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   2015| January-June  | Volume 10 | Issue 1  
    Online since June 25, 2015

 
 
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ORIGINAL ARTICLES
Women's awareness of obstetric danger symptoms: is there a need to promote a preconceptional educational program?
Ammal M Metwally, Dalia M Elmosalami, Lobna A El Etreby, Amira Mohsen, Rehan M Saleh, Samia AR Hemeda
January-June 2015, 10(1):9-17
DOI:10.4103/1687-4293.159369  
Background/aim Awareness towards the symptoms of obstetric complications will lead to timely access to appropriate emergency obstetric care. The aim of the study was to assess and compare the awareness towards obstetric danger symptoms among never-pregnant and ever-pregnant women and to identify predictors of their awareness as a measure for the need to promote a preconceptional educational program in Egypt. Participants and methods This study was conducted in selected villages of Alfayoum and Benisuef governorates as a comparative study between 173 newly married never-pregnant women and 827 ever-pregnant women who were randomly targeted by a structured interview during a period of 8 months. The questionnaire included personal data, social data, and data related to awareness of obstetric danger symptoms, complications, and action taken on having any of these symptoms. The scoring system was designed for women's awareness, with one degree allocated for a correct answer. Results The study revealed that the percent of women who gained a score of knowledge of at least 50% was higher among ever-pregnant women than among never-pregnant women (43.9 and 19.1%, respectively). Although bleeding is the highest reported cause for obstetric complications and is one of the reported causes of maternal deaths in the studied villages, only 26.6 and 20.2% of the never pregnant and 43.9 and 34.3% of the ever pregnant groups, respectively, knew that bleeding is a danger symptom during delivery and the postnatal period. Meanwhile, better awareness about obstetric danger symptoms and exposure to health educational messages was significantly higher among ever-pregnant women (OR = 3.08 and 2.28, respectively) (P < 0.001). Conclusion This study reflects the need for intensifying antenatal health educational messages given to pregnant women and the need for the implementation of preconceptional health education programs.
  3,849 466 -
Determinants of unintended pregnancy and its impact on the health of women in some governorates of Upper Egypt
Ammal M Metwally, Rehan M Saleh, Amira M Abdelhamed, Somia I Salama, Carine W Mores, Fatma A Shaaban, Osama M Azmy
January-June 2015, 10(1):1-8
DOI:10.4103/1687-4293.159368  
Background/aim Worldwide, more than half of all unintended pregnancies end in abortion, indicating the preference for increasingly smaller families. The present work aimed to assess the determinants of unintended pregnancy and its impact on women's health in El Fayoum and Benisuef governorates. Participants and methods A community-based cross-sectional household survey was conducted among 827 married women of reproductive age. The study was conducted in two governorates, El Fayoum and Benisuef, for a period of 6 months. Results The current study revealed that 15.9% of women who participated in the study had an unmet need for family planning, with subsequent unintended pregnancy. Higher age of women and her age at the time of marriage, illiteracy, short interpregnancy spacing, exceeding the desired number of children, negative attitude of husbands toward the use of family planning methods, and absence of discussion between partners on the use of means to postpone pregnancy increased the number of unintended pregnancies. Also, women with unintended pregnancy were at a higher risk of experiencing health problems during her pregnancy. Conclusion Despite the efforts taken by family planners, the problem of unintended pregnancy continues to increase in Egypt, with its adverse effect on pregnancy and maternal outcomes. Therefore, the strategy for maternal mortality reduction in Egypt should focus on addressing the unmet needs of high-parity, uneducated, nonworking women.
  2,286 317 4
Impact of sperm cryopreservation on child sex after intracytoplasmic sperm injection
Ahmed M Omar, Mahmoud F Abdel Hamid, Amr H Abbassy
January-June 2015, 10(1):41-46
DOI:10.4103/1687-4293.159376  
Background/aim Sperm cryopreservation causes extensive damage to sperm membranes and its ultrastructural morphology, affecting the fertilization ability by decreasing the percentage of normal intact acrosomes and consequently the acrosine activity. This retrospective study aims at detecting the effect of sperm cryopreservation on the baby's sex after intracytoplasmic sperm injection (ICSI) in terms of the susceptibility of X versus Y chromosome baring spermatozoa to cryopreservation. Patients and methods This retrospective study included 87 ICSI cycles performed with post-thawed spermatozoa. The patients were classified into two groups (I and II) according to the total sperm count before freezing. Results This study included 87 ICSI cycles performed with post-thawed spermatozoa. Patients were classified into two groups (I and II) according to the total sperm count before freezing. Group I included 43 patients with a sperm count less than 0.1 × 10 6 /sample (countable samples). Group II included 44 patients with a sperm count more than 0.1 × 10 6 /sample (uncountable samples). The numbers of fertilized M II, good embryos, clinical pregnancy, and male babies were significantly higher in group I compared with group II. Conclusion ICSI using post-thawed spermatozoa of countable samples yielded a higher male sex ratio (80.8%) compared with uncountable samples (28.6%). Thus, spermatozoa that successfully survived the freeze-thaw procedure exhibited an improved chromatin structure and nuclear maturity. These data suggest that sperm cryopreservation may improve the fertilization rate, enhance early embryo development parameters, as well as pregnancy outcome after ICSI.
  2,340 180 -
Influence of sociodemographic factors and environmental conditions on husbands' behavior toward maternal healthcare
Ammal M Metwally, Ghada A Abdel-Latif, Lobna El Etreby, Amani Tawfik, Doaa Elsayed, Aida M Abdel Mohsen
January-June 2015, 10(1):18-26
DOI:10.4103/1687-4293.159370  
Background/aim Improving maternal health depends on husband's behavior which is affected by certain socio-demographic factors and environmental conditions. The study aimed to assess the husband's behavior toward maternal healthcare and emergency first aid measures for pregnancy and obstetric risks that might put life of women at risk of maternal death. The study also determined the socio-demographic factors and environmental conditions that influenced husband's behavior and attitude toward antenatal care providers and providers of assisted delivery. Methods One thousand husbands of women in childbearing period were randomly selected through a community-based study that was conducted in 23 rural villages of four chosen districts of Benisuef and Al Fayoum governorates of Egypt. The study is a cross-sectional investigation conducted over a period of 8 months starting from July 2010 until February 2011. Data were collected from interviews of husbands on their sociodemographic characteristics, environmental conditions, and their knowledge, attitudes, intention, and practices toward maternal healthcare and services provided as well as toward providers of maternal healthcare. Results The study revealed that husbands who were younger than 20 years at the time of marriage, had a lower middle environmental score, and an upper middle income were nearly two or more times as likely of being unaware of the risk symptoms during pregnancy [odds ratio (OR) = 2.73, 1.37, and 1.59, respectively], during delivery (OR = 1.93, 1.31, and 1.76, respectively), and during the postnatal period (OR = 2.42, 1.36, and 1.77, respectively) compared with those older than 20 at the time of marriage, who had an upper middle environmental score, and a lower middle income. Conclusion and recommendations It is recommended to target husbands as an influential factor among high-risk wives by educating them on maternal health risks and by increasing their accessibility to maternal and obstetric health services, with special emphasis on younger men and those living under poor environmental conditions irrespective of their economic status.
  1,991 268 -
Serum levels of monocyte chemoattractant protein-1, interlukin-6, and paraoxonase-1 in childhood obesity
Enas R Abd El Hamid, Azza A Abdel-Shaheed, Rania N Sabry, Eman R Youness, Mones M Abu Shady, Amr Said Megawer, Nadia A Mohamed
January-June 2015, 10(1):27-31
DOI:10.4103/1687-4293.159371  
Background/aim Obesity is becoming an epidemic health problem. Elevated cytokines and chemokines are prominent features in obesity, which play a main role in the development of other chronic diseases. The aim of this study was to determine the serum levels of monocyte chemoattractant protein-1 (MCP-1), interlukin-6 (IL-6), and serum paraoxonase-1 (PON1) in childhood obesity. Materials and methods The present study included 40 obese school-aged children (5-15 years) and 40 healthy children as controls. The patients were presented to the outpatient clinic in National Institute of Nutrition. MCP-1, IL-6, PON1, total cholesterol, and triglycerides were measured in all participants. Results The mean serum levels of MCP-1, IL-6, and total cholesterol were significantly higher in obese participants than in controls (P < 0.0001), whereas the PON1 was significantly lower in obese participants than in controls (P < 0.0001). MCP-1, IL-6, and serum cholesterol levels showed significant positive correlation with BMI (P < 0.05), whereas PON1 showed a significant negative correlation with BMI (P < 0.05). Multiple regression analysis showed a strong association between PON1 activity and BMI (P < 0.0001). Conclusion Childhood obesity is associated with increased serum MCP-1 and IL-6 and decreased PON1 and hypercholesterolemia suggesting an increase in adulthood disease risk. Measuring serum MCP-1, IL-6, PON1 activity in obese children may be a good predictor for future chronic disease development and complications.
  1,382 122 -
Assessment of the osteogenic potential of alendronate on isolated adipose-derived stem cells: An ex-vivo and in-vivo study
Mohamed S Ayoub, Effat A Abbas, Mohamed A Abd El Hamid, Houry M Baghdadi, Dina S Abd El Fattah, Marwa M Ellithy
January-June 2015, 10(1):32-40
DOI:10.4103/1687-4293.159374  
Background/aim Tissue engineering relies on the principle that mesenchymal stem cells are capable of differentiating to optimize almost all craniofacial structures. Temporary biomimetic scaffolds are necessary for accommodating cell growth and tissue genesis. The aim of this study was to evaluate the effect of alendronate on adipose-derived stem cells (ADSCs) from dogs and to compare bone regeneration in critical-sized calvarial bone defect in dogs using ADSCs in the presence and the absence of locally delivered alendronate. Materials and methods Seven dogs were used for the study. After isolating the adipose tissue from the inguinal pad of fat, stem cells were harvested and expanded in culture. The effect of alendronate 1 mg/ml on stem cells' osteogenic differentiation was tested for 7 days. Three critical-sized calvarial defects were created in each dog. One defect was filled with stem cells seeded on a chitosan scaffold and soaked in an osteogenic media, the second was filled with stem cells seeded on a chitosan scaffold and soaked with osteogenic medium, and the third one was filled with stem cells seeded on a chitosan scaffold. Bone formation was tested histologically after 8 weeks in each defect. Results Alendronate is capable of inducing osteogenic differentiation of ADSCs after 7 days of in-vitro culture. Bones such as trabeculae were deposited in alendronate and osteogenic medium defects, whereas the control group showed only fibrous tissue formation. There was no statistically significant difference in the surface area of the deposited bone trabeculae between the alendronate group and the osteogenic medium group. The surface area of individual bone trabeculae in this group was 147.99 ± 14.803 compared with the osteogenic group. Conclusion Alendronate may be used locally at a concentration of 10 mg/ml to induce osteogenic differentiation of ADSCs both in vitro and in vivo. The combination of a local, short-term alendronate treatment with ADSCs and biodegradable chitosan scaffold enhances the bone repair of a critical-sized calvarial defect in vivo.
  1,306 94 -
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