Management of iron deficiency anemia during pregnancy: a midwife-led continuity of care model.

Background: Globally, 36.5% of pregnancies are affected by anemia, particularly in low-and middle-income countries, posing significant risks to maternal and perinatal health. In rural Pakistan, 44.3% of pregnant women suffer from iron deficiency, contributing to the high prevalence of anemia. Limited accessibility to antenatal care exacerbates the challenge, necessitating innovative solutions. This study assessed a midwife-led continuity of care model, utilizing intravenous (IV) iron therapy for the management of anemia in Karachi, Pakistan. Methods: We performed a retrospective analysis of data from a prospective cohort study conducted in two primary healthcare facilities, which employed a community midwife (CMW)-led continuity of care model for antenatal care, including IV iron therapy. We extracted data from February 2021 to March 2022 for women who were diagnosed with anemia based on hemoglobin (Hb) levels, categorized as mild (10.0 to 10.9 g/dL), moderate (7.0 to 9.9 g/dL), or severe (less than 7.0 g/dL). Assessment occurred at the initial antenatal care (ANC) visit to establish baseline anemia severity, and approximately 2 weeks after intravenous (IV) iron therapy administration to evaluate post-treatment changes were considered. Results: We enrolled 114 pregnant women, where the majority presented with moderate (88.6%) anemia. After IV iron treatment, 48.5% improved to normal-mild levels, while 50% remained unchanged. Severe anemia affected 10.5% at baseline; 42% shifted to moderate and 50% to normal-mild post-treatment, with one remaining unchanged (p < 0.001). Among women enrolled in the first and second trimesters, severe anemia improved to normal-mild (50%) and moderate levels (50%) (pre-treatment: n = 10, post-treatment: n = 0), and moderate anemia decreased by 48% (pre-treatment: n = 92, post-treatment: n = 47). Conclusion: Our midwife-led model of care demonstrated an improvement in iron levels among pregnant women. The model addressed the challenges of anemia prevalence in Pakistan and underscored the significance of empowering front-line healthcare providers, such as community midwives (CMWs) for managing these common conditions.

Polymorphic Analysis of Genes PADI4 (rs2240340, rs1748033) and HLA-DRB1 (rs2395175) in Arthritis Patients in Pakistani Population.

Genes are an important factor for the initiation of any disease. Many genes are associated with rheumatoid arthritis (RA) other than environmental factors. The main objective of the study was to evaluate the association of genes PADI4 (peptidylarginine deiminases 14) (rs2240340, rs1748033) and Human leukocyte antigen class II histocompatibility, D-related beta chain (HLA-DRB1) (rs2395175) polymorphisms in RA patients from Punjab, Pakistan. Blood samples of RA patients were collected from different hospitals of Sargodha. DNA was extracted, followed by PCR. Polymorphic analysis was performed in 300 rheumatoid arthritis patients and 300 healthy controls on PADI4 (rs2240340, rs1748033) and HLA-DRB1 (rs2395175). In PADI4 gene, both homozygous mutant genotype (TT) and heterozygous (CT) of SNP rs2240340 showed significant association by increasing the risk of RA up to two fold (OR 2.55; 95% CI 1.57-4.15; p = 0.0002). In case of rs1748033 polymorphism, homozygous mutant genotype (TT) showed significant association with RA by increasing the risk of disease up to three fold (OR 3.46; 95% CI 1.97-6.07; p = 0.0001), while heterozygous genotype (CT) of the same SNP showed significant association with RA by playing a protective role (OR 0.57; 95% CI 0.36-0.91; p = 0.0197). In HLA-DRB1 gene, homozygous mutant genotype (GG) of SNP rs2395175 showed no significant association with RA, while heterozygous genotype (AG) of the same SNP showed significant association with RA by playing a protective role (OR 0.44; 95% CI 0.27-0.71; p = 0.0009). Highly significance association of genes PADI4 (rs2240340, rs1748033) and HLA-DRB1 (rs2395175) polymorphisms with RA was observed in Pakistani population.

Advanced methods of algal pigments extraction: A review.

Algae are exclusively aquatic photosynthetic organisms that are microscopic or macroscopic, unicellular or multicellular and distributed across the globe. They are a potential source of food, feed, medicine and natural pigments. A variety of natural pigments are available from algae including chlorophyll a, b, c d, phycobiliproteins, carotenes and xanthophylls. The xanthophylls include acyloxyfucoxanthin, alloxanthin, astaxanthin, crocoxanthin, diadinoxanthin, diatoxanthin, fucoxanthin, loroxanthin, monadoxanthin, neoxanthin, nostoxanthin, perdinin, Prasinoxanthin, siphonaxanthin, vaucheriaxanthin, violaxanthin, lutein, zeaxanthin, ß-cryptoxanthin, while carotenes include echinenone, α-carotene, ß-carotene, γ-carotene, lycopene, phytoene, phytofluene. These pigments have applications as pharmaceuticals and nutraceuticals and in the food industry for beverages and animal feed production. The conventional methods for the extraction of pigments are solid-liquid extraction, liquid-liquid extraction and soxhlet extraction. All these methods are less efficient, time-consuming and have higher solvent consumption. For a standardized extraction of natural pigments from algal biomass advanced procedures are in practice which includes Supercritical fluid extraction, Pressurized liquid extraction, Microwave-assisted extraction, Pulsed electric field, Moderate electric field, Ultrahigh pressure extraction, Ultrasound-assisted extraction, Subcritical dimethyl ether extraction, Enzyme assisted extraction and Natural deep eutectic solvents. In the present review, these methods for pigment extraction from algae are discussed in detail.

Ethnobotanical study of Mandi Ahmad Abad, District Okara, Pakistan.

This study hypothesized that native people have unique traditional knowledge of plant resources in the rural areas and basic objective was the documentation of this valuable inheritance. Ethnobotanical data was collected from a remote rural area of Mandi Ahmad Abad, Union council number NA-144 Tehsil Depalpur District Okara, Pakistan. A total of 94 informants were randomly interviewed to collect data about local names of plant species, mode of administration, recipes and ailments, and ethnobotanical uses through semi-structured questionnaire, interviews and group discussion methods. The collected data was statistically analyzed by calculating use value (UV), frequency of citation (FC), relative frequency of citation (RFC), factor of informant consensus (FIC), family importance value, and relative importance (RI). This study is also compared with ethnobotanical literature by using Jaccard's index (JI) for similarity analysis. A total of 126 species belonging to 52 families were documented. The Poaceae (13spp.), Leguminosae (12spp.), Solanaceae (10spp.) and Cucurbitaceae (10spp.) were dominant families. Highest used value (UV = 0.22) was obtained for Azadirachta indica. The minimum used value (UV) was showed by Alhagi maurorum, Eclipta prostrata, Hibiscus rosa-sinensis, Solanum virginianum and Trianthema potulacastrum (UV = 0.01). Hepatitis, stomach ulcer, bowel disorders, urinary problems, psoriasis, cancer, and leucoderma were the most treated ailments with ICF value of 1, followed by leucorrhea (ICF: 0.89), and vomiting (ICF: 0.86). The highest Jaccard's similarity index value (JI = 0.329) showed that plant species reported in our study was more similar with Arid regions of Northern Punjab, Pakistan. This novel ethnobotanical report concluded that traditional knowledge about use of medicinal plants is decreasing due to allopathic medicines. Immediate steps should be taken for conservation and documentation of traditional knowledge of plants especially those having medicinal properties.

Helminthological studies in francolins (Galliformes: Phasianidae) of Sindh, Pakistan with two new species and epidemiological parameters.

Francolins are among the very gregarious variety of game birds severely infected by various parasites that may cause an important source for infection transmission in humans by eating them very fondly in the country. During this study, two commonly found francolins species of the region; Francolinus francolinus (Black Francolin) and F. pondicerianus (Grey Francolin), were examined for helminthes fauna. The study deals with the primary survey of helminthic infection occur in the francolin birds (Phasianidae: Perdicinae) with reference to their forage in gut content. It is the first helminthological and epidemiological study in Sindh, Pakistan. At present, a total of 20 birds were examined, out of which 17 were found infected with cestode larvae of two species of genus Cotugnia and genus Raillietina, one species of trematode, Prosthogonimus potentially new species; one new species of acanthocephalan, Mediorhynchus francolinae sp. nov.; one species of nematode, Subulura brumpti (López-Neyra, 1922) were recovered, with new host records. The forage content and comparative incidence of helminth species were also observed and discussed in the current study, which revealed the high prevalence of infection in grey francolins than that of black francolin. The mean intensity of infection relative to the forage in guts of hosts was found significant (P < 0.05), observed 9.14 ± 1.65 in black francolins than in grey francolins (5.8 ± 0.51). The parasitic abundance was compared using Fisher's Exact Test, which showed no significant difference between cestodes and nematodes in the two hosts, however trematode and acanthocephalan was found only in grey francolin. The parasitic frequencies along with the confidence intervals were recorded higher in black francolins by cestodes and nematodes than the black francolins during the present study.