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  1. Praveena SM, Munisvaradass R, Masiran R, Rajendran RK, Lin CC, Kumar S
    Environ Sci Pollut Res Int, 2020 Dec;27(36):44757-44770.
    PMID: 32895790 DOI: 10.1007/s11356-020-10652-z
    Epidemiological studies have proven that children mental health can be affected by environmental pollutants which are believed to be visible in the form of psychological disorder later in their childhood. Moreover, the effects of children mental health are evidently clear in the case of phthalates which have been observed to increase psychological disorder, specifically attention-deficit hyperactivity disorder (ADHD). Hence, the present study aims to conduct a systematic review and provide an overview of the existing literature on the association between urinary phthalate metabolite concentrations and ADHD symptoms among children by emphasizing the confounding factors and limitations. Additionally, this review addressed the possible phthalate mechanism insights in human body including its impact on ADHD symptoms. In this case, 16 epidemiological studies (five cross-sectional, nine cohort and two case control studies) that met all the inclusion criteria were selected out of the total of 427 papers screened to show varying quantitative associations between phthalate exposure and ADHD symptoms among children with confounding factors and limitations in the existing studies in regard to the exposure and outcomes. This review also attempted to present possible explanation on phthalate mechanism in children body and its connection on neurodevelopment and ADHD symptom development which remains unclear in most of the studies. Finally, it is highly recommended for further research to carefully design cohort studies from prenatal to later childhood development with a complete sample size in order to understand phthalate impacts on children health.
    Matched MeSH terms: Pregnancy
  2. Nayan NM, Kadir SHSA, Husin A, Siran R
    Physiol Behav, 2024 Jun 01;280:114546.
    PMID: 38583549 DOI: 10.1016/j.physbeh.2024.114546
    Maternal bisphenol A (BPA) exposure has been reported to cause learning and memory deficits in born offspring. However, little is known that this impairment is potentially caused by epigenetic modulation on the development of NMDA receptor subunits. This study investigates the effect of prenatal BPA exposure on the hippocampal miR-19a and miR-539, which are responsible for regulating NMDA receptor subunits as well as learning and memory functions. Pregnant Sprague Dawley rats were orally administered with 5 mg/kg/day of BPA from pregnancy day 1 (PD1) until gestation day 21 (GD21), while control mothers received no BPA. The mothers were observed daily until GD21 for either a cesarean section or spontaneous delivery. The male offspring were sacrificed when reaching GD21 (fetus), postnatal days 7, 14, 21 (PND7, 14, 21) and adolescent age 35 (AD35) where their hippocampi were dissected from the brain. The expression of targeted miR-19a, miR-539, GRIN2A, and GRIN2B were determined by qRT-PCR while the level of GluN2A and GluN2B were estimated by western blot. At AD35, the rats were assessed with neurobehavioral tests to evaluate their learning and memory function. The findings showed that prenatal BPA exposure at 5 mg/kg/day significantly reduces the expression of miR-19a, miR-539, GRIN2A, and GRIN2B genes in the male rat hippocampus at all ages. The level of GluN2A and GluN2B proteins is also significantly reduced when reaching adolescent age. Consequently, the rats showed spatial and fear memory impairments when reaching AD35. In conclusion, prenatal BPA exposure disrupts the role of miR-19a and miR-539 in regulating the NMDA receptor subunit in the hippocampus which may be one of the causes of memory and learning impairment in adolescent rats.
    Matched MeSH terms: Pregnancy
  3. Tong CV
    Clin Med (Lond), 2020 Sep;20(5):e204-e205.
    PMID: 32934066 DOI: 10.7861/clinmed.2020-0151
    A 34-year-old woman (gravida 4; para 3) at 17 weeks of pregnancy presented with abnormal behaviour for 3 weeks associated with difficulties in walking. She had been admitted 2 months prior with hyperemesis gravidarum and was also diagnosed with thyrotoxicosis. Vomiting and poor oral intake persisted after discharge. She was euthyroid otherwise. Clinical examination revealed a dehydrated and confused patient. She had nystagmus and ataxic gate. Magnetic resonance imaging of the brain showed symmetrical signal changes of posteromedial part of thalamus. A diagnosis of Wernicke's encephalopathy (WE) was made and intravenous thiamine was given leading to gradual improvement of symptoms. Her thyroid function test normalised without any treatment. WE can occur in severe hyperemesis gravidarum. Prompt recognition of WE and replacement with thiamine is important to prevent neurological sequelae and mortality. Gestational transient thyrotoxicosis, which is self-limiting, is more prominent in patients with hyperemesis gravidarum and requires only symptomatic treatment.
    Matched MeSH terms: Pregnancy
  4. Zakaria WNA, Yoon SY, Wijaya A, Ahmad AH, Zakaria R, Othman Z
    Eur J Hum Genet, 2023 Oct;31(10):1181-1184.
    PMID: 37142766 DOI: 10.1038/s41431-023-01371-3
    This article seeks to highlight the most recent trends and themes in genetic counseling that are of broad interest. A total of 3505 documents were published between 1952 and 2021, with a trend toward increase in paper/year. The most common documents are original articles (2515, 71.8%), followed by review articles (341, 9.7%). Journal of Genetic Counseling publishes the highest number of genetic counseling articles (587, 16.7%), followed by Clinical Genetics (103, 2.9%) and the South American Journal of Medical Genetics (95, 2.7%). Co-occurrence analysis revealed five research themes: genetic testing, cancer, genetic counselor, prenatal diagnosis, and psychiatry. The genetic counselor theme contained most of the recent keywords, including "covid-19," "underrepresented population," "service delivery models," "workforce," "disparities," "service delivery," "professional development," "cultural competence," "access," "diversity," "telemedicine," and "health literacy." Genetic counseling researchers may use these keywords to find topics pertinent to their future research and practice.
    Matched MeSH terms: Pregnancy
  5. Chear CT, Ismail IH, Chan KC, Noh LM, Kassim A, Latiff AHA, et al.
    Front Immunol, 2023;14:1252765.
    PMID: 37809070 DOI: 10.3389/fimmu.2023.1252765
    BACKGROUND: Bruton's tyrosine kinase (BTK) is a cytoplasmic protein involved in the B cell development. X-linked agammaglobulinemia (XLA) is caused by mutation in the BTK gene, which results in very low or absent B cells. Affected males have markedly reduced immunoglobulin levels, which render them susceptible to recurrent and severe bacterial infections. Methods: Patients suspected with X-linked agammaglobulinemia were enrolled during the period of 2010-2018. Clinical summary, and immunological profiles of these patients were recorded. Peripheral blood samples were collected for monocyte BTK protein expression detection and BTK genetic analysis. The medical records between January 2020 and June 2023 were reviewed to investigate COVID-19 in XLA.

    RESULTS: Twenty-two patients (from 16 unrelated families) were molecularly diagnosed as XLA. Genetic testing revealed fifteen distinct mutations, including four splicing mutations, four missense mutations, three nonsense mutations, three short deletions, and one large indel mutation. These mutations scattered throughout the BTK gene and mostly affected the kinase domain. All mutations including five novel mutations were predicted to be pathogenic or deleterious by in silico prediction tools. Genetic testing confirmed that eleven mothers and seven sisters were carriers for the disease, while three mutations were de novo. Flow cytometric analysis showed that thirteen patients had minimal BTK expression (0-15%) while eight patients had reduced BTK expression (16-64%). One patient was not tested for monocyte BTK expression due to insufficient sample. Pneumonia (n=13) was the most common manifestation, while Pseudomonas aeruginosa was the most frequently isolated pathogen from the patients (n=4). Mild or asymptomatic COVID-19 was reported in four patients.

    CONCLUSION: This report provides the first overview of demographic, clinical, immunological and genetic data of XLA in Malaysia. The combination of flow cytometric assessment and BTK genetic analysis provides a definitive diagnosis for XLA patients, especially with atypical clinical presentation. In addition, it may also allow carrier detection and assist in genetic counselling and prenatal diagnosis.

    Matched MeSH terms: Pregnancy
  6. Yogamoorthy U, Saaid R, Gan F, Hong J, Hamdan M, Tan PC
    Am J Obstet Gynecol MFM, 2023 Nov;5(11):101158.
    PMID: 37734661 DOI: 10.1016/j.ajogmf.2023.101158
    BACKGROUND: Induction of labor in women with 1 previous cesarean delivery and unripe cervices is a high-risk process, carrying an increased risk of uterine rupture and the need for cesarean delivery. Balloon ripening is often chosen as prostaglandin use is associated with an appreciable risk of uterine rupture in vaginal birth after cesarean delivery. A shorter duration of placement of the balloon typically expedites delivery; however, this has not been evaluated in induction of labor after 1 previous cesarean delivery.

    OBJECTIVE: This study aimed to compare Foley balloon catheter placement for 6 vs 12 hours in induction of labor after 1 previous cesarean delivery.

    STUDY DESIGN: A randomized controlled trial was conducted in a university hospital in Malaysia from January 2022 to February 2023. Eligible women with 1 previous cesarean delivery admitted for induction of labor were enrolled. Participants were randomized after balloon catheter insertion for 6 or 12 hours of passive ripening before balloon deflation and removal to check cervical status for amniotomy. The primary outcome was the induction of labor to delivery interval. The secondary outcomes were largely derived from the core outcome set for trials on induction of labor (Core Outcomes in Women's and Newborn Health [CROWN]). The Student t test, Mann-Whitney U test, chi-square test, and Fisher exact test were used as appropriate for the data.

    RESULTS: Overall, 126 women were randomized, 63 to each intervention. The mean induction of labor to delivery intervals were 23.0 (standard deviation, ±8.9) in the 6-hour arm and 26.6 (standard deviation, ±7.1) in the 12-hour arm (mean difference, -3.5 hours; 95% confidence interval, -6.4 to -0.7; P=.02). The median induction of labor (Foley balloon catheter insertion) to Foley balloon catheter removal intervals were 6.0 hours (interquartile range, 6.0-6.3) in the 6-hour arm and 12.0 hours (interquartile range, 12.0-12.5) in the 12-hour arm (P

    Matched MeSH terms: Pregnancy
  7. Rahman M, Islam MJ, Haque SE, Saw YM, Haque MN, Duc NH, et al.
    Public Health Nutr, 2017 Feb;20(2):305-314.
    PMID: 27608854 DOI: 10.1017/S136898001600224X
    OBJECTIVE: To explore the association between high-risk fertility behaviours and the likelihood of chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition among women of reproductive age.

    DESIGN: The 2011 Bangladesh Demographic and Health Survey, conducted from 8 July to 27 December 2011.

    SETTING: Selected urban and rural areas of Bangladesh.

    SUBJECTS: A total of 2197 ever-married women living with at least one child younger than 5 years. Exposure was determined from maternal reports of high-risk fertility behaviours. We considered three parameters, maternal age at the time of delivery, birth order and birth interval, to define the high-risk fertility behaviours. Chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition among women were the outcome variables.

    RESULTS: A substantial percentage of women were exposed to have a high-risk fertility pattern (41·8 %); 33·0 % were at single high-risk and 8·8 % were at multiple high-risk. After adjusting for relevant covariates, high-risk fertility behaviours were associated with increased likelihood of chronic undernutrition (adjusted relative risk; 95 % CI: 1·22; 1·03, 1·44), anaemia (1·12; 1·00, 1·25) and the coexistence of anaemia and undernutrition (1·52; 1·17, 1·98). Furthermore, multiple high-risk fertility behaviours appeared to have more profound consequences on the outcome measured.

    CONCLUSIONS: Maternal high-risk fertility behaviours are shockingly frequent practices among women in Bangladesh. High-risk fertility behaviours are important predictors of the increased likelihood of women's chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition.

    Matched MeSH terms: Pregnancy; Pregnancy Complications/etiology; Pregnancy Complications/psychology
  8. Lai YM, Tan GC, Shah SA, Abd Rahman R, Mohd Saleh MF, Mansor S, et al.
    Placenta, 2024 Mar 06;147:21-27.
    PMID: 38278001 DOI: 10.1016/j.placenta.2024.01.012
    INTRODUCTION: Gestational diabetes mellitus (GDM) exerts a great impact on the placenta and reflects changes on placentas both morphological and functionally. The aims of this study are to evaluate the prevalence of placental histopathological lesions in pregnancies complicated by GDM compared to gestational age-matched controls, and their association with maternal and fetal complications.

    METHODS: Fifty-four singleton GDM-complicated pregnancies were recruited and compared to 33 consecutive normal pregnancies. Two pathologists, blinded to all clinical data, reviewed and evaluated all histological samples of the placentas in accordance with Amsterdam criteria. Relevant demographic, clinical data and primary birth outcomes were recorded.

    RESULTS: A myriad of histomorphological abnormalities, including chronic inflammation (n = 9/54, p = 0.031), histological chorioamnionitis (n = 23/54, p 

    Matched MeSH terms: Pregnancy
  9. Kaur S, Teoh AN, Shukri NHM, Shafie SR, Bustami NA, Takahashi M, et al.
    BMC Pregnancy Childbirth, 2020 Feb 11;20(1):96.
    PMID: 32046676 DOI: 10.1186/s12884-020-2797-2
    BACKGROUND: Circadian rhythm plays an important role as our internal body's clock that synchronizes behavior and physiology according to the external 24-h light-dark cycle. Past studies have associated disrupted circadian rhythm with higher risk of miscarriages, preterm birth and low birth weights. This paper described the protocol of a prospective cohort study which aims to determine the circadian rhythm in pregnant women, identify its association with maternal factors during pregnancy, gestational weight gain, birth and infant outcomes.

    METHODS: Ten government maternal and child health clinics in Kuala Lumpur, Malaysia will be randomly selected. Sample size of 438 first-trimester pregnant women will be followed-up until the birth of their infant. Salivary melatonin and cortisol concentration among subsample will be determined using enzyme-linked immunosorbent assay. Data on sleep quality, psychological distress and morningness/eveningness chronotype of pregnant women will be collected using validated questionnaires. Pedometer will be used to measure 5-day physical activity data. Total gestational weight gain will be determined at the end of pregnancy. Utilization of 3-day food record is to capture meal timing and nutrient intake. All measurements will be done in 2nd and 3rd trimester. Birth outcomes will be collected through clinic records and Centers for Disease Control and Prevention (CDC) Neonatal questionnaire. Infants will be followed-up at 6 and 12 months old to obtain anthropometric measurements.

    DISCUSSION: There is a growing recognition of the role of maternal circadian rhythm, which entrains fetal circadian rhythms that may subsequently have long-term health consequences. The present study will identify the effect of circadian rhythm on pregnancy outcomes and infant growth in the first year of life.

    Matched MeSH terms: Pregnancy; Pregnancy Complications/physiopathology*; Pregnancy Outcome
  10. Mustapa Kamal Basha MA, Majid HA, Razali N, Yahya A
    PLoS One, 2020;15(6):e0233890.
    PMID: 32542014 DOI: 10.1371/journal.pone.0233890
    BACKGROUND: Allergic conditions and respiratory tract infections (RTIs) are common causes of morbidity and mortality in childhood. The relationship between vitamin D status in pregnancy (mothers), early life (infants) and health outcomes such as allergies and RTIs in infancy is unclear. To date, studies have shown conflicting results.

    OBJECTIVE: This systematic review aims to gather and appraise existing evidence on the associations between serum vitamin D concentrations during pregnancy and at birth and the development of eczema, wheezing, and RTIs in infants.

    DATA SOURCES: PubMed, MEDLINE, ProQuest, Scopus, CINAHL, Cochrane Library and Academic Search Premier databases were searched systematically using specified search terms and keywords.

    STUDY SELECTION: Articles on the associations between serum vitamin D concentrations during pregnancy and at birth and eczema, wheezing, and RTIs among infants (1-year-old and younger) published up to 31 March 2019 were identified, screened and retrieved.

    RESULTS: From the initial 2678 articles screened, ten met the inclusion criteria and were included in the final analysis. There were mixed and conflicting results with regards to the relationship between maternal and cord blood vitamin D concentrations and the three health outcomes-eczema, wheezing and RTIs-in infants.

    CONCLUSION: Current findings revealed no robust and consistent associations between vitamin D status in early life and the risk of developing eczema, wheezing and RTIs in infants. PROSPERO registration no. CRD42018093039.

    Matched MeSH terms: Pregnancy; Pregnancy Complications/blood; Pregnancy Complications/epidemiology*
  11. Ahmad S, Drag MH, Salleh SM, Cai Z, Nielsen MO
    BMC Genomics, 2021 May 11;22(1):338.
    PMID: 33975549 DOI: 10.1186/s12864-021-07672-5
    BACKGROUND: Early life malnutrition is known to target adipose tissue with varying impact depending on timing of the insult. This study aimed to identify differentially expressed genes in subcutaneous (SUB) and perirenal (PER) adipose tissue of 2.5-years old sheep to elucidate the biology underlying differential impacts of late gestation versus early postnatal malnutrition on functional development of adipose tissues. Adipose tissues were obtained from 37 adult sheep born as twins to dams fed either NORM (fulfilling energy and protein requirements), LOW (50% of NORM) or HIGH (110% of protein and 150% of energy requirements) diets in the last 6-weeks of gestation. From day 3 to 6 months of age, lambs were fed high-carbohydrate-high-fat (HCHF) or moderate low-fat (CONV) diets, and thereafter the same moderate low-fat diet.

    RESULTS: The gene expression profile of SUB in the adult sheep was not affected by the pre- or early postnatal nutrition history. In PER, 993 and 186 differentially expressed genes (DEGs) were identified in LOW versus HIGH and NORM, respectively, but no DEG was found between HIGH and NORM. DEGs identified in the mismatched pre- and postnatal nutrition groups LOW-HCHF (101) and HIGH-HCHF (192) were largely downregulated compared to NORM-CONV. Out of 831 DEGs, 595 and 236 were up- and downregulated in HCHF versus CONV, respectively. The functional enrichment analyses revealed that transmembrane (ion) transport activities, motor activities related to cytoskeletal and spermatozoa function (microtubules and the cytoskeletal motor protein, dynein), and responsiveness to the (micro) environmental extracellular conditions, including endocrine and nervous stimuli were enriched in the DEGs of LOW versus HIGH and NORM. We confirmed that mismatched pre- and postnatal feeding was associated with long-term programming of adipose tissue remodeling and immunity-related pathways. In agreement with phenotypic measurements, early postnatal HCHF feeding targeted pathways involved in kidney cell differentiation, and mismatched LOW-HCHF sheep had specific impairments in cholesterol metabolism pathways.

    CONCLUSIONS: Both pre- and postnatal malnutrition differentially programmed (patho-) physiological pathways with implications for adipose functional development associated with metabolic dysfunctions, and PER was a major target.

    Matched MeSH terms: Pregnancy
  12. Vallikkannu N, Nadzratulaiman WN, Omar SZ, Si Lay K, Tan PC
    BMC Pregnancy Childbirth, 2014 Jan 28;14:49.
    PMID: 24468078 DOI: 10.1186/1471-2393-14-49
    BACKGROUND: External cephalic version (ECV) is offered to reduce the number of Caesarean delivery indicated by breech presentation which occurs in 3-4% of term pregnancies. ECV is commonly performed aided by the application of aqueous gel or talcum powder to the maternal abdomen. We sought to compare gel with powder during ECV on achieving successful version and increasing tolerability.

    METHOD: We enrolled 95 women (≥ 36 weeks gestation) on their attendance for planned ECV. All participants received terbutaline tocolysis. Regional anaesthesia was not used. ECV was performed in the standard fashion after the application of the allocated aid. If the first round (maximum of 2 attempts) of ECV failed, crossover to the opposing aid was permitted.

    RESULTS: 48 women were randomised to powder and 47 to gel. Self-reported procedure related median [interquartile range] pain scores (using a 10-point visual numerical rating scale VNRS; low score more pain) were 6 [5-9] vs. 8 [7-9] P = 0.03 in favor of gel. ECV was successful in 21/48 (43.8%) vs. 26/47 (55.3%) RR 0.6 95% CI 0.3-1.4 P = 0.3 for powder and gel arms respectively. Crossover to the opposing aid and a second round of ECV was performed in 13/27 (48.1%) following initial failure with powder and 4/21 (19%) after failure with gel (RR 3.9 95% CI 1.0-15 P = 0.07). ECV success rate was 5/13 (38.5%) vs. 1/4 (25%) P = 0.99 after crossover use of gel or powder respectively. Operators reported higher satisfaction score with the use of gel (high score, greater satisfaction) VNRS scores 6 [4.25-8] vs 8 [7-9] P = 0.01.

    CONCLUSION: Women find gel use to be associated with less pain. The ECV success rate is not significantly different.

    TRIAL REGISTRATION: The trial is registered with ISRCTN (identifier ISRCTN87231556).

    Matched MeSH terms: Pregnancy; Pregnancy Outcome; Pregnancy Trimester, Third*
  13. Wong LP, Alias H, Lee HY, AbuBakar S, Lin Y, Hu Z
    BMC Womens Health, 2024 Mar 21;24(1):190.
    PMID: 38515067 DOI: 10.1186/s12905-024-02999-z
    BACKGROUND: Although Zika virus infection is rarely reported now, continuous prevention is needed to achieve sustained eradication. This study aimed to explore the knowledge gaps, risk perception and preventive measures against Zika virus infection (ZIKV) in pregnant women in Malaysia.

    METHODS: We conducted in-depth virtual interviews with pregnant women between February and April 2022. The interviews were recorded and transcribed, and data were analyzed by content analysis.

    RESULTS: The majority of the participants demonstrated a commendable level of awareness regarding the signs and symptoms associated with ZIKV infection. They also exhibited a clear understanding of preventive measures, particularly emphasizing the importance of avoiding mosquito bites to minimize the risk of ZIKV transmission. However, a noteworthy gap in knowledge surfaced as a subset of participants remained uninformed about the potential for sexual transmission of ZIKV, which could lead to congenital ZIKV in pregnant women. Even among women who were cognizant of ZIKV and its potential negative health outcomes, associated with the infection, many of them did not perceive themselves to be at risk, mainly because ZIKV infection is infrequently discussed or heard of, leading to a sense of infections' rarity. While the adoption of preventive measures such as mosquito bite prevention during pregnancy was a common practice, however, prevention of sexually transmitted infections (STIs) including mosquito-borne diseases such as Zika is low. A minority of women express concerns about the sensitivity surrounding discussions and prevention of STIs within the context of marriage. Most of the participants were supportive of the provision of awareness of ZIKV infection in women during pregnancy and the involvement of men, especially in initiatives aimed at preventing transmission through sexual contact.

    CONCLUSION: This study uncovered gaps in both knowledge and practices pertaining ZIKV infection among pregnant women in the aftermath of the ZIKV pandemic. The insights gleaned from our research are valuable for shaping future interventions geared towards preventing the resurgence or facilitating the sustainable eradication of ZIKV.

    Matched MeSH terms: Pregnancy
  14. Shastri SS, Temin S, Almonte M, Basu P, Campos NG, Gravitt PE, et al.
    JCO Glob Oncol, 2022 Sep;8:e2200217.
    PMID: 36162041 DOI: 10.1200/GO.22.00217
    PURPOSE: To update resource-stratified, evidence-based recommendations on secondary prevention of cervical cancer globally.

    METHODS: American Society of Clinical Oncology convened a multidisciplinary, multinational Expert Panel to produce recommendations reflecting four resource-tiered settings. A review of existing guidelines, formal consensus-based process, and modified ADAPTE process to adapt existing guidelines was conducted. Other experts participated in formal consensus.

    RESULTS: This guideline update reflects changes in evidence since the previous update. Five existing guidelines were identified and reviewed, and adapted recommendations form the evidence base. Cost-effectiveness analyses provided indirect evidence to inform consensus, which resulted in ≥ 75% agreement.

    RECOMMENDATIONS: Human papillomavirus (HPV) DNA testing is recommended in all resource settings; visual inspection with acetic acid may be used in basic settings. Recommended age ranges and frequencies vary by the following setting: maximal: age 25-65 years, every 5 years; enhanced: age 30-65 years, if two consecutive negative tests at 5-year intervals, then every 10 years; limited: age 30-49 years, every 10 years; basic: age 30-49 years, one to three times per lifetime. For basic settings, visual assessment is used to determine treatment eligibility; in other settings, genotyping with cytology or cytology alone is used to determine treatment. For basic settings, treatment is recommended if abnormal triage results are obtained; in other settings, abnormal triage results followed by colposcopy is recommended. For basic settings, treatment options are thermal ablation or loop electrosurgical excision procedure; for other settings, loop electrosurgical excision procedure or ablation is recommended; with a 12-month follow-up in all settings. Women who are HIV-positive should be screened with HPV testing after diagnosis, twice as many times per lifetime as the general population. Screening is recommended at 6 weeks postpartum in basic settings; in other settings, screening is recommended at 6 months. In basic settings without mass screening, infrastructure for HPV testing, diagnosis, and treatment should be developed.Additional information is available at www.asco.org/resource-stratified-guidelines.

    Matched MeSH terms: Pregnancy
  15. Kumar CM, Seet E
    Best Pract Res Clin Anaesthesiol, 2023 Jun;37(2):139-156.
    PMID: 37321763 DOI: 10.1016/j.bpa.2023.02.007
    Continuous Spinal Anaesthesia (CSA) technique has all the advantages of single-shot spinal anaesthesia with the added benefit of prolonging the duration of anaesthesia. CSA has been used as a primary method of anaesthesia as an alternative to general anaesthesia in high-risk and elderly patients for various elective and emergency surgical procedures involving the abdomen, lower limbs, and vascular surgeries. CSA has also been used in some obstetrics units. Despite its advantages, CSA technique remains underutilised because it is surrounded with myths, mysteries, and controversies concerning neurological, other morbidities and minor technical difficulties. This article includes a description of CSA technique compared to other contemporary central neuraxial blocks. It also discusses the perioperative applications of CSA for different surgical and obstetrics procedures, advantages, disadvantages, complications, problems, and pointers on how to perform the technique safely.
    Matched MeSH terms: Pregnancy
  16. Ali S, Amjad Z, Khan TM, Maalik A, Iftikhar A, Khan I, et al.
    Parasitology, 2020 Sep;147(10):1133-1139.
    PMID: 32517832 DOI: 10.1017/S0031182020000967
    Toxoplasmosis is a parasitic zoonotic disease caused by Toxoplasma (T.) gondii. Limited data are available on the occurrence of T. gondii in women especially pregnant women in Pakistan. The present study aimed to determine the occurrence and risk factors associated with T. gondii in pregnant and non-pregnant women in Punjab Province, Pakistan. A cross-sectional study was conducted and 593 samples were collected from pregnant (n = 293) and non-pregnant (n = 300) women of District Headquarter Hospitals of Chiniot, Faisalabad, Jhang and Okara, Pakistan. Data related to demographic parameters and risk factors were collected using a pretested questionnaire on blood sampling day. Serum samples were screened for antibodies (IgG) against T. gondii using ELISA. A univariant and binomial logistic regression was applied to estimate the association between seropositive and explanatory variables considering the 95% confidence interval. P value ⩽0.05 was considered statistically significant for all analysis. Out of 593, 44 (7.42%) women were seropositive for T. gondii IgG antibodies. Occupation, age, sampling location, socioeconomic status, contact with cat, pregnancy status and trimester of pregnancy were significantly associated with seropositivity for T. gondii antibodies. Location and trimester of pregnancy were identified as potential risk factors for T. gondii seropositivity based on binomial logistic regression. Toxoplasma gondii is prevalent in pregnant and non-pregnant women. Therefore, now a necessitated awareness is required to instruct the individuals about these infectious diseases (toxoplasmosis) and their control strategies to maintain the health of human population. Moreover, health awareness among public can help the minimization of T. gondii infection during pregnancy and subsequent risk of congenital toxoplasmosis.
    Matched MeSH terms: Pregnancy; Pregnancy Complications, Parasitic/epidemiology*; Pregnancy Complications, Parasitic/parasitology
  17. Federspiel F, Mitchell R, Asokan A, Umana C, McCoy D
    BMJ Glob Health, 2023 May;8(5).
    PMID: 37160371 DOI: 10.1136/bmjgh-2022-010435
    While artificial intelligence (AI) offers promising solutions in healthcare, it also poses a number of threats to human health and well-being via social, political, economic and security-related determinants of health. We describe three such main ways misused narrow AI serves as a threat to human health: through increasing opportunities for control and manipulation of people; enhancing and dehumanising lethal weapon capacity and by rendering human labour increasingly obsolescent. We then examine self-improving 'artificial general intelligence' (AGI) and how this could pose an existential threat to humanity itself. Finally, we discuss the critical need for effective regulation, including the prohibition of certain types and applications of AI, and echo calls for a moratorium on the development of self-improving AGI. We ask the medical and public health community to engage in evidence-based advocacy for safe AI, rooted in the precautionary principle.
    Matched MeSH terms: Pregnancy
  18. Barber CV, Yo JH, Rahman RA, Wallace EM, Palmer KR, Marshall SA
    Placenta, 2023 May;136:35-41.
    PMID: 37028223 DOI: 10.1016/j.placenta.2023.03.008
    Activin A is a two-subunit protein belonging to the transforming growth factor β superfamily. First discovered almost three decades ago, it has since been implicated in diverse physiological roles, ranging from wound repair to reproduction. After 30 years of research, altered activin A levels are now understood to be associated with the development of various diseases, making activin A a potential therapeutic target. In pregnancy, the placenta and fetal membranes are major producers of activin A, with significantly enhanced serum concentrations now recognised as a contributor to numerous gestational disorders. Evidence now suggests that circulating levels of activin A may be clinically relevant in the early detection of pregnancy complications, including miscarriage and preeclampsia. This review aims to summarise our current understanding of activin A as a potential diagnostic marker in common pregnancy pathologies.
    Matched MeSH terms: Pregnancy
  19. Muul I, Liat LB
    J Mammal, 1974 May;55(2):393-400.
    PMID: 4833184
    Matched MeSH terms: Pregnancy
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