Influence of body mass index and polycystic ovarian syndrome on ICSI/IVF treatment outcomes: A study conducted in Pakistani women

Background: Obesity may establish a crucial barrier for effective fertility treatment in polycystic ovary syndrome (PCOS) females.Objective: To compare results of intra-cytoplasmic sperm injection (ICSI) in females with and without polycystic ovarian syndrome and further appraise the effect of obesity in PCOS females.Materials and methods: A cross-sectional study from June 2015 to July 2016 included non-PCOS and PCOS (recognized by Rotterdam criteria) females who underwent ICSI. The PCOS were further stratified into non-obese and Obese according to the South Asian criteria for body mass index. Results were categorized on the basis of beta-human chorionic gonadotropin (β-hCG) and transvaginal scan into non-pregnant (β-hCG /ml), preclinical abortion (β-hCG \u3e25 mIU/ml with no fetal cardiac activity) and clinical pregnancy (β-hCG \u3e25 mIU/ml with fetal cardiac activity on transvaginal scan). In addition, reproductive outcomes; implantation rate, clinical pregnancy rate and miscarriage rate among obese and non-obese PCOS and non-PCOS patients were compared.Results: Our results revealed 38.5% clinical pregnancy rate in non-PCOs females, 23.8% in non-obese PCOS females whereas 26.4% in obese PCOS. Preclinical abortions were found to be highest (31.5%) in non-obese PCOS females and were the lowest (26.2%) in non-PCOS females. In non-PCOS group and non-obese PCOS females 35.4% and 44.6%, respectively, failed to become pregnant.Conclusion: The success after ICSI in terms of number of clinical pregnancies was more in non-PCOS patients as compared to PCOS. Increase in body mass index reflected a negative impact on the reproductive outcome in PCOS patients

To determine the frequency of Group B Streptococcal colonization of vagina in women at 35-37 week pregnancy

BACKGROUND: Group B streptococci (GBS) is the usually present in vaginal canal in micro-flora, which usually do not exhibit any symptoms. Instead, in pregnancy, there are certain situations in GBS colonization in vagina, which may lead to several complications. OBJECTIVE: To determine the frequency of Group B Streptococcal colonization of vagina in women at 35-37 week pregnancy. STUDY DESIGN: Cross sectional survey SETTING: Antenatal clinic, Shalamar Hospital Lahore STUDY DURATION: 6 month i.e. From: 05-09-2014 to 06-03-2015 SUBJECTS & METHODS: 350 Booked Patients attending antenatal clinic at Shalamar hospital at 35-37 weeks of pregnancy for routine antenatal checkup were included. Lower vaginal swabs were taken without speculum using sterilized disposable cotton swab and transported to Amies Agar jell and transported to microbiology lab within 24 hours. Laboratory report was collected and reviewed by researcher regarding positive or negative culture for GBS. Patients with positive GBS culture were given intrapartum antibiotics. RESULTS: In our study, out of 350 cases, with the mean age of 26.92+4.84 years. Frequency of GBS colonization of vagina in women at 35-37 week pregnancy was recorded in 12.29% while remaining 87.71% had no findings of the morbidity. CONCLUSION: It was concluded that the frequency of GBS colonization of vagina in women at 35-37 week pregnancy is not very higher and in accordance with other regions of our country, but routine screening may further decline its incidence. KEYWORDS: Pregnancy, last trimester, Group B Streptococcal colonization of vagin

To determine the frequency of Group B Streptococcal colonization of vagina in women at 35-37 week pregnancy

BACKGROUND: Group B streptococci (GBS) is the usually present in vaginal canal in micro-flora, which usually do not exhibit any symptoms. Instead, in pregnancy, there are certain situations in GBS colonization in vagina, which may lead to several complications. OBJECTIVE: To determine the frequency of Group B Streptococcal colonization of vagina in women at 35-37 week pregnancy. STUDY DESIGN: Cross sectional survey SETTING: Antenatal clinic, Shalamar Hospital Lahore STUDY DURATION: 6 month i.e. From: 05-09-2014 to 06-03-2015 SUBJECTS & METHODS: 350 Booked Patients attending antenatal clinic at Shalamar hospital at 35-37 weeks of pregnancy for routine antenatal checkup were included. Lower vaginal swabs were taken without speculum using sterilized disposable cotton swab and transported to Amies Agar jell and transported to microbiology lab within 24 hours. Laboratory report was collected and reviewed by researcher regarding positive or negative culture for GBS. Patients with positive GBS culture were given intrapartum antibiotics. RESULTS: In our study, out of 350 cases, with the mean age of 26.92+4.84 years. Frequency of GBS colonization of vagina in women at 35-37 week pregnancy was recorded in 12.29% while remaining 87.71% had no findings of the morbidity. CONCLUSION: It was concluded that the frequency of GBS colonization of vagina in women at 35-37 week pregnancy is not very higher and in accordance with other regions of our country, but routine screening may further decline its incidence. KEYWORDS: Pregnancy, last trimester, Group B Streptococcal colonization of vagin

Pharmacoepidemiologic Study of the Complementary and Alternative Medicine (CAM) Use in Patient with Cancer in Benghazi, Libya

Background: Cancer patients are increasingly turning to complementary and alternative medicine (CAM) to improve their physical and psychological well-being. This study aimed to explore the prevalence of complementary and alternative medicine (CAM) use by Libyan populations in Benghazi city. Methods: This cross-sectional survey was conducted among 100 patients attending the National Cancer Center at Howari Hospital in Benghazi city. A 16-item questionnaire was used to collect the data. The questionnaire addressed the sociodemographic characteristics, cancer conditions, and use of CAM. The main outcome of interest was “use of any CAM therapy since cancer diagnosis.” Results:  The total prevalence of CAM among cancer patients was 100%, regardless of cancer type. Lung and breast cancer were the most prevalent in our study (23 and 22%), with stage 2 being the most common cancer (47%). Prayer was the most widely used CAM modality among study participants (100%). Our data also showed that males had a higher number (57%), and the age group 40-59 was the most common. The highest percentage of participants had a diploma or bachelor degree (54%). Similarly, those living in the city had the highest rates (69%). As well, our results revealed that the most prevalent reason for using CAM was to improve sleep and reduce pain (68%). Conclusions: This study revealed a prevalent CAM use among cancer patients in the city of Benghazi. It is necessary to promote a patient-centered approach to CAM use

Mitigating Salt-Induced Damages in Wheat with Foliar-Applied Nigella sativa Seed Extract: A Comprehensive Study

Nigella sativa, a medicinal plant, known for its diverse bioactive compounds, including antioxidants and phytohormones, have shown potential in mitigating salt stress in various plant species. Amongst naturally occurring plant growth stimulants, it has attained enormous attention being rich in thymoquinineand carvacrol in seeds for scavenging free radicals. This research aimed to investigate the effect of Nigella sativa seed extract (NSE) as foliar spray (0, 50, 100 and 150g seeds per liter each) on wheat growth under salt stress (0mM, 75mM and 150mM). Results revealed that salinity decreased growth attributes and accumulation of photosynthetic pigments. On the other hand, salinity stress boosted the contents of malondialdehyde, hydrogen peroxide, glycinebetaine, leaf free proline, Na+ and Cl-. Foliar application of NSEameliorated the negative effects of salinity to considerable extent by enhancing growth traits, chlorophyll contents, glycinebetaine and prolineand decreased Na+, Cl-,malondialdehyde andhydrogen peroxide. This research provides valuable insights into the potential use of NSE as natural and sustainable solution to alleviate salt stress in wheat crop. These findings contribute to the development of eco-friendly strategies for enhancing crop resilience in saline environments, ultimately addressing the global challenge of food security in the face of increasing soil salinity

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Rescuing Gender Equality from the False Dichotomies of Secularism Versus Shariah in Muslim Majority Countries

This article presents a macro-national perspective of gender equality in employment in two Muslim majority Countries, Turkey and Pakistan. The article examines and compares the institutional implications of secularism and Islamic shariah for gender equality in employment in the two countries. Drawing on case studies of a selection of influential public and private sector organizations engaged in promoting and implementing gender equality in Turkey and Pakistan, the article argues that secularism and shariah as dominant ideologies present poor agendas for gender equality. Indeed, secularism and shariah hijack gender equality discourses paying only partial lip service to genuine demands for equality. The article argues that there is a need to rescue gender equality from the clasp of ideology and bring in genuine processes of equal opportunity and social justice in the workplace

Entrepreneurial Intentions: Gem Based Emipirical Analysis on the Northern Europe and Asian Countries

The requirement to contextualize research in the field of entrepreneurship has converted into the main theme from the last two decades. Therefore, this study bridges the gap by analyzing the relationship between the entrepreneurial activity in northern Europe and the Asian region countries in perspective of an individuals’ perception skills, attitudes, and the subjective norms. Based on our research, we propose a new conceptual framework to analyze EI in the context of entrepreneurship by using the theory of planned behavior (TBP) and the Global Entrepreneurship Monitor (GEM). We empirically examine the influence of key developmental differences on the entrepreneurial intentions (EI) model with structural equation modeling (SEM). In the studied GEM countries, our findings affirm the applicability of the EI model across countries confirming that entrepreneurial activities are the key drivers of economic growth. The findings also recommend that the progression from perception to intent is modified across the 23 European and Asian countries, though there exist several cultural differences to the extent of casual effects also including the differences of influential factors. This study contributes to the debate on entrepreneurship by analyzing key factors influencing the EI model and extends our understanding of entrepreneurship

Synergistic antibacterial activity of surfactant free Ag–GO nanocomposites

Abstract Graphene oxide–silver (Ag–GO) nanocomposite has emerged as a vital antibacterial agent very recently. In this work, we report a facile one step route of Ag–GO nanocomposite formation excluding the aid of surfactants and reductants and was successfully applied to negative Escherichia Coli (E coli) to investigate antibacterial activity by varying doze concentration. The successful formation of Ag–GO nanocomposite via facile one step route was confirmed using Fourier transform infrared spectroscopy (FTIR) and Raman Spectroscopy. The absorption spectra (peak ~ 300 nm) for GO and the (peak ~ 420 nm) for silver nanoparticles were observed. XRD study confirmed the formation of Ag–GO nanocomposite while atomic force microscopy (AFM) showed crumbled GO sheets decorated with Ag nanoparticles. It was observed that the functional groups of GO facilitated the binding of Ag nanoparticles to GO network and enhanced the antibacterial activity of the nanocomposite