Impact of recurrent pregnancy loss on depression, anxiety and fertility related stress in Omani women: A cross sectional survey.

Pregnancy is a state of happiness and hope not only for a woman but for her family as well as near and dear ones. However, this phase of happiness comes shattering down for some couple who are not able to successfully complete pregnancy and end up losing a baby in the early stages of pregnancy. Recurrent pregnancy loss (RPL) is prevalent among Omani women and the psychosocial impact of RPL is heavy upon these young women devastating their overall quality of life. Researchers conducted a cross sectional survey among 184 Omani women who had a history of recurrent pregnancy loss in a pioneering teaching tertiary care hospital. Data collection done from using a self-reported questionnaire to assess the depression, anxiety and RPL associated stress of women with history of RPL The mean age of women with RPL was 34.05 and 81% reported 2-3 pregnancy loss. Participants reported higher mean scores of depression (9.94), Anxiety (10.32) and fertility related stress (30.28). Women with multiple pregnancy losses (above 3) reported higher level of anxiety which was significant at (p<0.05%) The findings from current study also indicated that women with RPL experience higher levels of depression, anxiety, and fertility related stress.

La grossesse est un état de bonheur et d'espoir non seulement pour une femme mais aussi pour sa famille ainsi que pour ses proches. Cependant, cette phase de bonheur s'effondre pour certains couples qui ne parviennent pas à mener à bien leur grossesse et finissent par perdre un bébé au début de la grossesse. Les fausses couches récurrentes (RPL) sont répandues chez les femmes omanaises et l'impact psychosocial de la RPL est lourd sur ces jeunes femmes, dévastant leur qualité de vie globale. Les chercheurs ont mené une enquête transversale auprès de 184 femmes omanaises ayant des antécédents de fausses couches récurrentes dans un hôpital universitaire de soins tertiaires pionnier. Collecte de données effectuée à l'aide d'un questionnaire autodéclaré pour évaluer la dépression, l'anxiété et le stress associé au RPL des femmes ayant des antécédents de RPL. L'âge moyen des femmes atteintes de RPL était de 34,05 ans et 81 % ont signalé 2 à 3 fausses couches. Les participants ont signalé des scores moyens plus élevés de dépression (9,94), d'anxiété (10,32) et de stress lié à la fertilité (30,28). Les femmes ayant subi plusieurs fausses couches (plus de 3) ont signalé un niveau d'anxiété plus élevé qui était significatif à (p<0.05%). Les résultats de l'étude actuelle ont également indiqué que les femmes atteintes de RPL connaissent des niveaux plus élevés de dépression, d'anxiété et de stress lié à la fertilité.

Therapeutic Donor Kidney Transplant Outcomes: Comparing Early US Experiences Using Optimal Matching.

Background: Therapeutic donors (TDs) are individuals who undergo organ removal for medical treatment with no replacement organ, and the organ is then transplanted into another person. Transplant centers in the United States have started using TDs for kidney transplantation (KT). TD-KT recipient outcomes may be inferior to those of non-TD-living-donor (non-TD-LD)-KT or deceased-donor (DD)-KT because of the conditions that led to nephrectomy; however, these outcomes have not been sufficiently evaluated. Methods: This was a retrospective cohort study using Organ Procurement and Transplantation Network data. Via optimal matching methods, we created 1:4 fivesomes with highly similar characteristics for TD-KT and non-TD-LD-KT recipients and then separately for TD-KT and DD-KT recipients. We compared a 6-mo estimated glomerular filtration rate (eGFR) between groups (primary endpoint) and a composite of death, graft loss, or eGFR <30 mL/min/1.73 m2 at 6 mo (secondary). Results: We identified 36 TD-KT recipients with 6-mo eGFR. There was also 1 death and 2 graft losses within 6 mo. Mean ± SD 6-mo eGFR was not significantly different between TD-KT, non-TD-LD-KT, and DD-KT recipients (59.9 ± 20.7, 63.3 ± 17.9, and 59.9 ± 23.0 mL/min/1.73 m2, respectively; P > 0.05). However, the 6-mo composite outcome occurred more frequently with TD-KT than with non-TD-LD-KT and DD-KT (18%, 2% [P < 0.001], and 8% [P = 0.053], respectively). Conclusions: Early graft function was no different between well-matched groups, but TD-KT demonstrated a higher risk of otherwise poor 6-mo outcomes compared with non-TD-LD-KT and DD-KT. Our results support selective utilization of TD kidneys; however, additional studies are needed with more detailed TD kidney information to understand how to best utilize these kidneys.

Comparison of Short-Term Outcomes in Kidney Transplant Recipients from SARS-CoV-2-Infected versus Noninfected Deceased Donors.

BACKGROUND: Acceptable post-transplant outcomes were reported in kidney transplant recipients from donors with coronavirus disease 2019 (COVID-19); however, there are no comparative studies with well-matched controls. METHODS: This multicenter, prospective observational study, which included three transplant centers in the United States, enrolled 61 kidney recipients from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected deceased donors. Using optimal matching methods, we matched every recipient to three comparators receiving kidneys from SARS-CoV-2-negative deceased donors with otherwise highly similar characteristics in the same transplant centers to compare 6-month eGFR. RESULTS: Among recipients of SARS-CoV-2-infected donor kidneys, one recipient died with a functional graft within 6 months. Mean 6-month eGFR was not significantly different between SARS-CoV-2-infected and noninfected donor groups (55±21 and 57±25 ml/min per 1.73 m 2 , respectively; P = 0.61). Six-month eGFR in recipients from SARS-CoV-2-infected donors who died of reasons other than COVID-19 was not significantly different from those from SARS-CoV-2-negative donors (58±22 and 56±25 ml/min per 1.73 m 2 , respectively; P = 0.51). However, recipients from donors who died of COVID-19 had significantly lower 6-month eGFR than those from SARS-CoV-2-negative donors (46±17 and 58±27 ml/min per 1.73 m 2 , respectively; P = 0.03). No donor-to-recipient SARS-CoV-2 transmission was observed. CONCLUSIONS: Six-month eGFR was not significantly different between recipients of kidneys from SARS-CoV-2-infected and noninfected donors. However, those receiving kidneys from donors who died of COVID-19 had significantly lower 6-month eGFR. Donor-to-recipient SARS-CoV-2 transmission was not observed.

Preferences for printed books versus E-books among university students in a Middle Eastern country.

Background: Learning styles vary among the students at the university level which has changed from traditional to more technology pervaded strategies involving digital gadgets. The Academic libraries are being challenged to upgrade from old fashioned hard copy resources to digital libraries including electronic books. Purpose: The main purpose of the study is to assess the preferences of using printed books versus e-books. Methods: A descriptive cross sectional survey design was used to collect the data. A total of 607 students were included in the study. Data collected was analyzed using descriptive and inferential statistics. Results: Results showed that 86.8% of the students were in undergraduate program with 48.9% students in the second year of the program, 95.6% in the age group of 17-26 years and 59.5% of them being females. The study concluded that 74.6% of students prefer e-books in terms of easy to carry and 80.6% of them spent more than 1 h reading from e-books, while 66.7% of the students preferred printed books due to the ease in studying and 67.9% favored as it is easy to make notes. However, 54% of them felt studying from the digital copies difficult. Conclusion: The study concludes that the students prefer e-books as they spent more time reading from e-books and are easy to carry; while traditional printed copy is comfortable to use and easy to take notes and study for exams. Implications for practice: As many changes are happening in the instructional design strategies with the introduction of hybrid methods of teaching and learning, the findings of the study will guide the stake holders and educational policy makers to design novel and modernized educational design that has a psychological, and social impact among the students.

Prevalence of Urinary Incontinence and its Relationship With Sociodemographic and Obstetrical Variables Among Omani Women.

Objective: Urinary incontinence (UI) is defined by the International Continence Society as any complaint of involuntary urine leakage. This research study highlights the prevalence, types, and associated factors of UI among women in Oman. Methodology: A descriptive cross-sectional design was used to collect data using purposive sampling technique from 400 women between 20 and 60 years; who were attending outpatient department of a referral hospital in Oman. Women were assessed using the Questionnaire for Urinary Incontinence Diagnosis to determine the type of UI. The severity and the impact of UI in women were assessed using the female urinary tract symptoms module (ICIQ-UI-SF). Descriptive statistics were used to determine the prevalence and type of UI, and the Chi-square test was used to find the association between UI and sociodemographic and obstetrical variables. Results: In our study, 28.25% of the women belonged to the age of 50-59 years. The point prevalence (per 1000) of UI among Omani women who were between 20 and 60 years was 44%. In the women who had UI, the majority were having stress UI (41.6%). In the women who had UI, the severity of UI, according to the ICIQ-UI-SF scoring, 15.2% of the women had slight, 50.3% had moderate, 33.1% had severe, and only 1.3% had very intense. Conclusion: Understanding the prevalence of UI in every community and associated factors is essential for the policy makers and healthcare providers to consider the early diagnosis, prevention, health promotion, and management of UI.

Case Study Analysis as an Effective Teaching Strategy: Perceptions of Undergraduate Nursing Students From a Middle Eastern Country.

Background: Case study analysis is an active, problem-based, student-centered, teacher-facilitated teaching strategy preferred in undergraduate programs as they help the students in developing critical thinking skills. Objective: It determined the effectiveness of case study analysis as an effective teacher-facilitated strategy in an undergraduate nursing program. Methodology: A descriptive qualitative research design using focus group discussion method guided the study. The sample included undergraduate nursing students enrolled in the Maternal Health Nursing Course during the Academic Years 2017 and 2018. The researcher used a purposive sampling technique and a total of 22 students participated in the study, through five (5) focus groups, with each focus group comprising between four to six nursing students. Results: In total, nine subthemes emerged from the three themes. The themes were "Knowledge development", "Critical thinking and Problem solving", and "Communication and Collaboration". Regarding "Knowledge development", the students perceived case study analysis method as contributing toward deeper understanding of the course content thereby helping to reduce the gap between theory and practice especially during clinical placement. The "Enhanced critical thinking ability" on the other hand implies that case study analysis increased student's ability to think critically and aroused problem-solving interest in the learners. The "Communication and Collaboration" theme implies that case study analysis allowed students to share their views, opinions, and experiences with others and this enabled them to communicate better with others and to respect other's ideas which further enhanced their team building capacities. Conclusion: This method is effective for imparting professional knowledge and skills in undergraduate nursing education and it results in deeper level of learning and helps in the application of theoretical knowledge into clinical practice. It also broadened students' perspectives, improved their cooperation capacity and their communication with each other. Finally, it enhanced student's judgment and critical thinking skills which is key for their success.

Ergonomic Stressors Among Pregnant Healthcare Workers: Impact on pregnancy outcomes and recommended safety practices.

Workplace environment can have a considerable impact on the physical, psychological and maternal health of pregnant healthcare workers. This article aimed to summarise the impact of work-related ergonomic stressors on pregnancy outcomes for healthcare workers, along with potential interventions to resolve these stressors. A narrative review analysis using the Pearl Growing Strategy was conducted between February 2019 and June 2020 to identify English-language articles published between 2000 and 2020. A total of 89 studies were identified from the SCOPUS (Elsevier, Amsterdam, Netherlands), MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA) databases and Google Scholar (Google LLC, Menlo Park, California, USA). The results indicated that poor work-related ergonomics had detrimental effects on pregnancy outcomes, resulting in spontaneous abortions, preterm delivery, low birth weight babies and infertility. Policymakers and employers should conduct ergonomic assessments and implement appropriate practices to ensure the safety of pregnant healthcare workers.

Data set on the characterization of the phytoestrogenic extract and isolated compounds of the roots of Inula racemosa Hook F (Asteraceae).

The data presented in this article are related to the research article entitled ' Phyto estrogenic effect of Inula racemosa Hook. f - A cardio protective root drug in traditional medicine, (Mangathayaru K, Divya R, Srivani T et al., 2018) [1]. It describes the characterization details of the root extract and the compounds isolated from them that were shown to be phytoestrogenic in vivo and in vitro respectively.

Phytoestrogenic effect of Inula racemosa Hook f - A cardioprotective root drug in traditional medicine.

ETHNOPHARMACOLOGICAL RELEVANCE: Roots of Inula racemosa are used as a cardio protective in Ayurveda in India, being prescribed as a medicine for precordial chest pain, cough and dyspnoea, both singly and as a poly herbal. AIM: Evaluation of Phytoestrogenic activity of the root extracts of Inula racemosa and compounds isolated therefrom in vivo, in silico and in vitro. MATERIALS AND METHODS: Alcohol (IrA) and hexane (IrH) extracts characterized by HPTLC/GC-MS analysis respectively and processed for compound isolation were evaluated for estrogenic activity (100 & 250mg/kg bw) by the Immature rat uterotrophic assay using ethinylestradiol (EE -30µg/kg bw) as standard drug. Alantolactone (ALT), Isoalantolactone (IALT) and Stigmasterolglucoside (SG) isolated from the extracts were characterized and screened in silico for ERα, ERß binding affinity, assessed in vitro for growth modulatory effects on MCF-7 cells by MTT assay and cell cycle distribution analysis using Flow cytometry. RT-PCR analysis evaluated the mRNA expression of pS2 in these cells post exposure to ALT, IALT and SG. RESULTS: In the IrA treated groups there has been a statistically significant increase (P < 0.05) in absolute and normalised uterine weight, uterine diameter, endometrial thickness, luminal epithelial cell height,diameter of ovary and in the number of primary and secondary ovarian follicles relative to untreated controls. Presence of ciliated epithelial cells in the oviduct, elevated number of early growing follicles characterized by an increased oocyte diameter, and signs of vascularization in the cortex of ovarian sections in this group relative to EE treated group are indicative of pervasive activation of follicular growth and initiation. Virtual docking demonstrated ERα affinity for IALT, ERß affinity for ALT, while SG showed a high binding affinity to both with a relatively greater ERß binding affinity. Dose dependent decrease in cell viability mediated by IALT and SG in the MTT assay is corroborated by a statistically significant increase (p < 0.05) in sub G0-G1 cells by SG at 200 and 400µM in cell cycle analysis and there has been an induction of pS2 by IALT and SG in the ER regulated MCF-7 cells. CONCLUSIONS: Demonstration of classical morphological changes induced by estrogen stimulation mediated by IrA in vivo at both the tested doses, isolation of the antioxidant SG from IrA and its dose dependent growth inhibitory effect on estrogen sensitive MCF-7 cells through apoptotic induction and an up regulation of pS2 are suggestive of an anti-estrogenic effect through estrogen receptor binding affinity, typical of phytoestrogens that bind to ER but do not elicit a full estrogenic response. The observed estrogenic effect of IrA suggests a multi mechanistic molecular action involving antioxidant as well as redox signalling pathways acting in consonance with their anti-estrogenic effects owing to the weak estrogen like competitive receptor binding of SG.

The potential of hybrid forward osmosis membrane bioreactor (FOMBR) processes in achieving high throughput treatment of municipal wastewater with enhanced phosphorus recovery.

Extensive research in recent years has explored numerous new features in the forward osmosis membrane bioreactor (FOMBR) process. However, there is an aspect, which is revolutionary but not yet been investigated. In FOMBR, FO membrane shows high rejection for a wide range of soluble contaminants. As a result, hydraulic retention time (HRT) does not correctly reflect the nominal retention of these dissolved contaminants in the bioreactor. This decoupling of contaminants retention time (CRT, i.e. the nominal retention of the dissolved contaminants) from HRT endows FOMBR a potential in significantly reducing the HRT for wastewater treatment. In this work, we report our results in this unexplored treatment potential. Using real municipal wastewater as feed, both a hybrid microfiltration-forward osmosis membrane bioreactor (MF-FOMBR) and a newly developed hybrid biofilm-forward osmosis membrane bioreactor (BF-FOMBR) achieved high removal of organic matter and nitrogen under HRT of down to 2.0 h, with significantly enhanced phosphorus recovery capacities. In the BF-FOMBR, the used of fixed bed biofilm not only obviated the need of additional solid/liquid separation (e.g. MF) to extract the side-stream for salt accumulation control and phosphorus recovery, but effectively quarantined the biomass from the FO membrane. The absence of MF in the side-stream further allowed suspended growth to be continuously removed from the system, which produced a selection pressure for the predominance of attached growth. As a result, a significant reduction in FO membrane fouling (by 24.7-54.5%) was achieved in the BF-FOMBR due to substantially reduced bacteria deposition and colonization.

Towards high through-put biological treatment of municipal wastewater and enhanced phosphorus recovery using a hybrid microfiltration-forward osmosis membrane bioreactor with hydraulic retention time in sub-hour level.

This work uncovers an important feature of the forward osmosis membrane bioreactor (FOMBR) process: the decoupling of contaminants retention time (CRT) and hydraulic retention time (HRT). Based on this concept, the capability of the hybrid microfiltration-forward osmosis membrane bioreactor (MF-FOMBR) in achieving high through-put treatment of municipal wastewater with enhanced phosphorus recovery was explored. High removal of TOC and NH4(+)-N (90% and 99%, respectively) was achieved with HRTs down to 47min, with the treatment capacity increased by an order of magnitude. Reduced HRT did not affect phosphorus removal and recovery. As a result, the phosphorus recovery capacity was also increased by the same order. Reduced HRT resulted in increased system loading rates and thus elevated concentrations of mixed liquor suspended solids and increased membrane fouling. 454-pyrosequecing suggested the thriving of Bacteroidetes and Proteobacteria (especially Sphingobacteriales Flavobacteriales and Thiothrix members), as well as the community succession and dynamics of ammonium oxidizing and nitrite oxidizing bacteria.

Conservative Care of the Elderly CKD Patient: A Practical Guide.

Palliative care is a branch of medicine dedicated to the relief of symptoms experienced during the course of illness. Renal palliative medicine or kidney supportive care is an evolving branch of nephrology, which incorporates the principles of palliative care into the care of CKD and ESRD (dialysis, transplant, and conservatively managed) patients. Conservative (non-dialytic) management is a legitimate option for frail, elderly CKD patients in whom dialysis may not lead to an improvement in quality or duration of life. Patients with advanced CKD have a high symptom burden that often worsens before death. Palliative or supportive care by visiting nurses, palliative care programs, or knowledgeable CKD programs should be routine for conservatively managed CKD patients. Decision-making about dialysis or conservative management requires patients and families be given information on prognosis, quality of life on dialysis, and options for supportive care. Advance care planning is the process by which these issues can be explored. In addition to advance care planning, because patients with ESRD have a high symptom burden, this needs to be addressed. Patients with ESRD have a high symptom burden, which needs to be addressed in any treatment plan. Common symptoms include pain, fatigue, insomnia, pruritus, anorexia, and nausea. Symptoms appear to increase as the patient nears death, and this must be anticipated. Recommendations for management are discussed in the article. Hospice care should be offered to all patients who are expected to die within the next 6 months, and supportive care should be provided to all CKD patients managed conservatively or with dialysis.