Effectiveness of peppermint aromatherapy upon labour Pain and coping among parturient mothers

An experimental study to assess the effectiveness of aromatherapy upon first stage labour pain, and coping among Primi parturient mothers at selected hospital, Chennai. PRIMARY OBJECTIVES: 1. To assess the level of labour pain and coping before and after peppermint aromatherapy among control and experimental group of primi parturient mothers. 2. To assess the effectiveness of aromatherapy upon first stage labour pain, and coping among Primi parturient mothers 3. To determine the level of satisfaction upon peppermint aroma therapy among experimental group of primiparturient mothers. 4. To find out the association between the selected demographic variables and the level of labour pain, coping before and after therapy in the control and experimental group primiparturient mothers. 5. To find out the association between the selected obstetrical variables and the level of labour pain, coping before and after pepper mint aroma therapy in control and experimental group of primiparturient mothers SECONDARY OBJECTIVES: 1. To assess the fetomaternal parameters before and after peppermint aromatherapy among control and experimental group of primi parturient mothers. 2. To compare the fetomaternal parameter among control and experimental group of primi parturient mothers before and after peppermint aromatherapy. The conceptual framework setup for the study was Swanson’s Caring theory. The variables of the study were aromatherapy, Labour pain and Coping. Null hypotheses were formulated. An extensive review of literature was made based on the opinions of the experts. An experimental study of Time series with multiple institution of treatment design was used. The study included 60 parturient mothers who were selected by Simple random sampling. The study was conducted at Andhra Mahila Sabha Hospitals, Chennai. Demographic variable Proforma, Obstetric variable proforma, Visual Pain Analogue scale, Pain Coping Scale, Rating Scale on Satisfaction of peppermint aromatherapy and Modified WHO Partograph were the various tools used by the researcher. The validity was obtained from various experts and reliability was established. The main study was conducted after the pilot study. The level of Labour pain, Coping and Feto-maternal parameters were assessed for the Control and Experimental group of parturient mothers. The peppermint aromatherapy provided for every 30minutes in the Experimental group till the first stage of labour is completed. Then the level of labour pain, coping and feto-maternal parameters were assessed for both the groups. The level of satisfaction on peppermint aromatherapy was assessed among the experimental group of parturient mothers after the labour. The data obtained were analyzed using Descriptive and Inferential statistics. Descriptive Statistics such as Mean, Median and Standard deviation. Inferential statistics such as Chi- Square and paired “t” test. MAJOR FINDINGS OF THE STUDY: ❖ The parturient mothers in both the control and experimental group were in the age group of 21 -25 years (53.33%, 60%), resided in sub urban areas (53.33%, 53.33%), majority of them belonging to nuclear family (73.3%, 86.66%) and none of them received information regarding peppermint aromatherapy previously. ❖ The mothers were between 39 – 40 weeks of gestation in both control and experimental group (43.33%, 63.33%) during delivery. All of them attended more than four antenatal visits and APGAR score of newborn at birth were between 7-10 for both control and experimental group. ❖ Majority of the women were able to do 3 R’s (Rhythm, Ritual and Relaxation) (90%, 86.7%) before therapy and significant percentage of them were able to do 3 R’s (6.66%, 40%) after therapy in both control and experimental group respectively. ❖ The Mean pain level was high after therapy (M=5.8, SD=0.88) compared to before therapy (M=4, S.D=1.17) in control group whereas the mean pain level was low (M=3.8, SD=0.60) after therapy compared to before therapy (M=3.8, SD=0.60) in experimental group. Hence null hypothesis Ho1 “There will be no significant relationship between the level of labour pain, coping feto maternal parameters and aroma therapy in control and experimental group of parturient mothers” was rejected. ❖ The Mean coping level was low after therapy (M=2.00, SD=0.87) in comparison with before therapy (M=4.2, SD=0.94) in control group and the mean coping level was high after therapy (M=4.3, SD=0.69) in comparison with before therapy (M=3.3, SD=0.60) in experimental group. Hence null hypothesis Ho1 “There will be no significant relationship between the level of labour pain, coping feto maternal parameters and aroma therapy in control and experimental group of parturient mothers” was rejected. ❖ The cervical dilatation and uterine contraction were increased after therapy in comparison with before therapy for experimental group (M=4, SD=0; M=6, SD=0), (M=2.5,SD=0.50; M=3.9, SD=0.11) and control group (M=4,SD=0; M=6, SD=0), (M=3 SD=0; M=4, SD=0) of parturient mothers which shows that peppermint aromatherapy was not having any adverse effects over uterine contractions and cervical dilatation. ❖ The Majority of the parturient mother in Experimental group were highly satisfied (86.66%) with the peppermint aromatherapy and none of them reported dissatisfaction towards the intervention. In both the Control and Experimental group of parturient mothers, no significant association was found between Demographic variables and the level of labour pain perception which proves that Demographic variables has no influence over the pain perception. Hence some type of pain relief methods are essential for the women to reduce the pain. ❖ Similarly No association was found between Demographic variables and the level of coping in both the Control and Experimental group of parturient mothers which means that Demographic variables may not influence the coping level of the women and hence it is the responsibility of the nurse midwife to help the mother in coping with the labour pain. ❖ There was no significant association between Obstetric variables such as gravida, parity, gestational age in weeks, number of antenatal visits, cervical dilatation, duration of first, second, third stage of labour and APGAR score of newborn at birth with the level of labour pain after peppermint aromatherapy in the control and experimental group(P>0.05) Hence null hypothesis Ho3 “There will be no significant association between selected obstetric variables and level of labour pain and, coping before and after aroma therapy in control and experimental group of parturient mothers” was retained. ❖ There was no significant association between Obstetric variables such as gravida, parity, gestational age in weeks, number of antenatal visits, cervical dilatation, duration of first, second, third stage of labour and APGAR score of newborn at birth with the level of coping after peppermint aromatherapy in the control and experimental group(P>0.05) Hence null hypothesis Ho3“There will be no significant association between selected obstetric variables and level of labour pain and, coping before and after aroma therapy in control and experimental group of parturient mothers” was retained. ❖ The above study findings reveled that peppermint aromatherapy used by the researcher to reduce the level of pain perception in parturient mothers was found to be effective. RECOMMENDATIONS: 1. The same study can be conducted with large number of samples. 2. A comparison can be made between primi and multigravid women. 3. A comparison can be made with different stages of labour. 4. The same study can be conducted at different setting. 5. A comparison can be made between different types of alternative and complementary therapies

Deficiency in the mouse mitochondrial adenine nucleotide translocator isoform 2 gene is associated with cardiac noncompaction.

The mouse fetal and adult hearts express two adenine nucleotide translocator (ANT) isoform genes. The predominant isoform is the heart-muscle-brain ANT-isoform gene 1 (Ant1) while the other is the systemic Ant2 gene. Genetic inactivation of the Ant1 gene does not impair fetal development but results in hypertrophic cardiomyopathy in postnatal mice. Using a knockin X-linked Ant2 allele in which exons 3 and 4 are flanked by loxP sites combined in males with a protamine 1 promoter driven Cre recombinase we created females heterozygous for a null Ant2 allele. Crossing the heterozygous females with the Ant2(fl), PrmCre(+) males resulted in male and female ANT2-null embryos. These fetuses proved to be embryonic lethal by day E14.5 in association with cardiac developmental failure, immature cardiomyocytes having swollen mitochondria, cardiomyocyte hyperproliferation, and cardiac failure due to hypertrabeculation/noncompaction. ANTs have two main functions, mitochondrial-cytosol ATP/ADP exchange and modulation of the mitochondrial permeability transition pore (mtPTP). Previous studies imply that ANT2 biases the mtPTP toward closed while ANT1 biases the mtPTP toward open. It has been reported that immature cardiomyocytes have a constitutively opened mtPTP, the closure of which signals the maturation of cardiomyocytes. Therefore, we hypothesize that the developmental toxicity of the Ant2 null mutation may be the result of biasing the cardiomyocyte mtPTP to remain open thus impairing cardiomyocyte maturation and resulting in cardiomyocyte hyperproliferation and failure of trabecular maturation. This article is part of a Special Issue entitled 'EBEC 2016: 19th European Bioenergetics Conference, Riva del Garda, Italy, July 2-6, 2016', edited by Prof. Paolo Bernardi

Inhibition of Intestinal Bile Acid Transporter Slc10a2 Improves Triglyceride Metabolism and Normalizes Elevated Plasma Glucose Levels in Mice

Interruption of the enterohepatic circulation of bile acids increases cholesterol catabolism, thereby stimulating hepatic cholesterol synthesis from acetate. We hypothesized that such treatment should lower the hepatic acetate pool which may alter triglyceride and glucose metabolism. We explored this using mice deficient of the ileal sodium-dependent BA transporter (Slc10a2) and ob/ob mice treated with a specific inhibitor of Slc10a2. Plasma TG levels were reduced in Slc10a2-deficient mice, and when challenged with a sucrose-rich diet, they displayed a reduced response in hepatic TG production as observed from the mRNA levels of several key enzymes in fatty acid synthesis. This effect was paralleled by a diminished induction of mature sterol regulatory element-binding protein 1c (Srebp1c). Unexpectedly, the SR-diet induced intestinal fibroblast growth factor (FGF) 15 mRNA and normalized bile acid synthesis in Slc10a2−/− mice. Pharmacologic inhibition of Slc10a2 in diabetic ob/ob mice reduced serum glucose, insulin and TGs, as well as hepatic mRNA levels of Srebp1c and its target genes. These responses are contrary to those reported following treatment of mice with a bile acid binding resin. Moreover, when key metabolic signal transduction pathways in the liver were investigated, those of Mek1/2 - Erk1/2 and Akt were blunted after treatment of ob/ob mice with the Slc10a2 inhibitor. It is concluded that abrogation of Slc10a2 reduces hepatic Srebp1c activity and serum TGs, and in the diabetic ob/ob model it also reduces glucose and insulin levels. Hence, targeting of Slc10a2 may be a promising strategy to treat hypertriglyceridemia and diabetes

Acquisition of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) carriage after exposure to systemic antimicrobials during travel: systematic review and meta-analysis

BACKGROUND: International travel is an important risk factor for colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE). Antimicrobial use during travel likely amplifies this risk, yet to what extent, and whether it varies by antimicrobial class, has not been established. METHODS: We conducted a systematic review that included prospective cohorts reporting both receipt of systemic antimicrobials and acquired ESBL-PE isolated from stool or rectum during international travel. We performed a random effects meta-analysis to estimate odds of acquiring ESBL-PE due to antimicrobials during travel, overall and by antimicrobial class. RESULTS: Fifteen studies were included. The study population was mainly female travellers from high income countries recruited primarily from travel clinics. Participants travelled most frequently to Asia and Africa with 10% reporting antimicrobial use during travel. The combined odds ratio (OR) for ESBL-PE acquisition during travel was 2.37 for antimicrobial use overall (95% confidence interval [CI], 1.69 to 3.33), but there was substantial heterogeneity between studies. Fluoroquinolones were the antibiotic class associated with the highest combined OR of ESBL-PE acquisition, compared to no antimicrobial use (OR 4.68, 95% CI, 2.34 to 9.37). CONCLUSIONS: The risk of ESBL-PE colonization during travel is increased substantially with exposure to antimicrobials, especially fluoroquinolones. While a small proportion of colonized individuals will develop a resistant infection, there remains the potential for onward spread among returning travellers. Public health efforts to decrease inappropriate antimicrobial usage during travel are warranted

Autophagy is defective in collagen VI muscular dystrophies and its reactivation rescues myofiber degeneration

n/

Living on social assistance with chronic illness: Buffering and undermining features to well-being

<p>Abstract</p> <p>Background</p> <p>In Sweden, the social security and sickness insurance systems are comprehensive and aim to provide people whose illness prevents them from earning their own living, with either sickness benefits or disability pension. Some, however, are not entitled to these benefits or receive social insurance benefits at a level too low for subsistence, and are referred to social assistance. The purpose of this study was to explore in depth how social assistance recipients with chronic illness perceive and respond to the experience of living on social assistance.</p> <p>Methods</p> <p>Seventeen in-depth interviews were carried out with chronically ill people who had received social assistance for several years. Grounded theory informed the design of the study.</p> <p>Results</p> <p>The study showed that different strategies (living one day at a time, taking steps forwards and backwards and making attempts to find ways out of the situation) were employed by social assistance recipients to maintain or improve their well-being. Contextual features like the prevailing welfare system, public services and the local neighbourhood could buffer or undermine these strategies and their overall well-being. These features together influenced how interviewees perceived their situation, the possible ways out of the situation and the consequences for their well-being.</p> <p>Conclusion</p> <p>From this study it is evident that the way in which individuals on social assistance interact with services and how they are treated by professionals plays an important role in their well-being, in combination with what kind of help and support is available for recipients through the welfare system. In this respect, persons living on social assistance with chronic illness are particularly vulnerable. This study suggests that more effort should be made to find long term solutions concerning income support, rehabilitation and other services provided to this group.</p

Hexokinase II Detachment from Mitochondria Triggers Apoptosis through the Permeability Transition Pore Independent of Voltage-Dependent Anion Channels

Type II hexokinase is overexpressed in most neoplastic cells, and it mainly localizes on the outer mitochondrial membrane. Hexokinase II dissociation from mitochondria triggers apoptosis. The prevailing model postulates that hexokinase II release from its mitochondrial interactor, the voltage-dependent anion channel, prompts outer mitochondrial membrane permeabilization and the ensuing release of apoptogenic proteins, and that these events are inhibited by growth factor signalling. Here we show that a hexokinase II N-terminal peptide selectively detaches hexokinase II from mitochondria and activates apoptosis. These events are abrogated by inhibiting two established permeability transition pore modulators, the adenine nucleotide translocator or cyclophilin D, or in cyclophilin D knock-out cells. Conversely, insulin stimulation or genetic ablation of the voltage-dependent anion channel do not affect cell death induction by the hexokinase II peptide. Therefore, hexokinase II detachment from mitochondria transduces a permeability transition pore opening signal that results in cell death and does not require the voltage-dependent anion channel. These findings have profound implications for our understanding of the pathways of outer mitochondrial membrane permeabilization and their inactivation in tumors