scholarly journals Maternal Pregnancy Associated Plasma Protein-A Levels in Late First Trimester as a Predictor of Miscarriage- A Cross-sectional Study

Author(s):  
Nivedita Sinha ◽  
Alpana Singh ◽  
BD Banerjee ◽  
Rachna Agarwal ◽  
Himsweta Srivastva

Indroduction: Miscarriage is the most common complication of pregnancy. Defective implantation is one of the common causes of miscarriage. Pregnancy Associated Plasma Protein-A (PAPP-A) is secreted from syncytiotrophoblast and it enables trophoblast invasion. Few studies have shown association of PAPP-A with miscarriage. However, there is limited data available to establish the role of PAPP-A as a predictive marker of miscarriage, especially in Indian population. Aim: To determine the potential of maternal PAPP-A level estimation in asymptomatic women in late first trimester (10-13 weeks) with viable foetus in predicting subsequent miscarriage. Materials and Methods: This was an observational, cross-sectional study conducted from November 2016 to April 2018 at University College of Medical Science and Guru Teg Bahadur Hospital, Delhi, India. Asymptomatic pregnant women (N=500) at 10-13 weeks of gestation were recruited from an antenatal clinic after confirmation of foetal viability. A 2 mL of blood sample was collected and serum PAPP-A level was measured. Independent t-test and Chi-square test was used to compare continuous data and Mann-Whitney U test was used to compare PAPP-A Multiple of Median (MOM). Logistic regression was used to estimate risk of miscarriage. Results: Out of 500 participants, 9 were lost to follow-up. From remaining N=491, 32 (6.5%) women had a miscarriage. PAPP-A levels were significantly decreased in miscarriage group compared to ongoing pregnancy group with median MOM 0.116 (0.080-0.17) and 1.25 (0.665-3.249) respectively (p-value <0.001). PAPP-A MOM value of ≤10th percentile sensitivity and specificity of detection of miscarriage was 81.25% and 94.98% and at ≤5th percentile sensitivity and specificity was 40.62% and 97.82%, respectively. Lower the percentile cut-off of serum PAPP-A value, higher was the specificity and positive predictive value for prediction of miscarriage. By applying logistic regression we found that if PAPP-A MOM decreases by 1 unit the chances of miscarriage increased by 1.2 times. By this model 63.2% of cases could be explained (Nagelkerke R Square=0.632). For prediction of pregnancies likely to miscarry, the area under Receiver Operator Characteristic (ROC) curve (95% CI) was 0.969 (0.955-0.983). Conclusion: Low serum PAPP-A levels from asymptomatic women in late 1st trimester is a good predictive marker of miscarriage.

PLoS ONE ◽  
2016 ◽  
Vol 11 (8) ◽  
pp. e0159592 ◽  
Author(s):  
Joyce L. Browne ◽  
Kerstin Klipstein-Grobusch ◽  
Maria P. H. Koster ◽  
Dhivya Ramamoorthy ◽  
Edward Antwi ◽  
...  

2016 ◽  
Vol 6 (3) ◽  
pp. 172-173 ◽  
Author(s):  
Joyce L. Browne ◽  
Kerstin Klipstein-Grobusch ◽  
Maria P.H. Koster ◽  
Dhivya Ramamoorthy ◽  
Edward Antwi ◽  
...  

2020 ◽  
Vol 17 (1) ◽  
pp. 82-93
Author(s):  
Mary-Joe Youssef ◽  
Antoine Aoun ◽  
Aline Issa ◽  
Lana El-Osta ◽  
Nada El-Osta ◽  
...  

Background: The prevalence of gastroesophageal reflux disease (GERD) is increasing worldwide and the related chronic symptoms can be associated with morbidity and poor quality of life. Objective: The objective of this study was to identify foods and beverages consumed by the Lebanese population, dietary habits, socio-demographic and lifestyle factors, health parameters and perceived stress, implicated in increasing GERD symptoms. Methods: This observational cross-sectional study was carried among Lebanese adults in 2016. A convenient sample of 264 participants was equally divided into a GERD group and a control group. Data on socio-demographic characteristics, lifestyle, health status and dietary habits including Lebanese traditional dishes were collected. The perceived stress scale (PSS) was also used to assess the participants’ perception of stress. Logistic regression analyses were conducted with GERD symptoms (presence or absence) being the dependent variable. Results: The GERD symptoms were significantly associated with age (-p-value=0.017), family history of GERD symptoms (-p-value<0.001), smoking (-p-value=0.003) and chronic medical conditions (-p-value<.001). Regarding the dietary factors, participants who ate three meals or less/day, between meals and outside homes were 2.5, 2.9 and 2.4 times at a higher risk of experiencing GERD symptoms than others, respectively. Moreover, the logistic regression model showed that the GERD symptoms were significantly associated with the consumption of coffee (-p-value=0.037), Lebanese sweets (-p-value=0.027), fried foods (-p-value=0.031), ‘Labneh’ with garlic (-p-value<0.001), pomegranate molasses (-p-value=0.011), and tomatoes (-p-value=0.007). Conclusion: Some specific lifestyle factors and components of the Lebanese Mediterranean diet could be associated with GERD symptoms.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maru Mekie ◽  
Dagne Addisu ◽  
Minale Bezie ◽  
Abenezer Melkie ◽  
Dejen Getaneh ◽  
...  

Abstract Background Preeclampsia has the greatest impact on maternal mortality which complicates nearly a tenth of pregnancies worldwide. It is one of the top five maternal mortality causes and responsible for 16 % of direct maternal death in Ethiopia. Little is known about the level of knowledge and attitude towards preeclampsia in Ethiopia. This study was designed to assess the knowledge and attitude towards preeclampsia and its associated factors in South Gondar, Northwest Ethiopia. Methods A multicenter facility-based cross-sectional study was implemented in four selected hospitals of South Gondar Zone among 423 pregnant women. Multistage random sampling and systematic random sampling techniques were used to select the study sites and the study participants respectively. Data were entered in EpiData version 3.1 while cleaned and analyzed by Statistical Package for Social Sciences (SPSS) version 23. Descriptive and inferential statistics were performed. Adjusted odds ratio with 95 % confidence interval were used to identify the significance of the association between the level of knowledge on preeclampsia and its predictors. Results In this study, 118 (28.8 %), 120 (29.3 %) of the study participants had good knowledge and a positive attitude towards preeclampsia respectively. The likelihood of having good knowledge on preeclampsia was found to be low among women with no education (AOR = 0.22, 95 % CI (0.06, 0.85)), one antenatal care visit (ANC) (AOR = 0.13, 95 % CI (0.03, 0.59)). Whereas, those who booked for ANC in the first trimester (AOR = 6.59, 95 % CI (1.43, 30.33)), gave the last birth at a health facility (AOR = 2.61, 955 CI (1.03, 6.61)), and experienced a complication during previous births (AOR = 3.67, 95 % CI (1.78, 7.57)) were more likely to be knowledgeable on preeclampsia. Conclusions No formal education and not attending four ANC visits were associated with poor knowledge of preeclampsia. While participants who visited health facilities during the first trimester, who gave birth at health facilities, and those who experienced a complication in previous births were more likely to be knowledgeable on preeclampsia. Improving the numbers of ANC visits and encouraging facility delivery are important measures to improve women’s knowledge on preeclampsia. Health education regarding preeclampsia risk factors, symptoms, and complications shall be emphasized.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tesfaldet Mekonnen Estifanos ◽  
Chen Hui ◽  
Afewerki Weldezgi Tesfai ◽  
Mekonnen Estifanos Teklu ◽  
Matiwos Araya Ghebrehiwet ◽  
...  

Abstract Background Youth in general and young females, in particular, remain at the center of HIV/AIDS epidemic. To avoid and prevent HIV infection, comprehensive knowledge as well as correct understanding of transmission and prevention strategies are crucial. Thus, the aim of this study is to explore the predictors of comprehensive knowledge on HIV/AIDS and accepting attitude towards PLWHIV. Methods A cross-sectional study was conducted using data from the 2016 Uganda Demographic Health Survey. A two-stage probability sampling method was applied and data were collected using a standard questionnaire. Of the total 8674 women aged 15–49 years, 1971 eligible women aged 15–24 years were included in this analysis. Data analysis was done using SPSS version 23. A Chi-square test followed by logistic regression analysis was used to explore the relationship between specific explanatory variables and outcome variables. The results were reported using odds ratios with 95% confidence interval. P value less than 0.05 was considered as statistically significant. Results Overall, 99.3% of the unmarried women aged 15–24 years were aware of HIV/AIDS, but only 51.9% had comprehensive knowledge on HIV/AIDS. Around 70% of the respondents were aware that "using condoms every time when having sex" and "having only one faithful uninfected partner" can prevent HIV transmission. About 68% of the unmarried women rejected at least two common local misconceptions about HIV/AIDS. An alarmingly small (20.6%) proportion of the respondents had a positive acceptance attitude towards PLWHIV. All variables were significantly associated with having comprehensive knowledge on HIV/AIDS in the unadjusted logistic regression analysis. After adjustment, older age (20–24 years), being educated, wealthier, and ever been tested for HIV/AIDS became predictors of adequate comprehensive HIV/AIDS knowledge. Moreover, respondents with adequate comprehensive knowledge of HIV/AIDS were more likely (OR 1.64, 95% CI 1.30–2.08) to have a positive acceptance attitude towards PLWHIV than their counterparts. Conclusion Our study demonstrated a remarkably high level of awareness about HIV/AIDS among study participants, but the knowledge and positive acceptance attitude towards PLWHIV were not encouraging. Thus, endeavors to expand and strengthen educational campaigns on HIV/AIDS in communities, health facilities, and schools are highly recommended. Attention should particularly focus on young-aged and disadvantaged women with low educational level, poor socioeconomic status and those who have never been tested for HIV/AIDS.


Author(s):  
AA Toubasi ◽  
BR Khraisat ◽  
RB AbuAnzeh ◽  
HM Kalbouneh

Objective Medicine is considered one if not the most stressful educational field. Thus, the aim of this study is to investigate the prevalence of stress and poor sleeping quality among medical students and the association between them. Method This cross-sectional study was conducted at the University of Jordan on second- and third-year medical students. The questionnaire consisted of: 1) Demographics; 2) The assessment tools which were Pittsburgh Quality of Sleep Index (PSQI) and Kessler Psychological Distress Status (K10). Binary logistic regression, chi-square and linear regression were used to investigate the association between PSQI, K10, and their determinants. Results The mean for PSQI score was 6.76 ± 3.32. PSQI scores interpretation revealed that 61.7% of the 282 participants of this study were poor sleepers. Logistic regression results showed that only the category of not napping at all from the napping hours variable was significantly associated with sleeping quality. Furthermore, the mean of K10 scores was 24.5 ± 8.5. K10 scores revealed that 66.3% of the participants were stressed. Logistic regression results showed that gender and regular exercise were significantly associated with psychological distress. Additionally, chi-square test, logistic regression and linear regression showed that PSQI was significantly associated with K10 (P <0.01). Conclusions Stress and poor sleeping quality in medical students at the University of Jordan were highly prevalent and strongly associated. What determined PSQI was daytime napping, and for K10 were regular exercise and gender. Further investigations into stress and sleep quality in the Arabian region are needed.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jéssika M Siqueira ◽  
Jéssika D P Soares ◽  
Thaís C Borges ◽  
Tatyanne L N Gomes ◽  
Gustavo D Pimentel

AbstractCancer patients possess metabolic and pathophysiological changes and an inflammatory environment that leads to malnutrition. This study aimed to (i) determine whether there is an association between neutrophil-to-lymphocyte ratio (NLR) and nutritional risk, and (ii) identify the cut-off value of NLR that best predicts malnutrition by screening for nutritional risk (NRS 2002). This cross-sectional study included 119 patients with unselected cancer undergoing chemotherapy and/or surgery. The NRS 2002 was applied within 24 h of hospitalisation to determine the nutritional risk. Systemic inflammation was assessed by blood collection, and data on C-reactive protein (CRP), neutrophils, and lymphocytes were collected for later calculation of NLR. A receiver operating characteristic (ROC) curve was used to identify the best cut-point for NLR value that predicted nutritional risk. Differences between the groups were tested using the Student’s t-, Mann–Whitney U and Chi-Square tests. Logistic regression analyses were performed to assess the association between NLR and nutritional risk. The ROC curve showed the best cut-point for predicting nutritional risk was NLR > 5.0 (sensitivity, 60.9%; specificity, 76.4%). The NLR ≥ 5.0 group had a higher prevalence of nutritional risk than the NLR < 5.0 group (NLR ≥ 5.0: 73.6% vs. NLR < 5.0: 37.9%, p = 0.001). The NLR group ≥ 5.0 showed higher values of CRP and NLR than the NLR < 5.0 group. In addition, patients with NLR ≥ 5.0 also had higher NRS 2002 values when compared to the NLR < 5.0 group (NLR ≥ 5.0: 3.0 ± 1.1 vs. NLR < 5.0: 2.3 ± 1.2, p = 0.0004). Logistic regression revealed an association between NRS and NLR values. In hospitalised unselected cancer patients, systemic inflammation measured by NLR was associated with nutritional risk. Therefore, we highlight the importance of measuring the NLR in clinical practice, with the aim to detect nutritional risk.


2020 ◽  
pp. 201010582096214
Author(s):  
Tsegu Hailu Gebru ◽  
Haftea Hagos Mekonen ◽  
Kbrom Gemechu Kiros

Background: Good knowledge of self-care related to heart failure (HF) is key to improve patient outcomes. However, information regarding how much patients know about self-care is lacking in developing countries, particularly in the study setting. Objective: The objectives of this study were to assess HF patients’ knowledge about self-care and to explore predictors among HF patients in Ayder comprehensive specialised referral hospital, Tigray, Ethiopia. Methods: This hospital-based cross-sectional study design was undertaken in Ayder comprehensive specialised referral hospital, Tigray, Ethiopia. A total of 408 HF patients participated, and the study was done between February and April 2018. An interviewer-assisted structured questionnaire was used to collect data. Bivariate logistic regression and multivariable logistic regression were conducted to identify the predictors associated with knowledge about self-care. Results: The mean age of the participants was 45.4 years (standard deviation=19 years). Around 255 (62.5%) of the participants had poor self-care knowledge. Age, New York Heart Association classes, duration of the disease and previous hospitalisation were the factors associated with knowledge about self-care. Conclusion: More than half of all participants had poor knowledge about self-care. Improving existing prevention strategies and strengthening patients’ knowledge are recommended to address this knowledge deficit.


2016 ◽  
Vol 28 (4) ◽  
pp. 389-396 ◽  
Author(s):  
Henry Namme Luma ◽  
Servais Albert Fiacre Bagnaka Eloumou ◽  
Ellis Atemlefeh Fualefeh-Morfaw ◽  
Agnes Malongue ◽  
Elvis Temfack ◽  
...  

While gastrointestinal disease is common among HIV infected individuals, the prevalence and distribution of ano-rectal pathology has not been well studied in our setting. The objective of this study therefore was to determine the prevalence and determinants of ano-rectal pathology in HIV infected patients attending the Douala General Hospital HIV treatment centre. A hospital-based cross-sectional study was undertaken. We collected socio-demographic, clinical and laboratory data using a structured questionnaire and patients’ files. Each study participant had a full physical and ano-rectal examination. We further studied factors associated with having at least one ano-rectal lesion by logistic regression reporting odds ratios (ORs) and their 95% confidence intervals (CI). We included 390 HIV infected patients. The mean age was 41 (SD: 8) years and 48% were men. Median duration since HIV diagnosis was 3 (interquartile range: 2–5) years and median CD4 cell count was 411 (interquartile range: 234–601) cells/mm3. Prevalence of ano-rectal pathology was 22.8% (95% CI: 18.7–27.3). Hemorrhoids and proctitis were most common lesions found; each in 10% of patients. From multivariate logistic regression, factors associated with ano-rectal pathology were CD4 < 350 cells/ml (OR: 2.1, 95% CI: 1.1–4.2), not on highly active antiretroviral therapy (OR: 2.2, 95% CI: 1.1–4.6), inpatient (OR: 2.3, 95% CI: 1.2–4.3), ano-rectal intercourse (OR: 5.0, 95% CI: 1.7–15.1), and more than one sexual partner (OR: 2.4, 95% CI: 1.3–4.2). Ano-rectal pathology is common amongst HIV infected patients. Care givers should actively investigate and treat them as this will improve the quality of life of people living with HIV/AIDS.


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