Background: The focus of recent research has been directed toward the probiotic potential of Bacillus amyloliquefaciens(BA) on the gut health of animals. However, little is known about BA's effects on piglets with...Background: The focus of recent research has been directed toward the probiotic potential of Bacillus amyloliquefaciens(BA) on the gut health of animals. However, little is known about BA's effects on piglets with intra-uterine growth retardation(IUGR). Therefore, this study investigated the effects of BA supplementation on the growth performance,intestinal morphology, inflammatory response, and microbiota of IUGR piglets.Methods: Eighteen litters of newborn piglets were selected at birth, with one normal birth weight(NBW) and two IUGR piglets in each litter(i.e., 18 NBW and 36 IUGR piglets in total). At weaning, the NBW piglet and one of the IUGR piglets were assigned to groups fed a control diet(i.e., the NBW-CON and IUGR-CON groups). The other IUGR piglet was assigned to a group fed the control diet supplemented with 2.0 g BA per kg of diet(i.e., IUGR-BA group). The piglets were thus distributed across three groups for a four-week period.Results: IUGR reduced the growth performance of the IUGR-CON piglets compared with the NBW-CON piglets. It was also associated with decreased vil us sizes, increased apoptosis rates, reduced goblet cel numbers, and an imbalance between pro-and anti-inflammatory cytokines in the smal intestine. Supplementation with BA improved the average daily weight gain and the feed efficiency of the IUGR-BA group compared with the IUGR-CON group(P < 0.05). The IUGR-BA group exhibited increases in the ratio of jejunal vil us height to crypt depth, in ileal vil us height, and in ileal goblet cel density. They also exhibited decreases in the numbers of jejunal and ileal apoptotic cel s and ileal proliferative cel s(P < 0.05). Supplementation with BA increased interleukin 10 content, but it decreased tumor necrosis factor alpha level in the smal intestines of the IUGR-BA piglets(P < 0.05). Furthermore, compared with the IUGR-CON piglets, the IUGR-BA piglets had less Escherichia coli in their jejunal digesta, but more Lactobacil us and Bifidobacterium in their ileal digesta(P < 0.05).Conclusions: Dietary supplementation with BA improves morphology, decreases inflammatory response, and regulates microbiota in the smal intestines of IUGR piglets, which may contribute to improved growth performance during early life.展开更多
Background: Intra-uterine crowding(IUC) observed in hyperprolific sows impairs myofiber hyperplasia and overall fetal growth. Arginine supplementation(ARG) in gestation diets has been shown to positively affect litter...Background: Intra-uterine crowding(IUC) observed in hyperprolific sows impairs myofiber hyperplasia and overall fetal growth. Arginine supplementation(ARG) in gestation diets has been shown to positively affect litter and muscle development. The study objective was to assess whether the effect of ARG on offspring characteristics, with special emphasis on myofiber hyperplasia, differs under IUC conditions from these responses,because in that situation growth retardation is particularly prevalent due to reduced fetal nutrient supply.Unilateral oviduct ligation(OL) was used as a model for an uncrowded and hyperprolificacy(IN) as a model for a crowded intra-uterine environment.Methods: Five OL and five IN sows were fed a diet supplemented daily with either 43 g L-alanine(Ctrl) or 25 g L-arginine from d 14 to 28 of gestation in a cross-over design(two periods: 5^( th) and 6^( th) parity). At farrowing, two male and two female offspring, respectively, with a low and intermediate birth weight(BtW) were selected. After euthanization, the Semitendinosus muscle(STM) was removed and weighed, and the light and dark portions(STM_d and STM_l) were prepared for myofiber histochemistry using ATPase staining and the entire STM for gene expression analysis of myogenesis-related genes using RT-qPCR. In addition, various organs were removed and weighed. Data were analyzed using the MIXED model in SYSTAT.Results: No effect of either IUC or dietary treatment was found in litter characteristics. Offspring of ARG sows displayed a greater muscle area in STM(P < 0.01) as a result of the greater myofiber hyperplasia(P < 0.01). The increase was more distinct in the STM_l(P < 0.05) than in the STM_d(P = 0.131). Offspring of OL sows were heavier at birth(P < 0.01), had a heavier STM(P < 0.05), liver(P < 0.01) and kidney(P < 0.05), but when expressed relative to birth weight, these differences were absent. In addition, IUC had an effect(P < 0.05) on the expression of one of the myogenesis-related genes investigated.Conclusions: Independent from the extent of IUC, ARG improved Bt W, muscle and organ weights and myofiber hyperplasia in offspring.展开更多
Background: The redox status of intra-uterine growth retardation(IUGR) piglets post-weaning has been poorly studied.Methods: Newborns from twenty-four sows were weighted, weaned at 21 d and fed a starter diet unti...Background: The redox status of intra-uterine growth retardation(IUGR) piglets post-weaning has been poorly studied.Methods: Newborns from twenty-four sows were weighted, weaned at 21 d and fed a starter diet until sampling.Sampling was done at 14 d post-weaning. A piglet was defined as IUGR when its birth weight was 2 SD below the mean birth weight of the total population. At weaning, eighteen piglets with nearly equal body weight from each category(i.e. IUGR or normal birth weight(NBW) piglets) were selected and then allocated to two treatments,consisted of six replicates with each pen having three piglets.Results: Compared with NBW group, IUGR significantly decreased average daily gain(P 〈 0.001), average daily feed intake(P = 0.003), and feed efficiency(P 〈 0.001) of piglets during the first two weeks post-weaning. IUGR decreased the activities of total antioxidant capacity(P = 0.019), total superoxide dismutase(T-SOD, P = 0.023),and ceruloplasmin(P = 0.044) but increased the levels of malondialdehyde(P = 0.040) and protein carbonyl(P = 0.010) in plasma. Similarly, the decreased activities of T-SOD(P = 0.005), copper- and zinc-containing superoxide dismutase(Cu/Zn-SOD, P = 0.002), and catalase(P = 0.049) was observed in the liver of IUGR piglets than these of NBW piglets. IUGR decreased hepatic Cu/Zn-SOD activity(P = 0.023) per unit of Cu/Zn-SOD protein in piglets when compared with NBW piglets. In addition, IUGR piglets exhibited the decreases in accumulation of copper in both plasma(P = 0.001) and liver(P = 0.014), as well as the concentrations of iron(P = 0.002) and zinc(P = 0.048) in liver. Compared with NBW, IUGR down-regulated m RNA expression of Cu/Zn-SOD(P = 0.021) in the liver of piglets.Conclusions: The results indicated that IUGR impaired antioxidant capacity and resulted in oxidative damage in fully weaned piglets, which might be associated with the decreased levels of redox-active trace minerals. This study highlights the importance of redox status in IUGR offspring and provides a rationale for alleviating oxidative damage by dietary interventions aiming to supplement trace minerals and to restore redox balance in the future.展开更多
Global contraceptive use is at 64%, Africa lagging behind at 33.4%. Kenya has an unmet need for family planning at 23%. Hormonal injections are the most used in Africa at 9.8% and Intra-Uterine Contraceptive Devices a...Global contraceptive use is at 64%, Africa lagging behind at 33.4%. Kenya has an unmet need for family planning at 23%. Hormonal injections are the most used in Africa at 9.8% and Intra-Uterine Contraceptive Devices at 3.8%. Low uptake of 3.4% was reported in Meru Hospital and lack of literature on immediate Post Partum Intra Uterine Contraceptive Device (PPIUCD) uptake. Immediate Post Partum Intra Uterine Contraceptive Device is a long acting reversible contraceptive device inserted into the uterus immediately within 48 hours after delivery. The objective was to assess Barriers to Immediate Post-Partum Intra-Uterine Contraceptive Device uptake among Mothers delivering in Meru Hospital. Descriptive research design was used and a population of 289 mothers was targeted. Sample size of 74 respondents was selected using simple random sampling. Questionnaires and interview schedules were used to collect data. The collected data were entered and analyzed using Statistical Package for Social Science windows version 23.0. Descriptive analysis was used to obtain frequencies and percentages. Chi-square was used to test the relationship of study variables and presented in tables. The qualitative data were analyzed thematically. The findings revealed that provider related barriers such as none provision of the services and untimely counseling for the insertion had the highest impact to low uptake (57%). Clients lacked information where 68% reported that they were not counseled. Demographic and reproductive characteristics also played a role in low uptake. Using the chi square test, there was a significant relationship, P = 0.001 between young age of the mothers, unemployment (53%), low parity (56%) and low uptake. Preference for other alternative contraceptives (25.8%) such as hormonal methods was a barrier to the uptake. Therefore, barriers to PPIUCD uptake are provider related, alternative methods of contraception and client related such as lack of information, unemployment, young age and low parity. The findings will inform Meru hospital management on barriers to immediate PPIUCD uptake. The study recommends an investigation on why providers hinder PPIUCD uptake and create awareness on PPIUCD services to the community.展开更多
Intrauterine diagnosis of small intestinal volvulus is extremely rare;a small bowel volvulus may be caused, by an atresia or malrotation, and it can also be an etiology for intestinal atresia. Early antenatal diagnosi...Intrauterine diagnosis of small intestinal volvulus is extremely rare;a small bowel volvulus may be caused, by an atresia or malrotation, and it can also be an etiology for intestinal atresia. Early antenatal diagnosis of fetal intestinal volvulus is difficult. Care full and meticulous prenatal radiological investigations in the experience hand may suggest the diagnosis. We present a male child who presented 9 hours after birth with gangrenous proximal dilated loop volvulus in a type III B intestinal atresia diagnosed intraoperative and was treated successfully. Presence of focal abdominal wall edema in a newborn with intestinal obstruction may suggest this diagnosis.展开更多
Background: In Mali, contraceptive prevalence is low, while the unmet need for family planning is very high. Postpartum contraception can help to significantly reduce these unsatisfied needs. The introduction of the i...Background: In Mali, contraceptive prevalence is low, while the unmet need for family planning is very high. Postpartum contraception can help to significantly reduce these unsatisfied needs. The introduction of the intrauterine device (IUD) in the postpartum quickly encountered problems with the type of forceps used to make the insertions (Kelly or Heart forceps), and also their availability at the various health centers. Thus, in 2016, the Population Services International Mali (PSI-Mali) introduced the insertion of the IUD in the postpartum with the new inserter in order to counter this forceps problem and to contribute to guaranteeing the quality of postpartum IUD insertions. Objectives: They were to determine the frequency, the socio-demographic and clinical characteristics and to report the side effects and the complications. Methods: This was a descriptive and analytical cross-sectional study from September 1st 2016 to August 31st, 2018. All deliveries that met the eligibility criteria, having chosen and benefited the postpartum intra-uterine device with the new inserter were included. Results: During the 2 years, we recorded 73 cases of insertion of the postpartum intra-uterine device with the new inserter over 7797 clients meeting of the world health organization’s criteria of medical admissibility for the use of an intra-uterine device with a frequency of 0.93%. They were married in 97% of cases, large multiparous in 48% of cases, aged between 30 and 39 years in 62% of cases. We didn’t notice any complications in 96% of cases. Expulsion with 4% was the only complication. The clients didn’t have any side effects in 98% of cases. Conclusion: The insertion of a postpartum intra-uterine device with the new inserter has supplanted the insertion techniques using forceps in our center because of its ease and speed. Its use is worth being popularized to help reduce the unmet need for family planning.展开更多
Background: Snakebite envenomation in pregnancy is uncommon. It can lead to a poor outcome in both the mother and the fetus. We describe our approach to envenomation in pregnancy based on the currently available evide...Background: Snakebite envenomation in pregnancy is uncommon. It can lead to a poor outcome in both the mother and the fetus. We describe our approach to envenomation in pregnancy based on the currently available evidence. Case: We reported two case of snakebite in the third trimester of pregnancy having caused placental abruption with expelling a fresh still born baby and a live baby. In both cases, consumption coagulopathy occurred. managed by polyvalent anti-snake and blood transfusion. Their investigations became normal and they were discharged of hospitalization. Conclusion: Snakebite envenomation in pregnant is a maternal and fetal emergency. Treatment must be quick and well adapted.展开更多
Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is important to promote uptake of family planning services because it is one of the four pillars of...Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is important to promote uptake of family planning services because it is one of the four pillars of the Safe Motherhood Initiative to reduce maternal death in developing countries. It is also enshrined in health related Sustainable Development Goals. Post Partum Intra Uterine Contraceptive Device (PPIUCD) is the oldest methods of family planning. During the ancient times, foreign bodies like stones were introduced into the woman’s uterus for prevention of pregnancy. Post partum method of contraception is highly recommended because it is long acting, convenient, safe and highly effective with minimal side effects compared to the hormonal methods. Despite these advantages, the method is the lowest in use globally, regionally and locally. According to the Meru Hospital records for the year 2017, the immediate PPIUCD uptake was very low at 3.4%. The broad objective of this study was to assess the factors that facilitate uptake of PPIUCD at Meru Hospital. The study site was post natal ward maternity department of Meru Hospital for a period of two months that is September and October in the year 2018. A descriptive research design was used and the study population was the mothers who were admitted in the ward during the study period. A sample size of 74 respondents was used as the representative to the target population of 289 mothers. Simple random sampling was used to get the sample for the facilitators. Data were collected using structured questionnaires and interview schedules. The data collection instruments were pretested at Embu Level five Hospital and split half reliability test technique used. Validity was ensured through review of literature from similar studies and by consulting supervisors in the department. Permission to conduct the study was sought from National Commission for Science, Technology and Innovation through Chuka University Ethics and Research Committee. Descriptive analysis was done to get percentages using Statistical Package for Social Science (SPSS) for windows version 23.0. Qualitative data were analyzed by grouping data into themes according to the study objectives. The analyzed data were presented in tables, charts and narratives. The findings of the study revealed that;the main client related facilitators to PPIUCD uptake were older age above 30 years, employment, tertiary level of education and knowledge on the method as a result of the providers’ effort to share information. That is 70% of older aged mothers, 60% of the employed and 40% with tertiary education had the insertion. The main provider facilitator to PPIUCD uptake was timely counseling and insertion services. 20% of those who had the insertion said that timely counseling was done during antenatal period. The main method related facilitator to PPIUCD uptake was past experience and preference to alternative methods of contraception. 50% of those who accepted the insertion had previous bad experience and side effects of other alternative methods. Some 30% of users perceived that the method was effective and convenient because once inserted no need for frequent visits to the clinic. The study concluded that clients, providers and method factors facilitated uptake of immediate PPIUCD. The study recommends putting in place strategies to improve the uptake of the method by considering the client, provider and method related facilitators.展开更多
The purpose of this study was to investigate the effects of copper/low-density polyethylene nanocomposite(nano-Cu/LDPE)on the endometrial angiogenesis in rats,and 100 sexual mature female SD rats were randomly divided...The purpose of this study was to investigate the effects of copper/low-density polyethylene nanocomposite(nano-Cu/LDPE)on the endometrial angiogenesis in rats,and 100 sexual mature female SD rats were randomly divided into five groups:sham-operation groups(SO group,n=20),bulk copper groups(Cu group,n=20),LDPE groups(n=20),nano-Cu/LDPE groups I(n=20)and II(n=20).The levels of angiopoietin-2(Ang-2),its receptor(Tie-2)and CD34 of the rats’endometria in each group were examined by using the S-P method of the immunohistochemistry 30 and 180 days after insertion,respectively.Compared with those in the SO group,the expression of Ang-2 and Tie-2 in all the experimental groups was obviously increased 30 days after insertion,and these parameters in nano-Cu/LDPE groups,except for Ang-2 level in nano-Cu/LDPE group II,were significantly lower in comparison with those in Cu group(P<0.05).On the 180th day after insertion,Ang-2 and Tie-2 levels were still higher in Cu group and LDPE group,but there was no difference of Ang-2 and Tie-2 levels between nano-Cu/LDPE groups and the SO group(P>0.05).Com-pared with those in the SO group,the significant increases in microvessel density(MVD)were observed on the 30th and the 180th day after the insertion of the bulk copper(P<0.05).There was no significant difference in MVD counts before and after the insertion of nano-Cu/LDPE(P>0.05).The results show that Nano-Cu/LDPE have slighter influence on the endometrial angiogenesis than bulk copper.展开更多
基金provided by the National Science-Technology Support Plan Projects of China(No.2013BAD10B02–03)the Phase Ⅱ Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions
文摘Background: The focus of recent research has been directed toward the probiotic potential of Bacillus amyloliquefaciens(BA) on the gut health of animals. However, little is known about BA's effects on piglets with intra-uterine growth retardation(IUGR). Therefore, this study investigated the effects of BA supplementation on the growth performance,intestinal morphology, inflammatory response, and microbiota of IUGR piglets.Methods: Eighteen litters of newborn piglets were selected at birth, with one normal birth weight(NBW) and two IUGR piglets in each litter(i.e., 18 NBW and 36 IUGR piglets in total). At weaning, the NBW piglet and one of the IUGR piglets were assigned to groups fed a control diet(i.e., the NBW-CON and IUGR-CON groups). The other IUGR piglet was assigned to a group fed the control diet supplemented with 2.0 g BA per kg of diet(i.e., IUGR-BA group). The piglets were thus distributed across three groups for a four-week period.Results: IUGR reduced the growth performance of the IUGR-CON piglets compared with the NBW-CON piglets. It was also associated with decreased vil us sizes, increased apoptosis rates, reduced goblet cel numbers, and an imbalance between pro-and anti-inflammatory cytokines in the smal intestine. Supplementation with BA improved the average daily weight gain and the feed efficiency of the IUGR-BA group compared with the IUGR-CON group(P < 0.05). The IUGR-BA group exhibited increases in the ratio of jejunal vil us height to crypt depth, in ileal vil us height, and in ileal goblet cel density. They also exhibited decreases in the numbers of jejunal and ileal apoptotic cel s and ileal proliferative cel s(P < 0.05). Supplementation with BA increased interleukin 10 content, but it decreased tumor necrosis factor alpha level in the smal intestines of the IUGR-BA piglets(P < 0.05). Furthermore, compared with the IUGR-CON piglets, the IUGR-BA piglets had less Escherichia coli in their jejunal digesta, but more Lactobacil us and Bifidobacterium in their ileal digesta(P < 0.05).Conclusions: Dietary supplementation with BA improves morphology, decreases inflammatory response, and regulates microbiota in the smal intestines of IUGR piglets, which may contribute to improved growth performance during early life.
文摘Background: Intra-uterine crowding(IUC) observed in hyperprolific sows impairs myofiber hyperplasia and overall fetal growth. Arginine supplementation(ARG) in gestation diets has been shown to positively affect litter and muscle development. The study objective was to assess whether the effect of ARG on offspring characteristics, with special emphasis on myofiber hyperplasia, differs under IUC conditions from these responses,because in that situation growth retardation is particularly prevalent due to reduced fetal nutrient supply.Unilateral oviduct ligation(OL) was used as a model for an uncrowded and hyperprolificacy(IN) as a model for a crowded intra-uterine environment.Methods: Five OL and five IN sows were fed a diet supplemented daily with either 43 g L-alanine(Ctrl) or 25 g L-arginine from d 14 to 28 of gestation in a cross-over design(two periods: 5^( th) and 6^( th) parity). At farrowing, two male and two female offspring, respectively, with a low and intermediate birth weight(BtW) were selected. After euthanization, the Semitendinosus muscle(STM) was removed and weighed, and the light and dark portions(STM_d and STM_l) were prepared for myofiber histochemistry using ATPase staining and the entire STM for gene expression analysis of myogenesis-related genes using RT-qPCR. In addition, various organs were removed and weighed. Data were analyzed using the MIXED model in SYSTAT.Results: No effect of either IUC or dietary treatment was found in litter characteristics. Offspring of ARG sows displayed a greater muscle area in STM(P < 0.01) as a result of the greater myofiber hyperplasia(P < 0.01). The increase was more distinct in the STM_l(P < 0.05) than in the STM_d(P = 0.131). Offspring of OL sows were heavier at birth(P < 0.01), had a heavier STM(P < 0.05), liver(P < 0.01) and kidney(P < 0.05), but when expressed relative to birth weight, these differences were absent. In addition, IUC had an effect(P < 0.05) on the expression of one of the myogenesis-related genes investigated.Conclusions: Independent from the extent of IUC, ARG improved Bt W, muscle and organ weights and myofiber hyperplasia in offspring.
基金supported by the National Natural Science Foundation of China (31272454)
文摘Background: The redox status of intra-uterine growth retardation(IUGR) piglets post-weaning has been poorly studied.Methods: Newborns from twenty-four sows were weighted, weaned at 21 d and fed a starter diet until sampling.Sampling was done at 14 d post-weaning. A piglet was defined as IUGR when its birth weight was 2 SD below the mean birth weight of the total population. At weaning, eighteen piglets with nearly equal body weight from each category(i.e. IUGR or normal birth weight(NBW) piglets) were selected and then allocated to two treatments,consisted of six replicates with each pen having three piglets.Results: Compared with NBW group, IUGR significantly decreased average daily gain(P 〈 0.001), average daily feed intake(P = 0.003), and feed efficiency(P 〈 0.001) of piglets during the first two weeks post-weaning. IUGR decreased the activities of total antioxidant capacity(P = 0.019), total superoxide dismutase(T-SOD, P = 0.023),and ceruloplasmin(P = 0.044) but increased the levels of malondialdehyde(P = 0.040) and protein carbonyl(P = 0.010) in plasma. Similarly, the decreased activities of T-SOD(P = 0.005), copper- and zinc-containing superoxide dismutase(Cu/Zn-SOD, P = 0.002), and catalase(P = 0.049) was observed in the liver of IUGR piglets than these of NBW piglets. IUGR decreased hepatic Cu/Zn-SOD activity(P = 0.023) per unit of Cu/Zn-SOD protein in piglets when compared with NBW piglets. In addition, IUGR piglets exhibited the decreases in accumulation of copper in both plasma(P = 0.001) and liver(P = 0.014), as well as the concentrations of iron(P = 0.002) and zinc(P = 0.048) in liver. Compared with NBW, IUGR down-regulated m RNA expression of Cu/Zn-SOD(P = 0.021) in the liver of piglets.Conclusions: The results indicated that IUGR impaired antioxidant capacity and resulted in oxidative damage in fully weaned piglets, which might be associated with the decreased levels of redox-active trace minerals. This study highlights the importance of redox status in IUGR offspring and provides a rationale for alleviating oxidative damage by dietary interventions aiming to supplement trace minerals and to restore redox balance in the future.
文摘Global contraceptive use is at 64%, Africa lagging behind at 33.4%. Kenya has an unmet need for family planning at 23%. Hormonal injections are the most used in Africa at 9.8% and Intra-Uterine Contraceptive Devices at 3.8%. Low uptake of 3.4% was reported in Meru Hospital and lack of literature on immediate Post Partum Intra Uterine Contraceptive Device (PPIUCD) uptake. Immediate Post Partum Intra Uterine Contraceptive Device is a long acting reversible contraceptive device inserted into the uterus immediately within 48 hours after delivery. The objective was to assess Barriers to Immediate Post-Partum Intra-Uterine Contraceptive Device uptake among Mothers delivering in Meru Hospital. Descriptive research design was used and a population of 289 mothers was targeted. Sample size of 74 respondents was selected using simple random sampling. Questionnaires and interview schedules were used to collect data. The collected data were entered and analyzed using Statistical Package for Social Science windows version 23.0. Descriptive analysis was used to obtain frequencies and percentages. Chi-square was used to test the relationship of study variables and presented in tables. The qualitative data were analyzed thematically. The findings revealed that provider related barriers such as none provision of the services and untimely counseling for the insertion had the highest impact to low uptake (57%). Clients lacked information where 68% reported that they were not counseled. Demographic and reproductive characteristics also played a role in low uptake. Using the chi square test, there was a significant relationship, P = 0.001 between young age of the mothers, unemployment (53%), low parity (56%) and low uptake. Preference for other alternative contraceptives (25.8%) such as hormonal methods was a barrier to the uptake. Therefore, barriers to PPIUCD uptake are provider related, alternative methods of contraception and client related such as lack of information, unemployment, young age and low parity. The findings will inform Meru hospital management on barriers to immediate PPIUCD uptake. The study recommends an investigation on why providers hinder PPIUCD uptake and create awareness on PPIUCD services to the community.
文摘Intrauterine diagnosis of small intestinal volvulus is extremely rare;a small bowel volvulus may be caused, by an atresia or malrotation, and it can also be an etiology for intestinal atresia. Early antenatal diagnosis of fetal intestinal volvulus is difficult. Care full and meticulous prenatal radiological investigations in the experience hand may suggest the diagnosis. We present a male child who presented 9 hours after birth with gangrenous proximal dilated loop volvulus in a type III B intestinal atresia diagnosed intraoperative and was treated successfully. Presence of focal abdominal wall edema in a newborn with intestinal obstruction may suggest this diagnosis.
文摘Background: In Mali, contraceptive prevalence is low, while the unmet need for family planning is very high. Postpartum contraception can help to significantly reduce these unsatisfied needs. The introduction of the intrauterine device (IUD) in the postpartum quickly encountered problems with the type of forceps used to make the insertions (Kelly or Heart forceps), and also their availability at the various health centers. Thus, in 2016, the Population Services International Mali (PSI-Mali) introduced the insertion of the IUD in the postpartum with the new inserter in order to counter this forceps problem and to contribute to guaranteeing the quality of postpartum IUD insertions. Objectives: They were to determine the frequency, the socio-demographic and clinical characteristics and to report the side effects and the complications. Methods: This was a descriptive and analytical cross-sectional study from September 1st 2016 to August 31st, 2018. All deliveries that met the eligibility criteria, having chosen and benefited the postpartum intra-uterine device with the new inserter were included. Results: During the 2 years, we recorded 73 cases of insertion of the postpartum intra-uterine device with the new inserter over 7797 clients meeting of the world health organization’s criteria of medical admissibility for the use of an intra-uterine device with a frequency of 0.93%. They were married in 97% of cases, large multiparous in 48% of cases, aged between 30 and 39 years in 62% of cases. We didn’t notice any complications in 96% of cases. Expulsion with 4% was the only complication. The clients didn’t have any side effects in 98% of cases. Conclusion: The insertion of a postpartum intra-uterine device with the new inserter has supplanted the insertion techniques using forceps in our center because of its ease and speed. Its use is worth being popularized to help reduce the unmet need for family planning.
文摘Background: Snakebite envenomation in pregnancy is uncommon. It can lead to a poor outcome in both the mother and the fetus. We describe our approach to envenomation in pregnancy based on the currently available evidence. Case: We reported two case of snakebite in the third trimester of pregnancy having caused placental abruption with expelling a fresh still born baby and a live baby. In both cases, consumption coagulopathy occurred. managed by polyvalent anti-snake and blood transfusion. Their investigations became normal and they were discharged of hospitalization. Conclusion: Snakebite envenomation in pregnant is a maternal and fetal emergency. Treatment must be quick and well adapted.
文摘Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is important to promote uptake of family planning services because it is one of the four pillars of the Safe Motherhood Initiative to reduce maternal death in developing countries. It is also enshrined in health related Sustainable Development Goals. Post Partum Intra Uterine Contraceptive Device (PPIUCD) is the oldest methods of family planning. During the ancient times, foreign bodies like stones were introduced into the woman’s uterus for prevention of pregnancy. Post partum method of contraception is highly recommended because it is long acting, convenient, safe and highly effective with minimal side effects compared to the hormonal methods. Despite these advantages, the method is the lowest in use globally, regionally and locally. According to the Meru Hospital records for the year 2017, the immediate PPIUCD uptake was very low at 3.4%. The broad objective of this study was to assess the factors that facilitate uptake of PPIUCD at Meru Hospital. The study site was post natal ward maternity department of Meru Hospital for a period of two months that is September and October in the year 2018. A descriptive research design was used and the study population was the mothers who were admitted in the ward during the study period. A sample size of 74 respondents was used as the representative to the target population of 289 mothers. Simple random sampling was used to get the sample for the facilitators. Data were collected using structured questionnaires and interview schedules. The data collection instruments were pretested at Embu Level five Hospital and split half reliability test technique used. Validity was ensured through review of literature from similar studies and by consulting supervisors in the department. Permission to conduct the study was sought from National Commission for Science, Technology and Innovation through Chuka University Ethics and Research Committee. Descriptive analysis was done to get percentages using Statistical Package for Social Science (SPSS) for windows version 23.0. Qualitative data were analyzed by grouping data into themes according to the study objectives. The analyzed data were presented in tables, charts and narratives. The findings of the study revealed that;the main client related facilitators to PPIUCD uptake were older age above 30 years, employment, tertiary level of education and knowledge on the method as a result of the providers’ effort to share information. That is 70% of older aged mothers, 60% of the employed and 40% with tertiary education had the insertion. The main provider facilitator to PPIUCD uptake was timely counseling and insertion services. 20% of those who had the insertion said that timely counseling was done during antenatal period. The main method related facilitator to PPIUCD uptake was past experience and preference to alternative methods of contraception. 50% of those who accepted the insertion had previous bad experience and side effects of other alternative methods. Some 30% of users perceived that the method was effective and convenient because once inserted no need for frequent visits to the clinic. The study concluded that clients, providers and method factors facilitated uptake of immediate PPIUCD. The study recommends putting in place strategies to improve the uptake of the method by considering the client, provider and method related facilitators.
基金support of National“the eleven-fifth”Project of Ministry of Science and Technology of China(NO.2006BAI13B01).
文摘The purpose of this study was to investigate the effects of copper/low-density polyethylene nanocomposite(nano-Cu/LDPE)on the endometrial angiogenesis in rats,and 100 sexual mature female SD rats were randomly divided into five groups:sham-operation groups(SO group,n=20),bulk copper groups(Cu group,n=20),LDPE groups(n=20),nano-Cu/LDPE groups I(n=20)and II(n=20).The levels of angiopoietin-2(Ang-2),its receptor(Tie-2)and CD34 of the rats’endometria in each group were examined by using the S-P method of the immunohistochemistry 30 and 180 days after insertion,respectively.Compared with those in the SO group,the expression of Ang-2 and Tie-2 in all the experimental groups was obviously increased 30 days after insertion,and these parameters in nano-Cu/LDPE groups,except for Ang-2 level in nano-Cu/LDPE group II,were significantly lower in comparison with those in Cu group(P<0.05).On the 180th day after insertion,Ang-2 and Tie-2 levels were still higher in Cu group and LDPE group,but there was no difference of Ang-2 and Tie-2 levels between nano-Cu/LDPE groups and the SO group(P>0.05).Com-pared with those in the SO group,the significant increases in microvessel density(MVD)were observed on the 30th and the 180th day after the insertion of the bulk copper(P<0.05).There was no significant difference in MVD counts before and after the insertion of nano-Cu/LDPE(P>0.05).The results show that Nano-Cu/LDPE have slighter influence on the endometrial angiogenesis than bulk copper.