Association of birth and periodontal disease in Bolivia, Chile and Colombia / Asociación de parto prematuro y enfermedad periodontal en Bolivia, Chile y Colombia

ABSTRACT Introduction. Preterm birth is a major medical, social, and economic problem that causes a large proportion of neonatal mortality and morbidity, has a high impact on the healthcare system, and affects family quality of life. The weight of newborns with mothers with periodontal disease is significantly lower compared to mothers not affected by this oral disease. This adverse outcome is considered a global public health problem based on epidemiological data. Objective. To determine the association between the prevalence of preterm births and periodontal disease in Bolivia, Chile, and Colombia from 2000 to 2020. Materials and methods. This ecological study considered the population of women in Bolivia, Chile, and Colombia, according to the prevalence of preterm births and periodontal disease discriminated by age. The study covered the period between 2000 and 2020. The search strategy within the Institute for Health Metrics and Evaluation investigative tool included prevalence, age groups, causes of preterm births and periodontal disease, context and locations, women, and rates. Statistical analysis included a simple linear regression between preterm births and periodontal disease for each age group within each country. Results. Preterm birth rates were higher in the 15-19 years age group (Bolivia: 697,563; Chile: 844,864; Colombia: 804,126). The periodontal disease prevalence increased with age, as we observed in the 45-49 years group (Bolivia: 22,077,854; Chile: 34,297,901, Colombia: 32,032.830). According to age groups, the linear regression was statistically significant (p < 0.001) in all age groups for the Bolivian population over 30 years for the Colombian, and only in the 15-19 years group for the Chilean women. Conclusion. An association was found between preterm births and periodontal disease in all age groups in Bolivia, only in the group of 15 to 19 years in Chile, and 30 years and up in Colombia over the 20-year period.

RESUMEN Introducción. El parto prematuro es un problema médico, social y económico importante, causa gran mortalidad y morbilidad neonatal, tiene un impacto importante en el sistema de salud y afecta la calidad de vida de las familias. El peso de los recién nacidos de madres con enfermedad periodontal es significativamente menor en comparación con los de madres no afectadas por esta enfermedad bucal. Este resultado adverso se considera un problema de salud pública global según los datos epidemiológicos. Objetivo. Determinar la asociación entre la prevalencia de parto prematuro y la enfermedad periodontal en Bolivia, Chile y Colombia entre el 2000 y el 2020. Materiales y métodos. Este estudio ecológico consideró las poblaciones de mujeres de Bolivia, Chile y Colombia, y la prevalencia de partos prematuros y enfermedad periodontal, discriminadas por grupos de edad. El estudio abarcó el período entre el 2000 y el 2020. La estrategia de búsqueda con la herramienta de investigación del Institute for Health Metrics and Evaluation incluyó prevalencia, grupos de edad, años entre 2000 y 2020, causas de parto prematuro y enfermedad periodontal, contexto y ubicaciones, mujeres y tasas. El análisis estadístico incluyó una regresión lineal simple entre parto prematuro y enfermedad periodontal para cada grupo de edad dentro de cada país. Resultados. Las tasas de partos prematuros fueron mayores en el grupo de 15 a 19 años (Bolivia: 697.563, Chile: 844.864, Colombia: 804.126). La prevalencia de la enfermedad periodontal aumentó con la edad, particularmente en el grupo de 45 a 49 años (Bolivia: 22'077.854, Chile: 34'297.901, Colombia: 32'032,830). Según los grupos de edad, la regresión lineal fue estadísticamente significativa (p < 0,001) para todos los grupos evaluados de la población boliviana, en los grupos mayores de 30 años para las colombianas y solo en el grupo de 15 a 19 años para las mujeres chilenas. Conclusión. Se encontró asociación entre el parto prematuro y la enfermedad periodontal en todos los grupos de edad en Bolivia, solo en el grupo de 15 a 19 años en Chile, y de 30 años y más en Colombia en el período evaluado de 20 años.

Fast dissolving oral thin films: an innovative herbal drug delivery system

Fast-dissolving drug delivery systems were first developed as an alternative to common dosage forms in the late 1970s. The oral thin film is an innovative drug administration approach based on transdermal patch technology. These systems consist of solid dosage forms that dissolve and disintegrate quickly in the mouth without the need for water. Oral thin films (OTFs) and oral disintegrating tablets (ODTs) are two types of fast-acting pharmaceutical delivery methods. ODTs are "A solid dosage form containing medicinal substances, which disintegrates rapidly, usually within a matter of seconds, when placed upon the tongue." As a result, OTFs hydrate fast before dissolving or disintegrating, allowing the medicine to be absorbed locally and systemically. This method provides a solid platform for extending the patient lives of existing products while also developing new ones without infringing on patients. Fast- dissolving oral thin films are being used for sublingual and gastro retentive administration methods in addition to the buccal technique. This review focusses on the composition of various types of polymers, both natural and synthetic, as well as manufacturing processes, packaging materials, and OTF evaluation tests.

A retrospective observational study to assess the maternal and neonatal outcomes with instrumental delivery in tertiary care hospital

Background: In modern obstetrics, the number of vaginal deliveries is reducing, and instrumental delivery are still reduced. This could be due to need for obstetrician skill for instrumental delivery, increased perineal tears or foetal injuries. The objective of this study was to assess the maternal and neonatal outcomes with instrumental delivery.Methods: This is a retrospective observational study conducted in tertiary care hospital from January 2023 to December 2023. In this study, 31 cases of forceps delivery and 15 cases of vacuum were studied for maternal and neonatal outcomes.Results: The total number of deliveries were 2693 and vaginal deliveries were 999 and instrumental deliveries were 46. It was observed that most patients (86.9%) requiring instruments in the second stage were primigravida. The most common indication for instrumental delivery is both fetal distress and poor maternal bearing down efforts. The maternal complications were more with forceps and included extension of episiotomy in 5 cases, third degree perineal tear in 6 cases, 2 cases of hematoma- one case of broad ligament hematoma and 2 patients required blood transfusion. The neonatal complications were more with forceps. However, the outcomes were favourable. We did not have any case of HIE stage 3, no baby required intubation. 3 babies with forceps had poor Apgar at birth and HIE stage 1.Conclusions: Instrumental delivery is relatively a safe and good option provided all the criteria are met. With proper technique, we can reduce the maternal complications as well.

Modes and timing of delivery along with maternal and neonatal conditions for preeclamptic patients of Rajshahi, Bangladesh

Background: We studied the gynaecological, obstetrical and family history, complications arisen, timing and mode of delivery, and post-delivery maternal and neonatal health conditions for preeclamptic patients in Rajshahi, Bangladesh. Methods: Using a cross-sectional longitudinal design, 90 women hospitalized with preeclampsia in 7 hospitals of Rajshahi, Bangladesh were considered, of which two-thirds were from tertiary referral Rajshahi medical college hospital. The data were collected by interviewing the patients, physical examinations and analyzing patients� pathological profile. For statistical analyses, SPSS software was employed. Results: The 58% of the preeclamptic patients became pregnant earlier, of which 56% had NVD, 24 % C/S and 20% abortion. The 85% patients had history of chronic constipation, ashma, blood transfusion, UTI, hypertension, liver disease, diabetes and preeclampsia. Regarding past surgical history, 40% had Appendisectomy, DE and C, MR, left Salphingo-oophorectomy and CS. Their gestational age ranged 40-32 weeks, averaging 37 weeks. About three-fourths of the patients� deliveries were made by CS. Generally, patients� BP fell down after delivery. One patient out of 88 had died after giving birth, but her female infant (weighing 2.0 kg) was in good condition. Only one case of twin-pregnancy was recorded. After giving births, 28% of mother had no complications, whereas 56% had mild complications and 16% had severe complications. Male children dominated (60%) over female children (40%). A total of 9 (10%) neonatal deaths were recorded. Among alive infants, 42% were premature. About 28% of the newborn infants had no complications, while 16% had mild complications and 56% had severe complications including asphyxia, IUGR, etc. Conclusions: After delivery (CS was 75%), mothers� health was good, but the infants� health deteriorated. Consequently, 1% maternal death and 10% neonatal deaths were recorded.

Efectos de la COVID-19 en la calidad de la atención de los servicios de salud en Colombia: Revisión de literatura / Effects of COVID-19 on the quality of health care services in Colombia: a literature review / Efeitos da covid-19 na qualidade dos serviços de saúde na colômbia: revisão da literatura

Introducción: La pandemia por COVID-19 ha afectado significativamente la calidad de los servicios de cuidado de la salud. Objetivo: Analizar los efectos en los atributos de la calidad en salud de los servicios de atención de enfermedades diferentes a la COVID-19 en Colombia, durante el periodo 2020-2022. Materiales y métodos: Se analizaron 24 artículos de alcance nacional y otros específicos de departamentos como Antioquia, Córdoba, Santander y Cundinamarca. Resultados: La pandemia por COVID-19 impactó la calidad de los servicios en la atención de enfermedades como cáncer, accidentes cerebrovasculares y de eventos como la interrupción voluntaria del embarazo. Conclusión: La calidad de la salud se vio afectada en todas sus dimensiones durante las fases de la pandemia, especialmente en la población con enfermedades crónicas y relacionadas con la salud infantil y materna. Además, se destacaron respuestas como el uso de la telemedicina y de la atención domiciliaria para contribuir a la calidad de la salud en Colombia.

Introduction: The COVID-19 pandemic has significantly affected the quality of health care services. Objective: To analyze the effects of COVID-19 on the quality of health care services focused on treating diseases other than COVID-19 in Colombia during the 2020-2022 period. Materials and methods: 24 articles were analyzed, which included some studies focused on national issues and others specific to the departments of Antioquia, Cordoba, Santander, and Cundinamarca. Results: The COVID-19 pandemic affected the quality of health services caring for diseases such as cancer, strokes, and critical circumstances like voluntary termination of pregnancy. Conclusion: All dimensions of health care were affected during the pandemic, especially impacting populations with chronic diseases and diseases related to child and maternal health. It is important to highlight that telemedicine and home care contributed to improving the quality of health in Colombia.

Introdução: A pandemia de COVID-19 afetou significativamente a qualidade dos serviços de saúde. Objetivo: Analisar os efeitos da COVID-19 nos atributos de qualidade em saúde dos serviços de atenção a outras doenças além da COVID-19 na Colômbia, durante o período 2020-2022. Materiais e métodos: foram analisados 24 artigos de âmbito nacional e outros específicos de departamentos como Antioquia, Córdoba, Santander e Cundinamarca. Resultados: A pandemia da COVID-19 impactou a qualidade dos serviços no cuidado de doenças como câncer, acidente vascular cerebral e eventos como a interrupção voluntária da gravidez. Conclusão: A qualidade da saúde foi afetada em todas as suas dimensões durante as fases da pandemia, especialmente na população com doenças crônicas e doenças relacionadas à saúde infantil e materna. Além disso, foram destacadas respostas como o uso da telemedicina e do atendimento domiciliar para contribuir para a qualidade da saúde na Colômbia.

Experiencias de mujeres en la atención del parto institucional en tiempos de la primera y segunda ola de COVID en México / Women's experiences in institutional childbirth care in times of the first and second waves of COVID in Mexico

Resumen Estudio de tipo cualitativo que explora las perspectivas y experiencias de un grupo de mujeres mexicanas que vivieron la atención institucionalizada del parto en la primera y segunda ola de la pandemia por COVID-19. A través de un guión semiestructurado se entrevistó a nueve mujeres que vivieron la experiencia de la atención del parto entre marzo y octubre de 2020, en hospitales públicos y privados de la ciudad de San Luis Potosí, en México. Bajo la propuesta de análisis de la teoría fundamentada, se identificó que las estrategias sanitarias implementadas en el marco de la pandemia, trajeron consigo un retroceso en la garantía del parto humanizado, las mujeres se narraron desconfiadas en los protocolos que siguió el personal para la atención de sus partos en los hospitales del sector público y muy confiadas en los que se implementaron en el sector privado. La realización de cesáreas sin una justificación clara emergió como una constante, igual que la separación temprana de los binomios. Continúa frágil la disposición y el convencimiento del personal sanitario y las instituciones para garantizar, proteger y defender el derecho de las mujeres a vivir el parto libre de violencia. Persisten resistencias para repensar la atención del parto desde un paradigma no biomédicalizante.

Abstract This is a qualitative study that explores the perspectives and experiences of a group of Mexican women who experienced institutionalized childbirth care in the first and second waves of the COVID-19 pandemic. Through a semi-structured script, nine women who experienced childbirth care were interviewed between March and October 2020 in public and private hospitals in the city of San Luis Potosí, Mexico. Under the Grounded Theory analysis proposal, it was identified that the health strategies implemented during the pandemic brought with them a setback in the guarantee of humanized childbirth. Women described themselves as distrustful of the protocols that personnel followed to attend to their births in public sector hospitals and very confident in those implemented in the private sector. The intervention of cesarean sections without a clear justification emerged as a constant, as did early dyad separation. Healthcare personnel's and institutions' willingness and conviction to guarantee, protect and defend the right of women to experience childbirth free of violence remain fragile. Resistance persists to rethink childbirth care from a non-biomedicalizing paradigm.

Percepções de cuidadoras informais sobre motivações, necessidades e benefícios do cuidado para o idoso dependente / Perceptions of informal caregivers about motivations, needs, and benefits of care for dependent older adults

Resumo O cuidador informal presta cuidados permanentes ou regulares a pessoas idosas em situação de dependência, sem remuneração. Objetivou-se identificar as percepções de cuidadores informais sobre motivações, necessidades e benefícios do cuidado ao idoso dependente. Estudo qualitativo realizado com 10 cuidadoras informais portuguesas, a partir de um instrumento com questões sobre o cuidado prestado ao idoso e suas percepções sobre o exercício dessa função. Os resultados revelaram como motivações para o cuidado: relação de proximidade e confiança, dever de cuidar, familiar mais disponível, proximidade da residência, inexistência de vagas e elevado custo das instituições de acolhimento e desejo do idoso permanecer na sua habitação. Os principais cuidados aos idosos são: hidratação, higiene, alimentação, administração terapêutica, companhia, apoio emocional, conforto, entretenimento, promoção da autonomia e dignidade. As necessidades identificadas pelas cuidadoras foram: apoio domiciliário, da segurança social e da entidade empregadora do cuidador, ajuda financeira, suporte psicológico e capacitação para cuidar do idoso. Os benefícios do cuidado informal para o idoso dependente apontados foram: celeridade do apoio familiar, segurança física e emocional, afeto e companheirismo. Este estudo dá voz a cidadãos cruciais.

Abstract The informal caregiver provides non-remunerated permanent or regular care to dependent older adults. This qualitative study aimed to identify the perceptions of informal caregivers about motivations, needs, and benefits of caring for dependent older adults. It was conducted with ten Portuguese informal caregivers, based on an instrument with questions about the care provided to older adults and their perceptions about performing this role. The results revealed the following motivations for care: proximity and trust relationship, duty of care, more available family members, home proximity, lack of vacancies, high cost of shelter institutions, and older adults' desire to remain in their homes. The primary care activities for older adults are hydration, hygiene, food, therapeutic administration, companionship, emotional support, comfort, entertainment, and promoting autonomy and dignity. The needs identified by the caregivers were home, social security, and the caregiver's employer support, financial help, psychological support, and training to care for the older adults. The benefits of informal care for dependent older adults were prompt family support, physical and emotional security, affection, and companionship. This study gives voice to crucial citizens.

Comparison of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in women with preterm premature rupture of membranes and women with preterm delivery

Background: Considering the adverse effect of PROM on birth outcomes and the condition of mother and fetus, early identification of risk factors of PROM and their control can reduce the occurrence of adverse outcomes for mother and fetus and improve their health. This study was conducted with the aim of comparing PLR and NLR in women with PROM and women with preterm delivery. Methods: This case-control study was conducted on 155 women with PPROM as case group and 155 women with preterm delivery as control group. Age, gestational age, type of delivery, baby's birth weight, gravida, parity, APGAR score, rate of hospitalization in Neonatal Intensive Care Unit (NICU), occurrence of neonatal sepsis and development of respiratory distress syndrome (RDS) were recorded from women's medical records. Also, the results of blood tests and PLR and NLR values were calculated for each pregnant woman. Collected data were analyzed by statistical methods in SPSS version 24. Results: The average gestational age and weight of babies at birth time in the case group were significantly lower than those with preterm delivery. The mean of NLR in case group with 4.8±2.5 was significantly higher than control group with 4.2±2.2. The mean of PLR in case group with 111.5±47.6 was significantly higher than control group with 100.98±43.4. Conclusions: The high values of PLR and NLR in the women with PROM compared to women with preterm delivery can be a marker to identify the risk of PPROM in pregnant women.

Comparative study of transdermal buprenorphine and fentanyl patch for post-operative analgesia in abdominal surgery under general anaesthesia: a randomised single blinded study

Background: Postoperative pain is one of the main concerns for the patient undergoing any major surgery. Effective control of post-operative pain is a major challenge to the surgeon and the attending anaesthesiologist. In spite of recent developments in pain treatment, many patients still experienced moderate to severe pain after surgery. Methods: The study groups divided into two, named group A and group B. The total sample size was 80, 40 patients in each group. Patients were allotted in two groups after block randomization viz: Group A (n=40)-patients received buprenorphine patch (10 ?g/h) and patients in group B (n=40) received fentanyl patch of (25 礸/h). Results: Difference in VAS scores among the two groups were found statistically significant from the end of surgery to 6 hours after surgery. However, from 12 hours after surgery, both the groups had comparable VAS scores. Among hemodynamic parameters, the heart rate and mean arterial pressure variation came out to be insignificant among both study groups. Group B showed more incidence of vomiting and constipation as compared to group A. There was no incidence of skin irritation, respiratory depression and urinary retention in both the groups. Conclusions: The present study concluded that for elective abdominal surgeries under general anaesthesia, transdermal buprenorphine 10 mcg/hr and fentanyl 25 mcg/hr administered 12 hours prior to surgery are safe, reliable, maintaining haemodynamic stability with continuous effective post operative pain relief. Buprenorphine patch is more cost effective and PONV is more with fentanyl and hence, buprenorphine is better than fentanyl patch.

GASTRORETENTIVE EFFERVESCENT FLOATING TABLETS (GREFT) OF DRUGS ACTING ON CARDIOVASCULAR DISEASES

Incidences of Cardio Vascular Diseases (CVDs) are increasing in an alarming proportion in India. Conventional oral dosage forms cannot be retained in the stomach for long owing to gastric emptying. Moreover, drugs which are commonly employed in management of chronic CVDs either have reduced solubility at alkaline pH, undergo colonic degradation, exhibit site-specific absorption or varying bioavailability with combination therapy. Gastro-retentive drug delivery systems (GRDDS) are designed to overcome these challenges. Since 2006, Food and Drug Administration has approved only few GRDDS for treating CVDs. The aim of the present review is to summarize the outcomes of research carried on GRRDS with drugs for CVDs since last 15 y and comprehensive analysis of limitations of such studies due to which no product has been approved or commercialized in over last 18 y. Literature survey includes single unit, multi-particulate, monolayer and bilayer dosage forms with or without effervescence-inducing agents and made of natural and/or synthetic polymers like hydroxypropylmethyl cellulose, natural gums etc. Efforts have been made to compile in vitro buoyancy data such as floating lag time, total floating time, swelling index, release profile and release kinetics. Among various studies reported on monolayer and bilayer Gastro-Retentive Effervescent Floating Tablets, only 3 involved bioavailability studies in human volunteers. Toxicity studies in animals or stability studies are totally lacking. Observation with floating-type multi-particulate GRDDS is more disappointing. lack of safety, efficacy data, stability data, in vivo imaging studies and in vitro-in vivo correlation data might be actually responsible for lack of commercialization of any GRDDS for drugs acting on CVDs in 21st century.

Utilization status of Safe Motherhood Program: a study from Jumla district, Nepal

Background: Safe Motherhood Program is a national priority programme that aims to reduce maternal and neonatal mortality and morbidity through demand and supply side incentives and free delivery care. The study investigates Safe Motherhood Program’s utilization, changes post-implementation, and associated factors in Jumla district to enhance maternal health care access and reduce preventable maternal deaths. Methods: A community based cross sectional study using quantitative approach was conducted where the women of reproductive age group having at least one child of 3-15 months of age were interviewed using the semi structured interview schedule (n=228). Chi square test was used to show the association with independent and depended variables. All the test was carried out at the statistically significant of p value <0.05. Results: The study revealed significant associations between utilization of maternal health care services and various factors: respondent's education level (p=0.034, OR=1.834, CI=1.043-3.223), husband's education level (p=0.007, OR=2.300, CI=1.252-4.228), respondent's employment status (p=0.003, OR=7.155, CI=1.650-31.029), husband's employment status (p=0.001, OR=2.778, CI=1.526-5.055), monthly income (OR=5.556, CI=2.005-15.393), and involvement in social groups (p=0.009, OR=2.312, CI=1.217-4.390). Conclusions: Despite strong awareness of delivery incentives, the program success was restricted by poor knowledge of checkup incentives. The study identified the sociodemographic factors influencing the appropriate use of Jumla’s Safe Motherhood Program scheme. Pregnancy was highly registered, however less than two thirds of women had the necessary number of examinations performed. Institutional deliveries increased but there was disparity during the service delivery.

Instrumental deliveries and its outcome in tertiary care center

Background: Objective of the study was to determine the incidence and indication of assisted vaginal deliveries and to compare the fetal and maternal outcome of vacuum and forceps deliveries.Methods: This study done over a period of one and half year from March 2022 to August 2023 at NRI Medical College, Chinnakakani. Total number of vaginal deliveries are 1617, out of which 33 had a successful assisted vaginal delivery and studied in terms of maternal and fetal outcome. Verbal consent was taken, indication for instrumental application documented and pre requisites fulfilled before instrument application.Results: Out of 1617 vaginal deliveries in our institute, 33 cases successful underwent assisted vaginal deliveries in which 49% were vacuum assisted, 51% were forceps assisted deliveries. Most common indication for instrument application were fetal distress (51%), failure of maternal forces followed by maternal exhaustion (30%). We had 2nd degree perineal tear - 2 (11.76%), cervical tear - 1 (5.88%), PPH-1 (5.88%), 1- vaginal laceration (6.25%) as maternal complications. Out of 16 vacuum and 17 forceps deliveries, 5/16 (31.25%) and 8/17 (47.06%) were admitted in NICU respectively.Conclusions: In the present study showed that most common indication for assisted vaginal deliveries are fetal distress and maternal exhaustion. Maternal complications are seen more in forceps deliveries when compared to vaccum. There is no significant difference between vaccum and forceps deliveries in neonatal complications when compared.

A study of short cervix in mid trimester of pregnancy

Background: Preterm birth is truly a global problem. Cervical length is one of the major determinants of preterm births. Diagnosis of cervical insufficiency can be made by history of previous mid trimester loss, on clinical evaluation or sonographically by measuring cervical length or seeing funnelling of OS. The mainstay treatment of cervical insufficiency is the cervical cerclage.Methods: Present study includes 55 cases of cervical length less than or equal to 2.5 cm on TVS examination between 18 to 22 weeks of gestation of singleton pregnancy was conducted at department of obstetrics and gynaecology at SMT NHL medical municipal hospital, Ahmedabad from July 2022 to December 2023 and shows comparison of rate of full term and preterm deliveries.Results: Out of 55 patients with cervical incompetence, 22 (40%) patients were diagnosed on examination. Out of 55 patients with cervical incompetence 33 (60%) patients had preterm births and only 19 (35%) patients delivered full term, 3 (5%) had abortions. Present study shows there were 35% full term deliveries, 60% preterm deliveries and 5% had abortion among patients having cervical length less than or equal to 2.5 cm.Conclusions: Internal OS status of every patient should always be examined by ultrasound between 18 to 22 weeks. Thus, cervical length is very useful in prognostication and prediction of preterm birth. There are highest chances of late preterm in cervical incompetent patients. Our study showed better outcome with OS tightening group compared to conservative group.

Randomized control trial to find the safety and efficacy of the Kiwi OmniCup system in comparison with the conventional vacuum delivery

Background: Ventouse delivery, also known as vacuum extraction, is a medical procedure employed during childbirth to assist in the safe delivery of a baby when conditions necessitate a quicker or controlled delivery to safeguard the health and well-being of both the baby and the mother.Methods: The research was conducted in the labour room of the Department of Obstetrics and Gynaecology at Baba Raghav das Medical College in Gorakhpur, Uttar Pradesh during September 2019 to August 2020 involve all pregnant women undergoing the process of normal delivery. Thorough maternal histories, physical examinations, and diagnostic tests were conducted and documented. Group A undergoing conventional vacuum extraction and group B utilizing the Kiwi OmniCup. The outcomes of the procedures were meticulously recorded.Results: Instrumental deliveries in both the Ventouse and Kiwi OmniCup groups were primarily conducted due to fetal distress, with 16 cases (40%) and 23 cases (57.5%), respectively. Other medical conditions also contributed to instrumental deliveries, accounting for 16 cases (40%) in the Ventouse group and 9 cases (22.5%) in the Kiwi OmniCup group. Maternal exhaustion led to instrumental deliveries in 8 cases (20%) in both groups.Conclusions: Instrumental deliveries, primarily ventouse and Kiwi OmniCup, were mainly performed due to fetal distress, with ventouse often requiring longer cup application and resulting in more significant blood loss, while Kiwi OmniCup led to neonatal intensive care unit (NICU) admissions primarily due to respiratory distress; however, both methods showed comparable APGAR scores and low rates of severe neonatal complications.

Development and Evaluation of Phycocyanin-Infused Hydrogel Topical Formulations for Wound Healing

The healing of wounds is a complicated biological process impaired by several factors, and conventional treatments often result in undesirable side effects. Natural compounds have emerged as favorable alternatives due to their reduced side effects. C-phycocyanin (C-Pc), a natural phycobiliprotein derived from Spirulina platensis, shows promise in wound healing but is hindered by poor stability and low bioavailability. This study aimed to develop a hydrogel-based delivery system for C-Pc to enhance its stability and therapeutic efficacy in wound healing. We synthesized a grafted gum hydrogel to encapsulate C-Pc, ensuring its sustained release. The hydrogel’s physical properties, including clarity, pH, spreadability, and rheological behavior were characterized. The encapsulation efficiency, in-vitro release profile, antioxidant activity and adhesion were assessed. Furthermore, the hydrogel’s impact on wound healing was evaluated through in-vivo studies and assessments of skin irritation potential. The optimized hydrogel demonstrated excellent physical stability, appropriate viscosity and significant bioadhesive properties, making it suitable for topical application. The encapsulated C-Pc exhibited a controlled release, enhanced antioxidant activity, and greater wound-healing efficacy than free C-Pc. In-vivo studies confirmed accelerated wound closure with no irritation or allergy, suggesting high biocompatibility and therapeutic potential. Developing a C-Pc encapsulated hydrogel presents a promising approach to improving wound care. This innovative approach not only stabilizes C-Pc but also enhances its healing properties, providing a safe and effective option for patients. This study paves the way for a novel formulation with translatory potential.

Influence of non-pharmacological methods on duration of labor: a systematic review / A influência de métodos não farmacológicos na duração do parto: uma revisão sistemática

Abstract The article aims to verify the influence of MNFs on the duration of the birth process. A systematic review was carried out in the MEDLINE, Web of Science and LILACS databases, through a combination of terms that cover the topic addressed, from 1996 to 2021/April. The Excel spreadsheet was used to collect data to extract information regarding each selected article, in turn, data analysis included the evaluation and classification of quality, reliability and risk of bias, thus, the following tools were used: Cochrane RoB 2, Checklist and Newcastle-Ottawa Scale. Warm bath, walking, exercises with a birthing ball, breathing techniques, supine position, acupuncture, acupressure and water birth reduced labor time. While spontaneous pushing, massage and immersion baths prolonged labor. Non-pharmacological methods capable of reducing the duration of labor were hot/warm shower, walking, birth ball exercises, breathing techniques, maternal mobility, dorsal position, acupuncture, acupressure and water birth, as well. associated applied techniques such as hot/warm bath, ball exercises and lumbosacral massage, as well as immersion bath, ball exercises, aromatherapy, vertical postures and maternal mobility with alternating vertical postures, shortened the birth time.

Resumo O objetivo do artigo é verificar a influência dos MNFs na duração do processo de parto. Realizou-se uma revisão sistemática nas bases de dados MEDLINE, Web of Science e LILACS, por meio da combinação de termos que contemple a temática abordada, no período de 1996 a 2021/abril. Utilizou-se para coleta de dados a planilha Excel para extração de informações referentes a cada artigo selecionado, por sua vez, a análise dos dados compreendeu a avaliação e classificação da qualidade, confiabilidade e risco de viés, assim, utilizou-se como ferramentas: Cochrane RoB 2, Checklist e Escala de Newcastle-Ottawa. Reduziram o tempo de trabalho de parto banho morno, caminhada, exercícios com bola de parto, técnicas respiratórias, decúbito dorsal, acupuntura, acupressão e parto na água. Enquanto empurrões espontâneos, massagem e banho de imersão prolongaram o trabalho de parto. Os métodos não farmacológicos capazes de reduzir a duração do trabalho de parto foram banho de chuveiro quente/morno, caminhada, exercícios com bola de parto, técnicas de respiração, mobilidade materna, posição dorsal, acupuntura, acupressão e parto na água, também encurtaram o tempo de parto técnicas aplicadas associadas como banho quente/morno, exercícios com bola e massagem lombossacral, assim como banho de imersão, exercícios com bola, aromaterapia, posturas verticais e mobilidade materna com posturas verticais alternadas.

Chicles de nicotina frente a cigarrillos electrónicos para la reducción del hábito tabáquico / Nicotine chewing gum against electronic cigarettes for the reduction of tobacco habit / Goma de mascar de nicotina contra cigarros eletrônicos para reduzir o hábito de tabaco

Resumen Objetivo: Comparar la efectividad de los chicles de nicotina frente al uso de cigarrillos electrónicos y mostrar si resultan más efectivos en la reducción del hábito tabáquico. Metodología: se incluyeron artículos en español, inglés y portugués disponibles en SciELO, Google Académico, EBSCO, Cochrane Library y LILACS, a través de ecuaciones construidas con MeSH y DeCS y operadores booleanos AND y OR (("Cigarrillos electrónicos" OR "e-Cigs" OR "Cigarros electrónicos") OR ("Chicle" OR "Goma de mascar de nicotina") AND ("Cesación de tabaquismo")), se clasificaron por nivel de evidencia y grado de recomendación. Las consideraciones éticas se adoptaron conforme a la Resolución 8430 de 1993. Resultados: la búsqueda inicial arrojó 1.468 artículos, que se redujeron a 28 textos que cumplieron los criterios de inclusión. Se construyeron cinco temáticas en las que se incluyen comparación de métodos, formas de evaluación, rangos etarios, índices de adicción, patologías asociadas e índice de mortalidad, componentes y efectos fisiológicos del cigarrillo electrónico y convencional. Conclusiones: se evidencia que las cantidades de nicotina de los cigarrillos electrónicos producen efectos adversos irreversibles para la salud y pueden generar mayor dependencia.

Abstract Objective: Compare the effectiveness of nicotine gum versus the use of electronic cigarettes and show whether they are more effective in reducing smoking. Methodology: Articles in Spanish, English and Portuguese, available from SciELO, Google Academic, EBSCO, Cochrane Library and LILACS, were included through equations built with MeSH and DeCS and Boolean operators AND Dec's OR (("Electronic cigarettes" OR "E-Cigs" OR "Electronic Cigars") OR ("Chewing gum" OR "Nicotine chewing gum") AND ("Smoking cessation")). The articles were critically read, and classified by level of evidence and degree of recommendation. Ethical considerations were adopted in accordance with Resolution 8430 of 1993. Results: The initial search yielded 1,468 articles, which were reduced to 28 units that contributed to the stated objective. Five themes were built, which include a comparison of methods, evaluation forms, age ranges, addiction rates, associated pathologies and mortality rate, components and physiological effects of the conventional and electronic cigarette. Conclusions: It is evident that the amounts of nicotine of e-cigarettes produce irreversible adverse health effects and can lead to increased dependency.

Resumo Objetivo: Compare a eficácia da goma de mascar de nicotina versus o uso de cigarros eletrônicos e mostre se eles são mais eficazes na redução do tabagismo. Metodologia: Os artigos em espanhol, inglês e português, disponíveis na SciELO, no Google Acadêmico, na EBSCO, na Cochrane Library e na LILACS, foram incluídos por meio de equações construídas com os operadores MeSH e DeCS e booleanos AND e OR (("cigarros eletrônicos" OU "E-Cigs" ou "charutos eletrônicos") OR ("goma de mascar" ou "goma de mascar de nicotina") AND ("cessação do tabagism")). Os artigos foram lidos criticamente e classificados por nível de evidência e grau de recomendação. Considerações éticas foram adotadas de acordo com a Resolução 8430 de 1993. Resultados: A pesquisa inicial produziu 1.468 artigos, reduzidos a 28 unidades que contribuíram para o objetivo declarado. Foram construídos cinco temas que incluem a comparação de métodos, formas de avaliação, faixas etárias, taxas de dependência, patologias e taxa de mortalidade associadas, componentes e efeitos fisiológicos dos cigarros convencionais e eletrônicos. Conclusões: É evidente que as quantidades de nicotina dos Os cigarros eletrônicos produzem efeitos adversos irreversíveis à saúde e podem levar ao aumento da dependência.

Comparative analysis of neonatal weight and length pattern in cross-cradle and other breastfeeding positions

Background: Breastfeeding is an art and a skill which needs to be learnt and mastered. There is no one right position for breastfeeding. Any breastfeeding position that is comfortable for the mother and infant for effective breast milk transfer is an acceptable position. Cross cradle hold works well for Mothers who are breastfeeding for the first time, with latching difficulties, having flat and inverted nipples. Also, it helps in deep latching which helps to improve the level of attachment among new born. Objective of the study was to compare cross-cradle hold and other breastfeeding positions in terms of their effects on weight and length pattern in neonates among primiparous breastfeeding mothers after full-term vaginal delivery.Methods: This prospective cohort study was conducted in the obstetrics and gynaecology department among 240 primipara mothers who delivered vaginally at the same tertiary care institute.Results: Total 50.42% mothers preferred cross-cradle hold breastfeeding position. Neonates of mothers who had adopted cross-cradle hold, had better gain in weight and length after one month.Conclusions: Significantly more gain in weight and length of neonates were observed in those mothers who have adopted cross-cradle breastfeeding position.

Fatores associados a lesões perineais em partos vaginais: análise multinível / Factors associated with perineal injuries in vaginal deliveries: multilevel analysis / Factores asociados con lesiones perineales en parto vaginal: análisis multinivel

Objetivo: Estimar a prevalência de lesão perineal e seus fatores associados em casa de parto, controlando-se o contexto de cidade de origem da parturiente. Métodos: Estudo transversal retrospectivo realizado com parturientes no Centro de Parto Normal de São Sebastião, Distrito Federal. Os dados de práticas obstétricas foram obtidos por meio de registros em prontuários físicos (n=400) coletados entre junho e setembro de 2016. Considerou-se como variável dependente 'lesão perineal', e independentes os registros de lacerações de primeiro, segundo e terceiro graus. Para o processo de análise de regressão logística multinível considerou-se dois níveis, I ­ variáveis individuais e II ­ contextual 'cidade de origem'. Resultados: A prevalência de lesão perineal foi 72,8% (IC 96% 6,85-77,2) nas mulheres assistidas. Permaneceram associadas positivamente à lesão perineal as variáveis independentes, anos de estudo <8 anos, primiparidade e uso de ocitocina intraparto. Conclusão: A alta prevalência de lesão perineal e seus fatores associados encontrados na população estudada reforçam a importância da atuação de enfermeiras obstétricas nestes dispositivos de atenção à saúde da mulher, visando a redução destes agravos. (AU)

Objective: To estimate the prevalence of perineal injury and its associated factors in the delivery home, controlling the mother's city of origin. Methods: Retrospective cross-sectional study carried out with parturients at the Normal Childbirth Center of São Sebastião, Distrito Federal. Data on obstetric practices were obtained through records in physical records (n=400) collected between June and September 2016. The dependent variable was 'perineal injury', and records of first, second and third lacerations were considered independent. degree. For the multilevel logistic regression analysis process, two levels were considered, I ­ individual variables and II ­ contextual 'city of origin'. Results: The prevalence of perineal injury was 72.8% (CI 96% 6.85-77.2) in women assisted. The independent variables, years of education <8 years, primiparity and use of intrapartum oxytocin remained positively associated with perineal injury. Conclusion: The high prevalence of perineal injury and its associated factors found in the studied population reinforce the importance of the role of obstetric nurses in these women's health care devices, aiming at reducing these injuries. (AU)

Objetivo: Estimar la prevalencia de lesión perineal y sus factores asociados en el hogar de parto, controlando la ciudad de origen de la madre. Métodos: Estudio transversal retrospectivo realizado con parturientas en el Centro de Parto Normal de São Sebastião, Distrito Federal. Los datos sobre prácticas obstétricas se obtuvieron a través de registros en registros físicos (n=400) recolectados entre junio y septiembre de 2016. La variable dependiente fue 'lesión perineal', y los registros de primer, segundo y tercer grado se consideraron independientes. Para el proceso de análisis de regresión logística multinivel, se consideraron dos niveles, I - variables individuales y II - contextual 'ciudad de origen'. Resultados: La prevalencia de lesión perineal fue 72,8% (IC 96% 6,85-77,2) en mujeres asistidas. Las variables independientes, años de educación <8 años, primiparidad y uso de oxitocina intraparto permanecieron asociadas positivamente con la lesión perineal. Conclusión: La alta prevalencia de lesión perineal y sus factores asociados encontrados en la población estudiada refuerzan la importancia del papel de las enfermeras obstétricas en los dispositivos de atención de salud de estas mujeres, con el objetivo de reducir estas lesiones. (AU)

Evaluation of the effects of epidural labour analgesia on mode of delivery

Background: Epidural analgesia is the most effective method of pain relief during labour and the only method that provides complete analgesia without maternal or foetal adverse effects. This study aimed to assess the mode of delivery outcomes of labour in women who had received effective epidural analgesia.Methods: After ethical approval, this quasi-experimental study was carried out in Dhaka Medical College Hospital for one year, from July 2021 to June 2022. A total of 100 admitted pregnant women (37 weeks to 41 weeks) in the labour ward were included in the study according to the inclusion and exclusion criteria. Among them, 50 women were in group A (with epidural analgesia), and the other 50 were in group B (without epidural analgesia). A detailed history and thorough clinical examination were carried out on each patient. Data were collected in separate case-record forms and analyzed using SPSS 24.Results: Mean age, gestational age, parity, and body mass index were statistically similar in both group A and B. Normal vaginal delivery rate (86% vs. 90%), instrumental delivery rate (10% vs. 6%), and caesarean section rate (4% vs. 4%) were not significantly different in both groups. Besides, both group A and B had statistically similar APGAR scores at 1st (8.66±0.87 and 8.80±0.83 respectively, p=0.414) and 5th min (9.66±0.68 and 9.74±0.59 respectively, p=0.537).Conclusions: Epidural labour analgesia can be safely recommended as a method of labour analgesia, provided the prerequisites are fulfilled. It has no significant adverse effect on the mode of delivery.