Frequency of Stress Urinary Incontinence during Third Trimester in pregnant female with Referral for the Physiotherapy

Introduction .Objectives of the study are:- 1) To determine the frequency of stress incontinence in pregnant females, 2) To determine the frequency of urinary incontinence is increased in primigravida (pregnant for first time), or multigravida. 3) To determine how many of the females are referred for physiotherapy. Methodology: A Cross-sectional survey was conducted among 600 pregnant females from January to June 2018 selected via the convenience sampling technique. Data was collected from different major cities of Pakistan using validated questionnaires including “The Questionnaire for Urinary Incontinence Diagnosis” (QUID) and “International consultation on incontinence questionnaire” (ICIQ-SF) and self-structured questions assessing the reference of pregnant women to physiotherapy, for urinary incontinence. Subjects were selected according to the inclusion and exclusion criteria with the consent and approval of the participants. Statistical analysis was done using SPSS v.20. Results Out of 600 females, 84.3% (506/600) had experienced stress urinary incontinence in pregnancy and a 64.5% urinary incontinence was found in multigravida females. According to the results, the complaints of urinary incontinence were increased during the 9th month to 35.5%. 6.2% of the participants were referred to a physiotherapist for exercise, out of which, 3.7% were prescribed daily exercise and 1% followed the exercise regime regularly. Conclusion This Study concludes that the frequency of stress urinary incontinence in third-trimester pregnant women especially during 9th-month multigravida is severed. Referral to physiotherapy for urinary incontinence in pregnancy is extremely low.

Changes of Rat Embryon Nephrogenesis during Cadmium Salt Intoxication in Pregnant Females

The purpose of the experimental study was to determine morphogenetic disorders of embryonic and fetal kidney development in chronic intragastric exposure to cadmium salts (cadmium chloride, cadmium citrate) in pregnant females. Materials and methods. Low doses of cadmium salts were selected for the study, which can be compared with the actual concentration of cadmium in the daily diets of women, including pregnant women, in industrial regions. In the experiment, female rats with a given gestational age were divided into groups as follows: Group 1 – control (number of females – n = 16, of which 8 left the experiment on the 13th day of pregnancy, and 8 on the 20th; the number of embryos – n13 = 76; n20 = 77); Group 2 – administration of cadmium chloride at a dose of 1.0 mg/kg body weight of the female (number of females – n = 16; number of embryos – n13 = 65; n20 = 62); Group 3 – administration of cadmium citrate at a dose of 1.0 mg/kg body weight of the female (number of females – n = 16; number of embryos – n13 = 69; n20 = 70). Results and discussion. New quantitative data on the effect of cadmium salts were obtained on the thickness of the cortical and cerebral layers of the kidneys, the diameter and area of the cavity of the nephron capsule in the prenatal period of development in chronic female intoxication. On the 13th day, the effect of cadmium salts on the development of embryonic kidneys was multidirectional: the effect of cadmium chloride led to an increase in the thickness of the mesonephros and mesonephric duct, and the effect of cadmium citrate reduced the studied parameters. On the 20th day of rat embryogenesis in the group exposed to cadmium chloride, the renal weights increased, and when exposed to cadmium citrate, the weight of the kidneys decreased significantly (p˂0.05) both in comparison with control values and in the group exposed to cadmium chloride. On the 20th day of development, in order to exclude an error in estimating the dynamics of changes in the weight of embryo mass and kidney mass, the nephrofetal index was calculated, i.e. the ratio of wet kidney mass to wet weight of fixed fetus. Histological parameters of nephron diameters were also compared. Conclusion. Cadmium citrate has been shown for the first time to be less non-photoxic than cadmium chloride. Calculation of the area of the cavity of the nephron capsule by the spline contour method showed a 2.6-fold decrease in the average area of the capsule cavity in the group exposed to cadmium chloride relative to the control mean values, indicating a violation of nephrogenesis. When exposed to cadmium citrate, there was also a decrease in the area of the cavity of the nephron capsule by 1.8 times, which indicates a lower level of nephrotoxic cadmium citrate compared to cadmium chloride, despite the identity of the dose of exposure

Evaluation of biparietal diameter and femur length by ultrasonography method, its correlation with fetal gestational age a comparative study in Chhattisgarh state of India

There few studies which tried to corelate biparietal diameter and gestational age in which an increase in biparietal diameter with the increase in gestational age was found but there was a discrepancy between 17 week of pregnancy and term and which is approximately 3 weeks. We conducted the present study to compare the gestational age and femur length and biparietal diameter in the population of Chhattisgarh state of India.A total of 380 pregnant females were enrolled for the study. They were between the 20 weeks to 38 weeks of gestation with their age ranging from 18-35 years.In the present study we observed a total of 158 cases in 2 trimester i.e. ranging from 20 to 27 weeks and 220 cases were in 3 trimester of pregnancy. Mean of BPD and FL observed was 73.1 and 56.2 respectively. The standard deviation and standard error of mean for biparietal diameter and femur length were 12.8, 11.6 and 0.63, 0.57 respectively.All parameters of present study are found to be highly correlated with gestational age. (r=, 0.987, 0.980 for, FL and BPD respectively).

Using commercial enzyme immunoassay for measuring pregnancy-associated glycoproteins to diagnose pregnancy in dairy cows under field conditions in Algeria

The purpose of the present work was to study effectiveness for early pregnancy diagnosis in cattle of the new enzyme immunoassay (EIA) sandwich kit commercially available based on the measurement of pregnancy-associated glycoproteins (PAGs). 120 Holstein-Friesian cattle of mixed age and parity were comprised from different dairy herds. The pregnant females (n = 68) were diagnosed by ultrasonography at day 35-40 after artificial insemination and confirmed by transrectal exploration at 2-3 months after AI. The non-pregnant females (n = 52) were housed in the absence of males during the experimental period. Blood samples were collected from coccygeal vessels of females into EDTA tubes. The serum was obtained by centrifugation and the serum was stored at - 20 C until assay. The PAG concentrations in pregnant and non-pregnant females were determined in serum by EIA kit. The reproducibility inter- and intra-assay of the PAG-EIA is satisfactory (2.78 and 13.19 %, respectively). The accuracy ( 94.8 %) and the test of parallelism were largely acceptable. No cross-reaction was observed with the different hormones tested at different dilutions. PAG-EIA system gave 100 % sensitivity and negative predictive values. Whereas, specificity and positive predictive value were 91.93 and 71.15 %, respectively. The accuracy of pregnancy diagnosis by PAG-EIA was 87.5 %. In conclusion, the present study shows clearly that the EIA kit can be used to measure PAG in serum cows for the detection of gestation in Algeria. Therefore, this alternative technique could be recommended to replace the radioactive methods in immunoassays to improve the reproductive performances and an efficient tool for reproductive management of dairy cattle.

Study to assess sub-foveal choroidal thickness in patients of preeclampsia through spectral domain optical coherence tomography

Background: Aim of the study was to assess sub-foveal choroidal thickness (SFCT) in preeclamptic patients by SD ocular coherence tomography (SD-OCT) and correlate its changes with severity of preeclampsia.Method: This case control, observational study, conducted in department of ophthalmology in association with department of obstetrics and gynaecology. The subjects were split into two groups: study and control. Study group was further divided in to 2 groups i.e., group A (Patients with preeclampsia) and group B (Pregnant females without preeclampsia). Control group (Group C) of non-pregnant females of similar age group. Total 100 patients were taken in each group. Subjects from both study and control groups were subjected to SD-OCT and mean choroidal thickness of both eyes was noted. Data was noted and comparison of 3 groups was done.Results: Baseline characters viz, age, period of gestation, and parity was comparable among all the groups as p>0.05. Mean arterial pressure (MAP) was 102.72±9.81 and 84.56±7.83 in group A and B respectively with statistically significant difference as p<0.01. Following a post hoc analysis, it was discovered that the SFCT of the healthy pregnancy group did not differ substantially from that of the control group, however the SFCT of the pre-eclampsia group was significantly higher than that of the control and healthy pregnancy groups.Conclusions: Pre-eclampsia causes a greater increase in sub-foveal choroidal thickness than normal pregnancy or non-pregnant women. It has the potential to be used as a predictor or marker of pre-eclampsia severity.

COMPARATIVE ASSESSMENT OF FOSFOMYCIN AND NITROFURANTOIN THERAPY IN URINARY TRACT INFECTION DURING PREGNANCY.

Background: Urinary tract infections in pregnancy can be complications if the microbes causing it are proven to be resistant to standard use antibiotics. Routinely a multi-dose regimen of nitrofurantoin is used as a management protocol, however recent literatures have highlighted the relative efficacy of Fosfomycin in successful treatment. The present study was done to comparatively assess the efficacy of single dose Fosfomycin and standard dose nitrofurantoin in UTI among pregnant females, Methodology: Study employed a pool of 60 subjects divided equally in two groups. The groups were provided either with Fosfomycin or nitrofurantoin. Observations: Fosfomycin showed a lower rate of side effects and microbial resistance as compared to nitrofurantoin. The clinical and laboratory analysis revealed a statistically significant superiority of Fosfomycin in the selected study sample. Conclusion: Fosfomycin showed a better outcome compared to nitrofurantoin in the selected study sample. Keywords: Fosfomycin, Nitrofurantoin, Pregnancy, UTI

Protracted Impairment of Maternal Metabolic Health in Mouse Dams Following Pregnancy Exposure to a Mixture of Low Dose Endocrine-Disrupting Chemicals, a Pilot Study

Pregnancy, a period of increased metabolic demands coordinated by fluctuating steroid hormones, is an understudied critical window of disease susceptibility for later-life maternal metabolic health. Epidemiological studies have identified associations between exposures to various endocrine-disrupting chemicals (EDCs) with an increased risk for metabolic syndrome, obesity, and diabetes. Whether such adverse outcomes would be heightened by concurrent exposures to multiple EDCs during pregnancy, consistent with the reality that human exposures are to EDC mixtures, was examined in the current pilot study. Mouse dams were orally exposed to relatively low doses of four EDCs: (atrazine (10 mg/kg), bisphenol-A (50 µg/kg), perfluorooctanoic acid (0.1 mg/kg), 2,3,7,8-tetrachlorodibenzo-p-dioxin (0.036 µg/kg)), or the combination (MIX), from gestational day 7 until birth or for an equivalent 12 days in non-pregnant females. Glucose intolerance, serum lipids, weight, and visceral adiposity were assessed six months later. MIX-exposed dams exhibited hyperglycemia with a persistent elevation in blood glucose two hours after glucose administration in a glucose tolerance test, whereas no such effects were observed in MIX-exposed non-pregnant females. Correspondingly, MIX dams showed elevated serum low-density lipoprotein (LDL). There were no statistically significant differences in weight or visceral adipose; MIX dams showed an average visceral adipose volume to body volume ratio of 0.09, while the vehicle dams had an average ratio of 0.07. Collectively, these findings provide biological plausibility for the epidemiological associations observed between EDC exposures during pregnancy and subsequent maternal metabolic dyshomeostasis, and proof of concept data that highlight the importance of considering complex EDC mixtures based of off common health outcomes, e.g., for increased risk for later-life maternal metabolic effects following pregnancy.

Effect of the use of dexmedetomidine as a local anesthetic adjuvant to bupivacaine 0.125% in epidural labor analgesia: randomized controlled study

Background Multiple methods exist for the management of pain during normal labor. Epidural analgesia has been reported to be an effective method in that perspective. The current study was conducted to evaluate the efficacy of dexmedetomidine as an adjuvant to local anesthetics in epidural analgesia for pregnant females presented for normal delivery. Sixty pregnant females were included in this prospective randomized study, and they were divided into two equal groups: control group which received bupivacaine alone and dexmedetomidine group that received bupivacaine with dexmedetomidine. The primary outcome was the onset of analgesia, while the secondary outcomes included the duration of analgesia, hemodynamic changes, labor progress, neonatal outcomes, and maternal complications. Results Dexmedetomidine group was associated with earlier onset of analgesia (P ˂ 0.001), prolonged duration (P ˂ 0.001), and lower need for top-up doses (P ˂ 0.001) compared to control group. Also, sedation and maternal satisfaction were significantly better in the same group (P = 0.001, 0.025; respectively). Labor progress parameters and neonatal outcomes were comparable between the two groups. Dexmedetomidine group has lower heart rate and mean arterial blood pressure compared to the control group. Despite of dexmedetomidine group had higher incidence of hypotension and bradycardia, it was statistically insignificant when compared to control group. Conclusions Dexmedetomidine is a reliable and an effective adjuvant to the local anesthetics in epidural analgesia during normal delivery as it resulted in earlier onset and significant prolongation of the analgesic time with decrease in the top-up doses intake. Trial registration Pan African Clinical Trial Registry (PACTR201710002664704). Register on 3 October 2017.