Search results for: maternal diet

Authors: Josiane Yaguibou, Ngoy Kishimba, Issiaka V. Coulibaly, Sabrina Pestilli, Falinirina Razanalison, Hantanirina Andremanisa

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Background: Madagascar has one of the least developed road networks in the world with a majority of its national and local roads being earth roads and in poor condition. In addition, the country is affected by frequent natural disasters that further affect the road conditions limiting the accessibility to some parts of the country. In 2021 and 2022, 2.21 million people were affected by drought in the Grand Sud region, and by cyclones and floods in the coastal regions, with disruptions of the health system including last mile distribution of lifesaving maternal health commodities and reproductive health commodities in the health facilities. Program intervention: The intervention uses drone technology to deliver maternal health and family planning commodities in hard-to-reach health facilities in the Grand Sud and Sud-Est of Madagascar, the regions more affected by natural disasters. Methodology The intervention was developed in two phases. A first phase, conducted in the Grand Sud, used drones leased from a private company to deliver commodities in isolated health facilities. Based on the lesson learnt and encouraging results of the first phase, in the second phase (2023) the intervention has been extended to the Sud Est regions with the purchase of drones and the recruitment of pilots to reduce costs and ensure sustainability. Key findings: The drones ensure deliveries of lifesaving commodities in the Grand Sud of Madagascar. In 2023, 297 deliveries in commodities in forty hard-to-reach health facilities have been carried out. Drone technology reduced delivery times from the usual 3 - 7 days necessary by road or boat to only a few hours. Program Implications: The use of innovative drone technology demonstrated to be successful in the Madagascar context to reduce dramatically the distribution time of commodities in hard-to-reach health facilities and avoid stockouts of life-saving medicines. When the intervention reaches full scale with the completion of the second phase and the extension in the Sud-Est, 150 hard-to-reach facilities will receive drone deliveries, avoiding stockouts and improving the quality of maternal health and family planning services offered to 1,4 million people in targeted areas.

Keywords: commodities, drones, last-mile distribution, lifesaving supplies

Procedia PDF Downloads 43

Authors: Yasmin A. M. Ferreira, Ana C. K. Pelissari, Sofia De C. F. Vicente, Raquel M. Da S. Campos, Deborah C. L. Masquio, Lian Tock, Lila M. Oyama, Flavia C. Corgosinho, Valter T. Boldarine, Ana R. Dâmaso

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The prevalence of overweight and obesity is growing around the world and currently considered a global epidemic. Food and nutrition are essential requirements for promoting health and protecting non-communicable chronic diseases, such as obesity and cardiovascular disease. Specific dietary components may modulate the inflammation and oxidative stress in obese individuals. Few studies have investigated the dietary Inflammation Factor Rating (IFR) in obese adolescents. The IFR was developed to characterize an individual´s diet on anti- to pro-inflammatory score. This evaluation contributes to investigate the effects of inflammatory diet in metabolic profile in several individual conditions. Objectives: The present study aims to investigate the effects of a multidisciplinary weight loss therapy on inflammation factor rating and cardiometabolic risk in obese adolescents. Methods: A total of 26 volunteers (14-19 y.o) were recruited and submitted to 20 weeks interdisciplinary therapy allied to health education website- Ciclo do Emagrecimento®, including clinical, nutritional, psychological counseling and exercise training. The body weight was monitored weekly by self-report and photo. The adolescents answered a test to evaluate the knowledge of the topics covered in the videos. A 24h dietary record was applied at the baseline and after 20 weeks to assess the food intake and to calculate IFR. A negative IFR suggests that diet may have inflammatory effects and a positive IFR indicates an anti-inflammatory effect. Statistical analysis was performed using the program STATISTICA version 12.5 for Windows. The adopted significant value was α ≤ 5 %. Data normality was verified with the Kolmogorov Smirnov test. Data were expressed as mean±SD values. To analyze the effects of intervention it was applied test t. Pearson´s correlations test was performed. Results: After 20 weeks of treatment, body mass index (BMI), body weight, body fat (kg and %), abdominal and waist circumferences decreased significantly. The mean of high-density lipoprotein cholesterol (HDL-c) increased after the therapy. Moreover, it was found an improvement of inflammation factor rating from -427,27±322,47 to -297,15±240,01, suggesting beneficial effects of nutritional counselling. Considering the correlations analysis, it was found that pro-inflammatory diet is associated with increase in the BMI, very low-density lipoprotein cholesterol (VLDL), triglycerides, insulin and insulin resistance index (HOMA-IR); while an anti-inflammatory diet is associated with improvement of HDL-c and insulin sensitivity Check index (QUICKI). Conclusion: The 20-week blended multidisciplinary therapy was effective to reduce body weight, anthropometric circumferences and improve inflammatory markers in obese adolescents. In addition, our results showed that an increase in inflammatory profile diet is associated with cardiometabolic parameters, suggesting the relevance to stimulate anti-inflammatory diet habits as an effective strategy to treat and control of obesity and related comorbidities. Financial Support: FAPESP (2017/07372-1) and CNPq (409943/2016-9)

Keywords: cardiometabolic risk, inflammatory diet, multidisciplinary therapy, obesity

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Authors: Raymond D. Uzoh, Philip K. Shallsuku, Christopher S. Vaachia

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Selected edible leafy vegetables from North-eastern Nigeria were analysed for their sodium and potassium content in mg/100 g and the ratio Na+/K+ worked out. From experimental results, Venonia amydalina (bitter leaf) contained 150 mg (0.15 g) of sodium and 20500 mg (20.5 g) potassium with a ratio of 0.007, Brassica oleracea var capitata (cabbage) contained 300 mg (0.3 g) of sodium and 19000 mg (19 g) of potassium with a ration of 0.012. Others are Telfairia occidentalis (fluted pumpkin) with 400 mg (0.45 g) of sodium and 19500 mg (19.5 g) of potassium with a ratio of 0.020; Hibiscus sabdriffa (sorrel) has 200 mg (0.2 g) of sodium and 600 mg (0.6 g) of potassium with a ratio of 0.300; and Amarantus caudatus (spinach) contained 450 mg (0.45 g) of sodium and 23000 mg (23 g) of potassium with a ratio of 0.020. The presence of sodium and potassium in foods has become increasingly important as recent studies and dietary information gathered in this research has shown that sodium intake is not the sole consideration in elevated blood pressure but its considered as a ratio Na+/K+ fixed at 0.6. This ratio has been found to be a more important factor, suggesting that our diet should contain 67 % more potassium than sodium.

Keywords: vegetables, sodium, potassium, blood pressure, diet, foods

Procedia PDF Downloads 452

Authors: Kmiecik Dominik, Kobus-Cisowska Joanna, Gramza-Michalowska Anna, Marcinkowska Agata, Korczak Józef

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The relationship between the choice of a proper diet, a diet, lifestyle man and his health has been known for a long time. Because of the increase in public awareness of food ingredients and their influence on health status, measures have been taken towards the production of food, which is designed to not only eat, but also to protect against the incidence of lifestyle diseases. For this purpose, the bio active products with healthy properties was developed. Mulberry have a very high nutritional value, rich in chemical composition and many properties used in the prevention of lifestyle diseases. In addition to basic chemical components, nutrients, mulberry fruit contain compounds having a physiological effect. The aim of this study was to assess the effect of white mulberry fruit on the sensory quality of bread to be healthy diet of people suffering from anemia, diabetes, obesity and cardiovascular disease. Sensory analysis was carried out by the profile method. Intra-operative differentiators color, aroma, taste, texture, and overall assessment. Sensory analysis showed that all test trials were characterized by a uniform and concise consistency, similar in color from dark to light beige. The taste and smell of herbal characteristic was designed in an attempt to prevention of diabetes, while the other samples were characterized by a typical taste and smell of bread grain. There were no foreign taste and odor in the test bread. It was found that the addition of white mulberry fruit does not affect the sensory quality of the newly developed bioactive bread.

Keywords: mulberry, bread, bioactive, sensory analysis

Procedia PDF Downloads 443

Authors: G. J. Fan, T. T. Lee, M. H. Chen, T. F. Shiao, B. Yu, C. F. Lee

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Rice straw with poor feed quality and spent mushroom substrate are both the most abundant agricultural residues in Taiwan. Edible mushrooms from white rot fungi possess lignocellulase activity. It was expected to improve the feeding value of rice straw for ruminant by solid-state fermentation pretreatment using spent mushroom substrate. Six varieties or subspecies of spent edible mushrooms (Pleurotus ostreatus (blue or white color), P. sajor-caju, P. citrinopileatus, P. eryngii and Ganoderma lucidium) substrate were evaluated in solid-state fermentation process with rice straw for 8 wks. Quality improvement of fermented rice straw was determined by its in vitro digestibility, lignocellulose degradability, and cell wall breakdown checked by scanning electron microscope. Results turned out that Pleurotus ostreatus (white color) and P. sajor-caju had the better lignocellulose degradation effect than the others and was chosen for advance in vivo study. Rice straw fermented with spent Pleurotus ostreatus or Pleurotus sajor-caju mushroom substrate 8 wks was prepared for growing and lactating feeding trials of dairy goat, respectively. Pangolagrass hay at 15% diet dry matter was the control diet. Fermented or original rice straw was added to substitute pangolagrass hay in both feeding trials. A total of 30 head of Alpine castrated ram were assigned into three groups for 11 weeks, 5 pens (2 head/pen) each group. A total of 21 head of Saanen and Alpine goats were assigned into three treatments and individually fed in two repeat lactating trials with 28-d each. In castrated ram study, results showed that fermented rice straw by spent Pleurotus ostreatus mushroom substrate attributed the higher daily dry matter intakes (DMI, 1.53 vs. 1.20 kg) and body weight gain (138 vs. 101 g) than goats fed original rice straw. DMI (2.25 vs. 1.81 kg) and milk yield (3.31 vs. 3.02 kg) of lactating goats fed control pangolagrass diet and fermented rice straw by spent Pleurotus sajor-caju mushroom substrate were also higher than those fed original rice straw diet (P < 0.05). Milk compositions, milk fat, protein, total solid and lactose, were similar among treatments. In conclusion, solid-state fermentation by spent Pleurotus ostreatus or Pleurotus sajor-caju mushroom substrate could effectively improve the feeding value of rice straw. Fermented rice straw is a good alternative fiber feed resource for growing and lactating dairy goats and 15% in diet dry matter is recommended.

Keywords: feeding value, fermented rice straw, growing and lactating dairy goat, spent Pleurotus ostreatus and Pleurotus sajor-caju mushroom substrate

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Authors: Tamara Romero, Manuel Romero-Huelva, Jose V. Segarra, Jose Castro, Carlos Fernandez

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Many foods resulting from processing and manufacturing end up as waste, most of which is burned, dumped into landfills or used as compost, which leads to wasted resources, and environmental problems due to unsuitable disposal. Using residues of the crop and food processing industries to feed livestock has the advantage to obviating the need for costly waste management programs. The main residue generated in citrus cultivations and rice crop are pruning waste and rice straw, respectively. Within Spain, the Valencian Community is one of the world's oldest citrus and rice production areas. The objective of this experiment found out the effects of including orange leaves and rice straw as ingredients in the concentrate diets of goats, on milk production and methane (CH₄) emissions. Ten Murciano-Granadina dairy goats (45 kg of body weight, on average) in mid-lactation were selected in a crossover design experiment, where each goat received two treatments in 2 periods. Both groups were fed with 1.7 kg pelleted mixed ration; one group (n= 5) was a control (C) and the other group (n= 5) used orange leaves and rice straw (OR). The forage was alfalfa hay, and it was the same for the two groups (1 kg of alfalfa was offered by goat and day). The diets employed to achieve the requirements during lactation period for caprine livestock. The goats were allocated to individual metabolism cages. After 14 days of adaptation, feed intake and milk yield were recorded daily over a 5 days period. Physico-chemical parameters and somatic cell count in milk samples were determined. Then, gas exchange measurements were recorded individually by an open-circuit indirect calorimetry system using a head box. The data were analyzed by mixed model with diet and digestibility as fixed effect and goat as random effect. No differences were found for dry matter intake (2.23 kg/d, on average). Higher milk yield was found for C diet than OR (2.3 vs. 2.1 kg/goat and day, respectively) and, greater milk fat content was observed for OR than C (6.5 vs. 5.5%, respectively). The cheese extract was also greater in OR than C (10.7 vs. 9.6%). Goats fed OR diet produced significantly fewer CH₄ emissions than C diet (27 vs. 30 g/d, respectively). These preliminary results (LIFE Project LOWCARBON FEED LIFE/CCM/ES/000088) suggested that the use of these waste by-products was effective in reducing CH₄ emission without detrimental effect on milk yield.

Keywords: agricultural waste, goat, milk production, methane emission

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Authors: Eunice Oluwayemisi Adeparusi, Mary Adedolapo Ijadeyila

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The study was carried out at the Federal University of Technology, Akure, Nigeria, West Africa. Seven set of diets were prepared comprising of two sets. The first set consisted of a combination of three diets from a combination of two different citrus peels from Orange (Citrus sinesis), Tangerine (Citrus tangerina / Citrus reticulata) and Tangelo (Citrus tangelo a hybrid of Citrus reticulata and Citrus maxima) at 50:50 while the other three consisted f50:50. Diet with 100% vitamin premix served as the control. Air-dried citrus peels were added in a 40% crude protein diet for the juveniles (4.49±0.05g) Clarias gariepinus. The experiment was carried out for a period of 56 days in triplicate trials. Fish were randomly distributed into twenty-one tanks at ten fish per tanks. The feed was extruded and fed to satiation twice daily. The result shows that fish fed Tangelo and Tangerine (TGL-TGR) had the best growth response in terms of final weight, specific growth rate, feed conversion ratio and feed utilization efficiency when compared with other diets. The FCR of fish in the diet ranges from 0.93-1.62. Fish fed the mixture of Orange peel and Vitamin-mineral premix (ORG-VIT) and those on Tangelo and Vitamin-mineral premix (TGL-VIT) had higher survival rate. There were significant differences (P<0.05) in the mean final weight, weight gain and specific growth rate. The result shows that citrus peels enhance the growth performance and feed utilization of the juvenile of African mud catfish, thereby reducing the cost of fish production.

Keywords: African mud catfish, growth, citrus peels, vitamin-mineral premix, nutrient utilization, additives

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Authors: Raj Raghupathy

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Recurrent Spontaneous Miscarriage (RSM) is a common form of pregnancy loss, 50% of which are due to ‘unexplained’ causes. Evidence exists to suggest that RSM may be caused by immunologic factors such as cytokines which are critical molecules of the immune system, with an impressive array of capabilities. An association appears to exist between Th2-type reactivity (mediated by Th2 or anti-inflammatory cytokines) and normal, successful pregnancy, and between unexplained RSM and Th1 cytokine dominance. If pro-inflammatory cytokines are indeed associated with pregnancy loss, the suppression of these cytokines, and thus the ‘redirection’ of maternal reactivity, may help prevent cytokine-mediated pregnancy loss. The objective of this study was to explore the possibility of modulating cytokine production using Dydrogesterone (Duphaston®), an orally-administered progestogen. Peripheral blood mononuclear cells from 34 women with a history of at least 3 unexplained recurrent miscarriages were stimulated in vitro with a mitogen (to elicit cytokine production) in the presence and absence of dydrogesterone. Levels of selected pro- and anti-inflammatory cytokines produced by peripheral blood mononuclear cells were measured after exposure to these progestogens. Dydrogesterone down-regulates the production of pro-inflammatory cytokines and up-regulates the production of anti-inflammatory cytokines. The ratios of Th2 to Th1 cytokines are markedly elevated in the presence of dydrogesterone, indicating a shift from potentially harmful maternal Th1 reactivity to a more pregnancy-conducive Th2 profile. We used a progesterone receptor antagonist to show that this cytokine-modulating effect of dydrogesterone is mediated via the progesterone receptor. Dydrogesterone also induces the production of the Progesterone-Induced Blocking Factor (PIBF); lymphocytes exposed to PIBF produce higher levels of Th2 cytokines, affecting a Th1 → Th2 cytokine shift which could be favourable to the success of pregnancy. We conclude that modulation of maternal cytokine production profiles is possible with dydrogesterone which has the merits that it can be administered orally and that it is safe.

Keywords: cytokines, dydrogesterone, progesterone, recurrent spontaneous miscarriage

Procedia PDF Downloads 265

Authors: Nkutere Chikezie Kanu, Nnamdi M. Anigbogu, Johnson C. Ezike

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The study was carried out to investigate the performance of Red Sokoto goats fed Municipal Oranic Wastes (MOW) subjected to two methods of in vivo degradation by Torula Yeast and Zymomonas mobilis. Two combination, Torula Yeast + Zymomonas mobilis (main degradation), and Zymomonas mobilis + Torula Yeast (Reciprocal degradation) were used to degrade MOW. Eighteen Red Sokoto goats of both sexes (9 males and 9 females) of ages between 6-8 were used for the study. The goats were randomly assigned into 3 treatments groups A, B and C respectively with 6 goats per treatment. The experiment was laid in a Completely Randomized Design and replicated 3 times. Treatment A groups were fed 30% Undegraded MOW base diet +concentrate mixture, Treatment B groups were fed 30% Main degraded MOW base diet +concentrate mixture, Treatment C groups were fed 30% Reciprocal degraded MOW base diet +concentrate mixture. The result of the daily weight gain was significantly (P<0.05) better than on the other Treatments. There was significant improvement (P<0.05) on the daily feed consumption in Treatment B than on the Treatments A and C. The feed conversion ratio revealed no significant (P>0.05) differences among the treatment groups but much better in the treatment B and C, the cost of feed consumed was much higher (P>0.05) in Treatment B followed by Treatment C, while Treatment A had the lowest. The cost/ kg weight gain that was recorded in Treatment A was better (P<0.05) than the Treatment B, followed by Treatment C, while the cost of production was high (P<0.05) in Treatment B than in other treatments. The gross profit was observed best (P<0.05) on the Treatment B, followed by Treatment C while Treatment A had the lowest. The net profit as noted in this study was much better (P<0.05) in Treatment B, and Treatment C, while the least was observed in Treatment A, where the return on investment was high in Treatments B and C, while Treatment A had the lowest.

Keywords: reciprocal, torula yeast, Zymomonas mobilis, organic waste

Procedia PDF Downloads 267

Authors: Davod Ahmadigheidari

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The main objective of this study was to explore prevalence of anthropometric indicators as well the factors associated with the anthropometric indications in Mali. Data on 2015, downloaded from the website of Unicef, were analyzed. A total of 16,467 women (ages 15-49 years) and 16,467 children (ages 0-59 months) were selected for the sample. Different statistical analyses, such as descriptive, crosstabs and binary logistic regression form the basis of this study. Child anthropometric indicators (i.e., wasting, stunting, underweight and BMI for age) were used as the dependent variables. SPSS Syntax from WHO was used to create anthropometric indicators. Different factors, such as child’s sex, child’s age groups, child’s diseases symptoms (i.e., diarrhea, cough and fever), maternal education, household wealth index and area of residence were used as independent variables. Results showed more than forty percent of Malian households were in nutritional crises (stunting (42%) and underweight (34%). Findings from logistic regression analyses indicated that low score of wealth index, low maternal education and experience of diarrhea in last two weeks increase the probability of child malnutrition.

Keywords: Mali, wasting, stunting, underweight, BMI for age and wealth index

Procedia PDF Downloads 133

Authors: A. Lubis, R. Widayanti, Z. Hikmah, A. Endaryanto, A. Harsono, A. Harianto, R. Etika, D. K. Handayani, M. Sampurna

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Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: neonatus lupus erythematous, maternal autoantibody, clinical characteristic, multiple organ manifestation

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Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha

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Background: The World Health Organization (WHO) recommends using the partograph to follow labour and delivery, with the objective to improve health care and reduce maternal and foetal morbidity and death. Methods: A retrospective document review was undertaken to assess the completion of the modified WHO partograph during labour in public health institutions of Addis Ababa, Ethiopia. A total of 420 of the modified WHO partographs used to monitor mothers in labour from five public health institutions that provide maternity care were reviewed. A structured checklist was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Frequency distributions, cross-tabulations and a graph were used to describe the results of the study. Results: All facilities were using the modified WHO partograph. The correct completion of the partograph was very low. From 420 partographs reviewed across all the five health facilities, foetal heart rate was recorded into the recommended standard in 129(30.7%) of the partographs, while 138 (32.9%) of cervical dilatation and 87 (20.70%) of uterine contractions were recorded to the recommended standard. The study did not document descent of the presenting part in 353 (84%). Moulding in 364 (86.7%) of the partographs reviewed was not recorded. Documentation of state of the liquor was 113(26.9%), while the maternal blood pressure was recorded to standard only in 78(18.6%) of the partographs reviewed. Conclusions: This study showed a poor completion of the modified WHO partographs during labour in public health institutions of Addis Ababa, Ethiopia. The findings may reflect poor management of labour and indicate the need for pre-service and periodic on-job training of health workers on the proper completion of the partograph. Regular supportive supervision, provision of guidelines and mandatory health facility policy are also needed in support of a collaborative effort to reduce maternal and perinatal deaths.

Keywords: modified WHO partograph, completion, public health institutions, Addis Ababa, Ethiopia

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Authors: Mohammad Nassiri, Farhad Ahmadi

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This research was carried out to investigate the effects of copper oxide nanoparticles (nano-CuO) on performance and gut morphology of broiler chickens. A total of 240 one-day-old male chickens (Ross-308) were randomly divided in a completely randomized design, the inclusion of 4 groups of 60 birds with 4 replicates and 15 birds in each. Experimental diets were as follow: T1 control (basal diets, without nano-CuO but contain 9.1 mg Cu/kg from CuO), T2, T3, and T4 basal diet supplementation with 30, 60, and 90 mg nano-CuO/kg, respectively. Feed intake (FI) and gain weight as weekly recorded and on d 21 feed conversion ratio (FCR) were calculated. Furthermore, at the end of the trial (21 d), four birds per treatment (one bird/replicate) randomly selected and after removed blood samples, they slaughtered and then to the analysis of gut morphological. A segment (10 cm) from the middle part of duodenum and jejunum was removed and put in the formalin 10% (pH = 7). The results revealed that nano-CuO had significantly increased body weight (P = 0.029, but feed intake (P = 0.017), and feed conversion ratio (P = 0.031) decreased in the birds that fed 90 mg nano-CuO when compared to control and the other groups. Total antioxidant capacity (P = 0.041), superoxide dismutase (P = 0.036), and glutathione peroxidase (P = 0.048) were more in the birds fed diet inclusion of 60 and 90 mg nano-CuO (T4) than other treatments. The lowest malonaldehyde (MDA) level was observed in T3 (P = 0.23) and T4 (P = 0.028) decreased (P = 0.17). The villi height and villi height to crypt depth (VH/CD ratio) numerically increased (P = 0.09) in the bird fed 90 mg nano-CuO in comparison with other treatments. According to present results, it could be concluded that dietary nano-CuO improved performance parameters and antioxidant status of broiler chickens during starter period. As well, the optimum improvement observed in the birds fed diet inclusion of 90 mg nano-CuO/kg.

Keywords: antioxidant, broilers, copper, performance, nanoparticles

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Authors: Alokananda Ghosh, Shraban Sarkar

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The study aims to identify suitable sites for new hospitals with critical obstetric care facilities in Birbhum, one of the vulnerable and underserved districts of Eastern India, considering six main and 14 sub-criteria, using GIS-based Analytic Hierarchy Process (AHP) and Multi-Attribute Utility Theory (MAUT) approach. The criteria were identified through field surveys and previous literature. After collecting expert decisions, a pairwise comparison matrix was prepared using the Saaty scale to calculate the weights through AHP. On the contrary, objective weighting methods, i.e., Entropy and Criteria Importance through Interaction Correlation (CRITIC), were used to perform the MAUT. Finally, suitability maps were prepared by weighted sum analysis. Sensitivity analyses of AHP were performed to explore the effect of dominant criteria. Results from AHP reveal that ‘maternal death in transit’ followed by ‘accessibility and connectivity’, ‘maternal health care service (MHCS) coverage gap’ were three important criteria with comparatively higher weighted values. Whereas ‘accessibility and connectivity’ and ‘maternal death in transit’ were observed to have more imprint in entropy and CRITIC, respectively. While comparing the predictive suitable classes of these three models with the layer of existing hospitals, except Entropy-MAUT, the other two are pointing towards the left-over underserved areas of existing facilities. Only 43%-67% of existing hospitals were in the moderate to lower suitable class. Therefore, the results of the predictive models might bring valuable input in future planning.

Keywords: hospital site suitability, analytic hierarchy process, multi-attribute utility theory, entropy, criteria importance through interaction correlation, multi-criteria decision analysis

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Authors: Cyoung-Huei Huang, Chiu-Li Yeh, Man-Hui Pai, Sung-Ling Yeh

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This study evaluated the effect of different dietary n-6/n-3 polyunsaturated fatty acid (PUFA) ratios on modulating helper T (Th) and regulatory T (Treg) lymphocytes in mice with dextran sulfate sodium (DSS)-induced colitis. There were 3 control and 3 colitis groups in this study. Mice were fed for 24 d with an AIN-93G diet either with soybean oil (S), a mixture of soybean oil and low fish oil content (LF) or high fish oil content (HF). The ratio of n-6/n-3 PUFA in the LF diet was 4:1, and that in the HF diet was 2:1. The control groups drank distilled water while colitis groups provided 2% DSS in drinking water during day 15-19. All mice drank distilled water from day 20-24 for recovery and sacrificed on day 25. The results showed that colitis resulted in higher Th1, Th2, and Th17 and lower Treg percentages in the blood. Also, plasma haptoglobin and proinflammatory chemokines were elevated in colon lavage fluid. Colitic groups with fish oil had lower inflammatory mediators in the plasma and colon lavage fluid. Further, the percentages of Th1, Th2, and Th17 cells in the blood were lower, whereas Treg cell percentages were higher than those in the soybean oil group. The colitis group with n-6/n-3 PUFA ratio 2:1 had more pronounce effects than ratio 4:1. These results suggest that diets with an n-6/n-3 PUFA ratio of 2:1 or 4:1 regulate the Th/Treg balance and attenuate inflammatory mediator production in colitis. Compared to the n-6/n-3 PUFA ratio 4:1, the ratio of 2:1 was more effective in reducing inflammatory reactions in DSS-induced colitis.

Keywords: inflammatory bowel disease, n-3 polyunsaturated fatty acids, helper T lymphocyte, regulatory T lymphocyte

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Authors: Adela Penesova, Zofia Radikova, Boris Bajer, Andrea Havranova, Miroslav Vlcek

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Background: The aim of our study was to compare the effect of intensified lifestyle intervention on insulin resistance (HOMA-IR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and Fibroblast growth factor (FGF) 21 after 8 weeks of lifestyle intervention. Methods: A group of 43 obese patients (13M/30F; 43.0±12.4 years; BMI (body mass index) 31.2±6.3 kg/m2 participated in a weight loss interventional program (NCT02325804) following an 8-week hypocaloric diet (-30% energy expenditure) and physical activity 150 minutes/week. Insulin sensitivity was evaluated according to the homeostasis model assessment of insulin resistance (HOMA-IR) and insulin sensitivity indices according to Matsuda and Cederholm were calculated (ISImat and ISIced). Plasma ALT, AST, Fetuin-A, FGF 21, and physical fitness were measured. Results: The average reduction of body weight was 6.8±4.9 kg (0-15 kg; p=0.0006), accompanied with a significant reduction of body fat amount of fat mass (p=0.03), and waist circumference (p=0.02). Insulin sensitivity has been improved (IR HOMA 2.71±3.90 vs 1.24±0.83; p=0.01; ISIMat 6.64±4.38 vs 8.93±5.36 p ≤ 0.001). Total, LDL cholesterol, and triglycerides decreased (p=0.05, p=0.04, p=0.04, respectively). Physical fitness significantly improved after intervention (as measure VO2 max (maximal oxygen uptake) (p ≤ 0.001). ALT decreased significantly (0.44±0.26 vs post 0.33±0.18 ukat/l, p=0.004); however, AST not (pre 0.40±0.15 vs 0.35±0.09 ukat/l, p=0.07). Hepatokine Fetuin-A significantly decreased after intervention (43.1±10.8 vs 32.6±8.6 ng/ml, p < 0.001); however, FGF 21 levels tended to decrease (146±152 vs 132±164 pg/ml, p=0.07). Conclusion: 8-weeks of diet and physical activity intervention program in obese otherwise healthy subjects led to an improvement of insulin resistance parameters and liver marker profiles, as well as increased physical fitness. This study was supported by grants APVV 15-0228; VEGA 2/0161/16.

Keywords: obesity, diet, exercice, insulin sensitivity

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Authors: Partha Saha, Uttam Kumar Banerjee

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Maternal and Child Healthcare (MCH) has always been regarded as one of the important issues globally. Reduction of maternal and child mortality rates and increase of healthcare service coverage were declared as one of the targets in Millennium Development Goals till 2015 and thereafter as an important component of the Sustainable Development Goals. Over the last decade, worldwide MCH indicators have improved but could not match the expected levels. Progress of both maternal and child mortality rates have been monitored by several researchers. Each of the studies has stated that only less than 26% of low-income and middle income countries (LMICs) were on track to achieve targets as prescribed by MDG4. Average worldwide annual rate of reduction of under-five mortality rate and maternal mortality rate were 2.2% and 1.9% as on 2011 respectively whereas rates should be minimum 4.4% and 5.5% annually to achieve targets. In spite of having proven healthcare interventions for both mothers and children, those could not be scaled up to the required volume due to fragmented health systems, especially in the developing and under-developed countries. In this research, a knowledge discovery based interactive Decision Support System (DSS) has been developed on web platform which would assist healthcare policy makers to develop evidence-based policies. To achieve desirable results in MCH, efficient resource planning is very much required. In maximum LMICs, resources are big constraint. Knowledge, generated through this system, would help healthcare managers to develop strategic resource planning for combatting with issues like huge inequity and less coverage in MCH. This system would help healthcare managers to accomplish following four tasks. Those are a) comprehending region wise conditions of variables related with MCH, b) identifying relationships within variables, c) segmenting regions based on variables status, and d) finding out segment wise key influential variables which have major impact on healthcare indicators. Whole system development process has been divided into three phases. Those were i) identifying contemporary issues related with MCH services and policy making; ii) development of the system; and iii) verification and validation of the system. More than 90 variables under three categories, such as a) educational, social, and economic parameters; b) MCH interventions; and c) health system building blocks have been included into this web-based DSS and five separate modules have been developed under the system. First module has been designed for analysing current healthcare scenario. Second module would help healthcare managers to understand correlations among variables. Third module would reveal frequently-occurring incidents along with different MCH interventions. Fourth module would segment regions based on previously mentioned three categories and in fifth module, segment-wise key influential interventions will be identified. India has been considered as case study area in this research. Data of 601 districts of India has been used for inspecting effectiveness of those developed modules. This system has been developed by importing different statistical and data mining techniques on Web platform. Policy makers would be able to generate different scenarios from the system before drawing any inference, aided by its interactive capability.

Keywords: maternal and child heathcare, decision support systems, data mining techniques, low and middle income countries

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Authors: Mengying Wang, Dongjing Liu, Holger Schwender, Ping Wang, Hongping Zhu, Tao Wu, Terri H Beaty

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Background: Maternal smoking is a recognized risk factor for nonsyndromic cleft lip with or without cleft palate (NSCL/P). It has been reported that the effect of maternal smoking on oral clefts is mediated through genes that influence nicotine dependence. The polymorphisms of cholinergic receptor nicotinic alpha (CHRNA) and beta (CHRNB) subunits genes have previously shown strong associations with nicotine dependence. Here, we attempted to investigate whether the above genes are associated with clefting risk through testing for potential gene-gene (G×G) and gene-environment (G×E) interaction. Methods: We selected 120 markers in 14 genes associated with nicotine dependence to conduct transmission disequilibrium tests among 806 Chinese NSCL/P case-parent trios ascertained in an international consortium which conducted a genome-wide association study (GWAS) of oral clefts. We applied Cordell’s method using “TRIO” package in R to explore G×G as well as G×E interaction involving environmental tobacco smoke (ETS) based on conditional logistic regression model. Results: while no SNP showed significant association with NSCL/P after Bonferroni correction, we found signals for G×G interaction between 10 pairs of SNPs in CHRNA3, CHRNA5, and CHRNB4 (p<10-8), among which the most significant interaction was found between RS3743077 (CHRNA3) and RS11636753 (CHRNB4, p<8.2×10-12). Linkage disequilibrium (LD) analysis revealed only low level of LD between these markers. However, there were no significant results for G×ETS interaction. Conclusion: This study fails to detect association between nicotine dependence genes and NSCL/P, but illustrates the importance of taking into account potential G×G interaction for genetic association analysis in NSCL/P. This study also suggests nicotine dependence genes should be considered as important candidate genes for NSCL/P in future studies.

Keywords: Gene-Gene Interaction, Maternal Smoking, Nicotine Dependence, Non-Syndromic Cleft Lip with or without Cleft Palate

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Authors: M. Weller Jones, J. Moffat, J. Taylor, J. Hartland, M. Natarajan

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Background: Uganda’s teenage pregnancy rate remains a significant problem for female and maternal health in the country. Teenage pregnancy is linked to higher rates of maternal and neonatal mortality and morbidity, including preterm labour, obstructed labour, vesicovaginal fistulae, infections, and maternal mental health morbidity. In 2015, the National Strategy to End Child Marriage and Teenage Pregnancy was launched in Uganda. Research is needed so that the interventions in this Strategy can be effectively applied at a local level. This study at Kitovu and Villa Maria Hospitals, two local community hospitals near Masaka, Uganda, aimed to measure change in the local teenage pregnancy rate over the past 5 years; and to explore the awareness and attitudes of teenagers and healthcare professionals towards 1) teenage pregnancy and, 2) the challenges female adolescents still currently face. Method: Teenage delivery rate, type of delivery, incidence of complications in labour and neonatal and maternal outcomes were collected from the labour ward admission books, at both hospitals, for a six month time period in 2011 and 2016. At Kitovu Hospital, qualitative data regarding the experience of, and attitudes towards teenage pregnancy was collected from interviews conducted with 12 maternity staff members and with eight female teenagers, aged 16-19, who were pregnant or post-partum. Results: The proportion of total births to teenage mothers fell from 14% in 2011 to 7% in 2016 (Kitovu), but it remains higher in rural locations (19%, Villa Maria). Beliefs about exacerbating factors included: poor access to contraception; misconceptions that contraception is damaging to women’s health; failing sex education in schools; and poor awareness of national campaigns to reduce teenage pregnancy. Staff felt that the best way to tackle teenage pregnancy was to improve sex education in schools and to sensitise families to these issues. Six of the eight teenagers wanted more frequent sex education and easier, cheap access to contraception. Only one teenager saw positive consequences stating that teenage pregnancy would ‘avoid operations later in life.’ Discussion: Teenage pregnancy is a recognised problem and strategies in the Masaka region should focus on improving sex education in schools and initiating an organisation that educates and supplies free contraception to teenagers.

Keywords: adolescents, attitudes, teenage pregnancy, Uganda

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Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris

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Background: Unhealthy diet is one of the modifiable risk factors for developing type 2 diabetes mellitus (T2DM). Improvement in diet can be beneficial for countering diabetes. For example, HbA1c, an important biomarker for diabetes, can be reduced by 1.1% through only alteration in diet. Ramadan fasting has been reported to provide positive health benefits. However, optimal benefits are not achieved, often due to poor dietary habits and lifestyle. There is a need to better understand the dietary habits of people fasting during Ramadan, so that necessary improvements can be made to develop this form of fasting as a non-pharmacological strategy for management and prevention of T2DM. Aim: This study aimed to assess the dietary patterns of Saudi adult patients with T2DM over three different periods (before, during, and after Ramadan) and relate this to HbA1c levels. Methods: This study recruited 82 Saudi with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for the study were obtained from De Montfort University and Saudi Ministry of Health. Dietary patterns were assessed by a self-administered questionnaire in each period. This assessment included the diet type and frequency. Blood samples were collected in each period for determination of HbA1c. Results: The number of meals per day for the participants significantly decreased during Ramadan (P < 0.001). The consumption of fruit and vegetables significantly increased during Ramadan (P = 0.017). However, the consumption of sugary drinks significantly increased during and after Ramadan (P = 0.005). Approximately 60% of the patients indicated that they ate sugary foods at least once per week. The consumption of bread and rice was reported to be at least two times per week. The consumption of rice significantly reduced during Ramadan (P = 0.002). The mean HbA1c significantly varied between periods (P = 0.001), with lowest level during Ramadan compared to before and after Ramadan. The increase in the consumption of fruits and vegetables had a medium effect size on the reduction in HbA1c during Ramadan. There was a variance of 7.7% in the mean difference in HbA1c levels between groups (who changed their fruit and vegetable consumption) which can be accounted for by the increase in the consumption of fruits and vegetables. Likewise, 9.3% of the variance in the mean HbA1c difference between the groups was accounted for by a decrease in the consumption of rice. Conclusion: The increase in the frequency of fruit and vegetables intake, and especially the reduction in the frequency of rice consumption, during Ramadan produce beneficial effects in reducing HbA1c level. Therefore, further improving the dietary habits of patients with T2DM, such as reducing their sugary drinks intake, may help them to obtain greater benefits from Ramadan fasting in the management of their diabetes. It is recommended that dietary guidance is provided to the public to maximise health benefits through Ramadan fasting.

Keywords: Diabetes, Diet, Fasting, HbA1c, Ramadan

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Authors: Niki Hayatgheib, SéGolèNe Calvez, Catherine Fournel, Lionel Pineau, Herve Pouliquen, Emmanuelle Moreau

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Furunculosis caused by infection with Aeromonas salmonicida subsp. salmonicida has been a known disease found principally in salmonid aquaculture. Vaccination has been partly successful in preventing this disease, but outbreaks still occur. The application of functional feed additive found to be a promising yield to improve fish health against diseases. In this study, we tested the efficacy of prebiotics and plant essential oils-enriched diet on immune response and disease resistance in vaccinated and non-vaccinated rainbow trout (Oncorhynchus mykiss) against furunculosis. A total of 600 fish were fed with the basal diet or supplement. On 4th week of feeding, fish were vaccinated with an autovaccine. Following 8 weeks, fish were challenged with Aeromonas salmonicida subsp. salmonicida and mortalities were recorded for 3 weeks. Lysozyme activity and antibody titer in serum were measured in different groups. The results of this study showed that lysozyme and circulatory antibody titer in plasma elevated significantly in vaccinated fish fed with additive. The best growth rate and relative percentage survival (62%) were in fish fed with a supplement, while 15% in control fish. Overall, prebiotics and essential oils association can be considered as a potential component for enhancing vaccine efficacy against furunculosis by increasing the growth performance, immune responses and disease resistance in rainbow trout.

Keywords: aeromonas salmonicida subsp. salmonicida, aquaculture, disease resistance, fish, immune response, prebiotics-essential oils feed additive, rainbow trout, vaccination

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Authors: Keri Alhadi Ighwela, Aziz Bin Ahmad, A. B. Abol-Munafi

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Three purified diets were formulated using fish meal, soya bean, wheat flour, palm oil, minerals and maltose. The carbohydrate in the diets was increased from 5 to 15% by changing the cellulose content to study the effect of dietary carbohydrate level on the growth parameters of Nile tilapia Oreochromis niloticus.The protein and the lipid contents were kept constant in all the diets. The results showed that, weight gain, protein efficiency ratio, net protein utilisation and hepatosomatic index of fish fed the diet containing 15% cellulose were the lowest among all groups. Addition, the fish fed the diet containing 5% cellulose had the best specific growth rate, and food conversion ratio. While, there was no effect of the dietary cellulose levels on condition factor and survival rate. These results indicate that Nile tilapia fingerlings are able to utilize dietary cellulose does not exceed 10% in their feed for optimum growth.

Keywords: dietary cellulose, growth parameters, oreochromis niloticus, purified diets

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Authors: Yi-Shuan ShaoShao, Yen-An Tsai, Chia-Huang Chang, Kai-Wei Liao, Ming-Song Tsai, Mei-Lien Chen

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Organophosphate pesticides (OPs) is an environmental hormone with proven endocrine-disrupting effects that may affect the growth and development in human. A large amount of organophosphate pesticides (OPs) is used throughout Taiwan, and human may be exposed through dietary intake or residential use. During pregnancy, OPs can be transferred to the blood stream reaching the fetus through the placenta. The aim of this study was to explore the association between maternal OPs exposure levels and fetal developments and birth outcomes. A birth cohort was follow-up. Maternal urine sample were collected at the first, second, and third gestational trimester. Fetal growth characteristics were measured by ultrasonic scan and birth outcomes were assessed by pediatrician. Urinary metabolite of organophosphate pesticides were assessed using gas chromatography-mass spectrometry. The analytes included dimethylphosphate (DMP), dimethylthiophosphate (DMTP), dimethyldithiophosphates (DMDTP), diethylphosphate (DEP), diethylthiophosphate (DETP), and diethyldithiophosphate (DEDTP). We found that all of urine samples in each trimester were detected at least one metabolite for dialkyl phosphate (DAP). The detection rate range of OP urinary metabolites were from the lowest 22% DEDTP to the highest 100% DMP and DMTP. And to compared geometric means (GM) of urinary metabolites with three trimesters, that third trimester had the highest concentration for DMPs, DEPs, and DAPs in pregnant women were 368.01, 169.85 and 543.75 nmol/g creatinine, respectively. We observed that DAPs concentration in first and second trimester were significantly negative association with head circumference. DMPs in first trimester was significantly negative association with thoracic circumference (p=0.05) by spearman correlation. Our results support associations with prenatal OPs exposure with fetal head circumference and thoracic circumference. It provided that maternal OPs exposure might affect birth outcomes. Thus, prenatal exposure to OPs and health risk worthy of attention and concern.

Keywords: DAPs, birth outcomes, organophosphate pesticides, prenatal

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Authors: R. M. K. S. Chandana, A. P. D. G. Pathirana, N. Priyankarage, W. A. D. Nayananjalie, S. S. P. Silva

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Full fat soybean meal (FFSBM) has been used in many parts of the world together with solvent-extracted soybean meal (SBM) in livestock feeds. Although some local FFSBM is available, their use has not been assessed experimentally. This study was carried out to evaluate the use of local extruded FFSBM in broiler rations. Four treatment diets were formulated by incorporating locally produced FFSBM (0, 10, 20, and 30%) as a replacement for soybean meal (SBM) in a two-phase (starter and finisher) feeding program. Two hundred Hubbard F 15 day old broiler chicks were randomly assigned into four treatments with five replicates per each. Bodyweight gain (BWG), feed intakes (FI), and feed conversion ratio (FCR) were calculated for a period of 42 days. Nutrient utilization in the form of dry matter (DM), energy, nitrogen, and fat retention were estimated by the total collection method in three weeks old broilers. At the end of the experiment, carcass weight was measured, and the dressing percentage was calculated. Data were analyzed using one way analysis of variance (ANOVA) in SAS. There was no significant effect of FFSBM on feed intakes of chicks fed different diets (p > 0.05). Birds fed the control diet, and FF10 (10% FFSBM diet) gained significantly more than that of birds fed FF20 or FF30 diets (p > 0.05). In the finisher period, control birds gained more than all the other treatment birds. FCR was poorer in bird fed higher levels of FFSBM compared to the control or FF10 birds during their early life, but that was not evident in the latter part of the experiment. Treatments did not alter (p > 0.05) the retention of DM and nitrogen, but energy utilization was lowest (p < 0.05) in birds fed with 0% FFSBM, and the highest fat digestibility was observed in birds fed with 30% FFSBM diets. Thus, it can be concluded that FFSBM can be used as a substitute for SBM in broiler rations and could be incorporated up to 10% of the diet safely with no adverse effects on broiler performances.

Keywords: body weight, broiler, digestibility, full fat soybean meal, soybean meal

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Authors: Simran Sharda

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There is increasing evidence that leads psychologists today to believe that the attachment formed between a mother and child plays a much more profound role in later-life outcomes than previously expected. Particularly, the fact that a link may exist between maternal attachment and the development in addition to the severity of social anxiety in middle childhood seems to be gaining ground. This research will examine and address a myriad of major issues related to the impact of mother-child attachment: behaviors of children with different levels of secure attachment, various aspects of anxiety in relation to attachment security as well as other styles of mother-child attachments, especially avoidant attachment and over-attachment. This analysis serves to compile previous literature on the subject and touch light upon a logical extension of the research. Moreover, researchers have identified links between attachment and the externalization of problem behaviors: these behaviors may later manifest as social anxiety as well as increased severity and likelihood of PTSD diagnosis (an anxiety disorder). Furthermore, secure attachment has been linked to increased health benefits, cognitive skills, emotive socialization, and developmental psychopathology.

Keywords: child development, anxiety, cognition, developmental psychopathology, mother-child relationships, maternal, cognitive development

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Authors: Yi-Ting Chen, Yu-Fang Huang, Pei-Wei Wang, Hai-Wei Liang, Chun-Hao Lai, Mei-Lien Chen

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Background: Bisphenol A (BPA) is commonly used in consumer products, such as inner coatings of cans and polycarbonated bottles. BPA is considered to be an endocrine disrupting substance (EDs) that affects normal human hormones and may cause adverse effects on human health. Pregnant women and fetuses are susceptible groups of endocrine disrupting substances. Prenatal exposure to BPA has been shown to affect the fetus through the placenta. Therefore, it is important to evaluate the potential health risk of fetal exposure to BPA during pregnancy. The aims of this study were (1) to determine the urinary concentration of BPA in pregnant women, and (2) to investigate the association between BPA exposure during pregnancy and birth outcomes. Methods: This study recruited 117 pregnant women and their fetuses from 2012 to 2014 from the Taiwan Maternal- Infant Cohort Study (TMICS). Maternal urine samples were collected in the third trimester and questionnaires were used to collect socio-demographic characteristics, eating habits and medical conditions of the participants. Information about birth outcomes of the fetus was obtained from medical records. As for chemicals analysis, BPA concentrations in urine were determined by off-line solid-phase extraction-ultra-performance liquid chromatography coupled with a Q-Tof mass spectrometer. The urinary concentrations were adjusted with creatinine. The association between maternal concentrations of BPA and birth outcomes was estimated using the logistic regression model. Results: The detection rate of BPA is 99%; the concentration ranges (μg/g) from 0.16 to 46.90. The mean (SD) BPA levels are 5.37(6.42) μg/g creatinine. The mean ±SD of the body weight, body length, head circumference, chest circumference and gestational age at birth are 3105.18 ± 339.53 g, 49.33 ± 1.90 cm, 34.16 ± 1.06 cm, 32.34 ± 1.37 cm and 38.58 ± 1.37 weeks, respectively. After stratifying the exposure levels into two groups by median, pregnant women in higher exposure group would have an increased risk of lower body weight (OR=0.57, 95%CI=0.271-1.193), smaller chest circumference (OR=0.70, 95%CI=0.335-1.47) and shorter gestational age at birth newborn (OR=0.46, 95%CI=0.191-1.114). However, there are no associations between BPA concentration and birth outcomes reach a significant level (p < 0.05) in statistics. Conclusions: This study presents prenatal BPA profiles and infants in northern Taiwan. Women who have higher BPA concentrations tend to give birth to lower body weight, smaller chest circumference or shorter gestational age at birth newborn. More data will be included to verify the results. This report will also present the predictors of BPA concentrations for pregnant women.

Keywords: bisphenol A, birth outcomes, biomonitoring, prenatal exposure

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Authors: Hamada Ahmed, Mervat A. Abdel-Latif, Alaa. A. Ghoraba, Samah A. Ganna

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An experiment was conducted to determine the effect of microbial phytase (Quantum Blue®) supplementation on layer chickens fed diets with required or low phosphorous level in corn-soybean based diets. One hundred and sixteen 23-week-old Lohman brown laying hens were used in 8-week feeding trial. Hens were randomly allotted into four treatments where the group (1) (control group) was fed basal diet without phytase, group (2) fed basal diet supplemented with phytase, group (3) fed diet supplemented with phytase as a replacement of 25% of monocalcium phosphate and group (4) fed diet supplemented with phytase as a replacement of 50% of monocalcium phosphate. Records on daily egg production, egg mass, egg weight and body weight of hens at the end of experimental period were recorded. Results revealed no significant (p ≥ 0.05) differences were observed among the other dietary treatments in BW, egg production, egg mass, feed intake or feed conversion when these parameters were evaluated over the duration of the experiment while egg weight showed significant (p < 0.05) increase in all phytase supplemented groups. There was no significant (p ≥ 0.05) differences in egg quality including egg length, egg width, egg shape index, yolk height, yolk width, yolk index, yolk weight and yolk albumin ratio while egg albumin was significantly increased (p < 0.05) in group (2) and group (3). Egg shell weight increased significantly (p < 0.05) in all phytase supplemented groups when compared with the control group also shell thickness increased significantly (p < 0.05) in both group (2 &3). No significant (P ≥ 0.05) difference was observed in serum Ca, P level while alkaline phosphatase was significantly (P ˂ 0.05) increased in group (3). Egg shell analysis showed increase in egg shell ash% in all phytase supplemented groups when compared with the control group, egg shell calcium % was higher in group (3) and group (4) than the control group while group (2) showed lower egg shell calcium% than the other experimental groups, egg shell phosphorous% was higher in all phytase supplemented groups than the control group. Phosphorous digestability was significantly (P ˂ 0.05) increased in all phytase supplemented groups than the control group and the highest p digestability was in group (4). Calcium digestability showed significant (P ˂ 0.05) increase in all phytase supplemented groups when compared with the control group and the highest digetability was in group (4).

Keywords: layers, microbial phytase, Ca and P availability, egg production, egg characteristics

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Authors: Yiqi Zhu, Jean Francois Trani, Rameez Ulhassan

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Extreme weather phenomena increased by 46% between 2007 and 2017 and have become more intense with the rise in global average temperatures. This increased intensity of climate variations often induces humanitarian crises and particularly affects vulnerable populations in low- and middle-income countries (LMICs). Expectant and lactating mothers are among the most vulnerable groups. Pakistan ranks 10th among the most affected countries by climate disasters. In 2022, monsoon floods submerged a third of the country, causing the loss of 1,500 lives. Approximately 650,000 expectant and lactating mothers faced systematic stress from climatic disasters. Our study used participatory methods to investigate the systematic impact of climatic disasters on maternal health. In March 2023, we conducted six Group Model Building (GMB) workshops with healthcare workers, fathers, and mothers separately in two of the most affected areas in Pakistan. This study was approved by the Islamic Relief Research Review Board. GMB workshops consist of three sessions. In the first session, participants discussed the factors that impact maternal health. After identifying the factors, they discussed the connections among them and explored the system structures that collectively impact maternal health. Based on the discussion, a causal loop diagram (CLD) was created. Finally, participants discussed action ideas that could improve the system to enhance maternal health. Based on our discussions and the causal loop diagram, we identified interconnected factors at the family, community, and policy levels. Mothers and children are directly impacted by three interrelated factors: food insecurity, unstable housing, and lack of income. These factors create a reinforcing cycle that negatively affects both mothers and newborns. After the flood, many mothers were unable to produce sufficient breastmilk due to their health status. Without breastmilk and sufficient food for complementary feeding, babies tend to get sick in damp and unhygienic environments resulting from temporary or unstable housing. When parents take care of sick children, they miss out on income-generating opportunities. At the community level, the lack of access to clean water and sanitation (WASH) and maternal healthcare further worsens the situation. Structural failures such as a lack of safety nets and programs associated with flood preparedness make families increasingly vulnerable with each disaster. Several families reported that they had not fully recovered from a flood that occurred ten years ago, and this latest disaster destroyed their lives again. Although over twenty non-profit organizations are working in these villages, few of them provide sustainable support. Therefore, participants called for systemic changes in response to the increasing frequency of climate disasters. The study reveals the systematic vulnerabilities of mothers and children after climatic disasters. The most vulnerable populations are often affected the most by climate change. Collaborative efforts are required to improve water and forest management, strengthen public infrastructure, increase access to WASH, and gradually build climate-resilient communities. Governments, non-governmental organizations, and the community should work together to develop and implement effective strategies to prevent, mitigate, and adapt to climate change and its impacts.

Keywords: climatic disasters, maternal health, Pakistan, systematic impact, flood, disaster relief.

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Authors: Mochache Vernon, Mwakusema Omar, Lakhani Amyn, El Busaidy Hajara, Temmerman Marleen, Gichangi Peter

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Background: Utilization of contraceptive methods has been associated with improved maternal and child health (MCH) outcomes. Unfortunately, there has been sub-optimal uptake of contraceptive services in the developing world despite significant resources being dedicated accordingly. It is imperative to granulate factors that could influence uptake and utilization of contraception. Methodology: Between March and December 2015, we conducted a mixed-methods cross-sectional study among women of reproductive age (18-45 years) from a pre-dominantly rural coastal Kenyan community. Qualitative approaches involved focus group discussions as well as a series of key-informant interviews. We also administered a sexual and reproductive health survey questionnaire at the household level. Results: We interviewed 745 women from 15 villages in Kwale County. The median (interquartile range, IQR) age was 29 (23-37) while 76% reported being currently in a marital union. Eighty-seven percent and 85% of respondents reported ever attending school and ever giving birth, respectively. Respondents who had ever attended school were more than twice as likely to be using contraceptive methods [Odds Ratio, OR = 2.1, 95% confidence interval, CI: 1.4-3.4, P = 0.001] while those who had ever given birth were five times as likely to be using these methods [OR = 5.0, 95% CI: 1.7-15.0, P = 0.004]. The odds were similarly high among women who reported attending antenatal care (ANC) [OR = 4.0, 95% CI: 1.1-14.8, P = 0.04] as well as those who expressly stated that they did not want any more children or wanted to wait longer before getting another child [OR = 6.7, 95% CI: 3.3-13.8, P<0.0001]. Interviewees reported deferring to the ‘wisdom’ of an older maternal figure in the decision-making process. Conclusions: Uptake and utilization of contraceptive methods among Digo women from Kwale, Kenya is positively associated with demand-side factors including educational attainment, previous birth experience, ANC attendance and a negative future fertility desire. Interventions to improve contraceptive services should focus on engaging dominant maternal figures in the community.

Keywords: unmet need, utilization of contraceptive methods, women, Digo community

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Authors: Eliza Torrigue, Efrelyn Iellamo

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Maternal death is one of the rising health issues in the Philippines. It is alarming to know that in every hour of each day, a mother gives birth to a child who may not live to see the next day. Statistics shows that intrapartum period and third stage of labor are the very crucial periods for the expectant mother, as well as the first six hours of life for the newborn. To address the issue, The Essential Intrapartum Newborn Care (EINC) was developed. Through this, Obstetric Delivery Room (OB-DR) Nurses shall be updated with the evidence-based maternal and newborn care to ensure patient safety, thus, reducing maternal and child mortality. This study aims to describe the compliance of hospitals, especially of OB-DR nurses, to the EINC Protocols. The researcher aims to link the profile variables of the respondents in terms of age, length of service and formal training to their compliance on the EINC Protocols. The outcome of the study is geared towards the development of appropriate training program for OB-DR Nurses assigned in the delivery room of the hospitals based on the study’s results to sustain the EINC standards. A descriptive correlational method was used. The sample consists of 75 Obstetric Delivery Room (OB-DR) Nurses from three government hospitals in the City of Manila namely, Ospital ng Maynila Medical Center, Tondo Medical Center, and Gat Andres Bonifacio Memorial Medical Center. Data were collected using an evaluative checklist. Ranking, weighted mean, Chi-square and Pearson’s R were used to analyze data. The level of compliance to the EINC Protocols by the respondents was evaluated with an overall mean score of 4.768 implying that OB-DR Nurses have a high regard in complying with the step by step procedure of the EINC. Furthermore, data shows that formal training on EINC have a significant relationship with OB-DR Nurses’ level of compliance during cord care, AMTSL, and immediate newborn care until the first ninety minutes to six hours of life. However, the respondents’ age and length of service do not have a significant relationship with the compliance of OB-DR Nurses on EINC Protocols. In the pursuit of decreasing the maternal mortality in the Philippines, EINC Protocols have been widely implemented in the country especially in the government hospitals where most of the deliveries happen. In this study, it was found out that OB-DR Nurses adhere and are highly compliant to the standards in order to assure that optimum level of care is delivered to the mother and newborn. Formal training on EINC, on the other hand, create the most impact on the compliance of nurses. It is therefore recommended that there must be a structured enhancement training program to plan, implement and evaluate the EINC protocols in these government hospitals.

Keywords: compliance, intrapartum, newborn care, nurses

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