Pregnant Ladies Research Articles

Effect of Per and Poly-Fluoroalkyl Substances on Pregnancy and Child Development.

Childhood obesity is significantly influenced by maternal exposure to Per- and Poly-Fluoroalkyl Substances (PFAS) during pregnancy. PFAS exposure occurs through the Peroxisome Proliferator-Activated Receptor (PPAR-γ) receptor, leading to increased fat deposition and profound health effects in child growth and development. Despite ongoing investigations, the relationship between maternal serum PFAS concentration and child obesity requires further exploration. This study aimedto review the possible effects of Per and poly-fluoroalkyl substances exposure and their mechanism in overweight/obese children from pregnant ladies. A detailed literature survey was conducted using online databases, including Science Direct, Google Scholar, Scopus, Cochrane, and PubMed. The study focused on the diverse effects of PFAS on maternal and child health, with particular emphasis on neurological complications. Child growth development depends upon breastfeeding and placenta health, which is disrupted by PFAS exposure, ultimately destroying the body mass index of the child. Neurotoxicity testing utilized the SH-SY5Y human-derived cell line as an in vitro model, revealing PFAS-induced increases in adipocyte number, reduced cell size, altered lipid conglomeration, increased adiposity, and changes in liver function. in vivo studies in mice and human cell lines indicated PPAR-γ and ER-α activation, leading to adiposity and weight gain through Estrogen signaling and Lipid metabolism. PFAS concentrations positively correlated in maternal sera, analyzed by liquid chromatography/quadrupole mass spectrometry. PFAS, with a long half-life of 3.5-8.5 years, is commonly found in the serum of pregnant women, crossing the placenta barrier. This exposure disrupts placental homeostasis, negatively impacting mechanisms of action and potentially leading to deterioration in pregnancy and child health. Further research is needed to comprehensively understand the complex interplay between PFAS exposure and its implications for maternal and child well-being.

Effect of Adolescent Pregnancy on Dental Caries Experience and Selected Salivary Physicochemical Characteristics

Background: Adolescent pregnancy is associated with major health consequences for adolescent pregnant women including medications and oral health problems such as dental caries and periodontal disease. Pregnancy is a unique state of physical, hormonal, and metabolic changes that can result in an oral cavity imbalance. Changes in salivary components and a decrease in salivary flow rate caused by an increase in progesterone may compromise saliva's protective effects, resulting in dental caries. Objectives: To evaluate dental caries experience in adolescent pregnancy. Method: A sample including 80 pregnant ladies were recruited in this study and categorized into a study group involving 40 primigravida adolescent females aged (15-19)years old and a control group involving 40 primigravida women (20-32) years old who married at age 20 years or more, all of them in the second trimester of pregnancy. Unstimulated salivary samples were collected, salivary flow rate, pH, and dental caries experience were assessed. Saliva samples were analyzed to estimate salivary lactoferrin concentration. Results: The mean (±sd) of decayed surface of the study group was (11.850±0.669) compared to (9.425±1.015) of the control group (p=0.049) and the level of salivary lactoferrin of the study group was (8.071± 0.558) compared to (6.610±0.447) of the control group (p=0.044), while the mean (±sd) of salivary flow rate of the study group was (0.349±0.020) compared to (0.540±0.157) of the control group (p=0.231) and the mean (±sd) salivary pH was (5.935±0.053) ) compared to (5.995±0.153) of the control group (p=0.712). Conclusion: Adolescent pregnancy is linked to increased dental caries experience by altering salivary characteristics, including lactoferrin levels. Received: June, 2023 Accepted: Aug, 2023 Published: Jan..2024

Analysis of Cesarean Section using Robsons classification at Teaching Hospital of Eastern Nepal

Introduction: Cesarean section is an operative procedure for delivery of fetus and placenta by making an incision over abdomen and uterus after period of viability. Aims: The aim of study is to analyze rate of cesarean section and perform an analysis based on Robsons ten group classification. Methods: A cross sectional study was conducted at Department of Obstetrics and Gynecology of a teaching hospital of eastern Nepal, over a period of one year from October 2022 to September 2023. All details regarding demography, obstetric history, medical history, labor status, indication of cesarean section, etc. were collected. Then all pregnant ladies were assigned to one of Robsons ten group classification systems and recorded into labor confinement book. The statistical analysis was performed using Statistical Package for Social Sciences version 21. Descriptive statistical tools were used to express the results. All tests were done with a significance level of 5% (p-value <0.05) and 95% confidence Interval. Results: The overall rate of cesarean section was 1,829(46.93%). Majority 1323(72.30%) were in age group 20-30 years. Maximum 1,629(89.10%) delivered at>37 weeks of gestation. Majority 789(43.10%) of cases had lower segment cesarean section because of previous cesarean delivery. According to Robsons classification system, Group 5 has highest cesarean section rate 725 (39.60%) followed by Group 2(A+B), 334(18.21%). Conclusion: Implementing Robsons Ten Group Classification System at our setting has helped us to identify major contributor of overall cesarean section rate. Group 5 was at top followed by group 2. Thus with adequate trial of labor after cesarean, proper labor monitoring and judicious use of induction protocol can significantly reduce rate of cesarean section.

Evaluation of difficulties and reproductive health issues faced by flood-affected pregnant women in refugee camps

Natural disasters jeopardize routine life, including health care system. This cross-sectional study was conducted to determine the difficulties faced by flood-affected pregnant women in refugee camps of the Hyderabad region of Pakistan. This study was conducted from October 2022 to September 2023. A field survey was done as part of quantitative research to find women affected by catastrophe who were residing in shelter camps. The primary data collection took place close to Jamshoro, Kotri and Hyderabad City in the regions where temporary flood-relief shelters were constructed and flood affected pregnant ladies referred to tertiary care (Countess Lady Duffirin Fund) Hospital with reproductive health issues e.g. high risk pregnancies for antenatal care, correction of anemia, control of blood pressure and diabetes, normal vaginal deliveries and emergency or elective caesarean sections. Eight hundred thirty-two patients were recruited, including 69.2% aged 15 – 25 years old, 44.2% with 2nd trimester of gestational age. All patients complained about unavailability of transportation, complained about the provision of medicine (62%), antenatal care (3.8%) disposable waste (3.8%), clean water supply (3.8%) and provision of food (19.2%). Women in relief camps face multifactorial problems which adversely affect their health including reproductive health.

A mixed method study to assess orodental problems and barriers to utilisation of orodental care in pregnant ladies of Himachal Pradesh

Background: The hormonal changes along with decreased salivation during pregnancy result in many orodental problems. The existing orodental conditions worsen due to barriers to the utilisation of orodental care during pregnancy. The objective of this study is to assess orodental problems and barriers to utilisation of orodenatl care in pregnant ladies Methods: Sample size is calculated using Cochran’s formula. The Purposive sampling technique was used to select hospitals and pregnant women from OPD of the gynecology and obstetrics department of hospitals selected in Himachal Pradesh. Using DMFT and CPI index, interview schedules the study's specific objectives are achieved. Results: Out of a sample of 112, 92.8% of pregnant women had dental caries, 34.8% of pregnant women had got restorative treatment and 25.8% had their teeth extracted. The majority of pregnant women (51.8%) had dental calculus and (29.5%) shallow periodontal pockets. The system, personal, and caregiver-related barriers are responsible for the underutilisation of orodental care among pregnant women. Conclusions: This study concluded many pregnant women face orodental problems along with a major factor of lack of dental education and no dental insurance associated with their orodental problems.

Period Prevalence of Antenatally Diagnosed Congenital abnormalities; Single Center Study

Objective: To find out the period prevalence of congenital malformation diagnosed in security forces hospital – Riyadh –kingdom of Saudi Arabia, during the study period from Jan 2012 till Dec 2014 and the possible associated risk factors. Method: This is a retrospective chart review of all pregnant ladies who were following at security forces hospital – Riyadh – in the period between Jan 2012 till Dec 2014 in whom congenital abnormalities were diagnosed by ultrasound. Results: out of 18748 scans done for 9374 patients during the study period, 283 cases of congenital abnormalities were diagnosed, which gives a period prevalence of 3.02 %. The majority -around 70% of these anomalies- involved one body system; out of them 31% were renal anomalies. Conclusion: The period prevalence of congenital abnormalities in our study group is similar to that seen in other population worldwide. Strikingly enough, consanguinity in our population appears to play a major associated risk factor.

Association of ABO and RH Blood Groups with Gestational Diabetes Mellitus in Patients Attending a Tertiary Care Hospital of Lahore, Pakistan

Objective: To find out any association of ABO and Rh blood groups with gestational diabetes mellitus (GDM). Study Design: Comparative cross-sectional study. Place and Duration of Study: Pathology and Gynecology departments of Combined Military Hospital-Lahore from Jun to Sep 2020. Methodology: A total of 250 patients of GDM and 250 pregnant ladies with normal glucose tolerance (NGT) were included in the study. The Oral glucose tolerance test (OGTT) was performed with a 75g glucose load, and results were interpreted according to the American Diabetes Association 2020 criteria. Blood glucose samples were taken in sodium fluoride containers in fasting conditions, 1 hour and 2 hours post-glucose load. Samples for blood groups were obtained in plain and EDTA containers. Blood glucose samples were analyzed using the Hexokinase method's automated chemistry analyzer, Cobas c-501. ABO and RhD blood grouping were carried out by forward and reverse techniques in the blood bank of CMH Lahore. Results: A total of 250 (50%) pregnant ladies with OGTT suggestive of Gestational Diabetes Mellitus and 250 (50%) pregnant ladies with OGTT suggestive of Normal Glucose Tolerance (NGT) were included in the study. No statistically significant difference was observed with ABO and RhD blood groups among them (p=0.944). Conclusion: There is no significant association found between ABO and RhD blood groups with Gestational Diabetes Mellitus.

A Cross-sectional study design of risk factors related to antenatal care service use among pregnant women in Sinana district, Bale zone, Ethiopia.

Maternal health refers to the well-being of women through pregnancy, childbirth and the postpartum period. Antenatal care refers to the care that is given to a pregnant woman from the time that conception is confirmed until the beginning of labour. Ethiopia was known in concert of the world's nation with primary maternal mortality proportions. The major goal of this study was to survey risk factors related with antenatal care service use among pregnant ladies at regenerative age. Data were obtained from primary sources. To dissect the information, descriptive and Bayesian multilevel binary logistic regression of random coefficient model was utilized. The convergence of parameters was assessed by Monte carol Markova Chain utilizing Stata 16 and MLwiN 2.31 programming. The descriptive result showed that out of the whole 636 pregnant women considered around 60.5%were obtained antenatal care benefits. The odds ratio of pregnant women living in the rural areas being receiving antenatal care services was 0.206(OR = 0.206, P ≤ 0.05). This indicates that the use of prenatal care by rural mothers has decreased by 79.4% compared to urban mothers. Similarly, the Odds ratio for Pregnant women with medium and rich wealth index are 1.571(OR = 1.571, P ≤ 0.05) and 1.90(OR = 1.90, P ≤ 0.05) respectively. This means that pregnant women who are with medium and rich wealth index level had 57.1% and 90% increased odds compared to those pregnant women with poor wealth index consecutively. Varieties between the kebeles in terms of antenatal care benefit utilize were lessening by 0.9 % in random coefficient model. Generally, the study showed that there was high variation among pregnant women not to utilize antenatal care benefits and the likelihoods of prenatal use were found to increase with the husband occupation, wealth index, age category 25-34, and husband education level.

Rancang Bangun Aplikasi Android Si-Raja sebagai Upaya Memantau Pertumbuhan Janin pada Ibu Hamil

Pregnancy is fertilization or union of spermatozoa and ovum, followed by nidation or implantation. Determining estimated fetal weight (TBJ) is vital in antenatal care, counseling, diagnosis and delivery approaches. Accurate predictions of a baby's birth weight are one of the most crucial metrics in pregnancy until the commencement of labor. The health application for pregnant women has been produced in prototype form that may be run on the Android smartphone operating system. Pregnant women used the application. Apart from that, the Si-RAJA Pregnant Application was a development of the Si-RAJA application version 1. This application was built so that pregnant ladies can use it to find out the estimated weight of their fetus. This program was provided with functions to compute weight gain, upper arm circumference, and hemoglobin level status, as well as health information about fetal growth that pregnant women need to know. One of the prerequisites that needed to be met before beginning the application was to install it on your smartphone via Google Playstore. The Si-Raja Bumil program comprises of the primary menu: Calculate predicted fetal weight, how to enhance TBJ, Calculate upper arm circumference, calculate weight gain, calculate Hb levels, as well as information about the size of the baby. The program is expected to go through significant enhancements, enabling pregnant women to effectively engage with midwives to transmit complaints, examination findings, and pregnancy-related information.

Probable Mode of Action of an Indigenous Drug Formulation in Garbhini Pandu wsr Iron Deficiency Anemia

Pregnancy marks a significant milestone in a woman's life, transitioning her from a woman to a mother. While it is a joyous journey, it brings about numerous physical and physiological changes that can lead to certain health challenges. Iron deficiency anemia is a prevalent health concern during pregnancy, particularly widespread in developing nations, necessitating urgent intervention to safeguard the lives of both the mother and the child. About 4 to 16% of maternal deaths are due to anemia. In contemporary science, to prevent complications like maternal and fetal mortality and morbidity, increased risk of infection, spontaneous abortion, intrauterine growth retardation, intrauterine death, premature delivery, low birth weight, postpartum hemorrhage etc during antenatal and postnatal period, various haematinic drugs are prescribed from 3rd month onwards. In Ayurveda this condition is considered as Garbhini Pandu. The Rasa and Rakta of the mother are carried to the fetus for its proper growth and development. If not, it leads to Rasa dhatu kshaya in Garbhini which finally leads to Garbhini Pandu. Ayurveda highlights the contradiction of Shodana in pregnant ladies, hence Shamana chikitsa can be followed judiciously. Considering the necessity of utilizing a safe and beneficial drug for Garbhini Pandu during pregnancy, certain indigenous drugs such as Agasthya, Amalaki, Draksha, Musta, Pippali, Sigru, Shuddha Kasisa, and Bhavana dravyas like Dadima, Bhringaraja, and Mandukaparni have been incorporated. This article highlights about the probable mode of action of indigenous drug formulation in Garbhini Pandu.

Prevalence of Gestational Diabetes Mellitus among Pregnant ladies Attendedto Alfadlab Hospital, River Nile State, Sudan

Background:Gestational diabetes mellitus represents a big problem to both mothers and their babies, due to the future expected consequences. Material and method: In this study we use glucosuria as indicator to the presence of GDM among 100 pregnant ladies attended to Alfadlab hospital, during the study period (August,2019). Result: The prevalence of gestational diabetes mellitus among the pregnant ladies involved in our study was 4%.Conclusion: The prevalence of gestational diabetes mellitus among the pregnant ladies included in our study (4%), is low in comparison to the worldwide reports. Further studies recommended with large sample size.

PENGARUH PEMBERIAN JUS BAYAM HIJAU TERHADAP PENINGKATAN KADAR HEMOGLOBIN PADA IBU HAMIL DENGAN ANEMIA DI KLINIK PRATAMA CITRA MARENDAL KEC. DELI TUA KAB. DELI SERDANG TAHUN 2023

Anemia in pregnant ladies is an indirect cause of maternal mortality in Indonesia. The effects of anemia in pregnant women are: miscarriage, extended transport, mom and baby infections, haemorrhage, untimely birth, low start weight, malnutrition of the fetus, intrauterine increase retardation (IUGR). Non-pharmacological methods, specifically the consumption of green amaranth (Amaranthus Viridis), are used in interventions to growth hemoglobin degrees. This observe turned into carried out at Citra Marendal number one faculty from February to June 2023. This sort of study is a pre-submit-trial organization trial. The population recognized in this look at was pregnant girls with anemia. The cutting-edge pattern length is sixteen individuals selected at random from the population. The p-price acquired was (0.000) due to a -variable evaluation of the effect of green spinach juice on increasing hemoglobin tiers in anemic pregnant girls. therefore, from the outcomes of two-variable analysis with p < α (0.05), it can be concluded that spinach juice has the impact of growing hemoglobin in pregnant ladies at Citra Marendal Pratama health facility, Deli Tua District, Deli Serdang regent. girls with anemia with the aid of 2023. it's far recommended that expectant moms could advantage more from non-pharmacological interventions together with often consuming spinach juice to boom hemoglobin stages.

Vacuum-assisted caesarean delivery assessment of maternal & fetal outcome

: The baby is delivered via incisions made in the mother's abdomen and uterus during a Caesarean delivery, sometimes known as a C-section. Whether medically necessary or elective, caesarean sections have increased sharply in recent decades all throughout the world, exceeding the WHO-recommended 10-15% rate. Every effort should be taken to give cesarean sections to women in need rather than aiming to achieve a target rate, according to a 2015 WHO statement. Therefore, we must investigate the strategies that can improve CD's maternal and neonatal health condition. This study compares the outcomes for the mother and the newborn in the vacuum-assisted CD and manual CD groups.: A progressive study was conducted at Lucknow's Green cross Hospital between June 2012 and April 2018. 500 pregnant ladies took part in this study as participants. This research was approved by the institutional human ethical committee. 250 caesarean sections were performed as part of this cohort study, each with vacuum assistance utilizing a soft cup vacuum extractor on the fetal scalp and manual removal of the skull as usual with fundal compression as support. Due to the absence of uterine activity and amniotic fluid, all of the patients underwent preplanned caesarean sections. The study's findings showed that manual extraction Caesarean birth is inferior to vacuum-assisted Caesarean delivery. Additionally, it was noted that Vacuum Assisted Caesarean Delivery resulted in less uterine incision extension, estimated blood loss, and maternal discomfort. : There was no difference between Vacuum and Manual Extraction caesarean deliveries in terms of Apgar Score, the requirement for infant resuscitation, or admission to the NICU.

Frequency of Vitamin D Deficiency in Patients with Bacterial Vaginosis during First Trimester of Pregnancy

Bacterial vaginosis (BV) is an infection mainly results due to overabundance of germs. Because it affects a variety of immune system functions, it is crucial for BV. In order to timely assess, rationalize prospectively, and manage patients to combat vitamin D deficiency in bacterial vaginosis, this study planned to conduct on patients with bacterial vaginosis in relation to vitamin D deficiency, evaluate the magnitude, and generate local data. Objective: To determine the frequency of vitamin D deficiency in patients with bacterial vaginosis during first trimester of pregnancy. Methods: This cross-sectional study was conducted at Gynecology and Obstetrics department of Shaikh Zaid Women Hospital, SMBBMU Larkana from 10-September-2018 to 10-march-2019. A total of 192 pregnant women of first trimester with bacterial vaginosis were selected for this study. All the pregnant ladies with bacterial vaginosis were recruited and entered in the study and was screened for vitamin D deficiency. The data were collected on prepared proforma. Results: The age range from 25 to 35 years with a mean of 29.8±6.5 years, with mean gestational age of 8.09 ±2.29 weeks. Frequency of vitamin D deficiency was 47.4% in women with bacterial vaginosis in their first trimester. Conclusions: Findings of our study suggest association between vitamin D insufficiencies with BV during first trimester of pregnancy.

Cut-Off Value of Thyrotropin-Receptor Antibodies in Grave's Disease in Basrah.

The diagnosis of Grave's disease (GD) poses a challenge. Thyrotropin-receptor antibodies (TRAb) are the key diagnostic feature of GD, as the American and European Thyroid Associations suggested. This study aims to find a cut-off level of TRAb in GD in Basrah. This is a retrospective study that included 617 patients with hyperthyroidism (530 GD and 87 non-Grave's disease (NGD) (thyroiditis or subclinical hyperthyroidism)). The candidates were patients presenting with hyperthyroidism who were referred for TRAb assay, while patients with thyroid carcinoma or nodular thyroid disease, pregnant ladies, and patients who were treated were excluded. The manufacturer cut-off value of 1.75 IU/L had a sensitivity of 88.1%, specificity of 72.4%, positive predictive value (PPV) of 95.1%, and negative predictive value (NPV) of 50.0%. Our data analysis through receiver operating characteristic (ROC) statistics revealed that the optimum cut-off point with the highest total sensitivity and specificity was determined to be 3.95 IU/L, as it had a sensitivity of 76.9%, specificity of 98.8%, PPV of 99.7%, NPV of 41.3%. For a more accurate diagnosis of GD, the findings of the present study support the implementation of a higher TRAb cut-off value (3.95 IU/L) than that predefined by the manufacturer (1.75 IU/L).

Antenatal screening for Thalassemia minor among conceiving females: A preventive measure

Beta Thalassemia is one of the most common global health concerns worldwide. It affects a large population in Pakistan, too, thereby increasing the financial burden. Several screening procedures have been proposed to lessen the cost burden associated with Beta Thalassemia. This study focuses on studying the occurrence of beta-thalassemia trait among pregnant ladies, the commonest mutations among Beta Thalassemia Trait cases, and defining the hematological parameters to overcome this expensive burden.Blood was collected via venipuncture to carry-out CBC (Complete Blood Count) and H.B. (Hemoglobin) Electrophoresis is used to detect beta-thalassemia minor. In this study, the main CBC parameters to screen BTT included MCV (≤75fl), MCH (≤25pg), RBCs (≥4.50 million), and Hemoglobin (≤12g/Dl), whereas Hb electrophoresis confirmed the final diagnosis. The cut-off values for the final confirmation of BTT through Hb electrophoresis were >3.5% HBA2 and <95% HBA. Statistical tests used during the study included Mean and Standard deviation. Tetra-arm multiplex PCR was carried out to detect mutations. Thalassemia minor was detected in 15 out of 509 conceiving females present in our study cohort, thus overall incidence rate being 2.9%. Moreover, the most reliable parameters for screening beta-thalassemia minor included MCV, MCH, RBCs, and RDW. Iron Deficiency Anemia (IDA) didn't hinder the accurate diagnosis of the beta-thalassemia minor. Moreover, our data revealed the IVS 1-5(G-C) (4 samples) and FSc 8-9 (+G) (4 samples) to be the commonest mutations among carrier females. However, CD 30 mutation was found in 2 samples. However, Primers were designed for the most commonly reported mutations in Pakistan including F.Sc 8/9, IVS 1- 5, 619bp deletion, CD 16, and CD 30. Extensive screening strategies and detailed genetic counselling are needed to identify the risk and genetic epidemiology of Beta Thalassemia in Pakistan.

Perception and Experience of Physicians Towards the Use of a Targeted Vitamin B-Complex Combination in Attaining Faster Recovery in Acute Illnesses Like Fever vs. Other Competing Combinations in the Market

Background: Vitamin B-complex aids in the development and maintenance of a healthy immune system and also helps to prevent or lessen various infections, especially cases of acute sickness like fever. This study investigates the opinions and experiences of doctors about the effectiveness and usefulness of the targeted vitamin B-complex combinations comprising of pyridoxine hydrochloride, cyanocobalamin, nicotinamide, chromium chloride, sodium selenite, L-lysine in hastening the recovery from acute diseases like fever and others. It offers insight on the perceived advantages, disadvantages and general efficacy of target vitamin B-complex combinations in comparison to other current medications by assessing doctors' preferences, clinical observations and patient outcomes. Additionally, the study also outlines the role of selenium, chromium and L-lysine aiding in the faster recovery along with the targeted vitamin B-complex combination. Studies show that selenium supplementation can reduce mortality rates in viral infections, improve recovery rates in COVID-19 patients and improve the recovery rate. Chromium offers antioxidant properties, and influences immune response and hence helps in the faster recovery of several acute illnesses. Lysine serves as a pivotal building block for proteins, which in turn contribute significantly to the growth and restoration of bodily tissues following damage. Methods: The study was a retrospective study in July 2023 used a questionnaire-based survey to assess the efficacy and tolerability of vitamin B-complex combinations for faster recovery in acute illnesses, focusing on fever. The study used a validated questionnaire with 13 questions, and data was entered into asoftware database. Complete cases were analyzed, and missing data was excluded due to low occurrence. The final report was prepared after cleaning the data. Result: The study included 132 doctors from various medical specializations aimed to understand their perception and experience of using vitamin B-complex for faster recovery from acute illnesses. The most important factor contributing to choosing vitamin B-complex was the uses of micronutrients, which help produce red blood cells (40.2%), followed by use in treating mouth ulcers (31.1%) and are critical for pregnant ladies (28.8%). Antioxidants like selenium and chromium were found to be significantly effective (57.6%) for faster recovery in acute illnesses, while 39.4% considered them moderately effective. The study revealed that 88.6% of doctors considered the use of vitamin B-complex combination advantageous due to the presence of folic acid, L-lysine and selenium, and that 97.7% of doctors had a positive attitude about continuing to prescribe vitamin B-complex supplementation in the future. The study found that the current vitamin B-complex combination outperforms its competitors mostly (82%), especially in helping to recover from acute illnesses faster. It was also found to be friendly for the elderly, as no side effects were observed. Conclusion: Results suggest that the targeted vitamin B-complex combination can improve acute disease management and help health care professionals make informed decisions for optimal well-being. The findings contribute to a deeper understanding of the medical decisionmaking process and the nuanced considerations that impact the prescription of specific treatment options for acute illnesses.

Knowledge and perception of Accredited Social Health Activists' about breastfeeding and complementary feeding practices: AQualitative study using Focus Group Discussion

Background: Accredited Social Health Activist (ASHA) workers bridge the gap between the health system to provide accessible, affordable, accountable, reliable, and effective primary healthcare. Aims and Objectives: To determine the views of ASHA workers about breastfeeding and complementary feeding. Materials and Methods: Focus Group Discussion (FGD) with ASHA workers in a rural Primary Health Centre was conducted to assess their knowledge and perception regarding breastfeeding and complementary feeding. It was a qualitative study conducted by using FGD. The study had been conducted in one block of one district of Maharashtra, which was selected purposively for the study. All ASHAs from the nearby nine villages belonging to Nere Primary Health Center were included as study participants. Statistical analysis: The interview transcribing method was used to analyze the data. Results:The ASHAworkers had good knowledge about the importance of breast milk and breastfeeding. Already, they were giving information to the pregnant ladies and lactating mothers in their villages. They had little knowledge about the Infant and Young Child Feeding practices, breastfeeding positions and suggested the conduction of training to learn effective breastfeeding techniques. Conclusions: All ASHA workers have good knowledge about the importance of breast milk, and they realized the importance of effective breastfeeding techniques. It is recommended to conduct lactation training for ASHAworkers, and pregnant and lactating women.

The Comparison Between Maternal and Umbilical Cord Blood Levels of Zinc and Copper in Active Labour Versus Elective Caesarean Section

Background: Multivitamin administration in the periconceptional time was correlated with 16% decrement risk of premature deliveries. This study was aimed to investigate maternal and umbilical cord blood levels of zinc and copper in active labour versus elective caesarean. Patients and Methods: A case-control study was carried out in Salah Al-deen general hospital form February to September 2020. The study included full term pregnant ladies with active labour or prepared for elective caesarean attending the labour unit in Salah Al-deen general hospital. A total of 60 full term pregnant ladies divided into two groups consist of: (30) women in active vaginal delivery women, and group of (30) women prepared for elective caesarean section. Trace elements’ levels were evaluated utilizing the spectrophotometry. Results: The mean maternal serum zinc level among vaginal delivery group was (87.45±14.99) μg/dL versus (87.84±13.8) μg/dL among caesarean group. The mean umbilical zinc level among vaginal delivery group was (90.34±22.56) μg/dL and was higher among caesarean group (88.8±31.9) μg/dL. The mean maternal serum copper level among vaginal delivery group (83.82±14.02) μg/dL was lower than among caesarean group (127.57±37.23) μg/dL. Conclusion: There was higher mean umbilical cord zinc than the maternal zinc level. The mean umbilical cord zinc was lower than the maternal zinc among caesarean group. There was significantly lower mean umbilical cord copper than the maternal copper level among vaginal delivery group and the caesarean group. There was a positive significant correlation between maternal zinc level and umbilical zinc level. There was positive significant correlation between maternal copper level and umbilical copper level. Therefore, trace elements may play an essential function in the human parturition process.

Universal Screening of Gestational Diabetes Mellitus In Upper Egypt: Prospective Cohort Study of The Prevalence, Risk Factors, and Short-Term Outcomes

Background: Despite the high prevalence of diabetes mellitus in Egypt, the real prevalence and epidemiology of gestational diabetes mellitus (GDM) in Upper Egypt is still lacking. Objective: This study aims to determine the prevalence and risk factors of GDM among pregnant women in Upper Egypt and to evaluate the foetal and maternal outcomes of this disease. Methods: This prospective cohort study was conducted between July 2014 and July 2018. Universal screening for GDM among all pregnant women attending primary health care clinics was done using Diabetes in Pregnancy Study Group of India (DIPSI) criteria. Those with GDM were followed up until the end of purpureum. Maternal and foetal outcomes were recorded. Results: GDM was diagnosed in 956 out of 7141 pregnant women (13.4%). Previous history of GDM, macrosomic babies, and family history of diabetes were all significantly higher in GDM women (P<0.001 each). However, no definite risk factors were observed in about half of the GDM women. 29% of GDM women responded to medical nutrition therapy (MNT) alone. When the oral glucose tolerance test (OGTT) was repeated Postpartum, diagnosis of DM was established in 14.3% of the cohort, while 25.7% had impaired glucose tolerance. Conclusions: The prevalence of GDM is relatively high in Upper Egypt. Half of GDM cases lack risk factors. Universal screening using OGTT should be routinely performed to all attendant pregnant ladies. Discrete MNT is not an enough management in most of GDM cases. Keywords: GDM; Postpartum OGTT; diabetes; MNT; foetal outcome; maternal outcome.