Determination of concentrations of indoor air pollutants emitted from briquette combustion / Монголын Анагаах Ухаан

Introduction@#This field assessment was performed to ensure the effective implementation of Order No. A/142 of the Deputy Prime Minister of Mongolia dated 30^th December 2021 and Order No. A/01 of the Head of the National Committee for Reducing Environmental Pollution dated 3^rd January 2022 and to monitor the level of indoor air pollutants emitted from traditional stoves and standard stoves. @*Purpose@#To determine the level of indoor air pollutants emitted from briquette combustion and to develop recommendations by comparing various types of stoves and dwellings. @*Materials and Methods@#Through analytical cross-sectional designs, three households from Songinokhairkhan district and one household from Chingeltei district were selected to participate in this assessment as they use briquettes for heating, vary in their dwelling types (ger (traditional Mongolian tent), house) and their stove types (traditional, standard), stay home during the day and chose to participate in the assessment. 24-hour continuous measurements were conducted for each dwelling and before taking measurements, we calibrated and adjusted the air suction velocity of the measuring instrument at the Central Metrology Laboratory. The monitor was placed at a distance of 0.5m from the stove and a height of 0.5-1.0m from the floor. The results were then compared with the Mongolian National Standard “General air quality and technical requirements MNS4585:2016” and WHO Guidelines for Indoor Air Quality 2021. Statistical analysis was performed using SPSS 24.0 software, mean, ANOVA test, and if the p-value is less than 0.05, our results are statistically significant.@*Results@#The concentration level of SO₂ in houses with “Dul” stoves was within the level specified in the Mongolian standard MNS4585: 2016 and WHO Guidelines for Indoor Air Quality 2021, while 24-hour SO₂ concentration in gers and houses with traditional stoves was 1.3-2.92 times higher than the standards. The 24-hour average concentration of nitrogen dioxide in houses with traditional stoves was 1.73 times higher than the Mongolian air quality standard MNS4585: 2016. There were statistically significant differences in the emission levels of SO₂ and NO₂ depending on dwelling and stove types (df=4, f=4.04, p=0.008 and df=4, f=17.17, p=0.001, respectively.). The 8-hour average (10,000 μg/m3) CO concentration was statistically significant for various types of dwellings and stoves (df=4, f=45.17, p=0.001), whereas there was a statistically significant difference in CO concentrations in gers with traditional stoves and gers with standard stoves in terms of morning, afternoon, and evening hours (df=3, f=33.17, p=0.001). @*Conclusion@#Indoor air pollutants in the households except for houses with “Dul” stoves have been determined to exceed the air quality standards set by the Mongolian air quality standards and WHO Guidelines for Indoor Air Quality 2021.

Vitamin D deficiency and adverse fetal outcome

Background: Vitamin D deficiency is recognized as the most untreated nutritional deficiency in the world. It is plausible that vitamin D deficiency could make the fetal heart more vulnerable to distress/birth asphyxia. Vitamin D deficiency has been hypothesized to be associated with low birth weight, low Apgar score at birth, higher rates of still births and admission to NICU. The aim of present study was to study prevalence of vitamin D deficiency in pregnancy and evaluate perinatal outcome.Methods: The study was conducted in the department of obstetrics and gynecology, Kamla Nehru Hospital, Shimla, India over a period of 12 months. Six hundred women were included in the study.Results: All the mothers who had still births suffered from vitamin D deficiency and the severe vitamin D deficiency was there in 90.91% (30) of these subjects. Severe vitamin D deficiency was seen in 78.95% (75) of the subjects having babies with birth weights <2.5 kg compared to 61.16% (288) subjects of the other group.Conclusions: Adverse fetal outcome are more common in vitamin D deficient group.

Vitamin D deficiency and maternal complications

Background: Vitamin D deficiency is prevalent in India, a finding that is unexpected in a tropical country with abundant sunshine. Vitamin D deficiency is recognized as the most untreated nutritional deficiency currently in the world. Several studies reported the relationship between maternal vitamin D deficiency and adverse maternal and fetal outcomes including gestational diabetes, preeclampsia, preterm labour, low birth weight and increased rate of caesarean section.Methods: The study was conducted in the department of obstetrics and gynecology, Kamla Nehru Hospital, Shimla, Himachal Pradesh, India over a period of 12 months. Six hundred women were included in the study.Results: Forty-eight (8%) subjects developed preeclampsia-eclampsia syndrome, of which none had sufficient vitamin D levels, whereas 48 (100%) subjects had vitamin D deficiency.Conclusions: Maternal antenatal complications are more common in vitamin D deficient group.

Effect of single low dose intrathecal labor analgesia on maternal and fetal outcome

Background: Labour is one of the most painful experiences women encounter during their lifetime and the experience is different for each women. Aim of the study was to evaluate the effect of low dose intrathecal labour analgesia using fentanyl, bupivacaine and morphine on maternal and fetal outcome.Methods: 100 parturients with uncomplicated pregnancy in spontaneous or induced labor at cervical dilatation 4-6cm were enrolled for the study. They were randomized into two groups of 50 each, using computer based block randomization. Group 1 (N=50) received intrathecal labor analgesia using. Fentanyl (25µg), bupivacaine (2.5mg) and morphine (250µg) and Group 2 (N=50) received programmed labor. The two groups were well matched in terms of age, weight, height, parity, baseline vitals and mean cervical dilatation at the time of administration of labor analgesia . Progress of labor, duration of analgesia, and neonatal APGAR score were recorded. Feto-maternal and neonatal outcomes were studied and compared between the two groups.Results: The mean duration of analgesia in group1 was 238.96±21.888 min whereas the mean duration of analgesia in group 2 was 98.4±23.505 min. The difference was significant P value 0.00. One out of 50 (2%) of the parturients required rescue analgesia in Group 1. On the contrary all 44 parturients in Group 2 required rescue analgesia. Difference was significant (p value=0.00) However duration of the stages of labor, operative and instrumental deliveries and APGAR score did not differ in the two groups.Conclusions: Single shot intrathecal labor analgesia is a safe, effective, reliable, cheap and satisfactory method of pain relief for labor and delivery. Moreover, it is devoid of major side effects.