. The question of strengthening the muscles of this area remains open. Currently, there are two main hypotheses related to the effect of physical exertion of the pelvic floor muscle. Objective: to review the literature to search for and discuss data in support of a hypothesis from the standpoint of the functional morphology of the pelvic floor and perineal muscles, the development of diseases in this area and the course of labor. Materials and methods. In our work, based on data from more than a hundred literature sources of the PubMed search engine, we are analyzing works on the topic of the pelvic floor support apparatus insufficiency in women engaged in intensive training (professional athletes, fitness instructors, military personnel, etc.) Results. According to research, we found out that the development of insufficiency of the pelvic floor support apparatus is formed in girls in adolescence with excessive physical exertion most often. Special exercises aimed at strengthening the muscles of this area contribute to the reduction of the first and second periods of labor, minimizing the likelihood of operative delivery. Conclusion. The lack of uniformity of methods for evaluating and interpreting data requires further elaboration of parameter registration and high-quality research.

Оценка эффективности и комплаентности применения Вожея® у женщин на этапе прегравидарной подготовки и в ранние сроки беременности

Aim: to assess the clinical efficacy, safety and tolerability of Vojea® in the prevention of iron-deficiency anemia and folic acid deficiency in women during the preconception (pregravid) period and early stages of pregnancy, as well as to evaluate patient compliance with this product. Patients and Methods: this prospective multi-center observational study was performed in 2022 in four medical centers and women's health clinics of Ekaterinburg. The study included 87 women with latent iron deficiency (mean ferritin level below 15 ng/ml). The first group consisted of 37 women during the pregravid preparation period, and the second group consisted of 50 pregnant patients with up to 12 weeks of pregnancy. Patients received the Vojea® once daily for three months. Clinical and laboratory efficacy (the absence of objective anemia signs and the changes in hemoglobin level, folate and ferritin blood tests over time), as well as tolerability (the rate of adverse events, tolerability of the taken product evaluated using the visual analog scale) was assessed at days 30, 60 and 90 after the beginning of treatment. Results: beginning from the first month of treatment with the studied complex, some positive changes in clinical symptoms and laboratory findings were reported in both groups. By the third month of therapy, the increment of hemoglobin level in the pregravid preparation group was 17 (13.9%) units, the level of ferritin increased by 6.3 times (clinically significant after two months of the product intake), and the level of blood serum folates increased by 4.6 times. In group 2, the increment of hemoglobin level, as pregnancy was progressing, in three months of the product intake reached 19 units (17%), the level of ferritin increased by 5.9 times (clinically significant after two months of treatment), and the level of blood serum folates increased by 3.9 times. In group 1, adverse events were reported only in 2/37 (5.4%) patients who had dark stool color on the 2nd month of follow-up. In group 2, such adverse events as nausea were reported in 3/50 (6%) patients during the 1st month of product intake. All patients informed that the product was well tolerated which ensured high patient compliance. Conclusion: maintaining iron and folic acid homeostasis by oral intake of the Vojea® complex during three months in the preconception period and early stages of pregnancy is a feasible option based on its high efficacy and good tolerability with the minimal risk of side effects, encouraging high patient compliance. KEYWORDS: ferric pyrophosphate, folic acid, pregravid preparation, pregnancy, active metabolite of folic acid, methyltetrahydrofolate, glucosamine salt, Quatrefolic, micronized microencapsulated ferric iron, Vojea, compliance. FOR CITATION: Kononova I.N., Kareva E.N., Stebenyaeva E.V. et al. Assessment of the efficacy and compliance with Vojea® in women during the pregravid preparation and the early stages of pregnancy. Russian Journal of Woman and Child Health. 2023;6(2):95–104 (in Russ.). DOI: 10.32364/2618-8430-2023-6-2-95-104.

Преждевременная недостаточность яичников: последствия для здоровья и стратегии заместительной гормональной терапии

Aim: analysis of modern views on the pathogenesis of complications and long-term consequences of sex hormone deficiency among patients with premature ovarian insufficiency (POI), as well as the possibilities and strategies of hormone replacement therapy (HRT) for their treatment and prevention. Key Points. The consequences of a sex hormones deficiency in women with POI are not only short-term clinical manifestations similar to menopause, but also long-term negative outcomes for general health and life. HRT has therapeutic and prophylactic potential for all clinical aspects of the disease. However, the currently developed standard therapeutic strategies do not always allow to completely stop the symptoms of POI and ensure reliable prevention of complications in the future. Conclusion. The choice of adequate doses and composition of HRT, along with an interdisciplinary approach to the treatment of this pathology, will make it possible to level the associated risks and ensure a high quality of life for patients. Keywords: premature ovarian insufficiency, hormone replacement therapy, cardiovascular diseases, osteoporosis, genitourinary menopausal syndrome.

Evaluation and Correlation of Vitamin D Levels and Jaw Bone Mineral Density in Premenopausal and Postmenopausal Female Patients Undergoing Implant Therapy: Protocol for a Cross-sectional Study

Introduction: Vitamin D deficiency is one of the most common nutritional deficiencies worldwide. The amount and quality of bone at the implant installation site have an impact on the implant’s prognosis however, the effects of menopause on jaw bone remain unknown. Few studies have looked at the prevalence of vitamin D deficiency in India’s general population, but none have looked at the link between vitamin D deficiency (osteoporosis) and postmenopausal women’s jaw Bone Mineral Density (BMD). This is the first study of its sort in India to look at postmenopausal women’s vitamin D levels and jaw BMD. Aim: To evaluate and correlate vitamin D levels and jaw BMD in pre and postmenopausal females undergoing implant therapy. Materials and Methods: This cross-sectional study will include 50 partially or completely premenopausal (n=25) and postmenopausal females (n=25) having edentulous anterior and posterior maxillary and mandibular jaws. Females will be tested to evaluate their vitamin D levels and jaw BMD with Cone Beam Computed Tomography (CBCT) and results will be recorded in Hounsfield Units (HU) using Planmeca romexis viewer software. Chi-square test and Students t-test will be used.

Thrombin Generation Decrease After LMWH Administration in an Antithrombin-Deficient Pregnant Woman With a Homozygous HBS II Mutation.

The cases of antithrombin (AT)-deficient pregnant women with a homozygous HBS II mutation are relatively rare and are accompanied by an increased thrombophilic risk, which is manifested by increased thrombin generation (TG). It is very difficult to ensure their prophylactic treatment during pregnancy. We aimed to determine the utility of the thrombin generation assay (TGA) and anti-factor Xa (anti-FXa) test to monitor the effects of a prophylactic dose of low-molecular-weight heparin (LMWH) in a 28-year-old woman with homozygous AT deficiency caused by mutation c.391C > T#, (p.Leu131Phe†) in the SERPINC1 gene and to compare the findings with those from a group of pregnant and non-pregnant women also treated with LMWH. TG monitoring was chosen due to severe AT deficiency that was manifested by low levels of anti-FXa activity when monitoring the efficacy of LMWH treatment. A significant decrease in TG was detected in all monitored groups (P < .05). There were no thrombotic complications during the whole pregnancy of the woman with AT deficiency. Consistent monitoring of TG with LMWH anticoagulant therapy administration during pregnancy together with AT administration before and after delivery may improve the overall condition of pregnant women and the quality of their care.

The effect of vitamin D3 supplementation in vitamin D3 deficient women with polycystic ovarian syndrome and it’s relation to insulin resistance and visceral fat thickness

Background: Polycystic ovary syndrome (PCOS) is a multifactorial, heterogeneous, endocrine-metabolic disorder that commonly affects women at their reproductive age. PCOS is a complex syndrome characterized by chronic oligo-or anovulation, menstrual irregularities, hyperandrogenism, infertility, and polycystic ovarian morphologic features. The aim of the work WAS to evaluate the effect of vitamin D3 supplementation on insulin resistance, and visceral fat thickness in vitamin D3 deficient women with polycystic ovarian syndrome.Methods: Patients were allocated randomly into 2 groups: Group I: 30 women received 50.000 Iu of oral vitamin D3 (Cholecalciferol) (Breva) once weekly for (12) weeks. Group II (placebo group): 30 women received placebo capsules once weekly for (12) weeks. Trans-abdominal US and transvaginal US examination were performed for detailed ovary imagingResults: The difference in the glucose tolerance profile after treatment. There was a statistically significant difference between both groups regarding the mean fasting blood sugar levels (p =0.001), where the mean FBS in the intervention group was (79.60±9.464), while that of the placebo group was (89.67±9.181). Moreover, the HOMA-IR level varied significantly (p=0.017), where in the intervention group the mean level was (2.99±0.621), compared to a mean of (3.59±1.179) in the placebo group., none of the mean hormonal levels varied significantly among the intervention group from before to after treatment, except for the mean 25- hydroxy-vitamin D level (p= <0.001), which increased from (13.26±7.203) before treatment, to (26.76±15.531) after treatment.Conclusion: In conclusion, Vitamin D supplementation in an oral dose of 50.000 IU of vitamin D3 (Cholecalciferol) once weekly for (12) weeks among women with PCOS significantly increased serum 25OHD levels, and significantly decrease insulin resistance and visceral fat thickness no potential effect was detected on BMI, waist circumference (WC)and waist to hip Ratio.

Vitamin D Deficiency is Associated With Increased Plasminogen Activator Inhibitor 1/Plasminogen Activator Inhibitor 2 Ratio in Pregnancy.

Vitamin D deficiency has recently been suggested as an independent risk factor for thrombosis. Notably, vitamin D deficiency is common in pregnant populations, whom already have an increased thrombotic risk. However, pregnant women are commonly excluded from studies investigating the hemostatic system, and knowledge on the impact of vitamin D on hemostasis in pregnancy is therefore limited. A cross-sectional study comparing the hemostatic profile of pregnant women (gestational week 12.9 ± 0.7) with vitamin D deficiency (≤50 nmol/L) (n = 70) and high adequate vitamin D status (≥100 nmol/L) (n = 59). Vitamin D deficient women displayed increased plasminogen activator inhibitor 1 levels and an increased plasminogen activator inhibitor 1/plasminogen activator inhibitor 2 ratio, even after adjusting for factors with potential influence on hemostasis (body mass index, smoking and use of fish oil supplements). Vitamin D deficiency is associated with increased plasminogen activator inhibitor 1/plasminogen activator inhibitor 2 ratio in pregnant women. As an increased plasminogen activator inhibitor 1/plasminogen activator inhibitor 2 ratio with high plasminogen activator inhibitor 1 levels may increase thrombotic risk and is associated with the development of pregnancy complications, further research is needed to determine the optimal vitamin D supplementation in pregnancy.

Interaction of Passive Smoking and Diet Habits on Vitamin D Deficiency among Women of Reproductive Age in Rural Central China.

Maternal dietary undernutrition is known to be associated with the risk of vitamin D (VD) deficiency. However, whether the risk of VD deficiency in women of reproductive age is influenced by the interaction between passive smoking and inadequate nutrition remains unknown. The aim of this study is to explore the interaction between passive smoking and dietary undernutrition on the risk of VD deficiency. A population-based case-control study including 1151 non-pregnant women of reproductive age between 18 and 40 years old was conducted in Henan Province, China from 2009 to 2010. Blood samples and information on exposure factors were collected. The prevalence of VD deficiency was estimated based on a result of serum 25-hydroxyvitamin D [25(OH)D] &lt; 26.0 ng/mL. A multivariate logistic regression analysis was performed to explore the risk of VD deficiency. The prevalence of VD deficiency was 61.5%. After adjusting for potential confounding factors, the interactions between passive smoking and no nutritional supplementation, passive smoking and insufficient egg intake, and passive smoking and insufficient milk dairy products intake were associated with the risk of VD deficiency, and the adjusted ORs were 3.40 (95% CI 2.26-5.13), 2.87 (95% CI 2.20-4.10), and 2.18 (95% CI 1.33-3.58), respectively. The interaction coefficients were calculated to be 2.35, 2.79, and 1.70, respectively, indicating there were significant interaction effects, as all of the coefficients were higher than 1. Our findings present that the risk of VD deficiency was potentially influenced by interactions between passive smoking and inadequate nutrition. Passive smoking might strengthen the effect of inadequate nutrition on the risk of VD deficiency among rural women of reproductive age. More attention should be paid to the health education and nutritional status improvement of women of reproductive age, especially in rural areas of developing countries.

PENERAPAN MODEL PEMBERDAYAAN KELOMPOK IBU HAMIL DALAM UPAYA PREVENTIF ANEMIA PADA KEHAMILAN DI WILAYAH PUSKESMAS MANGASA KECAMATAN RAPPOCINI KOTA MAKASSAR

ABSTRACTAnemia during pregnancy is not only a public health problem, although it is a result of physiological conditions in general view, but if it does not get adequate attention, it can cause conditions that endanger health during pregnancy. Ignorance of the public, especially pregnant women, regarding the need for food intake and the importance of consuming Fe, as well as the importance of screening for the possibility of infection, is one of the causes of anemia which until now has not been successfully reduced. The results of the analysis of the situation in the Mangasa Community Health Center with a prevalence of nutritionally deficient pregnant women reaching 13% of all registered pregnant women during 2022. Increasing public awareness requires approaches and cultivation in various disciplines, both technical health, technical production, socio-culture to be the right solution . Community service independently is the implementation of research results that have been carried out using educational methods with the target of empowering groups of pregnant women in an effort to prevent anemia during pregnancy as an effective strategy in increasing public awareness. The results of the final evaluation of the activity turned out to be able to increase knowledge on an average of 4.1±10.64 points, and change negative attitudes towards a more positive one to achieve a pattern of consuming nutritious food and an average Fe consumption pattern of 5.1±13.8 points. It is suggested the need for continuous education about nutrition during pregnancy and the pattern of Fe consumption until delivery.

Recurrent miscarriage in a woman with congenital factor V deficiency: a case report

Factor V deficiency is a rare bleeding disorder that can be either congenital or acquired. Factor V deficiency mostly present with mucosal bleeding. Coagulation factor V does not increase considerably during normal gestation. Since pregnancy can be threatened by blood clotting disorders, abnormal changes in coagulation factors level can pose challenges to pregnant women. We report a 40-year-old pregnant woman with prolonged gingival bleeding and epistaxis at 28weeks of pregnancy. Her past medical history included two unexplained abortions. Physical examination was unremarkable, but the blood test showed elevated PT and PTT with a considerable decrease in factor V activity, while other factors were within normal range. Subsequently, the patient was diagnosed with congenital factor V deficiency. After treatment with fresh frozen plasma, she underwent vaginal delivery and a baby with factor V deficiency was born. This is the second report of recurrent miscarriage in congenital factor V deficiency patients. Clinicians should consider the possibility of factor V deficiency in women with a history of idiopathic miscarriage even in patients without any symptoms.

Iron Deficiency Is Commonly Observed in Female Multiple Sclerosis (MS) Patients with Relapsed/Refractory or Primary Progressive Disease Referred for Biological Therapies

Introduction Iron deficiency with or without anemia is common, symptomatic, and often underdiagnosed in women. Aging related iron deposition in the brain has been associated with multiple chronic neurological conditions, including multiple sclerosis (MS). MS is an autoimmune and inflammatory neurologic disease with a variable presentation and disease severity resulting from demyelination in the central nervous system. In MS, iron deficiency has been associated with more severe depressive symptoms and poorer quality of life. Overlapping symptoms shared by iron deficient and MS patients include fatigue, cognitive dysfunction and restless leg. Recognizing and treating iron deficiency is important in MS patients and may play a role in improving quality of life. Methods We conducted a retrospective study from January 2017 to December 2021 of MS patients referred to OHSU hematology clinic for therapy with monoclonal antibodies including ocrelizumab, rituximab, or natalizumab. Patient demographic, clinical, treatment and laboratory characteristics were reviewed. Iron deficiency was defined by presence of Ferritin < 50 ng/ml. Patients identified as iron deficient were reviewed for further gastro-intestinal and gynecologic work-up. Results A total of 307 patients with MS were identified. The median age was 49.3 (range 18-84), 104 were males (average age 50.7 at time of study) and 203 were female (average age 48.5 years at time of study). The majority of patients received ocrelizumab, with a minority receiving rituximab due to insurance coverage and rare patients receiving natalizumab. Ferritin levels were available in 114 patients. Of 20 male patients whose ferritin was checked, 4 were iron deficient. Of 94 female patients whose ferritin was checked, 56 (60%) were found to have past or current iron deficiency. In 15 of these 56 patients, GI findings were noted including: rectal cancer, adenomas, esophagitis, gastritis, large hiatal hernias, inflammatory bowel disease, H. pylori and bariatric surgery. The average age of women with GI findings was 48.7 years with an average ferritin of 19.2 ng/ml. In 12 patients, obstetric and gynecologic conditions were diagnosed. The average age of women with OB/GYN sources was 31.2 years with an average ferritin of 21 ng/ml (range). Three patients had combined GI and GYN causes, 4 were pending GI evaluations and 22 were not worked up for cause. Twenty-two women received treatment with intravenous iron products (iron dextran, iron sucrose, ferumoxytol, ferric carboxymaltose). In the 22 women treated with intravenous iron, 4 developed progressive MS symptoms leading to change in therapy. Conclusion Results show a high frequency of iron deficiency in women with multiple sclerosis. GI and GYN sources were the main causes for iron deficiency. Intravenous iron was used in a subset of patients with iron deficiency. Worsening MS related symptoms were observed in 4 patients treated with intravenous iron. All women with multiple sclerosis should be evaluated for iron deficiency and investigated for cause if iron deficiency is found. Future studies on the effects of adequately diagnosing and treating iron deficiency in patients with multiple sclerosis are warranted.

Effect of inulin, galacto oligosaccharides and iron fortification on iron deficiency anemia among women of reproductive age; a randomized controlled trial

Iron supplementation and fortification are the well-known approaches to treat iron deficiency anemia (IDA) in women of reproductive age. The objective of the current randomized controlled trial (RCT) was to evaluate the cumulative effects of prebiotics and iron fortification among women of reproductive age. For this purpose, a total of 75 iron deficient women of childbearing age were recruited and randomly divided into 5 groups (4 treatment groups and 1 control group). Four different types of fortified wheat flour were prepared using two iron fortificants (NaFeEDTA and FeSO4) and two prebiotics [inulin and galacto oligosaccharides (GOS)], while control group was treated with iron fortified flour without any prebiotics. Blood samples were collected from overnight fasted women on monthly basis up to 90 days. Hematological indices such as Hemoglobin (Hb), Hematocrit, Red Blood Cell (RBC) Count and Mean Corpuscular Volume (MCV), as well as iron biomarkers including serum iron, ferritin, transferrin, and Total Iron Binding Capacity (TIBC) were evaluated for analyses. The results showed a considerable positive improvement in all iron biomarkers as well as hematological indices among the treatment groups (P-value < 0.05), as compared to the control group. A maximum Hb (11.86 ± 0.24 mg/dL) and hematocrit value (35.06 ± 1.32%), was reported in group G3 which was treated with fortified wheat flour at a dose of 963 mg/kg GOS + 15 ppm FeSO4. On the other hand, highest mean values for RBC Count (4.73 ± 0.41 mil/mm3), MCV (81.41 ± 3.21 fL), serum iron (75.62 ± 2.79 μg/dL), serum transferrin (16.82 ± 0.30 mg/dL), and TIBC (403.68 ± 7.27 μg/dL) were observed in G4 group receiving the fortified wheat flour at a dose of 963 mg/kg GOS + 30 ppm FeSO4 level. The study concluded that prebiotic fortification along with iron salts helps to enhance iron absorption among iron deficiency anemic women of reproductive age.

Efficacy and safety of Chinese herbal medicine Buzhong Yiqi decoction for postmenopausal women with osteoporosis: A protocol for systematic review and meta-analysis.

Postmenopausal osteoporosis (PMOP) is a disorder of bone metabolism caused by estrogen deficiency in women after menopause, which manifests clinically as pain, spinal deformities, and even fragility fractures, affecting the quality of life of patients and possibly shortening their life span. Traditional Chinese medicine prescription Buzhong Yiqi Decoction (BZYQD) has been widely used in clinical practice and achieved good results. But there is no high-level evidence to support this result. The aim of this study is to evaluate BZYQD's efficacy and safety in the management of PMOP. We will search articles in 7 electronic databases including Chinese National Knowledge Infrastructure, Wanfang Data, Chinese Scientific Journals Database, Chinese databases SinoMed, PubMed, Embase, and Cochrane Library databases. All the publications, with no time restrictions, will be searched without any restriction on language and status, the time from the establishment of the database to September 2022. Two reviewers will independently assess the quality of the selected studies, NoteExpress and Excel software will be used to extract data, and the content will be stored in an electronic chart. Different researchers will separately screen the titles and abstracts of records acquired potential eligibility which comes from the electronic databases. Full-text screening and data extraction will be conducted afterward independently. Statistical analysis will be conducted using RevMan 5.4 software. This study will evaluate the efficacy and safety of BZYQD in the treatment of PMOP, to provide high-quality, evidence-based clinical recommendations. The study provides a trustable clinical foundation for BZYQD in the treatment of PMOP.

Iron deficiency in women: ways to reduce prevalence

Iron deficiency states (IDSs) are common disorders at the nexus of various fields. The etiology and pathogenesis of IDSs have been well studied in recent decades, but their prevalence is still high. The highest incidence of IDSs is reported in women of reproductive age. The timely correction of iron deficiency improves women's quality of life and reduces pregnancy complications and infant morbidity. To achieve and maintain the improvement, caution in risk groups, early diagnosis, physiology-based therapy, and follow-up are necessary. Iron sulfate agents are well known as an effective way to treat iron deficiency anemia. However, the high rate of previously reported side effects posed significant challenges to the complete course of therapy. The development of a new molecule with prolonged iron release minimizes the complications of therapy, providing new prospects for iron deficiency treatment. The combination of folic acid to iron sulfate in one tablet simplifies prevention regimens and therapy for pregnant women and those planning to become pregnant and reduces the time to improve.

Australian fertility preservation guidelines for people with cancer 2022: review and recommendations.

Australian fertility preservation guidelines for people with cancer 2022: review and recommendations.

ПЛОТНОСТЬ КОСТНОЙ ТКАНИ И ЕЕ РЕГУЛЯЦИЯ В ЗАВИСИМОСТИ ОТ СОСТОЯНИЯ ОБМЕНА МАГНИЯ У ЖЕНЩИН ПОСТМЕНОПАУЗАЛЬНОГО ВОЗРАСТА С АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ И ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ

The aim of study was to identify markers of bone turnover such as osteoprotegerin (OPG), receptor activator for nuclear factor kappa-B ligand (RANKL), 25-hydroxyvitamin D (25(OH)D), and bone density (BMD) in postmenopausal women with arterial hypertension (AH) and heart failure with preserved ejection fraction (HFpEF), depending on magnesium (Mg) status. Material and methods. 140 postmenopausal women aged 52 to 76 years with AH and HFpEF were examined. Based on the Mg-tolerance test, patients were divided into 2 groups: with Mg deficiency (n=72) and without one (n=68). BMD in the neck and proximal femoral area, as well as L1-L4 vertebrae, was measured in by dual-energy X-ray absorptiometry. OPG, soluble RANKL (sRANKL) and 25(OH)D level was also determined by enzyme immunoassay. Results. In Mg deficiency group were noted lower BMD indices in L1-L4 vertebrae area (0,990±0,159 g/cm2 vs 1,046±0,193 g/cm2; p=0,041) and higher osteopenia incidence (RR=1,60; 95% CI: 1,08–2,38; p=0,019). Also, Mg deficient women had higher level of OPG (85,2 [69,1; 103,1] pg/ml vs 79,9 [63,4; 92,7] pg/ml, p=0,035) and sRANKL (3,98 [2,70; 5,45] pg/ml vs 2,85 [1,95; 3,82] pg/ml, p&lt;0,0001) expression, but lower OPG/sRANKL ratio (22.59 [15.34; 33.71] vs 26.01 [19.42; 41.19], p=0.028) in opposite to control group parameters. At the same time, patients with Mg deficiency had higher 25(OH)D impaired status incidence (97% vs 87%; p=0,028). Conclusion. Lower BMD and OPG/sRANKL ratio, but higher OPG and sRANKL expression and higher frequency of 25(OH)D impaired status were revealed in postmenopausal women with AH, HFpEF and Mg deficiency compared to the control group.

Early pregnancy serum levels of folate and vitamin B12 in overweight and obese women in Khartoum, Sudan.

This study was conducted to assess serum levels of folate and vitamin B12 in overweight and obese pregnant women. A cross-sectional study was conducted at Saad Abualila Hospital, Sudan. Clinical data were collected through questionnaires and body mass index (BMI) was computed from weight and height. The serum folate and vitamin B12 levels were analyzed by immunofluorescence. Of 300 enrolled women, 44.7% were of normal weight, 32.3% were overweight and 3.0% were obese. The folate level was significantly lower in overweight women (median 4.79 ng/ml [IQR 2.70‒7.70]) than in normal-weight women (median 6.650 ng/ml [IQR 3.30‒10.55]; p=0.022). There was no significant difference in the prevalence of marginal and severe folate deficiencies in women in different BMI groups. Compared with normal-weight women (median 197.5 pg/ml [IQR 150.0‒263.0]), obese women (median 173.0 pg/ml [IQR 150.0‒213.0]; p=0.038) had significantly lower vitamin B12 levels and had a higher prevalence of vitamin B12 insufficiency. Fair negative correlations (p<0.01) were observed between folate and BMI (r = -0.157) and between vitamin B12 and BMI (r = -0.173). Overweight and obese pregnant Sudanese women had lower levels of serum folate and vitamin B12.

Correlation between Toxoplasmosis and Vitamin D Deficiency in women

Background: Recently it has been noticed that toxoplasmosis played an important role in distressing women’s pregnancy through certain outcomes such as congenital abnormalities and abortions. The lack in Vitamin D may play role fragility of bones like; osteoporosis, and bone deformities. Objective: To evaluate the association between the lake in vitamin D and toxoplasmosis seropositivity in the women’s sera in the age of childbearing by applying ELISA method. Materials and Methods: 56 women, from Central Public Health Laboratories in Baghdad Province were selected in this study, their age range between (17-45) years. The individuals were diagnosed with BOH (Bad Obstetric History). Among 56 women infected (44)or not infected (12)with toxoplasmosis blood samples were collected from patients who visited Central Public Health Laboratories in Baghdad Province . IgG and IgM Abs Antibodies against Toxoplasma gondii were detected using minividas kit ) BioMerieux /France). Also vitamin D was detected using by ELISA microwells method (Monobind Inc. USA). Results: The results were considered as statistically significant (P=0.386), it shows no important difference between toxoplasmosis and the concentration of vitamin D3 in women with history of abortion or not. Conclusion: The toxoplasmosis rate in women in childbearing age was elevated, and the association between vitamin D deficiency and toxoplasmosis was not considerable.

Knowledge, Attitude and Practices (KAP) of Preconceptional Folic Acid supplementation among pregnant women (18-45years) attending antenatal clinic in Alex Ekwueme Federal University Teaching hospital Abakaliki, Ebonyi State, Nigeria

Background: Folate deficiency is associated with poor pregnancy outcomes and is one of the most common vitamin deficiencies in women, especially those of reproductive age. Folic acid intake prior to, and during, the first months of pregnancy significantly reduces the risk of fetal neural tube defects. Maternal folate status has been associated with other adverse pregnancy outcomes such as preeclampsia, malformations (orofacial clefts, Neural tube defects, anencephaly and encephalocele resulting from incomplete neural tube closure during early embryogenesis), spontaneous abortion, fetal death, fetal growth restriction and preterm delivery. Methods: The study embraced a cross-sectional study that assess Knowledge, Attitude and Practice of preconceptional folic acid supplementation among pregnant women (18-45years) attending antenatal clinic in Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State. 152 women attending antenatal clinics in Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State were interviewed using structured questionnaire. Data collected were analyzed using SPSS version 21 for frequency and percentage at P &lt; 0.05 significance level. Results: 98.7% of the participants had heard about folic acid, but an analysis of data shows that 26.6% of them knew that folic acid is a vitamin. In addition, very few (29.6%) knew that folic acid could prevent neural tube defects. The main source of information about folic acid supplementation among the surveyed women were through the health workers. Incidence of at least one episode of adverse pregnancy outcome was noted in about 35.5% of the population under study though a majority indicated the form for their loss were miscarriage and stillbirth. Finding showed that 37.5% of the respondent claimed to have used folic acid before pregnancy while 40.1% of the women in this study were aware of the right time to start using folic acid. 46% of the women took folic acid during Antenatal care and their reason were attributed to late presentation for antenatal care, delayed prescription of the folic acid for women during pregnancy, unplanned pregnancy while others claimed they are getting enough folate from food. Approximately 40.8% of the respondents had started supplementation on antenatal booking and from analysis of data on the preferred/normal booking time of the respondents it shows that a high percentage of them attended antenatal from the third month of pregnancy this shows that the majority of the respondents started supplementation too late which is inconsistent with the ideal time to start folic acid supplementation in prevention of neural tube defect. In this study it has been revealed that 48% of the respondents could identify green leafy vegetable as the only source of folate in local foods and 0.7% could identify other food sources like legumes and fruits as sources of folate. Conclusion: There is a low overall level of awareness of folic acid among pregnant women including lack of understanding of its natural sources, usefulness in preventing Neural Tube Defects and preconceptional intake recommendation. Health education regarding the preconceptional use of folic acid among women of reproductive age is recommended.