Colposcopic evaluation in cases of persistent inflammatory Pap smear

Background: The aim of the study was to assess the colposcopic evaluation in cases of persistant inflammatory Papanicolaou (Pap) smear.Methods: This was a prospective analytical study, conducted amongst 78 women attending the outpatient department of obstetrics and gynaecology at Subharti Medical College. Pap smear was performed by the conventional method and colposcopy was done for all 78 sexually active women who came with complaints of pain abdomen, irregular cycles, white discharge per vaginum and urinary tract infections. Final correlation of Pap smear and colposcopy were based on histopathology and human papillomavirus deoxyribonucleic acid (HPV DNA).Results: In this study of 78 women, 21% of women had normal colposcopic findings whereas 79% had abnormal colposcopic findings. Histopathological examination (HPE) findings revealed that 69% women had cervical intraepithelial neoplasia (CIN) 1, 23% had CIN II, 6% had CIN III and 3% had SCC. 25% women tested positive for HPV DNA and 75% women tested negative for HPV DNA.Conclusions: Patients with persistent inflammatory Pap smear despite undergoing treatment show changes on Colposcopic directed biopsies.

Feeding Interventions for Infants with Growth Failure in the First Six Months of Life: A Systematic Review.

(1) Introduction: Current evidence on managing infants under six months with growth failure or other nutrition-related risk is sparse and low quality. This review aims to inform research priorities to fill this evidence gap, focusing on breastfeeding practices. (2) Methods: We searched PubMed, CINAHL Plus, and Cochrane Library for studies on feeding interventions that aim to restore or improve the volume or quality of breastmilk and breastfeeding when breastfeeding practices are sub-optimal or prematurely stopped. We included studies from both low- and middle-income countries and high-income countries. (3) Results: Forty-seven studies met the inclusion criteria. Most were from high-income countries (n = 35, 74.5%) and included infants who were at risk of growth failure at birth (preterm infants/small for gestational age) and newborns with early growth faltering. Interventions included formula fortification or supplementation (n = 31, 66%), enteral feeds (n = 8, 17%), cup feeding (n = 2, 4.2%), and other (n = 6, 12.8%). Outcomes included anthropometric change (n = 40, 85.1%), reported feeding practices (n = 16, 34%), morbidity (n = 11, 23.4%), and mortality (n = 5, 10.6%). Of 31 studies that assessed formula fortification or supplementation, 30 reported anthropometric changes (n = 17 no effect, n = 9 positive, n = 4 mixed), seven morbidity (n = 3 no effect, n = 2 positive, n = 2 negative), five feeding (n = 2 positive, n = 2 no effect, n = 1 negative), and four mortality (n = 3 no effect, n = 1 negative). Of eight studies that assessed enteral feed interventions, seven reported anthropometric changes (n = 4 positive, n = 3 no effect), five feeding practices (n = 2 positive, n = 2 no effect, n = 1 negative), four morbidity (n = 4 no effect), and one reported mortality (n = 1 no effect). Overall, interventions with positive effects on feeding practices were cup feeding compared to bottle-feeding among preterm; nasogastric tube feed compared to bottle-feeding among low birth weight preterm; and early progressive feeding compared to delayed feeding among extremely low birth weight preterm. Bovine/cow milk feeding and high volume feeding interventions had an unfavourable effect, while electric breast pump and Galactagogue had a mixed effect. Regarding anthropometric outcomes, overall, macronutrient fortified formula, cream supplementation, and fortified human milk formula had a positive effect (weight gain) on preterm infants. Interventions comparing human breastmilk/donor milk with formula had mixed effects. Overall, only human milk compared to formula intervention had a positive effect on morbidity among preterm infants, while none of the interventions had any positive effect on mortality. Bovine/cow milk supplementation had unfavourable effects on both morbidity and mortality. (4) Conclusion: Future research should prioritise low- and middle-income countries, include infants presenting with growth failure in the post-neonatal period and record effects on morbidity and mortality outcomes

Effectiveness of Breastfeeding Support Packages in Low- and Middle-Income Countries for Infants under Six Months: A Systematic Review.

Small and nutritionally at-risk infants under six months, defined as those with wasting, underweight, or other forms of growth failure, are at high-risk of mortality and morbidity. The World Health Organisation 2013 guidelines on severe acute malnutrition highlight the need to effectively manage this vulnerable group, but programmatic challenges are widely reported. This review aims to inform future management strategies for small and nutritionally at-risk infants under six months in low- and middle-income countries (LMICs) by synthesising evidence on existing breastfeeding support packages for all infants under six months. We searched PubMed, CINAHL, Cochrane Library, EMBASE, and Global Health databases from inception to 18 July 2018. Intervention of interest were breastfeeding support packages. Studies reporting breastfeeding practices and/or caregivers'/healthcare staffs' knowledge/skills/practices for infants under six months from LMICs were included. Study quality was assessed using NICE quality appraisal checklist for intervention studies. A narrative data synthesis using the Synthesis Without Meta-analysis (SWiM) reporting guideline was conducted and key features of successful programmes identified. Of 15,256 studies initially identified, 41 were eligible for inclusion. They were geographically diverse, representing 22 LMICs. Interventions were mainly targeted at mother-infant pairs and only 7% (n = 3) studies included at-risk infants. Studies were rated to be of good or adequate quality. Twenty studies focused on hospital-based interventions, another 20 on community-based and one study compared both. Among all interventions, breastfeeding counselling (n = 6) and education (n = 6) support packages showed the most positive effect on breastfeeding practices followed by breastfeeding training (n = 4), promotion (n = 4) and peer support (n = 3). Breastfeeding education support (n = 3) also improved caregivers' knowledge/skills/practices. Identified breastfeeding support packages can serve as "primary prevention" interventions for all infants under six months in LMICs. For at-risk infants, these packages need to be adapted and formally tested in future studies. Future work should also examine impacts of breastfeeding support on anthropometry and morbidity outcomes. The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO 2018 CRD42018102795)

Conocimientos, Actitudes y Prácticas sobre lactancia materna que poseen las madres que asisten al programa de Vigilancia promoción, crecimiento y desarrollo en el centro salud de Villa Libertad, Managua. Octubre -Diciembre 2015

Se determinaron los conocimientos, actitudes y prácticas sobre lactancia materna que poseen las madres que asisten al programa de Vigilancia, Promoción, Crecimiento y Desarrollo, mediante un estudio descriptivo de corte transversal, probabilístico, realizado en 73 mujeres en rangos de edad de 15 a 42 años, seleccionadas por muestreo aleatorio simple en el Centro de Salud Villa Libertad de la ciudad de Managua en el periodo de Octubre a Diciembre del año 2015. Una vez seleccionada el área de estudio se realizó coordinación con personal de salud y docente a cargo, se identificó el problema objeto de la investigación, se procedió a la elaboración de los objetivos y del instrumento de recolección de datos, posteriormente se hizo la validación del mismo. La entrada al escenario de trabajo para la evaluación se realizó aplicando el formulario conteniendo las variables de acuerdo a cada objetivo específico, los cuales están enmarcados en cuanto a identificar información sociodemográfica, de conocimientos, actitudes y prácticas sobre lactancia materna. Se utilizaron medios y programas informáticos para el proceso de recolección y análisis de datos. Una vez analizada la información se obtuvieron los resultados, donde encontramos que las mujeres estudiadas manifestaron tener adecuados conocimientos sobre lactancia materna obtenidos en la unidad de salud donde han sido atendidas, tienen una actitud favorable, pero la práctica de lactancia materna es inadecuada, porque es mixta debido a que además de la leche materna se implementa el uso de fórmulas lácteas y alimentación complementaria a temprana edad. Palabras Clave: Lactancia Materna, Conocimientos, Actitudes, Prácticas, Fórmul

Effectiveness of low dose versus high dose oxytocin regimen for induction of labour

ABSTRACTBackground: Induction of labour is an indispensable part of modern obstetrics and certainly one of the most frequently performed obstetric procedure in the world. Oxytocin, being the most common inducing agent with multiple protocols being practiced, further research is required for the establishment of better protocol with optimal maternal and neonatal outcomes.Methods: Randomized comparative study including 100 term nulliparous women (randomized into high dose, group-I and low dose, group-II with 50 patients in each group) was done. High dose regimen was started with 4mu/min with increment of 4mu/min up to a maximum of 32mu/min and low dose regimen was started with 2mu/min with increment of 2mu/min up to a maximum of 32mu/min. Induction to delivery interval was the primary outcome. Secondary outcomes noted were rate of caesarean section, tachysytole with or without fetal distress, failed induction, maternal outcomes like need for instrumental vaginal delivery, PPH and choriamnionitis, neonatal outcomes like NICU admission, umbilical cord pH and apgar score.Results: There was significant reduction seen in induction to delivery interval among those induced with high dose oxytocin regimen. It was found to be 6.96±3.77 hours in group-I and 9.05±4.65 hours in group-II (p value 0.034). Though incidence of tachysystole was more in high dose regimen, it was not statistically significant. No significant difference was seen in secondary outcomes.Conclusions: On the basis of present study, high dose oxytocin regimen can be considered for induction of labour as it has same effects as that of low dose regimen with lesser induction to delivery interval

Inactivation of Chikungunya virus by 1,5 iodonapthyl azide

<p>Abstract</p> <p>Background</p> <p>Chikungunya virus (CHIKV) is an arthropod borne alphavirus of the family <it>Togaviridae</it>. CHIKV is a reemerging virus for which there is no safe prophylactic vaccine. A live attenuated strain of CHIKV, CHIK181/25, was previously demonstrated to be highly immunogenic in humans, however, it showed residual virulence causing transient arthralgia.</p> <p>Findings</p> <p>In this study, we demonstrate the complete inactivation of CHIKV181/25 by 1,5 iodonapthyl azide (INA). No cytopathic effect and virus replication was observed in cells infected with the INA-inactivated CHIKV. However, a reduction in the INA-inactivated CHIK virus-antibody binding capacity was observed by western blot analysis.</p> <p>Conclusion</p> <p>INA completely inactivated CHIKV and can further be explored for developing an inactivated-CHIKV vaccine.</p

Fuzzy Logic Analysis of Sensory Attributes of Snack Bars Prepared from Multi-nutrient Composite Flour and Natural Binding Agents

Snack bars (SB) were developed using nutritionally rich composite mixes with honey (T1); honey, jaggery and corn syrup (T2); jaggery (T3); honey and jaggery (T4); and analysed for nutritional, functional textural and sensory properties (fuzzy logic) in comparison with a commercial bar (RB). The moisture content of T3 (4.0 %) was low, and at par with RB (3.7 %). The protein content was significantly (p&lt; 0.05) higher than RB with T1 and T3 containing 10.7 g.100g-1 of protein. Fat content (g.100g-1) ranged from 9.7 (T1) to 11.3 (RB); while T4 (8.47) showed the highest fibre (g.100g-1), followed by T2 (8.34). T3 had highest P (244 mg.100g-1) and Fe (5.5 mg.100g-1). Functional components of SB were significantly higher than RB. T4 showed highest phenolics (162.5 GAE.100g-1), T3 showed flavonoids (1.02 QE mg.100g-1) and anti-oxidants (92 % RSA). T3 had highest hardness (1.39 N) and lowest (41.18 N) cutting strength. Fuzzy logic showed order of preference of Good (RB, T3) and Medium (T2, T1 and T4). Mouth-feel and flavour were rated as highly important, while aroma, crispiness and colour were rated as important. Flavour and mouth-feel of all snack bars were found to be acceptable, except for T2 that had least acceptable mouth feel when compared to other attributes. The acceptability of crispiness of jaggery bar indicated that consumers accepted bars with greater hardness rather than a soggy or soft product. From nutritional, functional textural, and sensory analysis, T3 was found to be the best among all bars tested