Traditional Galactogogues and the Practices Related to Their Use by Post-Natal Women of India

@#Introduction: Traditional galactogogue recipes are still being used, though not widely, and scientific studies on their use are scanty. This research aimed to study commonly used traditional galactogogue-recipes using primary sources, to bring about nutritional enhancement in most popular recipes and compare the standard and nutrified galactogogue-recipes for nutrients, phytochemicals and sensory qualities. Methods: A cross-sectional survey was carried out among 120 mothers (older than 20 years) residing in Indian states of Rajasthan and Uttar-Pradesh in their 0-1 year of lactation period who consented to be a part of the study. Background-information and use of galactogogues was collected with the help of self-designed, pre-tested questionnaires. Nutritive-value (moisture, ash, protein, fat, dietary-fibre, carbohydrate, iron, and calcium) of two of the most popular galactogogues ajwain-laddu and harira were calculated to find out the nutrient(s) lacking in it. Ajwain-laddu was nutrified using whole milk-powder, drumstick leaves powder and additional amount of clarified-butter. Harira was nutrified using poppy-seeds, niger-seeds and carrots. Results: The commonly used galactogogues were ajwain-laddu, harira, Gond-laddu, and Sonth-laddu. There was a significant difference between nutrient content of standard and nutrified-recipes (p<0.05) whereas no statistical difference was observed for hedonic rating-scores (p>0.05). Conclusion: Mothers were consuming traditional galactogogues foods in order to increase milk production and strongly believed that regular consumption of galactogogues has enhanced their milk production. To optimize the nutritional value of galactogogues, it is advisable to integrate ingredients abundant in phytochemicals and micronutrients. This can be accomplished while preserving the authentic taste and presentation of these galactogogue-recipes.

Atención integrada madre-niño. efectos sobre adherencia y conocimientos de métodos anticonceptivos / Integrated mother-child care. Effects on adherence and knowledge of contraceptive methods

Resumen Introducción : La evidencia científica sugiere que es trategias de atención conjunta madre-hijo facilitarían el conocimiento de métodos anticonceptivos (MAC) y su acceso. El objetivo fue evaluar el efecto del Modelo de atención integrada de la madre y el niño sobre la adherencia y conocimientos de MAC en mujeres durante el primer semestre postparto. Métodos : Se realizó un estudio de intervención, se conformaron 2 grupos, GI: grupo de intervención (3 con troles hasta los 6 meses postparto) y GC: grupo control (un control a los 6 meses postparto). La intervención consistió en asesoramiento presencial acerca de MAC combinada con folletería informativa y mensajes de WhatsApp®. Se recabaron datos sociodemográficos, an tecedentes gineco-obstétricos, uso y conocimientos de MAC. Se comparó la adherencia al uso y el conocimiento de MAC en ambos grupos a los 6 meses post parto. El análisis se realizó mediante el software R versión 4.0.3. Resultados : Se incorporaron 39 mujeres en cada grupo. Se halló una diferencia en el uso de MAC entre grupos a los 6 meses (92.3% vs. 64.1%), siendo más eleva do su uso en el GI. Se hallaron diferencias significativas en el conocimiento de algunos MAC a los 6 meses. Un mayor porcentaje de mujeres del GI conocía las pastillas anticonceptivas (p = 0.009), ligadura de trompas (p = 0.04) y la vasectomía (p = 0.010), en comparación con el GC. Discusión : La intervención en el postparto temprano con diversas estrategias de comunicación e información pueden ser útiles para elegir el MAC que se considere más adecuado para cada mujer y su utilización correcta.

Abstract Introduction : Scientific evidence suggests that moth er-child joint care strategies would facilitate knowledge of contraceptive methods (MAC) and their access. The objective was to evaluate the effect of the Integrated Mother and Child Care Model on adherence and knowl edge of CAM in women during the first postpartum semester. Methods : An intervention study was carried out, 2 groups were formed, GI: intervention group (3 controls up to 6 months postpartum) and GC: control group (one control at 6 months postpartum). The intervention con sisted of face-to-face counseling about MAC combined with informative brochures and WhatsApp® messages. Sociodemographic data, gynecological and obstetric history, use and knowledge of contraceptive methods were collected. Adherence to the use and knowledge of MAC were compared in both groups at 6 months post partum. The analysis was performed using R software version 4.0.3. Results : Thirty-nine women were incorporated into each group. A difference was found in the use of MAC between groups at 6 months (92.3% vs. 64.1%), its use being higher in GI. Significant differences were found in the knowledge of some MAC at 6 months. A higher percentage of women in GI knew about birth control pills (p = 0.009), tubal ligation (p = 0.04) and vasectomy (p = 0.010), compared to GC. Discussion : Early postpartum intervention with vari ous communication and information strategies can be useful to choose the MAC that is considered most ap propriate for each woman and its correct use.

Diagnóstico prenatal de malformaciones del tracto urinario: evaluación posnatal y resultado clínico / Prenatal diagnosis of urinary tract malformations: postnatal evaluation and clinical outcome

Resumen Antecedentes: Las malformaciones del tracto urinario representan el 15-20% de las anomalías por ecografía prenatal; la prevalencia oscila entre 3 y 6 por cada 1,000 nacimientos. Objetivo: Conocer el desenlace clínico de los recién nacidos diagnosticados prenatalmente con malformación del tracto urinario. Material y métodos: Observacional, analítico, ambispectivo. Recién nacidos con diagnóstico prenatal de malformación urinaria. Evaluación posnatal con pruebas diagnósticas, analizamos días de estancia hospitalaria, intervención quirúrgica y seguimiento. Resultados: 45 pacientes, 55% varones, 65% de término, 77% cesárea. El diagnóstico prenatal más frecuente fue hidronefrosis, 100% se realizó ultrasonido renal posnatal, 27% cistograma miccional, 42% gammagrama renal; 60% requirió estancia hospitalaria prolongada, 27% intervención quirúrgica, 60% seguimiento. 89% de los casos diagnosticados prenatalmente se corroboró algún tipo de malformación del tracto urinario, solo en el 75% de los casos fue el mismo diagnóstico. Conclusión: La evaluación posnatal siempre requiere la realización de un ultrasonido renal y no en todos los casos realización de cistograma miccional o gammagrama renal.

Abstract Background: Urinary tract malformations represent 15-20% of abnormalities in prenatal ultrasound; the prevalence oscillates between 3-6 per 1000 births. Objective: To know the clinical outcome of newborns diagnosed prenatally with some malformation of the urinary tract. Material and methods: Observational, analytical, ambispective. Newborns with prenatal diagnosis of malformation urinary. Postnatal evaluation diagnostic tests performed, we analyzed the days of hospital stay, surgical intervention, follow-up. Results: 45 children, 55% male, 65% term, 77% c-section. Prenatal diagnosis with higher frequency was hydronephrosis. In all cases postnatal renal ultrasound was performed, 27% voiding cystogram, 42% renal gammagram. A 60% of the cases required prolonged hospital stay, 27% required a surgical intervention, 60% were follow-up. 89% of the cases diagnosed prenatally corroborated some type of malformation of the urinary tract, only in 75% of the cases was the same diagnosis. Conclusion: Postnatal evaluation always requires the performance of a renal ultrasound and not in all cases the performance of voiding cystogram or renal gammagram.

Pesticide exposure and its effects on intrauterine and postnatal development / Exposición a plaguicidas y sus efectos en el desarrollo intrauterino y posnatal

Abstract Background: The period between conception and the first two postnatal years is critical and marks the individual, largely determining their health and disease patterns. Objective: To review the effect of pesticide exposure in utero and in the 1st years of life. Materials and methods: The scientific literature in relation to the subject was reviewed, both in animal models and in humans. Results: The presence of various types of pesticides in umbilical cord blood and in meconium is well documented in newborns worldwide, including Mexico. Pesticides have been associated with low birth weight, and various birth defects at the heart, gastrointestinal tract, genitourinary system, musculoskeletal system, and neurodevelopmental disorders. These substances may play a role in the increase in cases of autistic disorder. Conclusions: Despite the evidence, there are no public policies in many countries, including Mexico, to control the sale and use of pesticides. It is required to prevent exposure to these substances in the population and to do follow-up studies in mother-child pairs where exposure is suspected.

Resumen Introducción: El periodo comprendido entre la concepción y los primeros dos años posnatales es crítico y marca al individuo, determinando en buena parte sus patrones de salud y enfermedad. Objetivo: Hacer una revisión sobre el efecto de la exposición a plaguicidas en útero y en los primeros años de vida. Material y métodos: Se revisó la literatura científica en relación con el tema, tanto en modelos animales como en humanos. Resultados: La presencia de diversos tipos de plaguicidas en la sangre de cordón umbilical y en meconio está bien documentada en recién nacidos en todo el mundo, incluyendo México. Los plaguicidas se han asociado con bajo peso al nacer y diversos defectos congénitos a nivel cardiaco, del tracto gastrointestinal, sistema genitourinario y sistema musculoesquelético, así como a trastornos en el desarrollo neurológico. Estas sustancias pueden tener participación en el incremento de casos de trastorno autista. Conclusiones: A pesar de las evidencias, no existen en muchos países, incluyendo México, políticas públicas para controlar la venta y uso de plaguicidas. Se requiere prevenir la exposición a estas substancias en la población y hacer estudios de seguimiento en binomios madre-hijo donde se sospeche exposición.

Distribution of calcitonin gene-related peptide and vascular endothelial growth factor in the mouse lung at the embryonic and postnatal stages / Distribución del péptido relacionado con el gen de la calcitonina y el factor de crecimiento endotelial vascular en el pulmón de ratón en las etapas embrionaria y posnatal

SUMMARY: Neuropeptide calcitonin gene-related peptide (CGRP) is a neurotransmitter related to vasculogenesis during organ development. The vascular endothelial growth factor A (VEGF-A) is also required for vascular patterning during lung morphogenesis. CGRP is primarily found in organs and initially appears in pulmonary neuroendocrine cells during the early embryonic stage of lung development. However, the relationship between CGRP and VEGF-A during lung formation remains unclear. This study investigates CGRP and VEGF-A mRNA expressions in the embryonic, pseudoglandular, canalicular, saccular, and alveolar stages of lung development from embryonic day 12.5 (E12.5) to postnatal day 5 (P5) through quantitative real-time polymerase chain reaction (qRT-PCR) and in situ hybridization. Further, we analyzed the expression of CGRP via immunohistochemistry. The VEGF-A mRNA was mainly scattered across the whole lung body from E12.5. CGRP was found to be expressed in a few epithelial cells of the canalicular and the respiratory bronchiole of the lung from E12.5 to P5. An antisense probe for CGRP mRNA was strongly detected in the lung from E14.5 to E17.5. Endogenous CGRP may regulate the development of the embryonic alveoli from E14.5 to E17.5 in a temporal manner.

El péptido relacionado con el gen de la calcitonina (CGRP) es un neurotransmisor vinculado con la vasculogénesis durante el desarrollo de órganos. El factor de crecimiento endotelial vascular A (VEGF-A) también se requiere para el patrón vascular durante la morfogénesis pulmonar. El CGRP se encuentra principalmente en los órganos y aparece inicialmente en las células neuroendocrinas pulmonares durante la etapa embrionaria temprana del desarrollo pulmonar. Sin embargo, la relación entre CGRP y VEGF-A durante la formación de los pulmones sigue sin estar clara. Este estudio investiga las expresiones de ARNm de CGRP y VEGF-A en las etapas embrionaria, pseudoglandular, canalicular, sacular y alveolar del desarrollo pulmonar desde el día embrionario 12,5 (E12,5) hasta el día postnatal 5 (P5) a través de la reacción en cadena de la polimerasa cuantitativa en tiempo real. (qRT-PCR) e hibridación in situ. Además, analizamos la expresión de CGRP mediante inmunohistoquímica. El ARNm de VEGF-A se dispersó principalmente por todo parénquima pulmonar desde E12,5. Se encontró que CGRP se expresaba en unas pocas células epiteliales de los bronquiolos canaliculares y respiratorios del pulmón desde E12,5 a P5. Se detectó fuertemente una sonda antisentido para ARNm de CGRP en el pulmón de E14,5 a E17,5. El CGRP endógeno puede regular el desarrollo de los alvéolos embrionarios de E14,5 a E17,5 de manera temporal.

Breastfeeding Education: A Scoping Review

@#The aim of this scoping review was to explore the evidence related to breastfeeding education in postpartum mothers from relevant databases (PubMed, Science Direct, and Wiley). There were nine eligible studies in which all of them used quantitative design. The data was organized into seven themes including targets, materials, methods, media, officers and places, time, and the effect or influence of breastfeeding education. Almost all (8/9) articles informed breastfeeding education targets. There were 5/9 articles that reported the methods, 6/9 articles discussed the media, 8/9 articles talked about the officers and places, 7/9 articles concerned about the time of implementation, and all studies reported the effect of breastfeeding education. Breastfeeding education included at least 5 existing components. Breastfeeding education must be planned properly and must be carried out continuously from the antenatal until the postnatal period.

Infection of AIDS ， syphilis and hepatitis B in 24 546 pregnant women in Yueyang City， Hunan Province / 上海预防医学

ObjectiveTo investigate the infection situation of AIDS， syphilis and hepatitis B among pregnant women in Yueyang City， to provide formulated treatment and intervention measures to reduce mother-to-child transmission， and to improve the quality of birth population. MethodsA total of 24 546 pregnant women who agreed to take the tests of AIDS， syphilis and hepatitis B from January 2018 to December 2021 in our hospital were retrospectively analyzed. ResultsThe positive rate of human immunodeficiency virus antibody （anti-HIV） was 0.045%； positive rates of syphilis antibody （anti-TP） and HBsAg were 4.64% and 0.64%， respectively. The positive rates of anti-HIV， anti-TP and HBsAg varied from 2018 to 2021， but the differences were not statistically significant （P>0.05）. The positive rate of HBsAg increased gradually with the increase of maternal age， and the difference was statistically significant （P<0.01）. There were 16 mixed infections among 1 309 positive cases， 15 of which were hepatitis B and syphilis mixed infections. ConclusionThe infection of AIDS， syphilis and hepatitis B in pregnant women in Yueyang City is relatively high. The screening of AIDS， syphilis and hepatitis B before pregnancy is helpful to prevent and reduce the risk of mother-to-child transmission of infectious diseases in time， which is of great significance to eugenic and eugenic education.

Postpartum Depression and its Clinico-Social Correlates – A Community-Based Study in Aligarh

Context: Postpartum depression (PPD) is onset of depressive symptoms in postpartum period from 2 weeks to 1 year. It causes maternal morbidity and long?term negative effects on growth and development of infant and child. It is often unreported and underdiagnosed. Aims: (1) To estimate the prevalence of PPD,(2) To determine socio?demographic, clinical, and obstetric correlates of the same. Settings and Design: A cross-sectional study was done in urban and rural areas of District Aligarh. Methods: A total of 304 females between 6 weeks and 6 months’ postpartum period giving consent were included in this study. Sociodemographic, obstetric, and clinico-social factors were recorded using predesigned, pretested questionnaire. Edinburgh Postnatal Depression Scale (EPDS) score ?10 was used to screen for PPD and International Classification of Disease (ICD?10) criteria for confirmation. Statistical Analysis Used: Correlates of PPD were determined using logistic regression analysis. Results: The prevalence of PPD was 9.5% using EPDS and was confirmed by ICD?10 criteria. History of abortion (adjusted odds ratio [AOR]: 6.0, 95% Confidence Interval [CI] 2.2–16.5), poor relationship with in?laws(AOR: 5.1; 95% CI 1.3–20.5), marital conflict (AOR: 13.3; 95% CI 2.2–77.6), and substance abuse in husband (AOR: 3.1; 95% CI 1.1–9.0) were found to be significant correlates for PPD. Conclusions: About one in every 10 postpartum females suffered from depression but did not seek health care for the same. Women facing social pathologies such as substance abuse in husband, marital conflict, and poor relationship with in?laws are more at risk of PPD. Screening for PPD should be included in the maternal and child health care programs to ensure early diagnosis and treatment.

Antenatal depression and its correlates - a cross-sectional study in an urban resettlement colony of Delhi

Background- Antenatal depression is affecting 10% pregnant women worldwide with higher prevalence in developing countries. This causes poor maternal and foetal outcome and also affects cognitive development of the child. Aim and objective: To estimate magnitude of antenatal depression and its risk factors. Methodology- A cross-sectional survey was done at the antenatal clinic of community health department catering to an urban resettlement colony, East Delhi. Estimated sample size was 216 (including 10% non-response rate). Pregnant women attending the ANC clinic from October 2019 to February 2020 were enrolled. EPDS questionnaire was used to assess depression during pregnancy. Results-The antenatal depression was found in 11.8% subjects as per EPDS score. Working female and belonging to Muslim religion, past history of abortion, complications in previous pregnancy, financial debt, physical violence and substance use in family showed significant association with antenatal depression. Conclusion –Depression was prevalent among antenatal women and was found to be associated with various risk factors.

Video-retroalimentación Focalizado en los Recursos para mejorar la sensibilidad en díadas madre-infante con síntomas depresivos: protocolo de un ensayo clínico aleatorizado piloto / Strength-based Video-feedback to improve maternal sensitivity in mother-infant dyads with maternal depressive symptoms: Study protocol for a randomized controlled feasibility trial

Introduction Maternal sensitivity and mentalization are fundamental for children's mental health development. These skills have been negatively associated with maternal postpartum depressive symptomatology. Moreover, its prevalence increases in low socioeconomic and psychosocial risk contexts, where the access to treatment is scarce. Even though Attachment Based Interventios, such as Video-Feedback has been internationally recognized as an effective intervention. Its cost, as well as the need for language translation and cultural adaptation makes it difficult to implement in Latinamerican countries. Aim The present study aims to assess the feasibility and acceptability of an online Video-Feedback intervention informed n mentalization aimed at mother-infant dyads with depressive symptomatology who attend Chilean public health centers. Method This is a pilot randomized clinical trial with two groups of 60 mother-infant dyads between 4 and 12 months of age. Participants will be randomly assigned to control and experimental groups in a 1:1 ratio. Even though both groups will receive usual treatment, the experimental group will also receive the present video-intervention. At the end of the study, feasibility will be assessed based on focus groups aimed at interveners and quantitative outcomes such as recruitment rate, questionnaire completion rate and intervention completeness. Acceptability will be assessed from in-depth interviews with participants. In addition, effect sizes of primary and secondary outcomes will be calculated. Expected results Results are expected to generate parameters to design a larger-scale clinical trial and to preliminary assess the effect of the reported mentalization-informed intervention on maternal sensitivity. Additionally, it seeks to contribute with a mental health intervention for low-income mother-infant dyads, which can be implemented remotely, at a low cost, and that would be suitable for implementation at a mental health care system policy. The protocol of this trial's design was registered at Clinical Trials (NCT04748731).

Introducción La sensibilidad y la mentalización materna constituyen competencias fundamentales para el desarrollo de la salud mental infantil. A su vez, dichas habilidades han sido negativamente asociadas con la presencia de sintomatología depresiva postparto, la cual aumenta su prevalencia en contextos de bajo nivel socioeconómico y riesgo psicosocial, en donde el acceso a tratamiento escasea. Paralelamente, si bien internacionalmente el video-retroalimentación constituye una herramienta efectiva en intervenciones basadas en el apego, el costo, idioma y necesidad de adaptación cultural dificultan su implementación en países latinoamericanos. Objetivo Evaluar la factibilidad y aceptabilidad de una video-intervención informada por la mentalización, dirigida a díadas madre-bebé con sintomatología depresiva, atendidas en centros públicos de atención en salud mental en Chile. Métodos Ensayo clínico aleatorio piloto con dos grupos de 60 díadas madre-bebé de entre 4 y 12 meses de edad, quienes serán asignados aleatoriamente a grupos control y experimental en una proporción de 1:1. Si bien ambos grupos recibirán el tratamiento habitual, el grupo experimental recibirá también la video-intervención. Al término del estudio se evaluará la factibilidad a partir de grupos focales dirigidos a interventores e indicadores de resultados cuantitativos tales como tasa de reclutamiento, de completación de cuestionarios y finalización de la intervención. La aceptabilidad se evaluará a partir de entrevistas en profundidad a las participantes. Adicionalmente se calculará tamaño del efecto de indicadores de resultados primarios y secundarios. Resultados esperados Se espera que los resultados del estudio generen parámetros para diseñar un ensayo clínico de mayor escala y evaluar preliminarmente el efecto de la intervención informada en la mentalización en la sensibilidad materna. Se busca además contribuir con una intervención en salud mental basada en la teoría del apego dirigida a díadas madre-bebé de bajos ingresos, que pueda ser implementada de manera remota, a bajo costo y apta para ser escalada a los sistemas de atención en salud mental.

Prácticas culturales de cuidado en el binomio madre-hijo durante el puerperio: Revisión integrativa / Cultural practices of care in the binomial mother-child during the puerperium: Integrative review / Práticas culturais de cuidado no binômio mãe-filho durante o puerpério: Revisão integrativa

Resumen Objetivo: identificar en la literatura las prácticas culturales de cuidado postnatal que realizan las mujeres y su familia durante el puerperio. Metodología: se realizó una revisión integrativa a través de búsqueda en las bases de datos: Gale Cengage Learning, Scielo, Redalyc, Dialnet, EBSCO, Proquest, Science Direct, PubMed y Medigraphic en idiomas inglés, español y portugués entre 2014 y 2019, utilizando los términos: prácticas de cuidado cultural, cuidado en el puerperio, cuidado al recién nacido y cuidado de enfermería materno perinatal; los datos se analizaron a partir de la construcción de una matriz en Excel. Resultados: se obtuvieron 70 artículos, de los cuales emergieron cuatro categorías temáticas de prácticas de cuidado cultural: cuidado de la mujer consigo misma, cuidado del neonato por la madre/familia, cuidado institucional de la puérpera y del neonato, siendo la lactancia materna el factor común entre las ellas. Conclusiones: la identificación de diversas prácticas de cuidado postnatal en el ámbito hospitalario y ambulatorio varían por aspectos sociales, económicos y culturales, pero la mayoría de ellas favorecen el vínculo con el neonato. Es difícil establecer prácticas culturales generalizadas y estáticas en Colombia, debido a la diversidad cultural dentro de cada país.

Abstract Objective: To identify in the literature the cultural practices of postnatal care carried out by women and their families during the puerperium. Methodology: an integrative review was carried out through a search in the Gale Cengage Learning, Scielo, Redalyc, Dialnet, EBSCO, Proquest, Science Direct, PubMed and Medigraphic databases in English, Spanish and Portuguese between 2014 and 2019, using the terms: cultural care practices, puerperium care, newborn care and maternal and perinatal nursing care. The data were analyzed from the construction of a matrix in Excel. Results: A total of 70 articles were obtained, from which four thematic categories of cultural care practices emerged: self-care of the woman, care of the newborn by the mother/family, institutional care of the puerperal woman and the newborn, with breastfeeding being the common factor among them. Conclusions: the identification of different postnatal care practices in the hospital and outpatient settings varies according to social, economic and cultural aspects, but most of them favor bonding with the newborn. It is difficult to establish generalized and static cultural practices in Colombia due to the cultural diversity within each country.

Resumo Objetivo: identificar na literatura as práticas culturais de cuidado post natal que realizam as mulheres e sua família durante o puerpério. Metodologia: Realizou-se uma revisão integrativa a través de busca nas bases de dados: Gale Cengage Learning, Scielo, Redalyc, Dialnet, EBSCO, Proquest, Science Direct, PubMed e Medigraphic em idiomas inglês, espanhol e português entre 2014 e 2019, utilizando os termos: práticas de cuidado cultural, cuidado no puerpério, cuidado ao recém-nascido e cuidado de enfermaria materna perinatal; os dados se analisaram a partir da construção de uma matriz em Excel. Resultados: obtiveram-se 70 artigos, dos quais emergiram quatro categorias temáticas de práticas de cuidado cultural: cuidado da mulher consigo mesma, cuidado do neonato pela mãe/família, cuidado institucional da puérpera e do neonato, sendo a lactância materna o fator comum entre elas. Conclusões: a identificação de diversas práticas de cuidado pós-natal no âmbito hospitalário e ambulatório variam por aspeitos sociais, econômicos e culturais, mas a maioria de elas favorece o vínculo com o neonato. É difícil estabelecer práticas culturais generalizadas e estáticas na Colômbia, devido à diversidade cultural dentro de cada país.

A Study to Assess the Knowledge of Post-Natal Mothers Regarding Post-Natal Exercises

Postpartum exercises (PPE) are critical for the involution process past delivery. PPE affects the physical and psychological wellbeing of post-natal mothers. Clinical observation shows a lack of exercise in post natal units. physical exercise during post natal period is beneficial to mothers. Exercise done after delivery is called post-natal exercise. Non-probability convenient sampling technique was used to select the sample and data were collected using structured Knowledge Questionnaire. Majority of the post-natal mothers (68.33%) had inadequate knowledge; 28.33 percent post-natal mothers had moderate knowledge and lowest (3.33%) post-natal mothers had adequate knowledge regarding post-natal exercise

Urine Specific Gravity Measurement for Fluid Balance in Neonates on Intravenous Fluids in a Neonatal Intensive Care Unit: An Open Label Randomized Controlled Trial

Background: Urine specific gravity reflects hydration status and correlates well with urine osmolality. Objective: To compare intravenous fluid therapy guided with and without inclusion of urine specific gravity to the standard parameters for maintaining postnatal weight loss within permissible limits in neonates admitted to the intensive care unit. Methods: An open-label randomized controlled trial was conducted, including neonates requiring intravenous fluids for ?72 hours, randomized into the study (urine specific gravity guided fluids) and control arms. The outcomes of the study were to determine proportion of neonates with weight loss within permissible limits, mean percentage weight loss and number of days to reach maximum weight loss. Results: 80 preterm and term neonates (40 in each arm) were enrolled. A comparable proportion of neonates had weight loss within permissible limits in study arm and in control arms [39 (97.5%) vs 36 (90%); P=0.165]. The (mean (SD) percentage weight loss was significantly less in the study arm compared to control arm [All neonates: 7.2(2.6) vs 9.3(3.5); P=0.004); preterm neonates: 7.7 (2.8) vs 11 (3.9); P=0.008)]. Preterm neonates in the study arm attained nadir weight significantly earlier than in the controls (P=0.03) and attained complete enteral feeding earlier. Urine specific gravity showed a moderate negative correlation with the percentage weight loss. Conclusion: Using urine specific gravity to regulate intravenous fluids in neonates resulted in a significant reduction in postnatal weight loss, especially in preterm neonates

Determinants Of Maternal Mortality: An Empirical Study of Indian States Based on The Random Effect Model Analysis

Background: Healthcare for mothers and children is a significant indicator of a country's well-being. In-dia is one of the nations that were experiencing a rather slow improvement in maternal and child health. Aims: The objective of this study is to analyse the changes in health infrastructure, government health expenditure, antenatal care, postnatal care, institutional delivery, Maternal Mortality Ratio (MMR) and the determinants of MMR in India. Methodology: The study is based on secondary data. It employs an Average Increasing Rate (AIR) and Average Reduction Rate (ARR), as well as a panel data random effect model. Results: Empirical results say MMR has a statistically significant inverse relationship with female litera-cy, Per capita Net State Domestic Product (PNSDP), and institutional delivery. The study concludes that after the introduction of NRHM and its constituent elements like JSY and JSSK, government expenditure on health, health infrastructure, the percentage of antenatal care, post-natal care, and institutional deliv-ery increased in most of the Indian states, thus helping to increase the pace of the reduction of MMR. However, state performance varies greatly. Conclusions: Policy alone will not provide the desired results; it is also critical to focus on education, particularly female literacy, and economic empowerment.

DEPRESSION STATUS AMONG THE FEMALES DURING THE FIRST POSTPARTUM PERIOD AT CLINICAL SETTINGS OF PRIMARY HEALTH CARE CENTRES IN ARAR CITY, SAUDI ARABIA.

Background: Postpartum depression is one of the most common, but often unrecognized, complications of childbirth and is considered as a serious psychological disorder that can affect women during or after birth and during pregnancy. Its risk increases during the ?rst 90 days and can last up to nearly two years. Objectives: To determine the prevalence of postpartum depression (PPD) and correlate it with variables of obstetric and demographic predictors among females attending primary health care centres in Arar city. Methodology: This was a cross-sectional study carried out by using Arabic version of questionnaire of Edinburgh Postnatal Depression Scale (EPDS) tool during the study period from August to September 2021. A total of 383 sample was taken by using convenience sampling method. Analysis was done by using Statistical Package for Social Sciences. Results: The prevalence of postpartum depression was 30.5%. Multiple associated factors were found to be signi?cantly increase the risk of PPD such as: females who had caesarean section delivery, unplanned pregnancy, complicated pregnancy, their baby had medical problem and had no or less husband support, had psychiatric disorders, had chronic medical problem, taking chronic medication, had life stressor, low education and low income (P < 0.05). The results of the logistic regression analysis showed that the odds of PPD signi?cantly increase in females had caesarean section delivery compared to vaginal delivery (P = .002), females had rare support from the husband (P = .002), females had psychiatric disorders (P = 0.016) and had life stressor (P = .000). Conclusions: The prevalence of postpartum depression in the city of Alar was clearly high. Our study also showed important predictors that could be used to identify high-risk females. It is advisable to provide social support to females during both prenatal and postnatal periods. Regular screening of women for postpartum depression should be encouraged for early detection and prompt intervention

Bladder function in children with posterior urethral valves: impact of antenatal versus postnatal diagnosis

ABSTRACT Purpose: Posterior urethral valves (PUVs) are the most common cause of congenital bladder obstruction in boys. Our aim was to assess the impact of early diagnosis and fulguration of PUVs on bladder function and compare their functional and urodynamic outcome with children who underwent delayed intervention. Materials and Methods: We retrospectively evaluated 153 patients who underwent primary valve ablation from two tertiary hospitals between 2001 and 2018. Patients have been divided into 2 groups, group 1 included 69 patients who were detected antenatally and underwent early fulguration of PUVs while group 2 included 84 children presented postnatally and underwent delayed valve ablation. The recorded data throughout follow-up in renal function tests, urodynamics and changes in the upper urinary tracts were evaluated and compared. Results: Median age at time of valve ablation was 10 days in group 1 and 7 months in group 2. The median follow-up period was 6.5 and 7 years in group 1 and 2, respectively. Chronic kidney disease (CKD) developed in 15 (22%) boys in group 1 while in group 2 it was observed in 31 (37%), p=0.04. While Q-max, mean bladder capacity and post-void residual (PVR) volumes were comparable in both groups, percent PVR was significantly higher in group 2 (3.27 vs. 1.44, p=0.002). Detrusor overactivity was slightly different in both groups (p = 0.07). Conclusions: Compared to delayed intervention, primary ablation of PUVs during the early neonatal life possibly provides the optimum chance to have optimum renal function without impact on bladder function.

The Health and Wellness Benefits of Traditional Postnatal Practice (TPC) on Postnatal Mothers: A Systematic Review

@#Introduction: Postnatal is a transition process for the mother back to her non-pregnancy state and involves the changes in hormones level. During the postnatal period, many health issues need to be addressed for both mother and newborn. One of the upsetting health issues for the mother due to the increasing trend is postnatal depression and if it is not identified and treated early, it may cause further complicated problems not only to the mother but also to the baby, family, and local community. With this issue, the Ministry of Health Malaysia has taken a few initiatives to encourage the postnatal mother to also practice the non-medical approaches or traditional postnatal care (TPC) as a self-care for the prevention of postnatal depression. Aim: To systematically identify and review studies examining the influence of TPC on postnatal mothers. Design & Data Sources: A systematic search strategy on the research trend for the period between the years 2013 to 2020 through the Scopus database, Science Direct, and PubMed database. Methods: This review has identified 7 journal articles based on the preferred reporting items for the systematic reviews (PRISMA) framework. Results: There are many methods of TPC, such as traditional postnatal body massage, herbal consumption, herbal bath, body steaming, and body wrapping based on own culture and beliefs. Besides the TPC preparation and techniques, some studies also describe the effects of TPC on a mother’s health and wellness. Conclusion: TPC shows encouraging health trends, and it helps to enhance the well-being and good health of postpartum mothers.

Influence of neonatal breast crawl on breastfeeding and psychological status of primipara in vaginal delivery / 中国实用护理杂志

Objective:To investigate the effect of neonatal breast crawling exercise on breastfeeding and psychological state of primiparas who delivered vaginally.Methods:Using convenience sampling method, 86 pairs of normal term infants and mothers who delivered vaginally in the First People′s Hospital of Yancheng from January 2019 to January 2020 were selected as the research objects, and divided into experimental group and control group according to the random number table method, there were 43 pairs in each group. The control group was given routine postpartum care, while the experimental group was given neonatal breast crawling exercise on the basis of routine postpartum care. The time of initiation of lactation, the success rate of first breastfeeding and the score of first Breastfeeding Assessment Tool (BAT) were compared between the two groups. The rates of exclusive breastfeeding, the scores of Breastfeeding Self-efficacy Scale Short Form (BSES-SF) and the scores of Edinburgh Postnatal Depression Scale (EPDS) were compared between the two groups at 72 h and 42 d after delivery respectively.Results:The time of initiation of lactation was (48.36 ± 6.12) h in the experimental group, which was significantly earlier than that in the control group(52.86 ± 7.29) h, the difference was statistically significant (t=3.08, P<0.05). The success rate of first breastfeeding and the BAT scores of the experimental group were 88.1% (37/42) and (9.74 ± 1.33), respectively, which were significantly higher than those in the control group 69.8% (30/43) and (8.84 ± 1.60), the differences were statistically significant (χ 2=4.28, t=2.82, both P<0.05). At 72 h and 42 d after delivery, the rate of exclusive breastfeeding were 42.9%(18/42) and 86.49%(32/37) in the experimental group, significantly higher than those in the control group 20.9% (9/43) and 60.00% (24/40), the differences were statistically significant (χ 2=4.71, 3.93, both P<0.05). At 72 h and 42 d after delivery, the BSES-SF scores were (38.48 ± 6.34) and (45.43 ± 11.45) in the experimental group, which were significantly higher than those in the control group (35.21 ± 4.87) and (40.10 ± 10.82), the differences were statistically significant (t=2.66, 2.10, both P<0.05); the EPDS scores were (5.52 ± 1.53) and (7.38 ± 2.25) in the experimental group, which were significantly lower than those in the control group (6.26 ± 1.63) and (8.73 ± 2.39), the differences were statistically significant (t=2.13, 2.54, both P<0.05). Conclusions:Neonatal breast crawl is an effective way to promote the breastfeeding. It can also enhance maternal confidence and alleviate maternal psychological status.

Clinical factors affecting the early postoperative prognosis of infants suffering surgery for congenital heart diseases: A single-center experience of 511 patients / 中南大学学报(医学版)

OBJECTIVES@#The integrated model of prenatal diagnosis and postnatal treatment for congenital heart disease (CHD) leads to an increasing number of operation in infants. This study aims to reveal the risk factors for postoperative early mortality and delayed recovery in infants less than 3 months old, who underwent surgical treatment for CHD in the Department of Cardiovascular Surgery, Second Xiangya Hospital, Central South University during the past 5 years.@*METHODS@#Clinical variables were collected via medical records. Delayed recovery was defined as the time of postoperative intubation, or cardiac intensive cure unit (CICU) stay, or hospital stay longer than its third quartile. Risk factors for early postoperative prognosis and the odds ratio (OR) were analyzed with logistic regression analysis.@*RESULTS@#A total of 511 infants underwent surgical treatment for CHD from January 2016 to June 2020 were retrospectively reviewed, including 217 (42.5%) infants with complex CHD. The median age was 60 days (3 hours-90 days); and median weight was 4.5 (1.7- 8.4 kg). There were 26 postoperative mortalities, making the incidence at 5.1%, including 5 (5/294, 0.7%) mortalities in patients with uncomplicated CHD, and 21 (9.6%) mortalities in patients with complex CHD. Based on multivariable analysis, risk factors for postoperative mortality were diagnosis of complex CHD (OR=5.53, P<0.001), weight under 4.0 kg (OR=9.86, P<0.001), preoperative symptoms (OR=3.17, P=0.012), and emergency operation (OR=11.66, P<0.001). The median time for postoperative intubation, CICU stay, and hospital stay were 21.0 (0.3-979.0) hours, 3.0 (0.5-91.0) days, and 11.5 (3.0-105.0) days, respectively. A total of 177 (34.6%) infants delayed recover, with risk factors including diagnosis of complex CHD (OR=3.41, P=0.001), weight under 4.0 kg (OR=4.55, P<0.001), and preoperative symptoms (OR=3.91, P<0.001).@*CONCLUSIONS@#Surgical treatment for infants (<3 months) with CHD is still a challenge, particularly for infants with complex CHD and weight under 4.0 kg. We can improve the prognosis of CHD treatment in infants by establishing the integrated model of prenatal diagnosis and postnatal treatment to choose the most suitable time window, avoid symptoms before surgery, and reduce emergency operation.

Early introduction of exercise prevents insulin resistance in postnatal overfed rats

Early childhood obesity increases the risk of developing metabolic diseases. We examined the early introduction of exercise in small-litter obese-induced rats (SL) on glucose metabolism in the epididymal adipose tissue (AT) and soleus muscle (SM). On day 3 post-birth, pups were divided into groups of ten or three (SL). On day 22, rats were split into sedentary (S and SLS) and exercise (E and SLE) groups. The rats swam three times/week carrying a load for 30 min. In the first week, they swam without a load; in the 2nd week, they carried a load equivalent to 2% of their body weight; from the 3rd week to the final week, they carried a 5% body load. At 85 days of age, an insulin tolerance test was performed in some rats. At 90 days of age, rats were killed, and blood was harvested for plasma glucose, cholesterol, and triacylglycerol measurements. Mesenteric, epididymal, retroperitoneal, and brown adipose tissues were removed and weighed. SM and AT were incubated in the Krebs-Ringer bicarbonate buffer, 5.5 mM glucose for 1 h with or without 10 mU/mL insulin. Comparison between the groups was performed by 3-way ANOVA followed by the Tukey post-hoc test. Sedentary, overfed rats had greater body mass, more visceral fat, lower lactate production, and insulin resistance. Early introduction of exercise reduced plasma cholesterol and contained the deposition of white adipose tissue and insulin resistance. In conclusion, the early introduction of exercise prevents the effects of obesity on glucose metabolism in adulthood in this rat model.