Assessing the safety and use of medicinal herbs during pregnancy: a cross-sectional study in São Paulo, Brazil

Background: Despite the lack of evidence supporting the safety and clinical efficacy of herbal medicine (HM), its use among pregnant women continues to increase. Given the high prevalence of contraindicated herbs among the pregnant population in Brazil, it is crucial to examine the use of HM and evaluate its safety based on the current scientific literature to ensure that women are using HM appropriately.Methods: A cross-sectional study was conducted from October 2022 to January 2023 at a public teaching hospital in São Paulo, Brazil. A total of 333 postpartum women in the postnatal wards and postnatal clinic were interviewed using a semi-structured questionnaire. The survey instrument consisted of 51 items covering the use of HM during pregnancy, sociodemographic and health-related characteristics, COVID-19 experiences, and pregnancy outcomes. For data analysis, chi-square and multivariate logistic regression were conducted using SPSS ver. 26.0.Results: Approximately 20% of respondents reported using HM during their most recent pregnancy, with a higher use observed among women from ethnic minority groups and those with prior HM experience. Among the 20 medicinal herbs identified, 40% were found to be contraindicated or recommended for use with caution during pregnancy. However, only half of the women discussed their HM use with obstetric care providers.Conclusion: This study emphasizes the continued public health concern regarding the use of contraindicated or potentially harmful HM among pregnant women in Brazil, highlighting the need for sustained efforts to reduce the risk of inappropriate HM use. By updating antenatal care guidelines based on the latest scientific evidence, healthcare providers can make informed clinical decisions and effectively monitor pregnant women’s HM use, ultimately promoting safer and more effective healthcare practices

Surgical Management among Patients with Acetabular-Pelvis Fractures in a Trauma Care Centre

Introduction: Surgical management of pelvic and acetabular fractures due to high-energy trauma is one of the most challenging in orthopaedics. Most patients are often associated with other life-threatening injuries. Several studies demonstrated that accurate fracture reduction decreases the incidence of post-traumatic arthritis and improves functional outcomes. The aim of the study was to find out the prevalence of the surgical management among patients with acetabular-pelvis fractures in a trauma care centre. Methods: This is a descriptive observational study conducted at a trauma hospital from 1 September 2016 to 31 August 2020. Ethical approval was obtained from the Institutional Review Committee. Patients with displaced fractures of the pelvis ring or acetabulum were included in the study whereas isolated pubic rami fractures and pathological fractures were excluded from the study. Operative plans were decided after radiographic X-rays and 3-dimensional reconstruction computed tomography scan evaluation. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 136 patients with acetabular-pelvis fractures, 64 (47.06%) (38.67-55.45, 95% Confidence Interval) underwent surgical management. The average time duration from injury to surgery was 7 days. All patients were able to weight bear 3 months. Conclusions: The prevalence of surgical management among patients with pelvic-acetabular fracture was found to be similar to the other studies done in similar settings