Search results for: early pregnancy losses

Authors: Ayman A. Swelum, Abdullah N. Al-Owaimer, Mohamed A. Abouheif

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This study aimed to evaluate the effects of sheep breed and the number of embryos transferred on the success of multiple ovulation and embryo transfer (MOET). Sixteen Najdi and Naeimi ewes were used as donors. Multiple ovulation was achieved using equine chorionic gonadotropin (eCG). Thirty-five recipient ewes were divided into four groups: Najdi or Naeimi ewes that received either one or two embryos. After lambing, the gestation length, litter size, and sex of the lambs were recorded. The rates of pregnancy, lambing, and embryo survival were lower in the recipient Najdi than Naeimi ewes when two embryos were transferred. In contrast, the Naeimi ewes that received one embryo had a significantly lower embryo transfer success. In conclusion, the response of ewes to multiple ovulation stimulation using eCG was significantly high in Naeimi ewes (9.8±1.17). Moreover, transferring one embryo resulted in a significantly high pregnancy rate in the Najdi sheep (60%).

Keywords: embryo transfer, multiple ovulation, Najdi, Naeimi, sheep

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Authors: Asnate Kirse, Daina Karklina, Sandra Muizniece-Brasava, Ruta Galoburda

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Pulses are high in plant protein and dietary fiber, and contain slowly digestible starches. Innovative products from pulses could increase their consumption and benefit consumer health. This study was conducted to evaluate physicochemical stability of processed cowpea (Vigna unguiculata (L.) Walp. cv. Fradel) and maple pea (Pisum sativum var. arvense L. cv. Bruno) spreads at 5 °C temperature during 62-day storage. Physicochemical stability of pulse spreads was compared after sous vide treatment (80 °C/15 min) and high pressure processing (700 MPa/10 min/20 °C). Pulse spreads were made by homogenizing cooked pulses in a food processor together with salt, citric acid, oil, and bruschetta seasoning. A total of four different pulse spreads were studied: Cowpea spread without and with seasoning, maple pea spread without and with seasoning. Transparent PA/PE and light proof PET/ALU/PA/PP film pouches were used for packaging of pulse spreads under vacuum. The parameters investigated were pH, water activity and mass losses. Pulse spreads were tested on days 0, 15, 29, 42, 50, 57 and 62. The results showed that sous-vide treatment and high pressure processing had an insignificant influence on pH, water activity and mass losses after processing, irrespective of packaging material did not change (p>0.1). pH and water activity of sous-vide treated and high pressure processed pulse spreads in different packaging materials proved to be stable throughout the storage. Mass losses during storage accounted to 0.1% losses. Chosen sous-vide treatment and high pressure processing regimes and packaging materials are suitable to maintain consistent physicochemical quality of the new products during 62-day storage.

Keywords: cowpea, flexible packaging, maple pea, water activity

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Authors: O. Arikan, C. Kocatepe, G. Ucar, Y. Hacialiefendioglu

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In this paper, influence of harmonics on medium voltage distribution system of Bogazici Electricity Distribution Inc. (BEDAS) which takes place at Istanbul/Turkey is investigated. A ring network consisting of residential loads is taken into account for this study. Real system parameters and measurement results are used for simulations. Also, probable working conditions of the system are analyzed for %50, %75 and %100 loading of transformers with similar harmonic contents. Results of the study are exhibited the influence of nonlinear loads on %THDV, P.F. and technical losses of the medium voltage distribution system.

Keywords: distribution system, harmonic, technical losses, power factor, total harmonic distortion, residential load, medium voltage

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Authors: Hassen Mohammed, Michelle Clarke, Helen Marshall

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Maternal immunization is an effective strategy to protect pregnant women and their offspring from vaccine-preventable diseases. Despite the recommendation of maternal influenza and more recently pertussis immunization in Australia, uptake of these vaccines has been suboptimal. Monitoring the impact of the current funded vaccine programs for pregnant women is limited. The study aimed to assess the impact of the funded program and determine factors associated with vaccine uptake in pregnant women. This observational prospective study was undertaken between November 2014 and July 2016 at the Women’s and Children’s Hospital in South Australia (WCH). Demographic details and vaccination history from South Australian pregnant women who attended the WCH were reviewed. A standardized self-reported survey was conducted in antenatal care with a follow up telephone interview at 8-10 weeks post-delivery. A midwife delivered immunization program for pregnant women in antenatal clinic commenced in April 2015. Of the 180 pregnant women who completed the survey questionnaire, 75.5% and 80.5 % received maternal influenza and pertussis vaccines respectively. First-time mothers had twice the odds of having received influenza vaccine during pregnancy than multiparous women (OR 2.4; CI 1.14 - 4.94; p= 0.021). The proportion of women who received pertussis vaccine during pregnancy, following the introduction of the midwife delivered pertussis vaccination program (140/155, 90.3%) was significantly higher compared with women who received maternal pertussis vaccination prior to the introduction of the program (5/22, 23.7%, p < 0.001). The odds of women receiving maternal pertussis vaccine following the implementation of the midwife delivered program were 31 times higher than women who delivered babies prior to the program (OR 31.7, CI 10.24- 98.27; p < 0.001). High uptake of influenza and pertussis vaccines during pregnancy can be attained with health care provider recommendation and inclusion of maternal immunization as part of standard antenatal care.

Keywords: influenza, maternal immunization, pertussis, provider recommendation

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Authors: Shu-Ling Wang

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Background: Multiple studies showed early skin-to-skin contact (SSC) with mothers was beneficial to newborns such as breastfeeding and maternal childcare. In cases of newborns unable to have early SSC with mothers, fathers’ involvement could let early SSC continue without interruption. However, few studies had explored the effects of early SSC by fathers in comparison to early SSC with mothers. Paternal involvement of early SSC should be equally important in term of childcare and breastfeeding. The purpose of this study was to evaluate the efficacy of early SSC by fathers in particular in their support of breastfeeding. Methods: A quasi-experimental design was employed by the study. One hundred and forty-four father-infant pairs had participated the study, in which infants were assigned either to SSC with their fathers (n = 72) or to routine care (n = 72) as the control group. The study was conducted at a regional hospital in northern Taiwan. Participants included parents of both vaginal delivery (VD) and caesarean section birth (CS) infants. To be eligible for inclusion, infants must be over 37-week gestational ages. Data were collected twice: as pretest upon admission and as posttest with online questionnaire during first, second, and third postpartum months. The questionnaire included items for Breastfeeding Social Support, methods of feeding, and the mother-infant 24-hour rooming-in rate. The efficacy of early SSC with fathers was evaluated using the generalized estimating equation (GEE) modeling. Research Result: The primary finding was that SSC with fathers had positive impact on fathers’ support of breastfeeding. Analysis of the online questionnaire indicated that early SSC with fathers improved the support of breastfeeding than the control group (VD: t = -4.98, p < .001; CS: t = -2.37, p = .02). Analysis of mother-infant 24-hour rooming-in rate showed that SSC with fathers after CS had a positive impact on the rooming-in rate (χ² = 5.79, p = .02); however, with VD the difference between early SSC with fathers and the control group was insignificant (χ² = .23, p = .63). Analysis of the rate of exclusive breastfeeding indicated that early SSC with fathers had a higher rate than the control group during first three postpartum months for both delivery methods (VD: χ² = 12.51, p < .001 on 1st postpartum month, χ² = 8.13, p < .05 on 2nd postpartum month, χ² = 4.43, p < .05 on 3rd postpartum month; CS: χ² = 6.92, p < .05 on 1st postpartum month, χ² = 7.41, p < .05 on 2nd postpartum month, χ² = 6.24, p < .05 on 3rd postpartum month). No significant difference was found on the rate of exclusive breastfeeding with both methods of delivery between two groups during hospitalization. (VD: χ² =2 .00, p = .16; CS: χ² = .73, p = .39). Conclusion: Implementing early SSC with fathers has many benefits to both parents. The result of this study showed increasing fathers’ support of breastfeeding. This encourages our nursing personnel to focus the needs of father during breastfeeding, therefore further enhancing the quality of parental care, the rate and duration of breastfeeding.

Keywords: breastfeeding, skin-to-skin contact, support of breastfeeding, rooming-in

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Authors: Sultana Razia

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The purpose of this study was to investigate the effect of early therapeutic intervention on children with an autism spectrum disorder. Participants were 140 children with autism spectrum disorder from Autism Corner in a selected rehabilitation center of Bangladesh. This study included children who are at aged of 18-month to 36-month and who were taking occupational therapy and speech and language therapy from the autism center. They were primarily screened using M-CHAT; however, children with other physical disabilities or medical conditions were excluded. 3-months interventions of 6 sessions per week are a minimum of 45-minutes long per session, one to one interaction followed by parent-led structured home-based therapy were provided. The results indicated that early intensive therapeutic intervention improves understanding, social skills and sensory skills. It can be concluded that therapeutic early intervention has a positive effect on diminishing symptoms of Autism Spectrum Disorder.

Keywords: autism, m-chat, reciprocal social behavior, CRP

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Authors: Akinwumi Omotayo, Badu-B Apraku, Joseph Olobasola, Petra Abdul Saghir, Yinka Sobowale

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In southwestern Nigeria, climate change has led to loss of at least two months of rainfall. Consequently, only one cycle of maize can now be grown because of the shorter duration of rainy season as against two cycles in the past. The Early and Extra-early maturing varieties of maize were originally developed for the semi-arid and arid zones of West and Central Africa where there are seasonal challenges of water threatening optimum performance of the traditional maize grown, which are commonly late in maturity (115 to 120 days). The early varieties of maize mature in 90 to 95 days; while the Extra-Early maize varieties reach physiological maturity in less than 90 days. It was broadly hypothesized that the extra early varieties of maize could mitigate the effects of climate change in southwestern Nigeria with higher levels of rainfall by reinstating the original two cycles of rain-fed maize crop. Trials were therefore carried out in southwestern Nigeria on the possibility of adapting the extra early maize to mitigate the effects of climate change. The trial was the Mother/Baby design. The mother trial involves the evaluation of extra-early varieties following ideal recommendations and closely supervised centrally at the University research farm and the Agricultural Development Programmes (ADPs). This requires farmers to observe and evaluate the technology and the management regime meant to precede the second stage of evaluation at several satellite farmers field managed by selected farmers. The Baby Trial is expected to provide a realistic assessment of the technology by farmers in their own environment. A stratified selection of thirty farmers for the Baby Trial ensured appropriate representation across the different categories of the farming population by age and gender. Data from the trials indicate that extra early maize can be grown in two cycles rain fed in south west Nigeria and a third and fourth cycle could be obtained with irrigation. However the long duration varieties outyielded the extra early maize in both the mother and baby trials. When harvested green, the extra early maize served as source of food between March and May when there was scarcity of food. This represents a major advantage. The study recommends that further work needs to be done to improve the yield of extra early maize to encourage farmers to adopt.

Keywords: adaptation, climate change, extra early, maize varieties, mitigation

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Authors: St. Subaedah, A. Takdir, Netty, D. Hidrawati

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Maize development at the rainfed lowland after rice is often confronted with the occurrence of drought stress at the time of entering the generative phase, which will cause be hampered crop production. Consequently, in the utilization of the rainfed lowland areas optimally, an effort that can be done using the varieties of early maturity to minimize crop failures due to its short rainy season. The aim of this research was evaluating the potential yield of genotypes of candidates of maize early maturity in the rainfed lowland areas. The study was conducted during May to August 2016 at South Sulawesi, Indonesia. The study used randomized block design to compare 12 treatments and consists of 8 genotypes namely CH1, CH2, CH3, CH4, CH5, CH6, CH7, CH8 and the use of four varieties, namely Bima 3, Bima 7, Lamuru and Gumarang. The results showed that genotype of CH2, CH3, CH5, CH 6, CH7 and CH8 harvesting has less than 90 days. There are two genotypes namely genotypes of CH7 and CH8 that have a fairly high production respectively of 7.16 tons / ha and 8.11 tons/ ha and significantly not different from the superior varieties Bima3.

Keywords: evaluation, early maturity, maize, yield potential

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Authors: Hanna Teklu Gebregziabher

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Background: A variety of techniques for medical termination of second-trimester pregnancy can be used, but there is no consensus about which is the best. Even though most evidence suggests the combined use of intracervical Foley catheter and vaginal misoprostol is safe, effective, and acceptable method for termination of second-trimester pregnancy, which is comparable to mifepristone-misoprostol combination regimen with lower cost and no additional maternal risks. The use of mifepristone and misoprostol alone with no other procedure is still the most common procedure in different institutions for 2nd-trimester pregnancy. Methods: A cross-sectional comparative prospective study design is employed on women who were admitted for 2nd-trimester medical abortion and medical abortion failed or if there was no change in cervical status after 24 hours of 1st dose of misoprostol. The study was conducted at St. Paulose Hospital Millennium Medical College. A sample of 44 participants in each arm was necessary to give a two-tailed test, a type 1 error of 5%, 80% statistical power, and a 1:1 ratio among groups. Thus, a total of 94 cases, 47 from each arm, were recruited. Data was entered and cleaned by using Epi-info and analyzed using SPSS version 29.0 statistical software and was presented in descriptive and tabular forms. Different variables were cross-tabulated and compared for significant differences and statistical analysis using the chi-square test and independent t-test, to conclude. Result: There was a significant difference between the two groups on induction to expulsion time and number of doses used. The mean ± SD of induction to expulsion time for those used misoprostol alone was 48.09 ± 11.86 and those who used trans-cervical catheter sequentially with misoprostol were 36.7 ±6.772. Conclusion: The use of a trans-cervical Foley catheter in conjunction with misoprostol in a sequential manner is a more effective, safe, and easily accessible procedure. In addition, the cost of utilizing the catheter is less compared to the cost of misoprostol and is readily available. As a good substitute, we advised using Trans-cervical Catether even for medical abortions performed in the second trimester.

Keywords: second trimester, medical abortion, catheter, misoprostol

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Authors: Nermeen Saad Elbeltagy, Hoda Ghareeb, Hesham Adel Elsheshtawy, Nadim Hamed, Amany Ibrahim Mostafa, Sara Hazem Hassan

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Introduction: Depression is one of the most common mental health problems occurring in women during their child bearing years. Perinatal depression refers to major and minor depressive episodes that occur either during pregnancy or aer delivery. Although perinatal depression is common in developing countries, it is under-recognized in low and middle income countries making a substantial contribution to maternal and infant morbidity and mortality. About 12.5 - 42% of pregnant women and, 12 - 50% of post natal mothers in low and middle income countries such as Ethiopia had depression AIM OF THE WORK: To study prevalence, associated factors and impact of maternal perinatal depression in Alexandria. Patients and method: This study was conducted on 300 mothers at the postnatal ward in ElShatby Maternity Hospital from April 2022 unl October 2022. Females with past history of depression before pregnancy or females who receive medications inducing depression were excluded. The participants were asked to complete the questionnaire that includes the Edinburgh Postnatal Depression Scale (EPDS) as a screening test to obtain information concerning the current frame of mind at antepartum, partum and postpartum periods Results: The prevalence of perinatal depression was 22.3%. It was found that there is a significant negave moderate correlation between socioeconomic status and perinatal depression(r=-0.42). The present study revealed that about two thirds (60.7%) of postpartum women had low socioeconomic level. Also, less than one fourth (20%) of parents had high education and only one fourth (25.3%) of postpartum women were working. There was a statically significance difference between the number of previous abortions and perinatal depression (p=0.04). There was a significant moderate correlation between the amount of blood lost during delivery and an increased risk of developing postpartum depression. The prevalence of perinatal depression was high in cases of female neonates more than male ones. Conclusion: the prevalence of perinatal depression among the studied women was 22.3% of studied group. The significant factors identified in this study can be targeted to reduce the occurrence of perinatal depression among pregnant women in Alexandria through appropriate health interventions which includes perinatal depression screening, counseling, and the provision of support for pregnant women during antenatal care as well as lifestyle modification.

Keywords: mental health, depression in pregnancy, mental disorders, psychology in pregnancy

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Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Heng-Hua Wang, Hui-Zhu Chen

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This paper discusses the experience of caring for a patient diagnosed with breast cancer and later received total mastectomy during a 2nd trimester pregnancy. She was hospitalized from January 31 to February 4, 2018. Using 'Gordon’s 11 Functional Health Patterns' through physical exams and interviews, the researcher assessed the patient’s physical and mental health and determined the patient to have anxiety, acute pain, and body image disturbance. After establishing a strong relationship with the patient, the researcher helped the patient express her anxiety and personal feelings. A multi-specialist team was formed to evaluate both the patient and her unborn child, before, during, and after surgery. This individualized care allowed the patient and her child to optimize the post-operative results. Aside from medication, the patient also received non-medicinal treatment, including improvement of sleep quality with body positioning, diaphragmatic breathing exercises for pain and stress relief after surgery. Throughout hospitalization, the patient’s physical and emotional needs were addressed daily with listening sessions and empathy. The patient’s husband was also incorporated in the patient’s recovery by teaching both he and the patient how to change the sterile wound dressing, which may have the added benefit of improving marital relationships through shared activities of nurturing. The patient was also given advice about how to improve self-confidence through clothing. Lastly, the patient was encouraged to join a support group for breast cancer patients. Through the sharing of experience in groups and within the family, the patient was helped to adapt to the change of her appearance and re-establish her self-confidence. This level of care expedited the patient’s return to her family life and role of being a mother.

Keywords: anxiety, body image disturbance, breast cancer during pregnancy, multi-specialist team

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Authors: Sofia Hartati

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This research is aimed at describing training in early childhood education program empirically, describing teachers ability to plan lessons empirically, and acquiring empirical data as well as analyzing the influence of guided and independent training toward teachers competence in planning early childhood learning program. The method used is an experiment. It collected data with a population of 76 early childhood educators in Tunjung Teja Sub District area through random sampling technique and grouped into two namely 38 people in an experiment class and 38 people in a controlled class. The technique used for data collections is a test. The result of the research shows that there is a significant influence between training for guided educators toward Teachers Ability toward Planning Early Childhood Learning Program. Guided training has been proven to improve the ability to comprehend planning a learning program. The ability to comprehend planning a learning program owned by teachers of early childhood program comprises of 1) determining the characteristics and competence of students prior to learning; 2) formulating the objective of the learning; 3) selecting materials and its sequences; 4) selecting teaching methods; 5) determining the means or learning media; 6) selecting evaluation strategy as a part of teachers pedagogic competence. The result of this research describes a difference in the competence level of teachers who have joined guided training which is relatively higher than the teachers who joined the independent training. Guided training is one of an effective way to improve the knowledge and competence of early childhood educators.

Keywords: competence, planning, teachers, training

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Authors: Hafiz A. Sakandar, M. Afzaal, U. Khan, M. N. Akhtar

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Food is the primary concern of living organisms, provision of diet for maintenance of good physical and mental health is a basic right of an individual and the outcome of factors related to diet on health has been matter of apprehension since ancient times. Healthy and fresh food always demanded by the consumers. Modern research has find out many alternatives of traditional packaging. Now the consumer knows that good packaging system is that which protects the food from the contaminants and increases shelf life of food product. While in Pakistan about 40% of fruits and vegetables lost due to spoilage caused by poor handling, transportation, and poor packaging interaction with other environmental conditions. So it is crucial for developing countries like Pakistan to pay attention to these exacerbating situations for economy losses by considering food packaging an ultimate solution to the problem.

Keywords: packaging, food safety, antimicrobial, food losses

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Authors: Malaw Ndiaye, Karim Konate

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Blockchain and smart contracts can be used to facilitate almost any financial transaction. Thanks to these smart contracts, the settlement of dividends and coupons could be automated. The blockchain would allow all these transactions to be saved in a single ledger rather than in many databases through many organizations as is currently the case. Smart contracts have become lucrative and profitable targets for attackers because they can hold a large amount of money. This paper takes stock of cryptocurrency crime by assessing attacks due to smart contracts and the cost of losses. These losses are often the result of two types of malicious contracts: vulnerable contracts and criminal smart contracts. Studying the behavior of malicious contracts allows us to understand the root causes and consequences of attacks and the defense capabilities that exist although they do not definitively solve the crime problem. It makes it possible to approach new defense perspectives which will be concretized in future work.

Keywords: blockchain, malicious smart contracts, crypto-currency, crimes, attacks

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Authors: Luv Sharma

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Sex determination has been the most intriguing puzzle for forensic pathologists and anthropologists, for which efforts have been made for a long. Sexual dimorphism is well established in the adult pelvis, and it is known to provide the highest level of information about sexual dimorphism. This study was conducted to know whether this dimorphism exists in fetal bones or not. A total of 34 pairs of fetal pelvis bones (22 males and 12 Females), ages ranging from 4 months to full term, were collected from unidentified dead fetuses brought to the Department of Forensic Medicine for routine medicolegal autopsies to study for sexual dimorphism in the Department of Anatomy, Pt. BD Sharma PGIMS, Rohtak. Samples were divided into 2 age groups, and various metric parameters were recorded with the help of a digital vernier caliper. Data obtained was subjected to descriptive and discriminant functional analysis. Results of Descriptive and Discriminant Functional Analysis showed that sex determination can be done with 100% accuracy by using different combinations of parameters of fetal ilium. This study illustrates that sexual dimorphism exists from early fetal life after mid-pregnancy; it can be clearly established by discriminant functional analysis.

Keywords: Ilium, fetus, sex determination, morphometric

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Authors: Camila Parodi, Viviana Letelier, Giacomo Moriconi

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The cement industry is responsible for around a 5% of the CO2 emissions worldwide and considering that concrete is one of the most used materials in construction its total effect is important. An alternative to reduce the environmental impact of concrete production is to incorporate certain amount of residues in the dosing, limiting the replacement percentages to avoid significant losses in the mechanical properties of the final material. Previous researches demonstrate the feasibility of using brick and rust residues, separately, as a cement replacement. This study analyses the variation in the mechanical properties of mortars by incorporating masonry residue composed of clay bricks and cement mortar. In order to improve the mechanical properties of masonry residue, this was subjected to a heat treatment of 650 ° C for four hours and its effect is analyzed in this study. Masonry residue was obtained from a demolition of masonry perimetral walls. The residues were crushed and sieved and the maximum size of particles used was 75 microns. The percentages of cement replaced by masonry residue were 0%, 10%, 20% and 30%. The effect of masonry residue addition and its heat treatment in the mechanical properties of mortars is evaluated through compressive and flexural strength tests after 7, 14 and 28 curing days. Results show that increasing the amount of masonry residue used increases the losses in compressive strength and flexural strength. However, the use of up to a 20% of masonry residue, when a heat treatment is applied, allows obtaining mortars with similar compressive strength to the control mortar. Masonry residues mortars without a heat treatment show losses in compressive strengths between 15% and 27% with respect to masonry residues with heat treatment, which demonstrates the effectiveness of the heat treatment. From this analysis it can be conclude that it is possible to use up to 20% of masonry residue with heat treatment as cement replacement without significant losses in mortars mechanical properties, reducing considerably the environmental impact of the final material.

Keywords: cement replacement, environmental impact, masonry residue, mechanical properties of recycled mortars

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Authors: C. Morris, W. Ashall, K. Telling, L. Kadiwal, J. Kirby, S. Mwale

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This paper addresses experiences of liminality in the early career phase of academia. Liminality is understood as a process moving from one state (in this case of being non-academic) to another (of being academic), caught between or moving in and out these modes of being. Drawing on life-history methods, a group of academics jointly reflected on experiences of the early career. Primarily focused on the theme of imposter syndrome at this career stage, the authors identified feelings of non-belonging and lack of fit with the academy, tracing the biographical, political, and affective dimensions of such responses. Uncertainty around status within seemingly impermeable hierarchies and barriers to progression in combination with our intersectional positionings shaped by sexism, racism, ableism, and classism, led to experiences of liminality, having not yet fully achieved the desired and potentially illusionary status of established academic. Findings are contextualised within the authors’ contrasting disciplinary, departmental, and institutional settings against a backdrop of neoliberalised academia. The paper thereby contributes nuanced understandings of early-career academic identities at a time when this career stage is ever more ill-defined, extended, precarious and uncertain, exposing ongoing impacts of inequities in the contemporary academic milieu.

Keywords: early career, identities, intersectionality, liminality

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Authors: Ojochenemi J. Onubi, Debbi Marais, Lorna Aucott, Friday Okonofua, Amudha Poobalan

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Background: Obesity is a worldwide epidemic with major health and economic consequences. Pregnancy is a trigger point for the development of obesity, and maternal obesity is associated with significant adverse effects in the mother and child. Nigeria is experiencing a double burden of under- and over-nutrition with rising levels of obesity particularly in women. However, there is scarcity of data on maternal obesity in Nigeria and other African countries. Aims and Objectives: This project aimed at identifying crucial components of potential interventions for maternal obesity in Nigeria. The objectives were to assess the prevalence, effects, and distribution of maternal obesity; knowledge, attitude and practice (KAP) of pregnant women and maternal healthcare providers; and identify existing interventions for maternal obesity in Nigeria. Methodology: A systematic review and meta-analysis were initially conducted to appraise the existing literature on maternal obesity in Africa. Following this, a quantitative questionnaire survey of the KAP of pregnant women and a qualitative interview study of the KAP of Health Care Workers (HCW) were conducted in seven secondary and tertiary hospitals across Nigeria. Quantitative data was analysed using SPSS statistical software, while thematic analysis was conducted for qualitative data. Results: Twenty-nine studies included in the systematic review showed significant prevalence, socio-demographic associations, and adverse effects of maternal obesity on labour, maternal, and child outcomes in Africa. The questionnaire survey of 435 mothers revealed a maternal obesity prevalence of 17.9% among mothers who registered for antenatal care in the first trimester. The mothers received nutrition information from different sources and had insufficient knowledge of their own weight category or recommended Gestational Weight Gain (GWG), causes, complications, and safe ways to manage maternal obesity. However, majority of the mothers were of the opinion that excess GWG is avoided in pregnancy and some practiced weight management (diet and exercise) during pregnancy. For the qualitative study, four main themes were identified: ‘Concerns about obesity in pregnancy’, ‘Barriers to care for obese pregnant women’, ‘Practice of care for obese pregnant women’, and ‘Improving care for obese pregnant women’. HCW expressed concerns about rising levels of maternal obesity, lack of guidelines for the management of obese pregnant women and worries about unintended consequences of antenatal interventions. ‘Barriers’ included lack of contact with obese women before pregnancy, late registration for antenatal care, and perceived maternal barriers such as socio-cultural beliefs of mothers and poverty. ‘Practice’ included anticipatory care and screening for possible complications, general nutrition education during antenatal care and interdisciplinary care for mothers with complications. HCW offered suggestions on improving care for obese women including timing, type, and settings of interventions; and the need for involvement of other stake holders in caring for obese pregnant women. Conclusions: Culturally adaptable/sensitive interventions should be developed for the management of obese pregnant women in Africa. Education and training of mothers and health care workers, and provision of guidelines are some of the components of potential interventions in Nigeria.

Keywords: Africa, maternal, obesity, pregnancy

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Authors: Allison Herlene Du Plessis, Dalena (R.M.) Van Rooyen, Wilma Ten Ham-Baloyi, Sihaam Jardien-Baboo

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Introduction: Women die in pregnancy and childbirth for five main reasons—severe bleeding, infections, unsafe abortions, hypertensive disorders (pre-eclampsia and eclampsia), and medical complications including cardiac disease, diabetes, or HIV/AIDS complicated by pregnancy. In 2015, WHO classified sepsis as the third highest cause for maternal mortalities in the world. Chorioamnionitis is a clinical syndrome of intrauterine infection during any stage of the pregnancy and it refers to ascending bacteria from the vaginal canal up into the uterus, causing infection. While the incidence rates for chorioamnionitis are not well documented, complications related to chorioamnionitis are well documented and midwives still struggle to identify this condition in time due to its complex nature. Few diagnostic methods are available in public health services, due to escalated laboratory costs. Often the affordable biomarkers, such as C-reactive protein CRP, full blood count (FBC) and WBC, have low significance in diagnosing chorioamnionitis. A lack of screening impacts on effective and timeous management of chorioamnionitis, and early identification and management of risks could help to prevent neonatal complications and reduce the subsequent series of morbidities and healthcare costs of infants who are health foci of perinatal infections. Objective: This integrative literature review provides an overview of current best research evidence on the screening of women at risk for chorioamnionitis. Design: An integrative literature review was conducted using a systematic electronic literature search through EBSCOhost, Cochrane Online, Wiley Online, PubMed, Scopus and Google. Guidelines, research studies, and reports in English related to chorioamnionitis from 2008 up until 2020 were included in the study. Findings: After critical appraisal, 31 articles were included. More than one third (67%) of the literature included ranked on the three highest levels of evidence (Level I, II and III). Data extracted regarding screening for chorioamnionitis was synthesized into four themes, namely: screening by clinical signs and symptoms, screening by causative factors of chorioamnionitis, screening of obstetric history, and essential biomarkers to diagnose chorioamnionitis. Key conclusions: There are factors that can be used by midwives to identify women at risk for chorioamnionitis. However, there are a paucity of established sociological, epidemiological and behavioral factors to screen this population. Several biomarkers are available to diagnose chorioamnionitis. Increased Interleukin-6 in amniotic fluid is the better indicator and strongest predictor of histological chorioamnionitis, whereas the available rapid matrix-metalloproteinase-8 test requires further testing. Maternal white blood cells count (WBC) has shown poor selectivity and sensitivity, and C-reactive protein (CRP) thresholds varied among studies and are not ideal for conclusive diagnosis of subclinical chorioamnionitis. Implications for practice: Screening of women at risk for chorioamnionitis by health care providers providing care for pregnant women, including midwives, is important for diagnosis and management before complications arise, particularly in resource-constraint settings.

Keywords: chorioamnionitis, guidelines, best evidence, screening, diagnosis, pregnant women

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Authors: Muluwerk Ayele Derebe

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Background: Antenatal care (ANC) is an essential element in the continuum of reproductive health care for preventing preventable pregnancy-related morbidity and mortality. Objective: The aim of this study is to assess the spatial pattern and predictors of ANC visits in Ethiopia. Method: This study was done using Ethiopian Demographic and Health Survey data of 2016 among 7,174 pregnant women aged 15-49 years which was a nationwide community-based cross-sectional survey. Spatial analysis was done using Getis-Ord Gi* statistics to identify hot and cold spot areas of ANC visits. Multilevel glmmTMB packages adjusted for spatial effects were used in R software. Spatial multilevel count regression was conducted to identify predictors of antenatal care visits for pregnant women, and proportional change in variance was done to uncover the effect of individual and community-level factors of ANC visits. Results: The distribution of ANC visits was spatially clustered Moran’s I = 0.271, p<.0.001, ICC = 0.497, p<0.001). The highest spatial outlier areas of ANC visit was found in Amhara (South Wollo, Weast Gojjam, North Shewa), Oromo (west Arsi and East Harariga), Tigray (Central Tigray) and Benishangul-Gumuz (Asosa and Metekel) regions. The data was found with excess zeros (34.6%) and over-dispersed. The expected ANC visit of pregnant women with pregnancy complications was higher at 0.7868 [ARR= 2.1964, 95% CI: 1.8605, 2.5928, p-value <0.0001] compared to pregnant women who had no pregnancy complications. The expected ANC visit of a pregnant woman who lived in a rural area was 1.2254 times higher [ARR=3.4057, 95% CI: 2.1462, 5.4041, p-value <0.0001] as compared to a pregnant woman who lived in an urban. The study found dissimilar clusters with a low number of zero counts for a mean number of ANC visits surrounded by clusters with a higher number of counts of an average number of ANC visits when other variables held constant. Conclusion: This study found that the number of ANC visits in Ethiopia had a spatial pattern associated with socioeconomic, demographic, and geographic risk factors. Spatial clustering of ANC visits exists in all regions of Ethiopia. The predictor age of the mother, religion, mother’s education, husband’s education, mother's occupation, husband's occupation, signs of pregnancy complication, wealth index and marital status had a strong association with the number of ANC visits by each individual. At the community level, place of residence, region, age of the mother, sex of the household head, signs of pregnancy complications and distance to health facility factors had a strong association with the number of ANC visits.

Keywords: Ethiopia, ANC, spatial, multilevel, zero inflated Poisson

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Authors: Demmiele Matu Kiiza, Constantine Steven Labongo Loum, Julaina Obika Asinasi

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Background: The use of traditional medicine in Uganda forms the preliminary therapeutic approaches among many people. Traditional medicines have been used in Uganda for many years, not only for the management of pregnancy-related complications but also for the management of other physical and psychological illnesses. Traditional medicines are always considered the first line of treatment by a considerable number of people. This study, therefore, sought to explore the lived experiences of pregnant women by assessing their perceptions of the transitional use of traditional medicine. Methods: Ethnography was used to capture data from an emic perspective. The ethnographic approach involved visiting a few selected pregnant women to observe and participate in the identification of traditional medicines. The ethnographic fieldwork was carried out within a period of three months. In-depth interviews were carried out and audio recorded and later transcribed verbatim. Data was thereafter analyzed thematically. The thematic analysis involved identifying statements made by research participants by transcribing audio and reading through field notes, coding was done, and themes were generated according to commonly mentioned experiences of using traditional medicine. Results: The findings revealed that women performed a ritual of ‘cutting the cord’ by making a small horizontal incision on the belly across the linea Nigra (also known as a pregnancy line) at around six months of pregnancy to avoid producing a baby with an umbilical cord tied around the baby’s neck. They also used crushed egg shells, crushed snail shells and herbs such as pawpaw roots, Entarahompo (crassocephalum vitelline), Ekyoganyanja (Erlangea tomentose), to manage Omushohokye (a term used by the study participants to refer to a situation where women pass out too much water when giving birth, producing a child with mold and oozing out of a milky liquid through the breasts before giving births); prepare for safe delivery and also to manage pregnancy-related complications. The study recommends the implementation of a traditional medicine use policy using a bottom-up approach. Designing and implementing of culturally sensitive maternal healthcare intervention programs and involving village health teams and the elderly in health education.

Keywords: traditional medicine, pregnant women, uganda, perceptions

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Authors: Muhammad Adamu Kwankwaso

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Early childhood is a critical period of rapid physical, cognitive and psycho-social development of a child. The quality of care and Education which a child receives at this crucial age will determine to a great extent the level of his/her physical and cognitive development in the future. In Nigeria, Early Childhood Care and Education (ECCE) is a fundamental aspect or form of Education for children between the age of 3-6. It was started after independence as pre-primary Education or early child development as contained in the 1977 National Policy on Education. The trends towards ECCE in Nigeria and the northwestern part of the country in particular keep up changing as in the case of other part of the world. The current trends are now towards expansions, inclusiveness, redefinition, early literacy, increased government participation and the unprecedented societal response and awareness towards the Education of the younger children. While all hands are on deck to ensure successful implementation of the ECCE programme, it is unfortunate that, ECCE is facing some challenges. This paper therefore, examines the trends in Early Childhood Care and Education and the major challenges in the north west of Nigeria. Some of the major challenges include, inadequate trained ECCE teachers, lack of unified curriculum, teacher pupil’s ratio, and the medium of instructions and inadequate infrastructural and teaching facilities respectively. To improve the situation the paper offered the following recommendations; establishment of more ECCE classes, enforcement for the use of mothers’ tongue or the languages of the immediate community as a medium of instructions, and adequate provision of infrastructural facilities and the unified curriculum across the northwestern States of Nigeria.

Keywords: early childhood care, education, trends, challenges

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Authors: Cynthia Zgheib, Yonna Sacre

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Pregnancy, this particular moment in the life of a woman, requires monitoring of eating behavior changes. However, the food choices during pregnancy should be varied and healthy, including the consumption of different food groups. Nutritional status is the process of acquisition and consumption of food. Therefore, a varied diet is associated with good nutritional status. This is why the nutrition education is a strategy commonly applied to improve maternal nutrition during pregnancy. Thus, it is crucial to assess 'The eating behavior and nutritional status of pregnant women living in Keserwan Lebanon.' In order to evaluate the association of different persona, socioeconomic and sociodemographic factors with the eating behavior and nutrition in the concerned study category, a cross-sectional descriptive study was conducted on a sample of 150 pregnant women aging between 18 and 40 years randomly selected from the hospitals and clinics located in Keserwan area and equally distributed between different cities and villages of the area according to altitude. The purpose of this study was to evaluate the eating behavior of the concerned population and to compare it to the recommendation of the food guide pyramid, their level of food awareness and finally to analyze their blood tests in order to detect any nutrients deficiency that they may face during the course of their pregnancy. Sociodemographic, lifestyle, eating behaviour, health, eating patterns, awareness, and food frequency questionnaire (FFQ) were collected through a validated questionnaire specifically adapted for the purpose of the study. Statistical analysis was carried out, and multivariate models were used in order to evaluate the association between several independent variables and the eating behaviour and nutritional status of Lebanese pregnant women The final analysis has shown that 48.7% of pregnant women were aged between 30 and 40 years old, 56% had a normal BMI between 18.5 and 24.9, thus age affects the eating behavior, so the older are the pregnant women, and the healthier is their eating behavior. In fact, 80.7% had acceptable food behavior which is based on an equilibrium between both quantity and quality of food, although the recommended foods are foods found in the food pyramid and available in the Lebanese diet. In addition, 68% had an acceptable level of awareness concerning the health importance of good eating habits, therefore, it is positively affecting their food choices. Moreover, 50 % have an acceptable nutritional status which is confirmed by their biological tests. Future governmental or national studies and programs could be settled aiming to increase the awareness about the good eating behaviors and nutritional status of Lebanese pregnant women.

Keywords: eating behavior, nutritional status, level of awareness, pregnant woman

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Authors: Anushree S. Panikkassery

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The paper analyses the pattern and trend of maternal health care in south Indian states. It studies the interstate disparities in terms of maternal health care. It also compares the trends in terms of achieving the target of sustainable development Goal is related to maternal health. The maternal health care (MHC) development is one of the key indicators for the development of health sector in the country and assumes significance from the socioeconomic and developmental perspectives. Maternal health care mainly consists of composite care during pregnancy, child birth as well as postpartum period. Antenatal care, identification, referral and management of high risk pregnancies, safe and healthy child birth and early postnatal care are some of the important issues pertaining to maternal health. Data is collected from national family health survey 1992-93, 1998-99, 2005-06, and 2015-16. A concentration index is used to study the disparities in equity of maternal health among south Indian states. The study shows that there has been an improvement in maternal health care in south Indian states with Kerala topping among the states. But there exist disparities among the south Indian states.

Keywords: antenatal care, disparities, equity, maternal health

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Authors: M. Pramila Devi, N. V. N. Indra Kiran

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Control charts, predominantly in the form of X-bar chart, are important tools in statistical process control (SPC). They are useful in determining whether a process is behaving as intended or there are some unnatural causes of variation. A process is out of control if a point falls outside the control limits or a series of point’s exhibit an unnatural pattern. In this paper, a study is carried out on four training algorithms for CCPs recognition. For those algorithms optimal structure is identified and then they are studied for type I and type II errors for generalization without early stopping and with early stopping and the best one is proposed.

Keywords: control chart pattern recognition, neural network, backpropagation, generalization, early stopping

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Authors: C. F. Ocoleanu, G. Cividjian, Gh. Manolea

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In this paper, we present two solutions for connections quality pre-control of Crimp Contacts and to identify in the first moments the connections improperly executed, before final assembly of a electrical machines. The first solution supposed experimental determination of specific losses by calculated the initial rate of temperature rise. This can be made drawing the tangent at the origin at heating curve. The method can be used to identify bad connections by passing a current through the winding at ambient temperature and simultaneously record connections temperatures in the first few minutes since the current is setting. The second proposed solution is to apply to each element crimping a thermal indicator one level, and making a test heating with a heating current corresponding to critical temperature indicator.

Keywords: temperature, crimp contact, thermal indicator, current distribution, specific losses

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Authors: Sudha Summarwar, Sudesh Agarwal, Deepali Lall, Nalini Kataria, Jyotsana Pandey

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Assessment of antioxidant status is an effective tool to appraise the presence of oxidative stress. A combination of assays can be used to evaluate the antioxidant status like serum catalase (CAT), superoxide dismutase (SOD) and monoamine oxidase (MAO). In human medicine pregnancy is known to be associated with oxidative stress. Oxidative stress produces harmful effects to the developing foetus. Several metabolic changes occur in the maternal body to meet the demand of energy of developing foetus. Due to these changes susceptibility of maternal body increases to oxidative stress. There is paucity of research work on this aspect in nondescript goats. Therefore, the present study was intended to appraise the oxidative stress in pregnant and non-pregnant non-descript goat. Blood samples were collected for serum separation in otherwise healthy pregnant and non-pregnant nondescript goats. Mean values of serum CAT, SOD and MAO were found on a higher side (p≤0.05) with serum SOD values showing a rise of 2.5 times higher than the control healthy value. Correlations among all the three parameters were found to be highly significant (p≤0.01) especially greatest in youngest group of pregnant animals. Illustration of result enlightened the veracity of bumped up production of free radicals in pregnant animals. Technical savoir-faire of oxidative stress supervision is essential for upholding of health status of foetus. The upshot of present study undoubtedly implied the development of oxidative stress in pregnant goats on the basis of altered antioxidant status. These findings conclude that initially the oxidative stress due to pregnancy is critically combated by the intricate defensive mechanism of natural antioxidant system of the body. It appears that this imbalance between oxidant and antioxidant must be checked in time to prevent cellular damage by regularly appraising the antioxidant status through laboratory methods.

Keywords: antioxidant, oxidative stress, pregnancy, serum catalase

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Authors: Kamel Abdelaziz Mohamed

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Intoduction:Inadequate knowledge about obstetric admission and infrequent dealing with the obstetric patients in ICU results in high mortality and morbidity. Aim of the work:To evaluate the indications, course, severity of illness, and outcome of obstetric patients admitted to the intensive care unit (ICU). Patients and Methods: We collected baseline data and acute physiology and chronic health evaluation II (APACHE II) scores. ICU mortality was the primary outcome. Results: Seventy obstetric patients were admitted to the ICU over 3 years, 36 of these patients (51.4 %) were admitted during the antepartum period. The primary obstetric indication for ICU admission was pregnancy-induced hypertension (22 patients, 31.4%), followed by sepsis (8 patients, 11.4%) as the leading non-obstetric admission. The mean APACHE II score was 19.6. The predicted mortality rate based on the APACHE II score was 22%, however, only 4 maternal deaths (5.7%) were among the obstetric patients admitted to the ICU. Conclusion: Evaluation of obstetric patients by (APACHE II) scores showed higher predicted mortality rate, however the overall mortality was lower. Regular follow up, together with early detection of complications and prompt ICU admission necessitating proper management by specialized team can improve mortality.

Keywords: obstetric, complication, postpartum, sepsis

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Authors: Fayez Hanna, Viet Tran

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A 20 years old lady- primigravida 6 weeks pregnant with unremarkable past history, presented to the emergency department at the Royal Hobart Hospital, Tasmania, Australia, with hyperemesis gravidarum associated with, dehydration and complicated with hematemesis and chest pain resistant. Accordingly, we conducted laboratory investigations which revealed: FBC: WBC 23.9, unremarkable U&E, LFT, lipase and her VBG showed a pH 7.4, pCo2 36.7, cK+ 3.2, cNa+ 142. The decision was made to do a chest X-ray (CXR) after explaining the risks/benefit of performing radiographic investigations during pregnancy and considering the patient's plan for the termination of the pregnancy as she was not ready for motherhood for shared decision-making and consent to look for pneumoperitoneum to suggest perforated viscus that might cause the hematemesis. However, the CXR showed pneumomediastinum but no evidence of pneumoperitoneum or pneumothorax. Consequently, a decision was made to proceed with CT oesophagography with imaging pre and post oral contrast administration to identify a potential oesophageal tear since it could not be excluded using a plain film of the CXR. The CT oesophagography could not find a leak for the administered oral contrast and thus, no oesophageal tear could be confirmed but could not exclude the Mallory-Weiss tear (lower oesophageal tear). Further, the CT oesophagography showed an extensive pneumomediastinum that could not be confirmed to be pulmonary in origin noting the presence of bilateral pulmonary interstitial emphysema and pneumothorax in the apex of the right lung that was small. The patient was admitted to the Emergency Department Inpatient Unit for monitoring, supportive therapy, and symptomatic management. Her hyperemesis was well controlled with ondansetron 8mg IV, metoclopramide 10mg IV, doxylamine 25mg PO, pyridoxine 25mg PO, esomeprazole 40mg IV and oxycodone 5mg PO was given for pain control and 2 litter of IV fluid. The patient was stabilized after 24 hours and discharged home on ondansetron 8mg every 8 hours whereas the patient had a plan for medical termination of pregnancy. Three weeks later, the patient represented with nausea and vomiting complicated by a frank hematemesis. Her observation chart showed HR 117- other vital signs were normal. Pathology showed WBC 14.3 with normal U&E and Hb. The patient was managed in the Emergency Department with the same previous regimen and was discharged home on same previous regimes. Five days later, she presented again with nausea, vomiting and hematemesis and was admitted under obstetrics and gynaecology for stabilization then discharged home with a plan for surgical termination of pregnancy after 3-days rather than the previously planned medical termination of pregnancy to avoid extension of potential oesophageal tear. The surgical termination and follow up period were uneventful. The case is considered rare as pneumomediastinum is a very rare complication of hyperemesis gravidarum where vomiting-induced barotrauma leads to a ruptured oesophagus and air leak into the mediastinum. However no rupture oesophagus in our case. Although the combination of pneumothorax and pneumomediastinum without oesophageal tear was reported only 8 times in the literature, but none of them was due to hyperemesis gravidarum.

Keywords: Pneumothorax, pneumomediastinum, hyperemesis gravidarum, pneumopericardium

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Authors: Madeleine Elder, Aye Htun

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Background: Myiasis is the parasitic infestation of body tissues by fly larvae. It predominantly occurs in poor socioeconomic regions of tropical and subtropical countries where it is associated with poor hygiene and sanitation. Cutaneous and wound myiasis are the most common presentations whereas urogenital myiasis is rare, with few reported cases. Case: a 26-year-old primiparous woman with a low-risk pregnancy presented to the emergency department at 37+3-weeks’ gestation after passing a 2cm black larva during micturition, with 2 weeks of mild vulvar pruritus and dysuria. She had travelled to India 9-months prior. Examination of the external genitalia showed small white larvae over the vulva and anus and a mildly inflamed introitus. Speculum examination showed infiltration into the vagina and heavy white discharge. High vaginal swab reported Candida albicans. Urine microscopy reported bacteriuria with Enterobacter cloacae. Urine parasite examination showed myiasis caused by Clogmia albipunctata species of fly larvae from the family Psychodidae. Renal tract ultrasound and inflammatory markers were normal. Infectious diseases, urology and paediatric teams were consulted. The woman received treatment for her urinary tract infection (which was likely precipitated by bladder irritation from local parasite infestation) and vaginal candidiasis. She underwent daily physical removal of parasites with cleaning, speculum examination and removal, and hydration to promote bladder emptying. Due to the risk of neonatal exposure, aspiration pneumonitis and facial infestation, the woman was steroid covered and proceeded to have an elective caesarean section at 38+3-weeks’ gestation, with delivery of a healthy infant. She then proceeded to have a rigid cystoscopy and washout, which was unremarkable. Placenta histopathology revealed focal eosinophilia in keeping with the history of maternal parasites. Conclusion: Urogenital myiasis is very rare, especially in the developed world where it is seen in returned travellers. Treatment may include systemic therapy with ivermectin and physical removal of parasites. During pregnancy, physical removal is considered the safest treatment option, and discussion around the timing and mode of delivery should consider the risk of harm to the foetus.

Keywords: urogenital myiasis, parasitic infection, infection in pregnancy, returned traveller

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