Antenatal care providers' practices and opinions on the services of antenatal syphilis screening in Ulaanbaatar, Mongolia

The objectives of this study were to review antenatal syphilis screening and to assess antenatal care providers' practices and opinions in Ulaanbaatar, Mongolia. A cross-sectional study on antenatal syphilis screening was conducted. The study settings were all 16 antenatal care clinics, and a random selection of 30 family units from six districts in Ulaanbaatar, Mongolia. Interviews were conducted with 150 antenatal care providers and 27 antenatal care heads/leaders. Antenatal syphilis screening in Ulaanbaatar was complex. Most pregnant women had antenatal care at family units or antenatal clinics, but syphilis blood testing could be performed only in some district general hospitals. Syphilis positive-screening cases were referred to the venereologists for confirmation of results, appropriate treatment, contact tracing, and follow-up. The providers agreed with the need for syphilis screening in pregnant women but identified as constraints the limited time for performing the screening due to late antenatal visit, women's lack of knowledge, poverty, and geographic barriers. The practice of providers varied, and the opinion on a one-stop service was positive. The main conclusions concerning the failure of universal antenatal syphilis screening were limited accessibility and feasibility of the service, and the ignorance of both women and providers on the importance of screening. It was agreed that decentralization of antenatal syphilis screening would improve the system.     

Riboflavin-deficient and Trichinella spiralis-induced stresses on plasma corticosterone associated with spermatogenesis in male Wistar rats

The objective of this study was to investigate the effects of riboflavin-deficient and Trichinella spiralis-induced stresses on corticosterone associated with spermatogenesis in male Wistar rats. Rats were allocated into 4 groups: Group 1: control; group 2: riboflavin-deficient diet; group 3: T. spiralis infection; group 4: riboflavin deficient diet with T. spiralis infection. This experiment lasted for 12 weeks. Plasma corticosterone was significantly enhanced when exposed to acute riboflavin deficiency and/or T. spiralis infection stress. When the rats were chronically subjected to such stresses, T. spiralis per se had prolonged effects, in a marked increase in corticosterone. T. spiralis per se tended to impact on such sperm characteristics as sperm motility, sperm count and daily sperm production, even defected seminiferous tubules. It was proposed that the Trichinella spiralis-induced stress probably had adverse effects on the level of adrenocortical-testicular axis whenever their habitats on muscle fibers were evident. However, riboflavin-deficient-induced stress had little implication in the adrenocortical-testicular axis.     

The effects of mode of delivery and time since birth on chronic pelvic pain and health-related quality of life

Objective

To assess the effects of mode of delivery and time since birth on chronic pelvic pain (CPP) and health-related quality of life (HRQoL) among primiparous Chinese women.

Methods

Primiparous women of childbearing age who had given birth at least 6 months previously were invited to participate in the present cross-sectional study, which was conducted from October 2011 to April 2012 in the Chaoyang District of Beijing. Time since birth was divided into the following 4 periods: less than 1 year, 1–5 years, 6–10 years, and more than 10 years. The factors associated with CPP status were analyzed using logistic regression.

Results

Among the 1456 participants, CPP was more common following cesarean delivery (11.2% versus 6.9% among women with a vaginal delivery; P = 0.007), and the rate of CPP increased with time since birth (2.3%, 9.3%, 10.7%, and 13.1% for the 4 specified time periods, respectively (P < 0.001). Cesarean delivery, longer time since birth, and CPP were all associated with a lower HRQoL utility score.

Conclusion

Although the absolute risks were small, cesarean delivery and time since birth were significant risk factors for CPP, which had a negative impact on the participants’ HRQoL.     

HLA-Cw*04 allele associated with nevirapine-induced rash in HIV-infected Thai patients

Background  

A high incidence of rash has been reported in HIV-1 patients who received the anti-retroviral drug nevirapine. In addition, several studies have suggested that polymorphisms of human leukocyte antigen (HLA) genes may play important roles in nevirapine-induced rash. The aim of the present study was to evaluate the effects of different HLA-C alleles on rash associated with nevirapine in patients who started highly active anti-retroviral therapy (HAART) containing nevirapine in Thailand.     

Is International or Asian Criteria-based Body Mass Index Associated with Maternal Anaemia,Low Birthweight,and Preterm Births among Thai Population?—An Observational Study

An observational study was conducted in the four southernmost provinces of Thailand aiming at determining the effect of international or Asian criteria-based body mass index (BMI) in predicting maternal anaemia, low birthweight (LBW), and preterm births among pregnant Thai women and the change in haemoglobin (Hb) level during pregnancy. Maternal anaemia was defined as a haemoglobin (Hb) level of <11 g/dL. Anaemia was detected in 27.4% and 26.9% of 1,192 pregnant women at their first prenatal visit and the third trimester respectively. The proportions of overweight and obese women according to the Asian criteria-based pre-pregnancy BMI were higher than the international criteria-based BMI (22.4% and 10.1% vs 15.5% and 3.4% respectively). No significant difference between pre-pregnancy BMI and pregnancy BMI at the first prenatal visit was demonstrated (mean±standard deviation=21.8±4.0 vs 22.8±4.1). Underweight women had a significantly higher prevalence of maternal anaemia, LBW, and preterm birth compared to women with normal weight. Overweight and obese women at pre-pregnancy by the Asian criteria-based BMI had a lower prevalence of anaemia. The Hb levels did not change significantly over time. In addition to BMI, maternal age, parity, and late prenatal visit were independently associated with maternal anaemia, low birthweight, and preterm birth. Underweight pregnant women classified by international or Asian criteria-based BMI increased the risk of maternal anaemia, low birthweight, and preterm birth.Key words: Anaemia, Body mass index, Observational studies, Pregnancy, Thailand     

Low zinc,iron, and calcium intakes of Northeast Thai school children consuming glutinous rice-based diets are not exacerbated by high phytate

Phytate, a salt of phytic acid (myo-inositol 1,2,3,4,5,6-hexakisphosphate), is found in certain plant-based foods. It strongly chelates minerals, forming insoluble complexes in the small intestine that cannot be digested or absorbed. Information on the phytate content of rice-based diets of children in Northeast Thailand is limited. In this study 1-day weighed duplicate diet composites were collected from 40 Northeast Thai children (age 6–13 years) randomly selected from participants (n=567) of an efficacy trial in Ubon Ratchathani province. Diet composites were analyzed for zinc, iron, and calcium by atomic absorption spectrophotometry, and for phytate (as inositol penta-phosphate and hexa-phosphate) by high-performance liquid chromatography; the accuracy and precision were established using a certified reference material for the minerals and an inter-laboratory comparison for phytate. The median (1st, 3rd quartiles) zinc, iron, and calcium contents of the diet composites were 4.3 (3.7, 6.1), 4.3 (3.2, 6.5) and 130 (82, 216) mg/day, respectively. The inositol penta-phosphate and hexa-phosphate levels were so low they were below the detection limit, attributed in part to leaching of water-soluble potassium and magnesium phytate from glutinous rice after soaking overnight before cooking. Clearly, phytate will not compromise mineral absorption from these diets. Instead, low zinc intakes are probably primarily responsible for the low zinc status of these children. In contrast, although intakes of dietary iron appear low, the prevalence of biochemical iron deficiency was also low, suggesting that iron absorption may have been higher than previously assumed. Whether the low calcium intakes compromise optimal bone health in these growing Northeast Thai school children is unknown.