Exploring Vaginal Birth After Cesarean: Success Rates and Cultural Decisions in the United Arab Emirates.

OBJECTIVE: This study explores the success rates and cultural influences on the decision-making process for vaginal birth after cesarean (VBAC) in the United Arab Emirates (UAE). METHODOLOGY: An observational cohort study was conducted at a hospital in the UAE accredited by Joint Commission International, enrolling 263 women eligible for VBAC from March 1, 2018, to February 28, 2019. The study focused on maternal-fetal outcomes, the proportions of women opting for trial of labor after cesarean (TOLAC) versus elective repeat cesarean section (ERCS), and the impact of cultural backgrounds on these decisions. RESULTS: The study found significant cultural variations in VBAC acceptance and success rates. Among local Emirati/Omani women, 86% (152 out of 177) opted for TOLAC, with an 83% success rate (126 out of 152). In contrast, lower TOLAC uptake and success rates were observed among other nationalities, such as Egyptian and other Arab women. The study also noted higher VBAC success rates in women with prior vaginal deliveries and those who experienced spontaneous labor. NICU admissions and maternal readmissions were lower in the TOLAC group (1% NICU admissions and 2% maternal readmissions) compared to the ERCS group (8.2% NICU admissions). CONCLUSION: The study underscores the influence of cultural factors in VBAC decision-making and outcomes, highlighting the need for culturally tailored counseling and care. It also confirms the safety and efficacy of VBAC in appropriately selected cases, advocating for more research into counseling practices and long-term outcomes in culturally diverse populations. Impact statement: This research adds to the understanding of how cultural and ethnic backgrounds influence VBAC decisions and outcomes, offering critical insights for clinical practice, especially in multicultural societies like the UAE. It emphasizes the role of tailored counseling and suggests avenues for future research in this domain.

Assess the knowledge of dentists regarding Hepatitis B serological profile: a cross-sectional study.

INTRODUCTION: The primary aim of the study was to determine the knowledge of dental practitioners regarding HBV serological markers. Second objective was to determine prevalence of occupational exposures to HBV amongst dentists. METHODOLOGY: A questionnaire was constructed pertaining to various aspects of HBV serology; validated by an expert panel; and piloted at 49 dentists. A Cronbach-alpha value of 0.7 was attained and thus extensive survey was conducted among dentists in routine practise treating hepatitis B patients at dental teaching hospitals in Peshawar, KP. The data was analysed using SPSS v.22. RESULTS: A response rate of 58% (a total of 290 respondents) was attained. All respondents were vaccinated against HBV. Over 50% reported not to follow Standard precautions for every patient. Overall, 20.3% experienced HBV exposure, eight were administered PEP. Fifty-four percent of FYs; 74.5% PGTs and 71.6% of faculty dentists correctly answered: HBsAg to be the 'serological hallmark of HBV infection'; this was the most correctly answered question. Sixty-four percent dentists failed to identify the infectious carrier phase. Over 50% of dentists in each category failed to correctly answer 5/8 of the HBV serology. CONCLUSIONS: Over 20% reported HBV occupational exposure but zero transmissions. Majority of dentists did not have correct information on HBV serological profile which may jeopardise cross-infection control. Further education on HBV serological markers and its clinical relevance to dentistry along with stringent adherence to Standard precautions is recommended.

Association Of Abo And Rh Blood Group Types To Hepatitis B, Hepatitis C, Hiv And Syphilis Infection, A Five Year' Experience In Healthy Blood Donors In A Tertiary Care Hospital.

BACKGROUND: Aim of the study: The aim of the study was to find out the frequency of Hepatitis B Hepatitis C, Syphilis, HIV and malaria in apparently healthy blood donors and to find out any association between ABO and Rh blood groups. METHODS: It was a descriptive study carried out at Rehman Medical Institute laboratory. All blood donors who volunteered for blood donation from Jan 2008 to Dec 2014 were reviewed for blood groups and screening tests. Those who were eligible were then screened for Hepatitis B, Hepatitis C, HIV, syphilis and malaria on Architect 8200i through chemiluminescent immunoassay whereas malaria was screened by a thin film. Blood group was determined by both forward and reverse grouping. Statistical analysis was carried out using SPSS software and expressed as frequencies. RESULTS: A total of 41033 apparently healthy donors were included in the study. All of them were voluntary donors. Their age ranged from 18-70 years with a mean age of 38±10.5years. Out of these 41033, 40245 (98.3%) were males and 788 (1.9%) were females. The most frequent blood group was B positive followed by O positive. Out of 41033 donors 961 (2.30%) had Hepatitis B, 566 (1.30%) had Hepatitis C, 363 (0.90%) had syphilis, 311 (0.76%) had malaria and 30 (0.07%) had HIV. There is a significant association between A blood group and HIV and hepatitis B. Donors with blood group O had no significant association with any blood transmitted infection. CONCLUSIONS: Blood group O may have some influence in protecting against blood transmitted infection. People having Blood group A are more prone to get Hepatitis B and HIV.