Feto-maternal outcome in grand multipara

Background: Grand multiparity has been considered as obstetric hazards both to the mother and foetus and thus, viewed with great caution. In present set up grand multiparity is associated with increased likelihood of feto-maternal complications.Methods: The study was conducted to determine the feto-maternal outcome in grand multipara pregnancy.Results: In present study, the prevalence of grand multipara was 0.72% out of 15196 deliveries in the period from September 2010 to august 2012. 79.1% of the grand multipara women belonged to the age group of 31-40 years. A majority of the women were in Para 5. Most of the women had no antenatal care attendance. The highest prevalence of grand multipara women was seen among Muslim community (1.65%). A majority (59.1%) of the women were anemic. Caesarean section rate was 30.0% in our study. Post-partum hemorrhage was the most common complication encountered. 7.0% were macrosomic babies, whereas 8.7% were LBW babies. There were 10 perinatal deaths, birth asphyxia being the most important cause for the perinatal mortality. There were no maternal deaths.Conclusions: Our study demonstrates that, there is increase in antenatal and intra-partum maternal complications like anaemia, hypertensive disorder, preterm labour, increase in the rate of caesarean section, PPH etc., leading to severe maternal morbidity. So, the study concludes that in grand multipara pregnancy, both the woman and the fetus are at a greater risk during pregnancy and labour. This risk can be effectively reduced with good antenatal care and delivery by trained personnel

NUTRITIONAL AND HEALTH STATUS OF TRIBAL PEOPLE: A REVIEW

Tribals have no fixed source of income and very little daily income. They are not regularly employed. They are not properly compensated. According to numerous studies, their economic and educational condition was insufficient. The majority of them were dependent on alcohol or tobacco and lived in mud-built homes. Several factors contribute to the poor nutritional condition of elderly people, including insufficient dietary iron, inadequate iron absorption, protein and micronutrient deficiencies, and infections. In a recent study, it was found that tribal people live an unfavorable lifestyle and are susceptible to respiratory, cutaneous, and other types of injuries. Low iron absorption, protein and micronutrient deficiencies, and infections lead to the poor nutritional status of the tribal people. In addition, tribal people are vulnerable to injuries, skin and respiratory problems, filarial diseases, and other illnesses due to their unfavorable lifestyles. According to the literature, various interventions, including nutrition and health promotion activities, are necessary to improve the occupational lifestyle of tribal people

Exposure to the Dioxin-like Pollutant PCB 126 Afflicts Coronary Endothelial Cells via Increasing 4-Hydroxy-2 Nonenal: A Role for Aldehyde Dehydrogenase 2

Exposure to environmental pollutants, including dioxin-like polychlorinated biphenyls (PCBs), play an important role in vascular inflammation and cardiometabolic diseases (CMDs) by inducing oxidative stress. Earlier, we demonstrated that oxidative stress-mediated lipid peroxidation derived 4-hydroxy-2-nonenal (4HNE) contributes to CMDs by decreasing the angiogenesis of coronary endothelial cells (CECs). By detoxifying 4HNE, aldehyde dehydrogenase 2 (ALDH2), a mitochondrial enzyme, enhances CEC angiogenesis. Therefore, we hypothesize that ALDH2 activation attenuates a PCB 126-mediated 4HNE-induced decrease in CEC angiogenesis. To test our hypothesis, we treated cultured mouse CECs with 4.4 µM PCB 126 and performed spheroid and aortic ring sprouting assays, the ALDH2 activity assay, and Western blotting for the 4HNE adduct levels and real-time qPCR to determine the expression levels of Cyp1b1 and oxidative stress-related genes. PCB 126 increased the gene expression and 4HNE adduct levels, whereas it decreased the ALDH2 activity and angiogenesis significantly in MCECs. However, pretreatment with 2.5 µM disulfiram (DSF), an ALDH2 inhibitor, or 10 µM Alda 1, an ALDH2 activator, before the PCB 126 challenge exacerbated and rescued the PCB 126-mediated decrease in coronary angiogenesis by modulating the 4HNE adduct levels respectively. Finally, we conclude that ALDH2 can be a therapeutic target to alleviate environmental pollutant-induced CMDs

The Impact of Educational Marketing on Universities Performance

This paper addresses the results of the various publicity strategies undertaken by selected private management organizations in Vietnam. The study has also investigated the activities of students from BBA and MBA who have been hired by their management college both at home and abroad. The development model for this study comprises with 7ps of a marketing blend designed for schools. 342 students from 9 colleges received self-administered questionnaires. For the analysis of the findings obtained, descriptive figures were used. The study of available information found that the best consideration for BBA and MBA was suggested by mates. Word of mouth, i.e. guidance from friends and relatives, colleges and newspaper ads, has also proved popular. The BBA demand for registration was too heavy, although at the MBA level profiles and teaching methods were high on the agenda, as were the opportunities for future employment and better work. Students, non-school event schemes and library facilities were the subject of the results. The study findings show that a universitys reputation lies deeply in its ability to meet stakeholder expectations; in the present extremely competitive environment, brand credibility management can be considered an important issue for most universities.The research results may be helpful in favor of instructional programs for administrators that create the strategies to encourage success in a university. We conclude that the results of this study clarify the psychology of the students and create adequate outreach campaigns for all colleges, advertising organizations and government departments. It will also help supervise those activities to better respond to the needs of students and service providers and make it more attractive for all potential students in private colleges

Maternal and fetal factors associated with stillbirth in singleton pregnancies in 13 hospitals across six states in India: a prospective cohort study

Methods: We conducted a secondary data analysis of a hospital-based cohort from the Maternal and Perinatal Health Research collaboration, India (MaatHRI), including pregnant women who gave birth between October 2018–September 2023. Data from 9823 singleton pregnancies recruited from 13 hospitals across six Indian states were included. Univariable and multivariable Poisson regression analysis were performed to examine the relationship between stillbirth and potential risk factors. Model prediction was assessed using the area under the receiver-operating characteristic (AUROC) curve. Results: There were 216 stillbirths (48 antepartum and 168 intrapartum) in the study population, representing an overall stillbirth rate of 22.0 per 1000 total births (95% confidence interval [CI]: 19.2–25.1). Modifiable risk factors for stillbirth were: receiving less than four antenatal check-ups (adjusted relative risk [aRR]: 1.75, 95% CI: 1.25–2.47), not taking any iron and folic acid supplementation during pregnancy (aRR: 7.23, 95% CI: 2.12–45.33) and having severe anemia in the third trimester (aRR: 3.37, 95% CI: 1.97–6.11). Having pregnancy/fetal complications such as hypertensive disorders of pregnancy (aRR: 1.59, 95% CI: 1.03–2.36), preterm birth (aRR: 4.41, 95% CI: 3.21–6.08) and birth weight below the 10th percentile for gestational age (aRR: 1.35, 95% CI: 1.02–1.79) were also associated with an increased risk of stillbirth. Identified risk factors explained 78.2% (95% CI: 75.0%–81.4%) of the risk of stillbirth in the population. Conclusion: Addressing potentially modifiable antenatal factors could reduce the risk of stillbirths in India

The complex relationship between iron status and anemia in pregnant and postpartum women in India: analysis of two Indian study cohorts of uncomplicated pregnancies

Low hemoglobin is widely used as an indicator of iron deficiency anemia in India and other low-and-middle income counties, but anemia need not accurately reflect iron deficiency. We examined the relationship between hemoglobin and biomarkers of iron status in antenatal and postnatal period. Secondary analysis of uncomplicated singleton pregnancies in two Indian study cohorts: 1132 antenatal women in third trimester and 837 postnatal women 12–72 h after childbirth. Associations of hemoglobin with ferritin in both data sets, and with sTfR, TSAT, and hepcidin in the postnatal cohort were examined using multivariable linear regression. Multinomial logistic regression was used to examine the association between severity of anemia and iron status. Regression models were adjusted for potential confounders. Over 55% of the women were anemic; 34% of antenatal and 40% of postnatal women had low ferritin, but 4% antenatal and 6% postnatal women had high ferritin. No evidence of association between hemoglobin and ferritin was observed (antenatal: adjusted coefficient [aCoef] −0.0004, 95% confidence interval [CI] −0.001, 0.001; postnatal: aCoef −0.0001, 95% CI −0.001, 0.001). We found a significant linear association of hemoglobin with sTfR (aCoef −0.04, 95% CI −0.07, −0.01), TSAT (aCoef −0.005, 95% CI −0.008, −0.002), and hepcidin (aCoef 0.02, 95% CI 0.02, 0.03) in postnatal women. Likelihood of low ferritin was more common in anemic than non-anemic women, but high ferritin was also more common in women with severe anemia in both cohorts. Causes of anemia in pregnant and postpartum women in India are multifactorial; low hemoglobin alone is not be a useful marker of iron deficiency

Polygenic Parkinson's Disease Genetic Risk Score as Risk Modifier of Parkinsonism in Gaucher Disease

Background: Biallelic pathogenic variants in GBA1 are the cause of Gaucher disease (GD) type 1 (GD1), a lysosomal storage disorder resulting from deficient glucocerebrosidase. Heterozygous GBA1 variants are also a common genetic risk factor for Parkinson's disease (PD). GD manifests with considerable clinical heterogeneity and is also associated with an increased risk for PD. Objective: The objective of this study was to investigate the contribution of PD risk variants to risk for PD in patients with GD1. Methods: We studied 225 patients with GD1, including 199 without PD and 26 with PD. All cases were genotyped, and the genetic data were imputed using common pipelines. Results: On average, patients with GD1 with PD have a significantly higher PD genetic risk score than those without PD (P = 0.021). Conclusions: Our results indicate that variants included in the PD genetic risk score were more frequent in patients with GD1 who developed PD, suggesting that common risk variants may affect underlying biological pathways. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA

Development of a standard of care for patients with valosin-containing protein associated multisystem proteinopathy

Valosin-containing protein (VCP) associated multisystem proteinopathy (MSP) is a rare inherited disorder that may result in multisystem involvement of varying phenotypes including inclusion body myopathy, Paget’s disease of bone (PDB), frontotemporal dementia (FTD), parkinsonism, and amyotrophic lateral sclerosis (ALS), among others. An international multidisciplinary consortium of 40+ experts in neuromuscular disease, dementia, movement disorders, psychology, cardiology, pulmonology, physical therapy, occupational therapy, speech and language pathology, nutrition, genetics, integrative medicine, and endocrinology were convened by the patient advocacy organization, Cure VCP Disease, in December 2020 to develop a standard of care for this heterogeneous and under-diagnosed disease. To achieve this goal, working groups collaborated to generate expert consensus recommendations in 10 key areas: genetic diagnosis, myopathy, FTD, PDB, ALS, Charcot Marie Tooth disease (CMT), parkinsonism, cardiomyopathy, pulmonology, supportive therapies, nutrition and supplements, and mental health. In April 2021, facilitated discussion of each working group’s conclusions with consensus building techniques enabled final agreement on the proposed standard of care for VCP patients. Timely referral to a specialty neuromuscular center is recommended to aid in efficient diagnosis of VCP MSP via single-gene testing in the case of a known familial VCP variant, or multi-gene panel sequencing in undifferentiated cases. Additionally, regular and ongoing multidisciplinary team follow up is essential for proactive screening and management of secondary complications. The goal of our consortium is to raise awareness of VCP MSP, expedite the time to accurate diagnosis, define gaps and inequities in patient care, initiate appropriate pharmacotherapies and supportive therapies for optimal management, and elevate the recommended best practices guidelines for multidisciplinary care internationally. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13023-022-02172-5

Quality assessment of health management information system (HMIS) data for maternal and child health in Jimma zone, Ethiopia

Health management information system (HMIS) data underpin attainment of health targets in low- and middle-income countries. However, the quality of HMIS data is often poor. The study appraised the completeness, timeliness, and internal consistency of eight key maternal and child health (MCH) indicators collected for all the primary health care units (PHCUs) located within three districts of Jimma Zone, Ethiopia. Results show that the HMIS may over-report the coverage of key MCH services, namely, antenatal care, skilled birth attendance and postnatal care. The quality of data at the zonal level could be improved to inform MCH research and programmatic efforts.Global Affairs Canada (GAC)Canadian institutes of Health Research (CIHR