Antidiarrheal Potential of Viola canescens: In Vivo and In Silico Approaches.

Viola canescens Wall. is an important medicinal plant with reported therapeutic benefits. The current work sought to investigate the antidiarrheal properties of V. canescens extracts both in vivo and in silico. This study applied molecular docking to unravel the molecular mechanism of V. canescens and to find the most effective phytocompounds with antidiarrheal effects. The antidiarrheal activity of V. canescens was assessed utilizing the castor oil-induced diarrhea assay and the charcoal meal assay. Antidiarrheal characteristics were evaluated by measuring parameters such as intestinal motility, fecal score, and hypersecretion. The V. canescens extract had a dose-dependent and statistically significant impact in the charcoal meal assay and castor oil-induced diarrhea assay. In the castor oil-induced diarrhea assay, the ethyl acetate fraction (65.96%) showed the highest percentage of defecation inhibition at the highest dose (300 mg/kg (bw)), followed by the uncorrected crystalline compound (63.83%), crude alkaloids (63.83%), chloroform fraction (63.83%), and crude flavonoids (55.32%), while the aqueous fraction (40.43%) and n-Hexane fraction (42.55%) revealed the lowest antidiarrheal potential. In addition, the molecular docking investigation showed emetine, quercetin, and violanthin, isolated chemicals of V. canescens, to have the highest binding affinity to the target µ and δ opioid receptors with significant inhibitory capacity. These pharmacologically active metabolites in V. canescens were effective in treating diarrhea. This study lends credence to the traditional usage of V. canescens in treating gastrointestinal disorders.

Fatigue Behavior of Sandstone Exposed to Cyclic Point-Loading: Implications for Improving Mechanized Rock Breakage Efficiency.

During the process of mechanized excavation, rock is essentially subjected to cyclic point loading (CPL). To understand the CPL fatigue behavior of rock materials, a series of CPL tests are conducted on sandstone samples by using a self-developed vibration point-load apparatus. The effects of loading frequency and waveform on rock fatigue properties under CPL conditions are specifically investigated. The load and indentation depth histories of sandstone samples during testing are monitored and logged. The variation trends of fatigue life (failure time) under different loading conditions are obtained. Test results indicate that the fatigue life of the sandstone sample exposed to CPL is dependent on both loading frequency and waveform. As the loading frequency rises, the fatigue life of the sandstone first declines and then increases, and it becomes the lowest at 0.5 Hz. In terms of waveform, the fatigue life of the sandstone is largest under the trigonal wave and is least under the rectangular wave. These findings can provide valuable theoretical support for optimizing the rock cutting parameters to enhance the efficiency of mechanized excavation.

Investigation of the acoustic emission and fractal characteristics of coal with varying water contents during uniaxial compression failure.

To investigate the effect of water on the mechanical properties and acoustic emission (AE) characteristics of coal in the failure and deformation processes. Coal samples of different content were subjected to uniaxial compression tests and AE signals were monitored. The characteristics of the AE signals were further analyzed using fractal analysis. The results show that saturated coal samples have substantially reduced mechanical properties such as uniaxial compressive strength (UCS), dissipation energy, peak stress, and elastic modulus. Under loading, stress-strain curves are characterized by five distinct stages: (1) compaction; (2) linear elastic; (3) crack stable propagation; (4) crack accelerating propagation; and (5) post-peak and residual stages. Using phase-space theory, a novel Grassberger Procaccia (GP) algorithm was utilized to find the AE fractal characteristics of coal samples in different stages. It is significant to note that AE energy does not exhibit fractal characteristics in either the first or second stages. Contrary to the first two stages, the third stage showed obvious fractal characteristics. Fractal analysis of AE time sequences indicates that fractal dimension values change as stress increases, indicating the initiation of complex microcracks in coal. In the fourth stage, the fractal dimension rapidly declines as the strength reaches its limit, indicating the occurrence of macrocracks. However, fractal dimensions continued to decrease further or increased slightly in the fifth stage. Consequently, the coal begins to collapse, potentially resulting in a disaster and failure. It is, therefore, possible to accurately predict coal and rock dynamic failures and microcrack mechanisms by observing the subsequent sudden drop in the correlation dimension of the AE signals in response to different stages of loading.

Application of KNN-based isometric mapping and fuzzy c-means algorithm to predict short-term rockburst risk in deep underground projects.

The rockburst phenomenon is the major source of the high number of casualties and fatalities during the construction of deep underground projects. Rockburst poses a severe hazard to the safety of employees and equipment in subsurface mining operations. It is a hot topic in recent years to examine and overcome rockburst risks for the safe installation of deep urban engineering designs. Therefore, for a cost-effective and safe underground environment, it is crucial to determine and predict rockburst intensity prior to its occurrence. A novel model is presented in this study that combines unsupervised and supervised machine learning approaches in order to predict rockburst risk. The database for this study was built using authentic microseismic monitoring occurrences from the Jinping-II hydropower project in China, which consists of 93 short-term rockburst occurrences with six influential features. The prediction process was succeeded in three steps. Firstly, the original rockburst database's magnification was reduced using a state-of-the-art method called isometric mapping (ISOMAP) algorithm. Secondly, the dataset acquired from ISOMAP was categorized using the fuzzy c-means algorithm (FCM) to reduce the minor spectral heterogeneity impact in homogenous areas. Thirdly, K-Nearest neighbor (KNN) was employed to anticipate different levels of short-term rockburst datasets. The KNN's classification performance was examined using several performance metrics. The proposed model correctly classified about 96% of the rockbursts events in the testing datasets. Hence, the suggested model is a realistic and effective tool for evaluating rockburst intensity. Therefore, the proposed model can be employed to forecast the rockburst risk in the early stages of underground projects that will help to minimize casualties from rockburst.

Monitoring land use land cover changes and its impacts on land surface temperature over Mardan and Charsadda Districts, Khyber Pakhtunkhwa (KP), Pakistan.

Land use/land cover (LULC) changes due to urban growth on the regional scale affect land surface temperature (LST). The present study aims to assess the LULC changes and their impact on LST over Mardan and Charsadda districts of Khyber Pakhtunkhwa (KP), Pakistan, in the period from 1990 to 2019. Landsat satellite (TM& ETM +) datasets in the period from 1990 to 2010 and Sentinel-2 images from 2016 to 2019 were used in this study. All the datasets were pre-processed and the LULC types were classified by maximum likelihood classification algorithm. The vegetation degradation was computed from normalized difference vegetation index (NDVI), and the LST was derived based on the LULC changes. The results showed that the overall accuracy of LULC classification was 87.84%. Dramatic LULC changes were observed during the last three decades, where the vegetation degradation area was decreased from 1307.8 (59.27%) to 1147.6 km2 (52.1%) and the barren land area increased from 816.6 (37.07%) to 961.4 km2 (42.64%). Similarly, the built-up area has also increased from 57.2 (2.5%) to 104.3 km2 (4.73%) in the years 1990 and 2019, respectively. These variations in LULC types have significantly influenced the LST from 1990 to 2019; specifically, the LST of built-up area, barren land, and vegetation cover increased from 20.1 to 32.1 °C, 21.5 to 35.5 °C, and 17.1 to 28.2 °C, respectively. The regression line plotted defines that the LST has a negative correlation with NDVI and a positive correlation with normalized difference of built-up index (NDBI). In particular, the vegetation and land covers dramatically transformed to barren land and/or to urban development over the study area in the period from 1990 to2019, which has severely affected the LST and the natural resources of the study area. Therefore, our study will be very helpful for managing the rapid environmental changes and urban planning.

Review on Green Synthesis of Silver Nanoparticles through Plants.

Nature has the potential to reduce metal salts to their relative nanoparticles. Traditionally, physical and chemical methods were used for the synthesis of nanoparticles but due to the use of toxic chemicals, non-ecofriendly methods and other harmful effects, green chemistry approaches are now employed for synthesizing nanoparticles which are basically the most cost effective, ecofriendly and non-hazardous methods. In this review, we aimed to evaluate and study the details of various mechanisms used for green synthesis of silver nanoparticles from plants, their size, shape and potential applications. A total of 150 articles comprising both research and review articles from 2009 to 2019 were selected and studied in detail to get in-depth knowledge about the synthesis of silver nanoparticles specifically through green chemistry approaches. Silver ions and their salts are well known for their antimicrobial properties and have been used in various medical and non-medical applications since the emergence of human civilization. Miscellaneous attempts have been made to synthesize nanoparticles using plants and such nanoparticles are more efficient and beneficial in terms of their antibacterial, antifungal, antioxidant, anti-biofilm and cytotoxic activities than nanoparticles synthesized through physical and chemical processes. Silver nanoparticles have been studied as an important research area due to their specific and tunable properties and their application in the field of biomedicine such as tissue and tumor imaging and drug delivery. These nanoparticles can be further investigated to find out their antimicrobial potential in cell lines and animal models.

Thinness and fecundability: Time to pregnancy after adolescent marriage in rural Bangladesh.

Undernutrition may affect fecundability, but few studies have quantified this relationship. In rural Bangladesh, where newlywed couples face strong pressures to become pregnant, we assessed fecundability, estimated by time to pregnancy (TTP), and its association with preconceptional thinness among nulligravid, newlywed female adolescents. During 2001-2002, 5,516 newlywed women aged 12-19 years participated in a home-based, 5-weekly surveillance system for 5-6 years to enrol pregnant women into an antenatal vitamin A or ß-carotene supplementation trial. Thinness was defined as a left mid-upper arm circumference (MUAC) ≤21.5 versus >21.5 cm. At each visit, staff obtained a monthly history of menstruation. Report of amenorrhea prompted a human chorionic gonadotropin urine test to confirm pregnancy. We derived hazard ratios (with 95% confidence intervals [CI]) for pregnancy and Kaplan-Meier curves for TTP. Ages of women at marriage and pregnancy detection (mean ± standard deviation) were 15.3 ± 1.9 and 17.0 ± 1.9 years, respectively. A total of 82.7% of thinner and 87.3% of better nourished women became pregnant. The unadjusted and multivariable relative hazard of ever becoming pregnant was 0.84 (95% CI [0.78, 0.89]) and 0.86 (95% CI [0.81, 0.92]), respectively, and TTP was 12 weeks longer (median [95% CI]: 63 [58-68] vs. 51 [49-54]) in women whose MUAC was ≤21.5 versus >21.5 cm. In rural Bangladesh, thin adolescent newlywed girls have a lower probability of becoming pregnant and experience a longer time to pregnancy.

In Vitro α-glucosidase Inhibition and Computational Studies of Kaempferol Derivatives from Dryopteris cycanida.

BACKGROUND: Dryopteris cycadina has diverse traditional uses in the treatment of various human disorders which are supported by pharmacological studies. Similarly, the phytochemical studies of this plant led to the isolation of numerous compounds. METHODOLOGY: The present study deals with α-glucosidase inhibition of various kaempferol derivates including kaempferol-3, 4/-di-O-α- L-rhamnopyranoside 1, kaempferol-3, 5-di-O-α-L-rhamnoside 2 and kaempferol-3,7-di-O-α- L-rhamnopyranoside 3. RESULTS: The results showed marked concentration-dependent inhibition of the enzyme when assayed at different concentrations and the IC50 values of compounds 1-3 were 137±9.01, 110±7.33, and 136±1.10 mM, respectively far better than standard compound, acarbose 290±0.54 mM. The computational studies revealed strong docking scores of these compounds and augmented the in vitro assay. CONCLUSION: In conclusion, the isolated kaempferol derivatives 1-3 from D. cycadina exhibited potent α- glucosidase inhibition.

Antenatal Multiple Micronutrient Supplementation Compared to Iron-Folic Acid Affects Micronutrient Status but Does Not Eliminate Deficiencies in a Randomized Controlled Trial Among Pregnant Women of Rural Bangladesh.

BACKGROUND: Antenatal multiple micronutrient (MM) supplementation improves birth outcomes relative to iron-folic acid (IFA) in developing countries, but limited data exist on its impact on pregnancy micronutrient status. OBJECTIVE: We assessed the efficacy of a daily MM (15 nutrients) compared with IFA supplement, each providing approximately 1 RDA of nutrients and given beginning at pregnancy ascertainment, on late pregnancy micronutrient status of women in rural Bangladesh. Secondarily, we explored other contributors to pregnancy micronutrient status. METHODS: Within a double-masked trial (JiVitA-3) among 44,500 pregnant women, micronutrient status indicators were assessed in n = 1526 women, allocated by cluster to receive daily MM (n = 749) or IFA (n = 777), at 10 wk (baseline: before supplementation) and 32 wk (during supplementation) gestation. Efficacy of MM supplementation on micronutrient status indicators at 32 wk was assessed, controlling for baseline status and other covariates (e.g., inflammation and season), in regression models. RESULTS: Baseline status was comparable by intervention. Prevalence of deficiency among all participants was as follows: anemia, 20.6%; iron by ferritin, 4.0%; iron by transferrin receptor, 4.7%; folate, 2.5%; vitamin B-12, 35.4%; vitamin A, 6.7%; vitamin E, 57.7%; vitamin D, 64.0%; zinc, 13.4%; and iodine, 2.6%. At 32 wk gestation, vitamin B-12, A, and D and zinc status indicators were 3.7-13.7% higher, and ferritin, γ-tocopherol, and thyroglobulin indicators were 8.7-16.6% lower, for the MM group compared with the IFA group, with a 15-38% lower prevalence of deficiencies of vitamins B-12, A, and D and zinc (all P < 0.05). However, indicators typically suggested worsening status during pregnancy, even with supplementation, and baseline status or other covariates were more strongly associated with late pregnancy indicators than was MM supplementation. CONCLUSIONS: Rural Bangladeshi women commonly entered pregnancy deficient in micronutrients other than iron and folic acid. Supplementation with MM improved micronutrient status, although deficiencies persisted. Preconception supplementation or higher nutrient doses may be warranted to support nutritional demands of pregnancy in undernourished populations. This trial was registered at clinicaltrials.gov as NCT00860470.

Potent in Vitro α-Glucosidase Inhibition of Secondary Metabolites Derived from Dryopteris cycadina.

α-glucosidase is responsible for the hydrolysis of complex carbohydrates into simple absorbable glucose and causes postprandial hyperglycemia. α-glucosidase inhibition is thus the ideal target to prevent postprandial hyperglycemia. The present study was therefore designed to analyze the effects of various compounds isolated from Dryopteris cycadina against α-glucosidase including ß-Sitosterol 1, ß-Sitosterol3-O-ß-d-glucopyranoside 2, 3, 5, 7-trihydroxy-2-(p-tolyl) chorman-4-one 3, Quercetin-3-0-ß-d-glucopyranoside (3/→0-3///)- ß-d- Quercetin -3-0- ß â»d-galactopyranoside 4 and 5, 7, 4/-Trihydroxyflavon-3-glucopyranoid 5. The in vitro spectrophotometric method was used for the analysis of test compounds against possible inhibition. Similarly, molecular docking studies were performed using the MOE software. These compounds showed concentration-dependent inhibition on α-glucosidase, and compounds 1 (IC50: 143 ± 0.47 µM), 3 (IC50:133 ± 6.90 µM) and 5 (IC50: 146 ± 1.93 µM) were more potent than the standard drug, acarbose (IC50: 290 ± 0.54 µM). Computational studies of these compounds strongly supported the in vitro studies and showed strong binding receptor sensitivity. In short, the secondary metabolites isolated from D. cycadina demonstrated potent α-glucosidase inhibition that were supported by molecular docking with a high docking score.

Unintended pregnancy is a risk factor for depressive symptoms among socio-economically disadvantaged women in rural Bangladesh.

BACKGROUND: Little is known about the relation between unwanted pregnancy and intention discordance and maternal mental health in low-income countries. The study aim was to evaluate maternal and paternal pregnancy intentions (and intention discordance) in relation to perinatal depressive symptoms among rural Bangladeshi women. METHODS: Data come from a population-based, community trial of married rural Bangladeshi women aged 13-44. We examined pregnancy intentions among couples and pregnancy-intention discordance, as reported by women at enrollment soon after pregnancy ascertainment, in relation to depressive symptoms in the third trimester of pregnancy (N = 14,629) and six months postpartum (N = 31,422). We calculated crude and adjusted risk ratios for prenatal and postnatal depressive symptoms by pregnancy intentions. RESULTS: In multivariable analyses, women with unwanted pregnancies were at higher risk of prenatal (Adj. RR = 1.60, 95% CI: 1.37-1.87) and postnatal depressive symptoms (Adj. RR = 1.32, 95% CI: 1.21-1.44) than women with wanted pregnancies. Women who perceived their husbands did not want the pregnancy also were at higher risk for prenatal (Adj. RR = 1.42, 95% CI: 1.22-1.65) and postnatal depressive symptoms (Adj. RR = 1.30, 95% CI: 1.19-1.41). Both parents not wanting the pregnancy was associated with prenatal and postnatal depressive symptoms (Adj. RR = 1.34, 95% CI: 1.19-1.52; Adj. RR = 1.13, 95% CI: 1.06-1.21, respectively), compared to when both parents wanted it. Adjusting for socio-demographic and pregnancy intention variables simultaneously, maternal intentions and pregnancy discordance were significantly related to prenatal depressive symptoms, and perception of paternal pregnancy unwantedness and couple pregnancy discordance, with postnatal depressive symptoms. CONCLUSIONS: Maternal, paternal and discordant couple pregnancy intentions, as perceived by rural Bangladeshi women, are important risk factors for perinatal maternal depressive symptoms.

Risk of Depressive Symptoms Associated with Morbidity in Postpartum Women in Rural Bangladesh.

Objectives Depression following pregnancy is common, but its extent and association with maternal morbidity in the first 6 months postpartum have not been well described in low resource settings such as rural Bangladesh. Methods We used data from a population-based, community trial of approximately 39,000 married rural Bangladeshi women aged 13-44 between 2001 and 2007 to examine the relation between women's reported morbidity symptoms from childbirth to 3 months postpartum, and subsequent depressive symptoms assessed at 6 months postpartum. We calculated crude and adjusted risk ratios for depressive symptoms following women's reports of reproductive, urinary, neurologic, nutrition and other illness measures constructed based on symptomatic reporting. Results In models adjusted for sociodemographic factors and co-morbidities, all postpartum illnesses were associated with an increased relative risk [RR, with 95% confidence intervals (CI) excluding 1] of depressive symptoms by 6 months postpartum. These morbidities included uterine prolapse (RR 1.20, 95% CI 1.04-1.39), urinary tract infection (RR 1.24, 95% CI 1.11-1.38), stress related incontinence (SRI) (RR 1.49, 95% 1.33-1.67), simultaneous SRI and continuously dripping urine (RR 1.60-2.96), headache [RR 1.20 (95% CI 1.12-1.28)], convulsions (RR 1.67, 95%CI 1.36-2.06), night blindness (RR 1.33, 95% CI 1.19-1.49), anemia (RR 1.38, 95% CI 1.31-1.46), pneumonia (RR 1.24, 95% CI 1.12-1.37), gastroenteritis (RR 1.24, 95% CI 1.17-1.31) and hepatobiliary disease (RR 2.10, 96% CI 1.69-2.60). Conclusions for Practice Illnesses during the first three postpartum months were risk factors for depressive symptoms, with the strongest associations noted for convulsions and hepatobiliary disease. Symptoms of depression may be of particular concern among women suffering from physical illnesses. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT0019882.

Daily Consumption of Lipid-Based Nutrient Supplements Containing 250 µg Iodine Does Not Increase Urinary Iodine Concentrations in Pregnant and Postpartum Women in Bangladesh.

Background: Maternal iodine deficiency during pregnancy and lactation is common in Bangladesh.Objective: We evaluated the effect of lipid-based nutrient supplements for pregnant and lactating women (LNS-PL) on urinary iodine concentration (UIC).Methods: We conducted a cluster-randomized controlled effectiveness trial in which we enrolled 4011 pregnant women at ≤20 gestational weeks. Women in 48 clusters received iron and folic acid (IFA; 60 mg Fe/d + 400 µg folic acid/d) and women in 16 clusters received LNS-PL (20 g/d, 118 kcal) containing 22 vitamins and minerals (including 250 µg I). We randomly selected a subsample of 1159 women for repeated urine sample collection, i.e., at enrollment, at 36 wk of gestation, and at 6 mo postpartum, for UIC analysis, a secondary outcome of the trial.Results: The geometric mean UIC at 36 wk of gestation and at 6 mo postpartum did not differ significantly between the IFA and LNS-PL groups. The median (quartile 1, quartile 3) UIC at 36 wk was 27.4 µg/L (16.9, 52.7 µg/L) in the IFA group and 30.2 µg/L (17.7, 56.6 µg/L) in the LNS-PL group; at 6 mo, these were 23.0 µg/L (10.0, 45.9 µg/L) in the IFA group and 22.2 µg/L (9.1, 50.4 µg/L) in the LNS-PL group.Conclusion: Daily consumption of LNS-PL containing 250 µg I did not increase the UICs of pregnant and lactating women in Bangladesh. Iodine from lipid-based nutrient supplements may have been stored in the thyroid gland or secreted in breast milk instead of being excreted in urine. Additional research that uses other biomarkers of iodine status is needed to determine how to meet the iodine requirements of pregnant and lactating women in Bangladesh and similar settings. This trial was registered at clinicaltrials.gov as NCT01715038.

Early newborn ritual foods correlate with delayed breastfeeding initiation in rural Bangladesh.

BACKGROUND: Early and exclusive breastfeeding may improve neonatal survival in low resource settings, but suboptimal breastfeeding still exists in areas with high infant mortality. Prelacteal feeding, the practice of giving a non-breastmilk food as a neonate's first food, has been associated with suboptimal breastfeeding practices. We examined the association of feeding a non-breastmilk food in the first three days of life (early neonatal food, or ENF) with time from birth to initiation of breastfeeding among 25,286 Bangladeshi mother-neonate pairs, in a secondary analysis of a randomized controlled trial in northwestern rural Bangladesh conducted from 2001-2007. METHODS: Trained interviewers assessed the demographic characteristics during pregnancy. At three months postpartum, the interviewers visited participants again and retrospectively assessed demographic and breastfeeding characteristics surrounding the birth. We assessed the relationship between ENF and time to initiation of breastfeeding in hours in both unadjusted and adjusted linear regression analyses. We also calculated reverse cumulative distribution curves for time to initiation of breastfeeding and analyses were stratified by an infant's ability to breastfeed normally at birth. RESULTS: The mean ± SD time from birth to initiation of breastfeeding was 30.6 ± 27.9 hours. Only 2,535 (10.0%) of women reported initiating breastfeeding in the first hour after birth and 10,207 (40.4%) reported initiating breastfeeding in the first 12 hours after birth. In adjusted linear regression analyses, feeding ENF was associated with a significant increase in time, in hours, to breastfeeding initiation both among children not able to breastfeed at birth (37.4; 95% CI 33.3, 41.5) and among children able to breastfeed at birth (13.3; 95% CI 12.7, 14.0). CONCLUSIONS: Feeding ENF was strongly associated with delayed initiation of breastfeeding, even after adjusting for other related factors and stratifying on the neonate's ability to suckle normally after birth. More research is needed to understand the impact of these findings on optimal breastfeeding in this setting. It is possible that ENF feeding and the ability to breastfeed immediately after birth are interrelated in their respective associations to suboptimal breastfeeding initiation. This study in a large population representative of other populations in rural South Asia, demonstrates significantly longer times to breastfeeding initiation than previously appreciated, with a possible important role of ENF feeding. TRIAL REGISTRATION: The randomized controlled trial on which this analysis is based, "Impact of Maternal Vitamin A or Beta-Carotene Supplementation on Maternal and Infant Mortality in Bangladesh", was registered with ClinicalTrials.gov as trial number ID GHS-A-00-03-00019-00 and identifier NCT00198822. The identifier was first received September 12, 2005 (retrospectively registered). The first participant was enrolled in August 2001.

A home calendar and recall method of last menstrual period for estimating gestational age in rural Bangladesh: a validation study.

BACKGROUND: The best method of gestational age assessment is by ultrasound in the first trimester; however, this method is impractical in large field trials in rural areas. Our objective was to assess the validity of gestational age estimated from prospectively collected date of last menstrual period (LMP) using crown-rump length (CRL) measured in early pregnancy by ultrasound. METHODS: As part of a large, cluster-randomized, controlled trial in rural Bangladesh, we collected dates of LMP by recall and as marked on a calendar every 5 weeks in women likely to become pregnant. Among those with a urine-test confirmed pregnancy, a subset with gestational age of <15 weeks (n = 353) were enrolled for ultrasound follow-up to measure CRL. We compared interview-assessed LMP with CRL gestational age estimates and classification of preterm, term, and post-term births. RESULTS: LMP-based gestational age was higher than CRL by a mean (SD) of 2.8 (10.7) days; differences varied by maternal education and preterm birth (P < 0.05). Lin's concordance correlation coefficient was good at ultrasound [0.63 (95 % CI 0.56, 0.69)] and at birth [0.77 (95 % CI 0.73, 0.81)]. Validity of classifying preterm birth was high but post-term was lower, with specificity of 96 and 89 % and sensitivity of 86 and 67 %, respectively. Results were similar by parity. CONCLUSIONS: Prospectively collected LMP provided a valid estimate of gestational age and preterm birth in a rural, low-income setting and may be a suitable alternative to ultrasound in programmatic settings and large field trials. TRIAL REGISTRATION: ClinicalTrials.gov NCT00860470.

Depressive symptoms in mothers after perinatal and early infant loss in rural Bangladesh: a population-based study.

PURPOSE: We examined stillbirth and neonatal death as predictors of depressive symptoms in women experiencing these events during the first 6 months postpartum. METHODS: We performed secondary analyses using data from 41,348 married women aged 13-44 years, originally collected for the JiVitA-1 study (2001-2007) in northwest Bangladesh. Adjusted relative risk ratios were estimated to determine the associations between stillbirth and early infant death and women's risk of reported depressive symptoms (trichotomized 0, 1-2, 3-5) up to 6 months after the death. Adjusted risk ratios, comparing 0-2 versus 3-5 depressive symptoms, were used in stratified analyses. RESULTS: Women having fetal/infant deaths had elevated risk of experiencing 1-2 postpartum depressive symptoms (adj RRRs between 1.2 and 1.7) and of experiencing 3-5 postpartum depressive symptoms (adj RRRs between 1.9 and 3.3), relative to women without a fetal/infant death. Notably, those whose infants died in the early postneonatal period had over a three-fold risk of 3-5 depressive symptoms (adj relative risk ratio [RRR] = 3.3; 95% confidence interval [CI], 2.6-4.3) compared to a two-fold risk for women experiencing a stillbirth (adj RRR = 1.9; 95% CI, 1.7-2.1). After early postneonatal deaths, women with higher levels of education were more likely to suffer 3-5 depressive symptoms (adj relative risk [RR] = 10.6; 95% CI, 5.2-21.7, ≥10 years of education) compared to women with lower levels of education (adj RR = 2.0; 95% CI, 1.6-2.4, no education; adj RR = 2.2; 95% CI, 1.6-2.9, 1-9 years of education). CONCLUSIONS: Women's mental health needs should be prioritized in low-resource settings, where these outcomes are relatively common and few mental health services are available.

Antipyretic and antinociceptive potential of extract/fractions of Potentilla evestita and its isolated compound, acacetin.

BACKGROUND: Fever and pain management is a very challenging job for the clinician as the available synthetic agents are causing serious side effects. The present research article deals with the antipyretic and antinociceptive activity of extract/fractions of Potentilla evestita and acacetin isolated from the chloroform fraction of the plant. METHODS: Various chromatographic and spectroscopic techniques were used for the isolation and characterizion of compound. In-vivo yeast induced fibrile mice were used for antipyretic activity while acetic acid induced writhing and formalin tests were used for antinociceptive. RESULTS: The extract/fractions of P. evestita caused marked antipyretic effect during various assessment times in which chloroform was the most prominent followed by ethyl acetate. When acacetin was injected, it produced marked effect with maximum activity of 33.28% and 55.01% at 5 and 10 mg/kg i.p respectively. When studied in acetic acid induced writhing test, the extract/fractions evoked significant antinociceptive effect in which chloroform was the most effective fraction followed by ethyl acetate. Acacetin showed significant antinociceptive effect with 44.77% and 67.03% reduction in abdominal constriction at 5 and 10 mg/kg i.p., respectively. Similarly, it evoked significant dose dependent reduction in noxious stimulation with 42.07% and 64.57% pain attenuation at 5 and 10 mg/kg i.p., respectively in initial phase. In the late phase, it illustrated more dominant effect with 46.32% and 67.29% reduction of painful sensation. CONCLUSIONS: In conclusion, the extract/fractions of P. evestita as well as the isolated compound, acacetin showed strong antipyretic and antinociceptive activity in various animal models possibly mediated through both peripheral and central mechanism.

Maternal morbidity in early pregnancy in rural northern Bangladesh.

OBJECTIVE: To determine the burden of maternal morbidity in early pregnancy in rural northern Bangladesh. METHODS: A cross-sectional analysis was performed on baseline morbidity data from 42 896 pregnant women enrolled in a vitamin A supplementation trial. One-week histories for 31 defined symptoms were collected at 5-12 weeks of gestation. Ten illnesses were defined, compatible with ICD-10 diagnoses and WHO definitions. Prevalence, duration, and treatment-seeking behaviors were determined for each symptom and illness. Risk of wasting malnutrition was compared between symptomatic and asymptomatic women. RESULTS: In total, 93.1% of women reported at least 1 symptom. The most frequent symptoms were poor appetite (53.3%), vaginal discharge (48.7%), and nausea (48.1%), each of which lasted 22-27 days. The most prevalent illnesses were anemia (36.4%), morning sickness (17.2%), excessive vomiting (7.0%), and reproductive tract infections (6.7%). Symptoms that prompted treatment seeking included jaundice, high-grade fever, and swelling of hands and face. Odds ratios for malnutrition were higher among women with symptoms of anemia (1.30; 95% confidence interval [CI], 1.24-1.36), vaginal discharge (1.37; 95% CI, 1.31-1.43), and high-grade fever (1.23; 95% CI, 1.10-1.37) than among those without symptoms. CONCLUSION: Women in rural Bangladesh report substantial morbidity in the first trimester.

Care-seeking patterns for fatal non-communicable diseases among women of reproductive age in rural northwest Bangladesh.

BACKGROUND: Though non-communicable diseases contribute to an increasing share of the disease burden in South Asia, health systems in most rural communities are ill-equipped to deal with chronic illness. This analysis seeks to describe care-seeking behavior among women of reproductive age who died from fatal non-communicable diseases as recorded in northwest rural Bangladesh between 2001 and 2007. METHODS: This analysis utilized data from a large population-based cohort trial in northwest rural Bangladesh. To conduct verbal autopsies of women who died while under study surveillance, physicians interviewed family members to elicit the biomedical symptoms that the women experienced as well as a narrative of the events leading to deaths. We performed qualitative textual analysis of verbal autopsy narratives for 250 women of reproductive age who died from non-communicable diseases between 2001 and 2007. RESULTS: The majority of women (94%) sought at least one provider for their illnesses. Approximately 71% of women first visited non-certified providers such as village doctors and traditional healers, while 23% first sought care from medically certified providers. After the first point of care, women appeared to switch to medically certified practitioners when treatment from non-certified providers failed to resolve their illness. CONCLUSIONS: This study suggests that treatment seeking patterns for non-communicable diseases are affected by many of the sociocultural factors that influence care seeking for pregnancy-related illnesses. Families in northwest rural Bangladesh typically delayed seeking treatment from medically certified providers for NCDs due to the cost of services, distance to facilities, established relationships with non-certified providers, and lack of recognition of the severity of illnesses. Most women did not realize initially that they were suffering from a chronic illness. Since women typically reached medically certified providers in advanced stages of disease, they were usually told that treatment was not possible or were referred to higher-level facilities that they could not afford to visit. Women suffering from non-communicable disease in these rural communities need feasible and practical treatment options. Further research and investment in adequate, appropriate care seeking and referral is needed for women of reproductive age suffering from fatal non-communicable diseases in resource-poor settings.