The Impact of Educational Sessions on Anxiety Levels among Women Undergoing Caesarean Section: A Quasi-Experimental Study.

Although the Caesarean section (CS) is considered a harmless surgery, it has various complications. Women scheduled for elective CSs often have high levels of anxiety due to a lack of knowledge. The aim of this quantitative quasi-experimental study was to determine the relationship between preoperative educational sessions and anxiety levels among women undergoing CSs. The study was conducted at the antenatal unit in the King Faisal Medical Complex (KFMC) in Taif, Saudi Arabia, using a structured interview questionnaire, the State-Trait Anxiety Inventory (STAI), and satisfaction interviews. A total of 50 pregnant women participated in this study, who were divided into two groups: 25 participants in the intervention group and 25 in the control group. Most participants (92%) in the intervention group had low anxiety levels following educational sessions, and 96% of the participants were very satisfied with the preoperative information they had been given. Women in the control group (again, 92%) had high anxiety levels, and there was a significant difference in the anxiety levels of the intervention and control groups (p ≤ 0.5) after the educational sessions. Providing proper preoperative education about CSs can reduce preoperative anxiety, improve patient outcomes, and enhance patients' involvement in their care and decision-making.

The Effect of Alternating Application of Cold and Hot Compresses on Reduction of Breast Engorgement Among Lactating Mothers.

BACKGROUND: Breast engorgement is a common issue that affects breastfeeding initiation and continuation. Engorgement can cause exhaustion, making it difficult to care for and feed the infant, and it can cause a mother to wean her baby before she intends to initiate breastfeeding. This study aimed to determine the effectiveness of the alternating application of cold and hot compresses in reducing breast engorgement among lactating mothers. Design, sample size and setting: A quasi-experimental study design is used to conduct this study. A purposeful sample of 100 lactating mothers was screened in the postnatal ward for the presence of breast engorgement. The 100 mothers with engorgement were divided into two equal groups of 50 mothers each - the first group (the intervention) and the second group (the control) - at the postnatal ward of King Abdulaziz Hospital-National Guard in Alahsa City. Sampling and tools: The data collection was conducted over five months, from January 2023 until May 2023. Data collection was done through a structured interview questionnaire sheet. The questionnaire was divided into six parts: socio-demographic data, obstetric and initial women assessment, the six-point engorgement scale (SPES), the visual analog scale (VAS), the LATCH breastfeeding charting scale, and the Infant Breastfeeding Assessment Tool (IBFAT). RESULT: The present study found no statistically significant difference between the study intervention and control groups in breast engorgement, LATCH level, or overall level of breastfeeding assessment before the intervention. While, in terms of breast engorgement, pain level, attachment, and LATCH, the overall levels of infant breastfeeding assessment across study time had a statistically significant variance among the study and control groups after the intervention at p values=<0.001. CONCLUSION AND RECOMMENDATIONS: The alternating application of cold and hot compresses can have a significant role in reducing breast engorgement among lactating mothers. Women should be encouraged to use hot compresses and cold gel packs as an alternative treatment to reduce engorgement and promote comfort. In addition, the study results can be utilized to aid Saudi Arabian nurses and midwives in understanding the advantages of applying a cold gel pack and a hot compress and to decrease levels of engorgement, improve latch, and relieve discomfort.

Exploring the Relationship Between Childbirth Expectations and Fear Among Primigravida Women in Saudi Arabia.

Background Childbirth is a significant life event that is accompanied by fear, particularly among primigravida mothers. However, little is known about the expectations and fears of childbirth of primigravida women in Saudi Arabia. Aim This study aimed to explore expectations and fears of childbirth among primigravidas. Methods An exploratory, descriptive, cross-sectional study involving 369 primigravidas was conducted at antenatal outpatient clinics at the Maternity and Children's Hospital in Tabuk, Saudi Arabia. Results In the current study, most participants were aged 25-34 years 204 (55.3%), married 355 (96.2%), and had secondary or higher education 279 (75.6%). A majority of participants 265 (71.8%) reported financial difficulties and 244 unplanned pregnancies (66.1%), while most were pregnant beyond 30 weeks 254 (66.4%). The results showed that the mean total score on the Wijma Delivery Expectancy Questionnaire (W-DEQ) fear of childbirth scale was 57.56, indicating moderate levels of fear on average among primigravida women, with the highest subscale score for the moment of birth. The mean total score on the Childbirth Expectations Questionnaire (CEQ) childbirth expectations scale was 108.15, also indicating moderate expectations on average, with other significant expectations having the highest subscale score. A significant negative correlation was found between the fear and expectations scales (r=-0.775, p<0.001). Sociodemographic factors such as older age, higher education, income, employment, and planned pregnancy were associated with higher expectations and lower fear, whereas younger age, lower education, income, employment, unplanned pregnancy, and medical issues were associated with higher fear. Conclusions The findings of this study provide valuable insights into the expectations and fears of childbirth of primigravida women in Saudi Arabia. The results could inform healthcare providers and policymakers about the predictors of fear and effective interventions to reduce fear and improve birth experience in primiparous women.

Maternal Outcomes Among Pregnant Women Diagnosed With COVID-19.

BACKGROUND: COVID-19 has the potential development of negative maternal outcomes for pregnant women. The risk of contracting COVID-19 is high as pregnancy alters the maternal immune system. Therefore, this study aims to assess maternal outcomes among pregnant women with COVID-19 in the Kingdom of Saudi Arabia. METHODS: A retrospective study was conducted in three hospitals during the pandemic over four months, from the beginning of December 2019 until the end of March 2020. Data was collected using a structured questionnaire filled by the researcher using computers from the medical records of three hospitals. The sampling was all confirmed cases of pregnant women who delivered while being positive for COVID-19. RESULTS: This study has identified a total of 82 pregnant women with confirmed COVID-19 infection over the study period, with ages ranging from 18 to >40 years. The majority of the pregnant women (84.1%) were symptomatic, with fever (48.8%) being the most frequent COVID-19 symptom, followed by cough (42.7%) and shortness of breath (41.5%). Some women (46.3%) had a spontaneous normal vaginal delivery, and 50.2% had a cesarean delivery. The most common adverse pregnancy outcome was premature delivery (36.5%), followed by fetal distress (20.7%), preeclampsia (2.4%), eclampsia (1.2%), and diabetic ketoacidosis (1.2%), as well as the death of three pregnant women. CONCLUSION: This study found that infected mothers faced various risks of maternal adverse outcomes. The majority of the pregnant women experienced mild to moderate illness symptoms and were delivered within 14 days of the onset of COVID-19 symptoms. Healthcare providers should provide more attention to pregnant women diagnosed with COVID-19.

A Quasi-Experimental Study of the Effect of Ginger Tea on Preventing Nausea and Vomiting in Patients With Gynecological Cancers Receiving Cisplatin-Based Regimens.

BACKGROUND: Cancer patients receiving chemotherapy experience acute and delayed nausea and vomiting. These side effects obligate the patients to use pharmacological and nonpharmacological methods. The effect of ginger tea as an antiemetic modality on preventing chemotherapy-related nausea and vomiting has not been confirmed in previous studies. OBJECTIVE: The aim of this study was to assess the effect of ginger tea, when given together with the standard antiemetic regimen, on preventing nausea and vomiting in patients with gynecological cancers receiving cisplatin-based regimens. METHODS: This study used a quasi-experimental research design with 2 groups (control and intervention groups, 50 participants each). A sociodemographic and medical survey and the Modified Rhodes Index of Nausea, Vomiting, and Retching were used to collect the data. Descriptive analyses, t test, and χ2 test were used to analyze the data. RESULTS: The total mean Modified Rhodes Index of Nausea, Vomiting, and Retching scores were lower in the intervention group in all measurements compared with the control group, and the differences between the total mean scores for symptom experience, development, and distress between the groups were statistically significant in the third (P < .05), fourth (P < .01), and fifth (P < .05) measurements. No ginger-related side effects were noted in this study. CONCLUSIONS: Ginger tea reduced the experience, development, and distress of nausea, vomiting, and retching in the intervention group. The use of ginger tea may be recommended for chemotherapy-associated nausea and vomiting in cancer patients receiving cisplatin-based regimens. IMPLICATIONS FOR PRACTICE: Oncology nurses can lead the implementation of ginger tea intervention to prevent chemotherapy-related nausea and vomiting.

Screening of Plasmodium parasite in vectors and humans in three villages in Aswan Governorate, Egypt.

Egypt has successfully eliminated malaria during 2010-2013, however, between May to mid-June 2014, an outbreak was reported in Al-Adwa village, Aswan Governorate indicating that malaria may be potentially re-emerging in the country. The aim of this work was to reevaluate malaria in Al-Adwa and surrounding villages, 1 year after malaria cases have been reported through entomological and human screening in collaboration with the Ministry of Health and Population. Four trips were conducted during the period from March 2015 to March 2016. Mosquitoes were collected, sorted and identified. Anopheles species were processed for detection of Plasmodium by polymerase chain reaction (PCR), and engorged abdomens in blood-fed mosquitoes were analyzed for host preference using multiplex PCR. Thick and thin blood films were prepared from all apparently healthy children (n = 188) attending El-Sheikh Mostafa preparatory school. Results showed that Anopheles genus existed only in East Al-Adwa village. A total of 38 Anopheles mosquitoes were collected and identified as Anopheles multicolor 70% (A. multicolor), A. sergenti 20% and A. pharoensis 10%. The latter showed 100% human blood preference compared to A. sergenti (20%) and An. multicolor (0%). All female Anopheles were 100% negative for Plasmodium DNA, and all blood films showed no detectable parasite. The absence of Plasmodium in the area under study does not rule out the risk of future infections as the vector is still present together with the imported cases and carriers. Regular screening for the presence of Plasmodium in the area is absolutely paramount for early warning.

Preliminary Screening of Mosquito Spatial Distribution in Togo: With Special Focus on the Aedes (Diptera: Culicidae) Species.

The Togolese Republic has a tropical and humid climate which constitutes an ideal environment for mosquitoes to breed and transmit diseases. The Aedes mosquito is known to transmit yellow fever (YF), dengue, chikungunya, and Zika viruses in West Africa. Togo has been suffering from YF virus transmission, despite vaccination efforts. Unfortunately, there is scarcity in the data that reflect mosquito spatial distribution in Togo, specifically possible YF vectors. In the current study, mosquito surveillance efforts targeted areas with confirmed YF cases between July and August 2012. Indoor mosquitoes were collected using knockdown insecticide spraying, whereas Biogents (BG) traps were used to collect outdoor mosquito adults. Mosquito larval surveillance was conducted as well. In total, 17 species were identified. This investigation revealed the presence of medically important vectors in Togo, especially the Aedes aegypti (Linnaeus) (Diptera: Culicidae) which was collected in the four regions. Screening of all pools of female Aedes mosquitoes for YF, by real-time PCR, showed negative results. This is the first record for Coquillettidia flavocincta (Edwards) (Diptera: Culicidae) species in West Africa. This preliminary work serves as a baseline for further mosquito distribution studies in Togo.

Comparative analysis of the diagnostic performance of crude sheep hydatid cyst fluid, purified antigen B and its subunit (12 Kda), assessed by ELISA, in the diagnosis of human cystic echinococcosis.

The diagnosis of patients with cystic echinococcosis (CE) by means of serology has a limited support in clinical practice due to cross-reactivity with other helminthes leading to overestimation of the parasite's true prevalence. A wealth of reports on the diagnostic performance of antigen B (AgB) has been produced. This study was designed to comparatively assess the diagnostic efficacy of crude sheep hydatid cyst fluid (HCF), AgB and its subunit (12 KDa) to detect IgG or IgG4 antibodies in CE patients' sera using enzyme-linked immunosorbent assay (ELISA).The best diagnostic performance was obtained with anti-HCF IgG ELISA which gave 92.4% sensitivity and 92.6% specificity. Despite the low sensitivity of anti AgB IgG ELISA (84%), it gave the best specificity (94.4%) with less cross-reaction with sera of subjects infected with other parasites. In conclusion, it is recommended to use anti-HCF IgG ELISA for initial screening in large seroprevalence studies. Further analysis of positive serum samples with anti AgB IgG ELISA would allow the confirmation of true positives. Specific IgG4 ELISA may represent a complementary assay, useful as secondary confirmatory tests for patients with suspected CE and negative for total IgG ELISA.

Genetic variability of antigen B among Echinococcus granulosus Egyptian isolates.

Genetic polymorphisms of encoding antigen B2 gene (AgB2) in Echinococcus granulosus were studied using PCR-RFLP and DNA sequencing among 20 Egyptian isolates. Five isolates from different host origins (humans, camels, pigs, and sheep) were collected and used. All examined isolates of each host group gave very similar patterns of PCR-RFLP after restriction enzyme digestion with AluI, with the gene size of approximately 140 bp and 240 bp for sheep and human isolates, and approximately 150 bp and 250 bp for pig and camel isolates. No digestion pattern was obtained after incubation of all studied isolates with EcoRI. These results reveal high intra-group homogeneity. DNA sequence analysis highlighted that human infecting strain showed 100% identity with respect to sheep infecting isolate, 96% and 99% with pig and camel infecting isolates, respectively.

Detection of molecular markers of toxoplasmosis among Egyptian patients with miscarriage using avidity IgG-ELISA and Western blotting.

A total of 54 miscarriage patients were divided into 3 groups. GI: 10 toxoplasmosis patients with +ve IgM-ELISA; GII: 24 toxoplasmosis patients with +ve IgG-ELISA, and GIII: 20 non-toxoplasmosis cross-matched females as a control. All groups were subjected to IgG-avidity ELISA & IgG-avidity immunoblotting. Avidity Indices (AI) by ELISA ranged from 22.6% to 73.3% in GI and from 9.6%-75.6% in GII. AI were high (>40%) in 3 (30%) patients in G I and in 8 (33.3%) patients in G II. Sera of GI recognized the 20, 28, 32, 60, 93 & 100 Kda bands with 55% reduction in the 38 and 60 Kda bands after treatment with 6 M urea solutions. Sera of GII recognized the 20, 28, 32, 38, 45, 95-97 & 106 Kda bands. There was 12.5%, 16.6% & 16.7% reduction in the 20, 32, & 106 Kda bands, respectively, after urea. The 38 & 60 Kda bands were identified as good diagnostic markers for the recent toxoplasmosis infection (GI). The 20, 32 & 106 Kda bands were good markers of high avidity antibodies during the chronic toxoplasmosis (GII).

Decreased basal non-insulin-stimulated glucose uptake by diaphragm in streptozotocin-induced diabetic mice infected with Schistosoma mansoni.

It had been suggested that chronic exposure to Schistosoma mansoni prevents the onset of Th1-mediated diseases such as diabetes mellitus. The present study was carried out on four groups of mice: (1) control group, (2) group infected with S. mansoni, (3) group injected with streptozotocin to induce diabetes, and (4) group infected and then 3 months postinfection injected with streptozotocin. No differences were detected between the infected non-diabetic and infected diabetic groups regarding worm burden, tissue egg count, and oogram. At the same time, results showed a reducing effect of S. mansoni infection on the rate of glucose uptake by the diaphragm with reduction in glycogen content of soleus muscle. This an important issue since skeletal muscle is the primary site for insulin-stimulated glucose disposal. In conclusion, because of the detected depressed peripheral glucose uptake by the diaphragm, the protecting effect of helminths infection in diabetes should be reconsidered, to be able to devise therapeutic strategies for the treatment of autoimmune diseases.

Effects of ovariectomy and thyroidectomy on course and outcome of Trichinella spiralis infection in rat.

Physiological hormones modulate immune responses and implicate in associated susceptibilities to infections. To clarify these endocrinological effects, the influence of estrogen and thyroid deficiency, due to ovariectomy and thyroidectomy, respectively, on course and outcome of Trichinella spiralis infection in rats was studied. While in ovariectomized rats there was significant increase in both adult and muscle larval counts as compared to intact infected rats, in thyroidectomized rats there was a significant increase in larval but not in adult count. Combined ovariectomy and thyroidectomy resulted in significant increase in both adult and larval counts. Serum CPK and blood glucose were significantly elevated in ovariectomized and/or thyroidectomized rats as compared to intact infected one. The deficiency of female sex hormones, and/or thyroid hormones in T. spiralis infected rats affected the host resistance to infection by increasing parasite burden influencing the course and outcome of parasitic infection.

Efficacy of medical ozone in attenuation of murine Schistosomiasis mansoni infection morbidity.

Mice were divided into 3 groups: non-infected control, S. mansoni infected non-treated for 10 weeks and group receiving ozone intraperitoneally for 21 days 10 weeks postinfection. Results showed that ozone therapy in chronic schistosomiasis mansoni decreased worm burden, increased number of dead eggs, decreased both mature and immature eggs, increased RBC count, improved hemoglobin concentration with reduced reticulocytes %, as well as increased lymphocyte %, decreased neutrophil % and markedly increased eosinophil %. Platelet count was increased and bleeding time was markedly shortened, markers for hepatic function were improved, and malondialdehyde concentration decreased in liver and spleen but increased in intestine. Reduction of associated hepato-splenomegaly was noticed, with reduction in number and size of hepatic and intestinal granulomas, collagen area % and number of macrophages, with preservation of hepatic and intestinal histological profile in almost all areas. The results point to medical ozone as a promising agent to complement schistosomiasis mansoni specific treatment, helping to attenuate infection morbidity.

Contrast staining of Trichinella spiralis larvae in fresh, frozen and formalin preserved muscles.

Fresh, frozen-thawed and formalin-preserved muscle samples heavily infected with Trichinella larvae were cut into several pieces and stained with Giemsa and Leishman and the reference Haematoxylineosin (H & E) stain. Observation under microscope revealed that both muscle larvae and nurse cells in fresh and formalin preserved specimens appeared as purplish blue structures contrasting with the pinkish color of non-infected muscle fibers in both Giemsa and Leishman stains. These findings were confirmed in H & E stained samples. However, frozen samples did not show contrast stain.

Molecular characterization of Egyptian Giardia lamblia isolates.

Six Giardia lamblia strains (4 from Egypt, one from the USA and one from Sudan) were used to study the phenotypic and genotypic variation in some Egyptian G. lamblia strains compared to other G. lamblia strains, which may be responsible for the difference in their behavioral characteristics. By using SDS-PAGE for antigenic study, E1 strain appeared different from the rest of the strains with two bands; one at 121 Kda and the other at 34 Kda which were not present in other strains, while bands at 130 and 43 Kda were present in all strains but absent in E1 strain. Another difference between E1 strain and the rest of the strains was obtained by CAE, using PGM enzyme where E1 strain gave a different zymodeme than the other strains. Based on the computerized RAPD- PCR analysis, 4 rapdemes were identified; rapdeme 1 contained E1 strain, rapdeme 2 contained E2, E3 and E4 isolates, rapdeme 3 contained Sudan strain and rapdeme 4 contained USA strain. In conclusion this study revealed diversity between G. lamblia strains especially E1 strain which showed unique characters.