Introduction: Iron deficiency represents a spectrum ranging from iron depletion to iron deficiency anaemia. In iron depletion, the amount of stored iron is reduced but the amount of transport and functional iron may not be affected. Iron deficiency is a major problem worldwide especially in women of reproductive age. Objectives: This study was designed to compare efficacy of two commonly used oral iron preparations among anemic pregnant women in private chamber of gynecologists and outdoor of Rajshahi Medical college hospital, Rajshahi, Bangladesh. Methods: We conducted analysis of data collected from Pregnant women between 18 to 40 years of age, >8 weeks of gestation, having iron deficiency anaemia (serum hemoglobin levels <10 gm/dl or serum ferritin <30μg/l). The patients were divided into 2 groups (n=30) each and treated with Ferrous fumarate and carbonyl iron respectively. Hemoglobin gm/dl and serum Ferritin ng/dl were recorded after the interval of 3 months from baseline. Data was analyzed using SPSS 16. Efficacy variables between groups calculated using Chi square and T- test. Results: We observed that patients treated with Ferrous Fumarate (FF) showed significant rise in Hb 0.69(±0.83) which was greater than that of Carbonyl iron (CI) group 0.07(±1.11) g/dl. Mean (± SD) rise of serum ferritin was significantly higher in FF group (55.45 ±34.66) as compared to CI group (19.88 ±15.33) (t=5.14, df =58, P<0.001). Conclusion: It can be concluded that, ferrous fumarate still can be considered better effective medication than Carbonyl iron for the treatment of Iron deficiency anemia in pregnancy.

Introduction: This study aimed to understand the perception of providers of the Mama Mosalisi health and maternity center perceive the rights of parturients and to explore their expectations. Method: We conducted a descriptive qualitative exploratory phenomenological study, the data collection was done through individual face-to-face interviews with 10 providers of the Maman Mosalisi Health Center (nurses, laboratory technicians, doctors, midwives), worker in the maternity ward. Results: Providers generally have a positive perception, characterized by the recognition of the rights of parturients. They affirm that it is important to respect the rights of the parturients because this respect makes it possible to avoid the bad course of the childbirth; to gain the confidence of parturients; to increase the clientele and the receipts in the structure; leads to conscientious work; and contributes to the reduction of mortality. In their experiences, service providers encounter several difficulties in the exercise of their profession; but they also recognize their failure to respect the rights of parturients, they feel this in the form of guilt. Finally, they expect managers to improve working conditions in their structure, provide for self-assessment sessions, that the State take charge of them in everything, that the organizations involved strengthen their capacities through continuous training, that researchers sensitize the public in general and parturients in particular on their rights which they are unaware of, in order to be able to claim them and reframe the practices of providers. Conclusion: These results plead in favor of concerted interventions between political and health decision-makers, the partners involved and the providers for the promotion of respectful maternity care in order to contribute to the reduction of maternal and infant mortality.

Summary: Introduction: Knowledge of the birth cycle is important in the organization of reproductive health services in a facility. The main objective was to study the determinants of the birth cycle at the Kalaban-Coro health center. However, it seems that there are other determinants of the birth cycle, hence the relevance of this study. Material and methods: This was a cross-sectional analytical study from October 1 to December 31, 2020. Results: The study included 977 parturients who gave birth in the department. It recorded more night deliveries (59.1%) than day deliveries (40.9%). The average age of the women was 25 years. Non-educated births were the most represented with 39% of cases. Nocturnal admissions were predominant (58.8%); 59% of parturients had a history of nocturnal delivery and 40% preferred to give birth at night, while 30% had no preference. At admission, 57.91% of parturients were in the active phase during the night, compared to 42.59% during the day; 52.6% of parturients had a nocturnal onset of labor, compared to 47.4% during the day. Conclusion: The study showed that childbirth is more frequent at night than during the day. It highlighted the admission nycthemer, the previous nycthemer of deliveries and the preference of the parturient as other determinants of the nycthemer of the delivery.

Carbon monoxide poisoning is a leading cause of mortality among accidental intoxications, it is responsible for severe tissular hypoxia leading to life-threatening complications. Pregnant women are more at risk to develop severe forms of intoxication due to their physiological changes and their higher oxygen requirements as well as for possible adverse fetal outcomes. We present two cases of monoxide intoxication in two pregnant women with acute heart failure and variant complications with different fetal outcomes.

Introduction: Abnormal level of circulating lipids refers to dyslipidemia. Dyslipidemia mostly affects non-communicable diseases like CHD, CVD, cancer, autoimmune disease, etc. The population group most affected by non-communicable diseases (NCDs) in Bangladesh comprises middle-aged persons and the elderly, having a major share of the disease burden and mortality in the country. Changing dietary habits and lifestyle, rapid urbanization, growth of commuting, tobacco use, uncontrolled growth and consumption of processed foods and beverages, indoor air pollution, road-traffic injuries, lack of awareness about healthful behavioral patterns, and psychological pressure are among the important factors responsible for such non-communicable diseases. The present study was conducted with the goal of observing any association between dyslipidemia and dietary habits in men and women. Aim of the study: The aim of the study was to observe the association of dyslipidemia with dietary habits. Methods: This cross-sectional analytical study was conducted at the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. The study duration was one year, from March 2016 to February 2017. Non-probability sampling method was used to select a total of 245 dyslipidemia cases from the adult population attending the BSMMU outpatient department during the study period. Result: The majority of the dyslipidemic patients had isolated hypercholesterolemia. All types of dyslipidemia had a significantly higher prevalence among the male population. Mixed hyperlipidemia was significantly higher among the older population. Statistical significance was only observed among the total cholesterol levels and the male population and TG level and the female population of mixed hyperlipidemic subjects in regards to healthy food consumption. Unhealthy food consumption had a high correlation with dyslipidemia in both male and female population. Conclusion: The study shows that isolated hypercholesterolemia is prevalent. Food habits also have an impact on lipid profile among study subjects. Healthy foods are mostly associated with high HDL-C. Unhealthy food consumption has a high correlation with dyslipidemia in both male and female populations.

Background: Pregnancy at extremes of age can be very challenging. The reflex of a woman to pregnancy is influenced by various factors through which woman's age at pregnancy time can be known as the single most important factor that has undeniable effect on pregnancy process and labour. Both adolescent and elderly pregnancy are considered to be high risk as they have unique outcomes. Objective: To assess the effect of maternal age on obstetric and neonatal outcome. Methods: This prospective observational study was conducted on 250 primiparous women who attended at Department of Obstetrics & Gynaecology, 300 Bed Hospital, Narayanganj, Bangladesh from March 2019-February 2020. A detailed history regarding maternal age, period of gestation, development of any signs and symptoms of various comorbidities is taken and antenatal examination is done. Routine antenatal investigations were done and all the cases were followed till delivery. Development of various maternal co-morbidities, mode of delivery and neonatal outcome was assessed. Results: Majority of our study population were in 20-34 years age group (72.0%), teenagers constituted 19.2%, advanced maternal age constituted 8.8%.The number of pre- term births in gestational age between 28 to 36 weeks were similar in teenage mothers (12.5%) and elderly primi (13.6%) where as in normal age group it was only 3.8%. Post term pregnancy where comparatively higher in elderly primi (18.8%) than teenagers (10.4%) Association of gestational age with maternal age is statistically significant (P <0.05). In our study 11% patients had Gestational Hypertension. Association of Hypertension in pregnancy with maternal age is statistically significant (p <0.05). In our study, GDM was present in 7.6%; in teenage mothers 2.1% and in elderly mothers 28.5%. In teenage 12.5% and in elderly mothers it is 31.8%. Association of Hypothyroid and maternal age is statistically significant (p<0.05). In our study anemia was seen in 4.1% of teenagers, 4.5% advanced maternal age, 3.3% in age group 20 to 34 years. In our study, 47.9% of teenage mothers delivered vaginally and 52.1% of them delivered by cesarean section. In age group 20 to 34 years, vaginal delivery was 50.2% and caesarean delivery was 49.7%. Whereas in elderly primis the rate of cesarean delivery was 71.4% and vaginal delivery was 28.5%. Association of mode of delivery with maternal age is statistically significant (p<0.05). In our study teenagers, term babies were 78.7%, pre-term babies were 12.7%, IUGR babies were 6.3% and IUD 2.1%. In advanced maternal age; term babies were 68.1%, pre- term were 13.6%, IUGR were 13.6% and IUD were 4.5%. Association of outcome of baby is statistically significant (p<0.05). In our study the babies which got admitted in NICU were 33.7% in teenage mothers and in elderly is 13.3%. Association of NICU admission among teenage and advanced maternal age is statistically significant. (p<0.05). Conclusion: Teenage pregnancy is an essential public health issue as it is associated with poor maternal and fetal outcome. Teenage and Elderly pregnancy are associated increased maternal and perinatal mortality and morbidity early detection of risk factors and prevention is necessary to reduce the morbidity.

Background: Human fetal medical biomonitoring, including that of fetal carboxyhemoglobin (fCOHb) had never been performed in the Niger Delta area of Nigeria irrespective of the devastating environmental pollution in the region. Aim: The goals of the study were to establish the severity of fetal impact on maternal exposure to CO in the first trimester of pregnancy in the Niger Delta by quantifying the levels of fetal fCOHb and to assess the impact of maternal demographic, social and obstetric characteristics on it. Material and methods: A cross-sectional study which was carried out at the Rivers State University Teaching Hospital (RSUTH) in Nigeria. 490 consecutive pregnant women in the first trimester were recruited from the antenatal clinic from January 2021 to January 2022. Gestational age was estimated with the aid of an ultrasound scan. Demographic, social and obstetric characteristics were taken. fCOHb concentrations were measured with the aid of a smokerlyser. Data was analyzed, using SPSS version 25.0 (Armonk, NY) software. Ethical approval was obtained from the RSUTH Ethics Committee. Results: The mean value of fCOHb concentration ± SD was 0.93±0.72%. There were statistically significant differences in its values in different age categories (t=2.742, p<0.019), educational levels (t=2.328, p<0.020), BMI (t=5.545, p<0.0001), gravidity (t=6.447, p<0.0001) and parity (t=2.833, p<0.038). Paradoxically, the differences in its levels in the groups namely, smoking habits and drinking status, were not statistically significant. Out of the total 490 participants, 331(67.60%) had fetuses with mild impact from CO exposure (fCOHb= 0.28 to 0.85%), 125 (25.51%) – moderate impact (fCOHb = >0.85 to 1.70%) and 34 (6.90%) had severe impact (fCOHb = >1.70% and above). There were statistically significant differences in the severity of fetal impact in association with different maternal characteristics namely age groups (X2=26.687, p<0.003), maternal alcohol intake (X2=18.866, p<0.0001), gravidity (X2=37.819, p<0.0001), parity (X2=12.098, p< 0.047) and BMI (x2=19.409; p<0.013) but there was no pattern in the directions of the differences except for BMI which showed significant positive correlation (r=0.214, p=0.0001) due mainly to maternal weight (r=0.181, p<0.0001). There was a paradoxical finding of 3 smokers having only mild impact. Conclusion: The mean value of fCOHb concentration ± SD 0.93±0.72% and the 3 degrees of fetal impact on exposure to CO were significantly affected by demographic, social and obstetric characteristics but there was no pattern in their effect except for BMI where a positive correlation was established.

Background: In the Niger Delta area of Nigeria, human medical biomonitoring, including that of maternal Carboxyhemoglobin (MCOHb) had never been performed irrespective of the devastating environmental pollution in the region. Aim: The goals of the study were to quantify the impact of maternal exposure to CO in the first trimester of pregnancy in the core Niger Delta by measuring MCOHb concentrations and to assess the effect of maternal demographic and obstetric characteristics on the impact. Material and methods: The study was of cross-sectional design carried out at the Rivers State University Teaching Hospital (RSUTH) in Nigeria. 490 consecutive pregnant women in the first trimester were recruited from the antenatal clinic from January 2021 to January 2022. Gestational age was estimated with the aid of an ultrasound scan. Demographic, social and obstetric characteristics were taken. MCOHb concentrations were measured with the aid of a smokerlyser. Data was analyzed, using SPSS version 25.0 (Armonk, NY) software. Ethical approval was obtained from the RSUTH Ethics Committee. Results: The mean value of MCOHb concentration was 1.15±0.40% Out of the 490 patients that were assessed, 461(94.08%) had mild impact from CO exposure (MCOHb= 0.78-1.5%), 18 (3.67%) – moderate impact (MCOHb = 1.75-2.23%) and 11 (2.24%) had severe impact (MCOHb = 2.39% and above). Moderate and severe impact were most prominent in women of 25-29 and 35-39 years of age respectively at which they occurred in 11 out of 145 (7.59%) and 7 out of 103 women (6.80%) respectively and the differences at various age groups were statistically significant [X2=23.119, p<0.010, 95%CI (0.038,0.046)]. The differences in the severity of maternal impact among women with different BMI classes were statistically significant [X2=56.707, p<0.001, 95%CI (0.001,0.001)] with those with class III BMI most likely to have severe impact [4(22.22%) out of 18 patients]. There was inverse relationship between parity and the severity of the impact of CO exposure but the differences at various parity groups were not statistically significant [X2=10.580, p<0.012, 95%CI (0.101,0.113)]. There was also a paradoxical finding of 3 smokers having only mild impact. Conclusion: The mean value of MCOHb was 1.15±0.40. Mild, moderate and severe impact from maternal CO exposure was established with the moderate and severe impacts more prominent at maternal ages of 25-39 years, at higher BMI and at lower parity.

Primigravidae are at increased risk of complications during pregnancy and labour. These risks of complication associated with Primigravidae if not properly anticipated and managed promptly can result in increased morbidity and mortality for both the mother and the baby. The aim of the study was to determine the pregnancy outcome among Primigravida at Usmanu Danfodiyo University Teaching Hospital. The specific objectives were to determine the complications encountered among the primigravida and to determine the association between some complications and pregnancy outcome. This was a retrospective study from 1st Jan.2017 - 31st dec.2021. The case records of all primigravidae who delivered at UDUTH within the study period were reviewed. There were 130 cases of primigravida managed during the 5-year study period. Among which 99 case notes were retrieved giving a retrieval rate of 76%. The majority of cases were between the ages of 20-30 years and 31-40 years (30.3% and 37.4% respectively). Most of the cases were Hausa/Fulani (74.7%). Majority were Muslims and 45.5% had secondary education. Majority of the cases (73.1%) had caesarean section and 22.2% had vaginal delivery. The most encountered pregnancy complication among them was preeclampsia/eclampsia in 29.6% of the cases. This is followed by post-dated pregnancy (9.4%) then breech presentation at term (13.3%). Majority of the participants that had preeclampsia and post-dated pregnancy ended up with caesarean section. There was significant association between the complication of preeclampsia and post-dated pregnancy with the mode of delivery (p < 0.001).