Relationship of Family Members’ Support with Practice of Community Midwives in Rural Sindh, Pakistan

Background: Pakistan has one of the highest maternal mortality rates in the world. Community Midwives (CMWs) were introduced in 2006 as a new cadre of birth attendants who would bring midwifery services to rural areas by being based in designated communities. The CMWs face many obstacles and retaining them in practice is a challenge. This study aimed to examine whether there was a relationship between family support and CMWs retention in midwifery practice. We hoped to learn about influences on retention that might improve the Maternal Newborn and Child Health (MNCH) programme. Methods: This was a cross-sectional survey conducted in five districts of rural Sindh, a province in Pakistan. A list of all CMWs who graduated between 2007 and 2012 was obtained from the MNCH programme Sindh. The CMWs were tracked by MCHIP (Maternal Child Health Integrated Program) clinical supervisors posted in the respective districts to gather information about families’ support of CMWs. Findings: Of the 148 CMWs in the MNCH list, 112 (76%) were tracked. Of 112, 44 (39%) CMWs were in active practice while 69 (61%) had completed their training but had not started a practice. Of the 44 practising CMWs, 82% had family members who worked in a health-related field or previously were traditional birth attendants (TBAs). Only 18% of those who established a practice had a family without this profile. Conclusion: These preliminary findings indicate a strong relationship between family engagement in health care work and the capacity of CMWs to establish a midwifery practice. A further comparative analysis of practising and non-practising CMWs is warranted

The effects of Nigella sativa ethanolic extract on proliferation and apoptosis of renal cell carcinoma ACHN cell line

زمینه و هدف: سیاه دانه (Nigella sativa) گیاهی ازتیره آلاله٬ علفی، یک ساله یا پایا است. ترکیبات این گیاه دارای خواص ضد سرطانی هستند. این مطالعه با هدف بررسی اثر سایتوتوکسیک و آپوپتوتیک عصاره الکلی سیاهدانه بر روی رشد سلول های سرطانی کلیه انسان رده ACHN و سلول های غیر سرطانی سالم رده L929 انجام شد. روش بررسی: در این مطالعه تجربی غلظت های مختلف عصاره الکلی سیاهدانه در محیط کشت، روی سلول های ACHN و L929 اثر داده شد. پس از 24، 48 و 72 ساعت، تغییرات مورفولوژیک ایجاد شده با میکروسکوپ معکوس ارزیابی گردید. با آزمون MTT اثر غلظت های عصاره بر درصد سلول های زنده هر دو رده سلولی در زمان‌های مذکور، از نظر کمی بررسی شد. بررسی میزان آپوپتوز با کیت فسفاتیدیل سرین با استفاده ار دستگاه فلوسیتومتری مشخص گردید. داده ها با استفاده از آنالیز آماری واریانس یک طرفه و آزمون تعقیبی Tukeyآنالیز شد. یافته ها: نتایج آزمون MTT نشان داد که غلظت های µg/ml 750 و بالاتر عصاره بر سلول های رده ACHN و غلظت های µg/ml 1250 و بالاتر عصاره بر روی سلول های رده L929 موجب کاهش معنی دار تعداد سلول های زنده ACHN و L929 می گردد (05/0P(P. نتیجه گیری: با توجه به نتایج این پژوهش عصاره الکلی سیاهدانه دارای اثرات آپوپتوتیک و سایتوتوکسیک بر سلول های سرطانی رده ACHN در مقایسه با سلول های سالم L929 است. لذا می توان عصاره الکلی سیاهدانه را به عنوان ترکیبی با اثرات سایتوتوکسیک روی سلول های سرطانی در درمان سرطان کلیه پیشنهاد کرد

Hyperhomocysteinemia in Pakistani women suffering from unexplained subfertility

Background: Hyperhomocysteinemia (hhcy) has been considered as a risk factor for several obstetrical complications such as early pregnancy loss, pre-eclampsia and IUGR. Recently its association with infertility has been underscored in IVF failures; however limited information is available about the relationship of hhcy and subfertility. Objective: To find out the association between unexplained subfertility and hhcy in Pakistani women. Materials and methods: This observational study was conducted in Department of Obstetrics and Gynaecology, Liaquat University Hospital Hyderabad from 1st April 2008 to 31st March 2009. Study group consisted of all those women who were subfertile for more then one year, have body mass index less than 25, regular menstrual cycle, normal pelvic examination findings and no past history of pelvic inflammatory disease. Exclusion criteria was male factor subfertility, endocrine and ovulatory dysfunction and tubal blockage. Evaluation was done by semen analysis, pelvic ultrasound scan, hystero-salpingography and hormonal assays. Fasting serum levels of homocysteine were determined using a fluorescence polarization immunoassay. Results: In total, 61 subjects were enrolled in the study including 49 subfertile women and 12 healthy women. Among subfertile women, 39 (80%) were suffering from primary subfertility while 10 (20%) were complaining of secondary subfertility. Majority of the subjects were young, house wives and residents of Hyderabad city. Mean serum fasting homocysteine levels were significantly higher in women suffering from unexplained subfertility as compared to controls (12.8+5.1 versus 9.7+1.7, p-value= 0.04). Conclusion: Hyperhomocysteinemia was observed in women suffering from unexplained subfertility. However large scale clinical studies are required to confirm the association

Hyperhomocysteinemia in Pakistani women suffering from unexplained subfertility

Abstract Background: Hyperhomocysteinemia (hhcy) has been considered as a risk factor for several obstetrical complications such as early pregnancy loss, pre-eclampsia and IUGR. Recently its association with infertility has been underscored in IVF failures; however limited information is available about the relationship of hhcy and subfertility. Objective: To find out the association between unexplained subfertility and hhcy in Pakistani women. . Study group consisted of all those women who were subfertile for more then one year, have body mass index less than 25, regular menstrual cycle, normal pelvic examination findings and no past history of pelvic inflammatory disease. Exclusion criteria was male factor subfertility, endocrine and ovulatory dysfunction and tubal blockage. Evaluation was done by semen analysis, pelvic ultrasound scan, hysterosalpingography and hormonal assays. Fasting serum levels of homocysteine were determined using a fluorescence polarization immunoassay. Results: In total, 61 subjects were enrolled in the study including 49 subfertile women and 12 healthy women. Among subfertile women, 39 (80%) were suffering from primary subfertility while 10 (20%) were complaining of secondary subfertility. Majority of the subjects were young, house wives and residents of Hyderabad city. Mean serum fasting homocysteine levels were significantly higher in women suffering from unexplained subfertility as compared to controls (12.8+5.1 versus 9.7+1.7, pvalue= 0.04). Conclusion: Hyperhomocysteinemia was observed in women suffering from unexplained subfertility. However large scale clinical studies are required to confirm the association