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European Journal of Midwifery 2024When managing elective and emergency cesarean births in the same operating room, unpredictable variations in the start times of the cesareans can prolong fasting periods.
A retrospective study of pre-operative fasting times prior to elective or emergency cesarean birth in a large maternity hospital: Lessons to be learned to minimize the fasting time.
INTRODUCTION
When managing elective and emergency cesarean births in the same operating room, unpredictable variations in the start times of the cesareans can prolong fasting periods.
METHODS
The fasting times were retrospectively analyzed on 279 consecutive cesarean births at Helsinki University Women's Hospital, Finland, during January-February 2023. The fasting times were compared between the urgency groups and for elective cesareans according to their scheduled order on the operation list. The primary outcome was the difference in the fasting times for food and drink, while the secondary outcome was fasting for both food >12 h and fluids >4 h. The fasting times were compared by one-way ANOVA and chi-squared test, respectively. Dichotomous data are presented as unadjusted odds ratios (OR with 95% CI).
RESULTS
Increasing urgency was associated with shorter fasting times. Fasting times for elective cesareans increased with the scheduled order on the daily list. The mean fasting periods (SD) increased from 10.55 h (SD=1.57) to 14.75 h (SD=2.02) from the first to the third cesarean of the day (p<0.01). The unadjusted odds ratio (95% CI) for fasting of the scheduled cesareans to exceed 12 h for solid foods and 4 h for clear fluids was 6.53 (95% CI: 2.67-15.9, p<0.001), for the third and fourth cesareans compared to the first two cesareans of the day.
CONCLUSIONS
When elective and emergency cesareans are performed by the same team, the woman undergoing the third elective surgery of the day should be advised to have breakfast before 5 a.m. at home. While waiting for the operation, a carbohydrate drink should be offered to limit the fast.
PubMed: 38957355
DOI: 10.18332/ejm/188801 -
European Journal of Midwifery 2024Postpartum depression negatively impacts maternal mental health and child development. The high prevalence of postpartum depression (PPD) in low and lower middle-income...
INTRODUCTION
Postpartum depression negatively impacts maternal mental health and child development. The high prevalence of postpartum depression (PPD) in low and lower middle-income countries raises questions about its predictors. This study examines the association between PPD and breastfeeding experience, child death, unresolved pregnancy, forced displacement, COVID-19 pandemic lockdown, marital, and financial status among Ukrainian women.
METHODS
This online study recruited 1634 Ukrainian mothers of children aged 0-5 years through non-governmental organizations providing services to them. The Edinburgh Postnatal Depression Scale (EPDS), with a cut-off of ≥13, was used to assess depressive symptoms in the postpartum period. Independent t-tests, chi-squared tests, one-way ANOVA, non-parametric correlations, and logistic regression tests were used to analyze the data.
RESULTS
The prevalence of depressive symptoms was 39.0% (n=1631). There was a positive association between EPDS scores and breastfeeding difficulties, pandemic lockdown, and financial difficulties. We did not find an association between PPD symptoms and unresolved pregnancy, death of a child, being affected by COVID-19, and forced displacement. We found that EPDS scores for women who did not experience forced displacement (n=1528) were significantly higher compared to displaced mothers (n=74).
CONCLUSIONS
The present study of Ukrainian women shows that women experienced depressive symptoms influenced by various factors including breastfeeding difficulties, pandemic lockdown, and financial difficulties. There is a need for additional research into such factors as unresolved pregnancy, the death of a child, being affected by COVID-19, and forced displacement.
PubMed: 38957354
DOI: 10.18332/ejm/188800 -
Ethiopian Journal of Health Sciences Jan 2024The Antenatal Care (ANC) Center is a conventional facility that caters for the prenatal healthcare needs of expectant mothers and ensures proper management by healthcare...
BACKGROUND
The Antenatal Care (ANC) Center is a conventional facility that caters for the prenatal healthcare needs of expectant mothers and ensures proper management by healthcare professionals; however, expectant mothers seek healthcare support from other sources. This study aimed to examine the utilization of social media for healthcare information among expectant mothers in the capital city of Ghana and explore the factors that influence its adoption.
METHOD
This study employed a non-experimental survey design. The study used a questionnaire to gather data from expectant mothers. Using 580 valid responses, SmartPLS structural equation modeling (SEM) was used to analyze the study model.
RESULTS
The study findings demonstrated the significant influence of performance expectancy of social media (PESM) and facilitating conditions of social media (FCSM) on social media healthcare information usage (SMHLU). The results also revealed that emotional support on social media and perceived vulnerability were influential factors that shaped expectant mothers' choices to use social media for healthcare information. However, the study showed that perceived severity and the relative advantage of social media had no significant effects on SMHIU. Interestingly, FCSM was found to be significantly associated with PESM, emphasizing that social media support enhances performance expectancy.
CONCLUSION
This study showed that information is important to expectant mothers, which compels them to seek digital healthcare. With these findings, healthcare providers can incorporate digital health services into their ANC service to support women during pregnancy.
Topics: Humans; Female; Social Media; Ghana; Pregnancy; Prenatal Care; Adult; Young Adult; Surveys and Questionnaires; Mothers; Information Seeking Behavior; Patient Acceptance of Health Care; Social Support; Adolescent
PubMed: 38957339
DOI: 10.4314/ejhs.v34i1.6 -
Ethiopian Journal of Health Sciences Jan 2024The National Immunization Program (NIP) was introduced in Ethiopia in 1980. The NIP has expanded the number of vaccines from six to more than 14 in 2023. However,...
The National Immunization Program (NIP) was introduced in Ethiopia in 1980. The NIP has expanded the number of vaccines from six to more than 14 in 2023. However, decisions on new vaccine introduction and other vaccine-related matters were not systematically deliberated nationally. Thus, the need to establish a national body to deliberate on vaccine and vaccination matters, in addition to the global immunization advisory groups, has been emphasized in the last decade. This article presents the establishment and achievements of the Ethiopian NITAG. The E-NITAG was established in 2016 and maintained its active role in providing recommendations for new vaccine introduction and improving the delivery of routine vaccines. The external assessment indicated the E-NITAG was highly functional and played a critical role in enhancing the vaccination practice in Ethiopia, especially during the COVID-19 pandemic. The absence of a dedicated secretariat staff was the major bottleneck to expanding the role of the E-NITAG beyond responding to MOH requests. The E-NITAG must be strengthened by establishing a secretariat that can eventually grow as an independent institution to address complex vaccine-related issues the NIP needs to address.
Topics: Humans; Ethiopia; Immunization Programs; Advisory Committees; COVID-19; Vaccination; SARS-CoV-2; COVID-19 Vaccines; Vaccines
PubMed: 38957337
DOI: 10.4314/ejhs.v34i1.12 -
Ghana Medical Journal Mar 2024To compare cervical ripening time with the use of vaginal Misoprostol plus Hyoscine-N-Butylbromide, with vaginal Misoprostol alone. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To compare cervical ripening time with the use of vaginal Misoprostol plus Hyoscine-N-Butylbromide, with vaginal Misoprostol alone.
DESIGN
A double-blind randomized controlled trial with Pan-African Clinical Trials Registry (PACTR) approval number PACTR202112821475292.
SETTING
Federal Medical Centre, Asaba, Nigeria.
PARTICIPANTS
A total of 126 eligible antenatal patients for cervical ripening were enrolled.
INTERVENTIONS
Participants in Group A had 25µg of vaginal misoprostol with 1ml of intramuscular placebo, and those in Group B had 25µg of vaginal misoprostol with 20mg of Intramuscular Hyoscine (1 ml). Oxytocin infusion was used when indicated, and the labour was supervised as per departmental protocol.
MAIN OUTCOME MEASURE
Cervical ripening time.
RESULTS
The mean cervical ripening time was statistically significantly shorter in the hyoscine group (8.48±4.36 hours) than in the placebo group (11.40±7.33 hours); p-value 0.02, 95% CI 0.80-5.05. There was no statistically significant difference in the mean induction-delivery interval in Group A (7.38±5.28 hours) compared to Group B (7.75±5.04 hours), with a value of 0.54. The mode of delivery was comparable. However, women in Group B (53, 84.1%) achieved more vaginal deliveries than women in Group A (50, 79.4%); p-value 0.49. Thirteen women in Group A (20.6%) had a caesarean section, while ten women (15.9%) in Group B had a caesarean section (p-value 0.49, RR 0.94, CI 0.80-1.11). Adverse maternal and neonatal outcomes were not statistically significant between the two groups.
CONCLUSION
Intramuscular hyoscine was effective in reducing cervical ripening time when used as an adjunct to vaginal Misoprostol, with no significant adverse maternal or neonatal outcome.
FUNDING
None declared.
Topics: Humans; Female; Pregnancy; Misoprostol; Double-Blind Method; Cervical Ripening; Adult; Administration, Intravaginal; Oxytocics; Young Adult; Butylscopolammonium Bromide; Nigeria; Labor, Induced; Time Factors; Drug Therapy, Combination
PubMed: 38957282
DOI: 10.4314/gmj.v58i1.7 -
The Lancet Regional Health. Southeast... Aug 2024Telemedicine is a promising solution to the challenges of delivering equitable and quality primary healthcare, especially in LMICs. This review evaluated peer-reviewed... (Review)
Review
Telemedicine is a promising solution to the challenges of delivering equitable and quality primary healthcare, especially in LMICs. This review evaluated peer-reviewed literature on telehealth interventions in Indian primary care published from Jan 1, 2011 to Dec 31, 2021, from PubMed, Scopus, TRIP, Google Scholar, Indian Kanoon, and Cochrane database The majority of Indian studies focus on key health issues like maternal and child health, mental health, diabetes, infectious diseases, and hypertension, mainly through patient education, monitoring, and diagnostics. Yet, there's a lack of research on telemedicine's cost-effectiveness, communication among providers, and the role of leadership in its quality and accessibility. The current research has gaps, including small sample sizes and inconsistent methodologies, which hamper the evaluation of telemedicine's effectiveness. India's varied healthcare landscape, technological limitations, and social factors further challenge telemedicine's adoption. Despite regulatory efforts, issues like the digital divide and data privacy persist. Addressing these challenges with a context-aware, technologically driven approach is crucial for enhancing healthcare through telemedicine in India.
PubMed: 38957222
DOI: 10.1016/j.lansea.2024.100431 -
Frontiers in Neuroscience 2024We utilized bibliometric and data visualization techniques to discern the primary research domains and emerging frontiers in the field of adult hippocampal neurogenesis...
OBJECTIVE
We utilized bibliometric and data visualization techniques to discern the primary research domains and emerging frontiers in the field of adult hippocampal neurogenesis (AHN).
METHODS
We systematically searched the Web of Science database for AHN-related articles published between 2004 and 2023. The retrieved articles were filtered based on publication types (articles and reviews) and language (English). We employed CiteSpace, VOSviewer, and the online bibliometric platform (bibliometric.com) to visualize and analyze the collected data.
RESULTS
In total, 1,590 AHN-related publications were discovered, exhibiting a steady increase in yearly publications over time. The United States emerged as the leading contributor in AHN research in terms of both publication quantity and national influence. Among all research institutions in the field of AHN, the University of California System exhibited the highest impact. Kempermann, Gerd was the most active author. The publications of the top three active authors primarily focused on the functions of AHN, and reversing hippocampal damage and cognitive impairment by improving AHN. An analysis of reference co-citation clustering revealed 8 distinct research clusters, and the notable ones included "adult hippocampal neurogenesis," "neurogenesis," "hippocampus," "dentate gyrus," "neural stem cell," and "depression." Additionally, a burst keyword detection indicated that 'anxiety' is a current research hotspot in the field of AHN.
CONCLUSION
This in-depth bibliographic assessment of AHN offers a deeper insight into the present research hotspots in the field. The association between AHN and cognitive diseases, such as Alzheimer's disease (AD) and anxiety, has emerged as a prominent research hotspot.
PubMed: 38957185
DOI: 10.3389/fnins.2024.1416738 -
International Journal of Nanomedicine 2024Salidroside (SAL) is the most effective component of , a traditional Chinese medicine. Cryptotanshinone (CT) is the main fat-soluble extract of , exhibiting considerable...
BACKGROUND
Salidroside (SAL) is the most effective component of , a traditional Chinese medicine. Cryptotanshinone (CT) is the main fat-soluble extract of , exhibiting considerable potential for application in osteogenesis. Herein, a polycaprolactone/gelatin nanofiber membrane loaded with CT and SAL (PSGC membrane) was successfully fabricated via coaxial electrospinning and characterized.
METHODS AND RESULTS
This membrane capable of sustained and controlled drug release was employed in this study. Co-culturing the membrane with bone marrow mesenchymal stem cells and human umbilical vein endothelial cells revealed excellent biocompatibility and demonstrated osteogenic and angiogenic capabilities. Furthermore, drug release from the PSGC membrane activated the Wnt/β-catenin signaling pathway and promoted osteogenic differentiation and vascularization. Evaluation of the membrane's vascularization and osteogenic capacities involved transplantation onto a rat's subcutaneous area and assessing rat cranium defects for bone regeneration, respectively. Microcomputed tomography, histological tests, immunohistochemistry, and immunofluorescence staining confirmed the membrane's outstanding angiogenic capacity two weeks post-operation, with a higher incidence of osteogenesis observed in rat cranial defects eight weeks post-surgery.
CONCLUSION
Overall, the SAL- and CT-loaded coaxial electrospun nanofiber membrane synergistically enhances bone repair and regeneration.
Topics: Osteogenesis; Animals; Nanofibers; Gelatin; Polyesters; Glucosides; Phenols; Phenanthrenes; Humans; Neovascularization, Physiologic; Human Umbilical Vein Endothelial Cells; Mesenchymal Stem Cells; Rats, Sprague-Dawley; Rats; Male; Bone Regeneration; Membranes, Artificial; Coculture Techniques; Drug Liberation; Cell Differentiation
PubMed: 38957181
DOI: 10.2147/IJN.S461141 -
ARP Rheumatology 2024Spondyloarthritis (SpA) is a group of chronic inflammatory diseases, often affecting women in reproductive age. These diseases can have a significant impact on the...
INTRODUCTION
Spondyloarthritis (SpA) is a group of chronic inflammatory diseases, often affecting women in reproductive age. These diseases can have a significant impact on the reproductive health of women. Preconception counseling and medication adjustments have shown to reduce flares and improve pregnancy outcomes in women with rheumatoid arthritis. However, in women with SpA data of the impact of preconception counselling on pregnancy outcomes is scarce. The aim of this study is to evaluate that.
METHODS
In this retrospective multicentric study, data was collected from medical records of women who gave birth from 2020 to 2022. The study included 45 pregnancies, which were divided into two categories whether they received preconception consultation or not. Data was collected on patient characteristics, disease duration, medications used, and preconception counselling. Outcomes were divided into two groups: maternal and fetal outcomes.
RESULTS
30 out of 45 pregnancies (66.67%) had received preconception counselling, having a significantly lower percentage of flares occurring postpartum compared to the non-counselling group (36.6% vs 6.4%, p=0.031) and lower percentage of contraindicated medication during pregnancy (20.0 vs 0.0%, p=0.011).
CONCLUSION
Preconception counselling in women with SpA can increase the likelihood of medication adjustments before pregnancy and decrease the occurrence of flares postpartum. These findings suggest that preconception counselling should be implemented in the management of pregnant women with SpA to improve pregnancy outcomes. Further studies are needed to confirm the effectiveness of preconception counselling and to determine the optimal approach.
Topics: Humans; Female; Pregnancy; Adult; Retrospective Studies; Preconception Care; Pregnancy Outcome; Pregnancy Complications; Counseling; Spondylarthritis
PubMed: 38956993
DOI: No ID Found -
Cell Proliferation Jul 2024The presence of extensive infiltrated macrophages with impaired phagocytosis is widely recognised as a significant regulator for the development of endometriosis (EMs)....
The presence of extensive infiltrated macrophages with impaired phagocytosis is widely recognised as a significant regulator for the development of endometriosis (EMs). Nevertheless, the metabolic characteristics and the fundamental mechanism of impaired macrophage phagocytosis are yet to be clarified. Here, we observe that there is the decreased expression of haematopoietic cellular kinase (HCK) in macrophage of peritoneal fluid from EMs patients, which might be attributed to high oestrogen and hypoxia condition. Of note, HCK deficiency resulted in impaired macrophage phagocytosis, and increased number and weight of ectopic lesions in vitro and in vivo. Mechanistically, this process was mediated via regulation of glutamine metabolism, and further upregulation of macrophage autophagy in a c-FOS/c-JUN dependent manner. Additionally, macrophages of EMs patients displayed insufficient HCK, excessive autophagy and phagocytosis dysfunction. In therapeutic studies, supplementation with glutamine-pre-treated macrophage or Bafilomycin A1 (an autophagy inhibitor)-pre-treated macrophage leads to the induction of macrophage phagocytosis and suppression of EMs development. This observation reveals that the aberrant HCK-glutamine-autophagy axis results in phagocytosis obstacle of macrophage and further increase the development risk of Ems. Additionally, it offers potential therapeutic approaches to prevent EMs, especially patients with insufficient HCK and macrophage phagocytosis dysfunction.
PubMed: 38956970
DOI: 10.1111/cpr.13702