Medicine and Health Sciences Commons^™

Editorial – July 2025, Edwin Van Teijlingen, Abeer Musaddique, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

The Evaluation Of Anti-Factor Xa Levels In Hospitalised Patients Receiving Low Molecular Weight Heparin (Lmwh): A Prospective Study, Tandzile Thandwayinkosi Simelane

Master of Medicine in Clinical Pathology

Background 

Patients admitted to the hospital have been reported to have coagulation abnormalities due to various factors including immobilisation, preexisting disease, and current illness. The overall incidence of venous thromboembolism (VTE) in critically ill patients varies from 15% to well over 50%, even with the use of prophylactic measures in most patients. Low molecular weight heparin (LMWH) and unfractionated heparin (UFH) are the recommended drugs for VTE prophylaxis in inpatient care. Although not standardly recommended, the laboratory can offer monitoring of anti-Factor Xa using the gold standard method of chromogenic anti-Factor X assay. The anti-Factor Xa levels are notably affected …

An Exploration Of The Effect Of Covid Restrictions On Maternity Care In Uganda, Hellen Kyakuwaire, Grace Edwards, Ahmed Mohammed Sarki

Journal of Asian Midwives (JAM)

Background: Uganda responded aggressively to the worldwide spread of COVID-19 by imposing a total lockdown, which forbade movement of the whole population, including pregnant women and other vulnerable groups. This phenomenological study explored pregnant women’s experiences during the total lockdown in Uganda and identified factors that influenced the quality of healthcare for pregnant women during the lockdown.
Methods: Thirty-two newly delivered women were selected across a wide geographical area to represent rural and urban areas. The sample was selected from women who had given birth at the selected health facilities from March 18, 2020, to April 30, 2020. …

The Effects Of Midwifery Students’ Simulation Training In Perineal Repair: A Quasi-Experimental Study, Zahra Sadat Pajohideh, Solmaz Mohammadi, Fatemeh Keshmiri, Azam Honarmandpour, Azam Jahangirimehr

Journal of Asian Midwives (JAM)

Background: The decrease in normal deliveries and episiotomies in midwifery practice has reduced the experience of midwifery students in perineum repair. This study examined the effect of perineal repair simulation training on the clinical skills of midwifery students by designing, implementing and evaluating simulation models in procedural education.
Methods and materials: This quasi-experimental study was conducted on 60 midwifery students in intervention and control groups at Shoushtar, Iran, from September 2018 to August 2021. The intervention group received simulation training before entering the formal clinical education courses, while the control group took part in workplace-based training. The clinical repair skills …

The Impact Of The Covid-19 Pandemic On Maternity Care Services: Lived Experiences Of Midwives In Indonesia, Mergy Gayatri, Oluwadamilare Akingbade, Indhar Wahyu Wira Harjo, Adepegba Folasade Rebecca, Salako Faith Adebola

Journal of Asian Midwives (JAM)

Background: There have been fundamental changes in global maternity care in response to the COVID-19 pandemic across the globe. However, there are limited studies in Indonesia that have explored the changes experienced by midwives in various health facilities during the COVID-19 pandemic.
Method: A qualitative phenomenological study was conducted among midwives with at least three years of clinical experience in midwifery practice and practicing at different levels of healthcare. Semi-structured interviews were conducted through WhatsApp or Phone calls, as face-to-face interviews were impossible during the pandemic. Data were analyzed using thematic analysis.
Results: In total, 24 midwives …

The Relationship Between Sleep Quality And Physical Fitness Toward The Menstrual Cycle In High School Students, Surya Adi Saputra, Raja Mohammed Firhan Bin Raja Azidin, Alifia Candra Puriastuti, Dessy Amelia, Zumroh Hasanah, Anggi Renawati

Journal of Asian Midwives (JAM)

Background: Sleep is essential for maintaining physical fitness and overall health, as it helps the body recover from intense physical activity and maintains endurance. Physical fitness is determined by heredity, gender, age, body composition, activity, and exercise. Adequate sleep positively impacts overall health, while poorer sleep can negatively affect the body. Teenagers often prefer excessive screen time and oversleep, which can affect their sleep quality. Physical fitness is related to physical activity, and the more often an individual engages in physical activities, the better their fitness. This condition can also impact reproductive health, as hormonal disorders can affect the menstrual …

Knowledge, Attitudes, And Practices Of Healthcare Workers Regarding Early Childhood Development: A Mixed-Methods Study At Secondary Care Maternal And Child Care Hospitals In Karachi, Pakistan, Sarosh Hirani, Shelina Bhamani, Hajra Malik, Samira Lakhani, Adeeb Kanji, Khairunnissa Hooda

Journal of Asian Midwives (JAM)

Introduction: Early childhood development (ECD) is a critical period that lays the foundation for a child's future growth and overall well-being. Healthcare settings play a significant role in shaping these developmental outcomes. However, there is limited research evaluating healthcare professionals' knowledge, attitude, and practices on ECD in Pakistan. This study aims to assess the awareness, attitudes, and practices of healthcare providers working in secondary hospitals regarding ECD.
Methods: A sequential explanatory mixed-methods approach was used. The study initially recruited healthcare workers, including physicians, nurses, trainees, and midwives from two secondary care hospitals. Participants completed the Caregiver Knowledge of Child Development …

Peer Mentorship Of Midwifery Faculty In Bangladesh: A Process Evaluation, Pronita Raha, Joy Kemp, Farida Begum, Rowsan Ara, Vibhavendra S. Raghuvanshi, Nabila Purno, Daniel Novak, Hoque Emdadul Hoque

Journal of Asian Midwives (JAM)

Development of midwifery faculty is key to strengthening quality midwifery education. This article presents a process evaluation of a peer mentorship programme, implemented between 2021 and 2023, for around 370 midwifery faculty in Bangladesh, including 40 newly deployed faculty. 20 peer mentors, prepared by international midwifery faculty, conducted quarterly visits to public midwifery education institutions (MEIs) to provide mentorship support to midwifery faculty and to monitor the quality of midwifery education. A digital community of practice was also created. Data were collected with a checklist based on the World Health Organization (WHO) midwifery educator competencies and entered into a digital …

Effects Of World Health Organization’S Educational Interventions On Clinical Competency Of Community Midwives In Managing Postpartum Hemorrhage, Afifah Abu-Ul-Hayat, Sarfaraz Masih, Madiha Mukhtar

Journal of Asian Midwives (JAM)

Background: Postpartum hemorrhage (PPH) is considered to be one of the most important causes of maternal mortality especially in low resource countries such as Pakistan. Community midwives (CMWs) have a very important role in the provision of midwifery care and their clinical competency are very crucial for the handling of PPH. This study evaluates the effect of a World Health Organization (WHO)-based educational intervention on the clinical competency of CMWs in Hazara Town, Quetta, in managing PPH.
Objective: This study aimed to determine the effectiveness of a WHO based educational intervention on improving the clinical competency of CMWs in managing …

Perceptions Of Risky Sexual Behavior Among Female Students: A Qualitative Analysis Of Contributing Factors, Consequences, And Prevention Strategies, Leila Bozorgian, Fatemeh Ansari, Fatemeh Janipour, Solmaz Mohammadi

Journal of Asian Midwives (JAM)

Background: Risky behaviors among young people are a significant concern for societies worldwide, leading to physical and psychosocial damage. Despite efforts to raise awareness about such risky behaviors over the past two decades, their prevalence continues to rise. Therefore, this study aimed to explain perceptions of the prevalence of risky sexual behaviors among female students.
Methods: A qualitative descriptive study using a conventional content analysis approach was conducted from August to mid-September 2024 in Yasoj, Iran. The study participants were selected using purposive sampling. The data were collected using semi-structured interviews conducted with 18 female students. Data collection …

Development And Validation Of Risk Assessment Tools For Hypertensive Disorder In Pregnancy, Vanitha K, Hepsibah Sharmil, Vijayalakshmi Kandasamy

Journal of Asian Midwives (JAM)

Aims and Background: Hypertensive disorders in pregnancy (HDP) have significant impact on both mothers and newborns leading to complications such as Eclampsia, Preterm delivery, Renal and cardiac problems, Intra Uterine Growth Retardation (IUGR) and Intra Uterine Fetal Death (IUFD). Early screening of hypertensive disorders in pregnancy is essential in the prevention and management of these complications. This research study aims to develop and validate a risk assessment tool for hypertensive disorders in pregnancy.
Materials and methods: A mixed-method research was carried out from December 2023 to December 2024 consisting of two steps. Step one involved the development of …

Using The Observational Medical Outcomes Partnership Common Data Model For A Multi-Registry Intensive Care Unit Benchmarking Federated Analysis: Lessons Learned, Aasiyah Rashan, Daniel P Püttmann, Nicolette F De Keizer, Dave A Dongelmans, Ronald Cornet, Otavio Ranzani, Wangari Siika, Matthew Smith, Steve Harris, Abi Beane

Anaesthesiology, East Africa

Objective: Federated analysis is a method that allows data analysis to be performed on similar datasets without exchanging any data, thus facilitating international research collaboration while adhering to strict privacy laws. This study aimed to evaluate the feasibility of using federated analysis to benchmark mortality in 2 critical care quality registry databases converted to the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM), describing challenges to and recommendations for performing federated analysis on data transformed to OMOP CDM.

Materials and Methods: To identify as many challenges as possible and to be able to complete the benchmarking phase, …

Exploring Covid-19 Vaccination Behavior: A Cross-Country Study Among Pregnant And Postpartum Women In Brazil, Ghana, Kenya, And Pakistan, Rupali Limaye, Berrhaun Fesshaye, Emily Miller, Prachi Singh, Saleem Jessani, Muhammad Asim, Ferdinand Okwaro, Sarah Saleem, Marleen Temmerman, Muhammad Asim

Centre of Excellence in Women and Child Health

Pregnant women infected with SARS-CoV2 are more likely to be hospitalized and require ventilation, compared to non-pregnant women. Although the development of the COVID-19 vaccine was regarded as a scientific breakthrough among many, the pace of development in combination with delayed and unclear recommendations for maternal vaccination led to slower vaccine uptake among this population. We explored the decision-making process for COVID-19 vaccination among pregnant and postpartum women in four countries: Brazil, Ghana, Kenya, and Pakistan through 201 in-depth interviews. A grounded theory approach was used for analysis, and a socio-ecological framework was used to synthesize emerging themes. Four levels …

Author Reply: Investment Case For Mental Health, Cyprian Mostert

Population Health, East Africa

No abstract provided.

Clinically Validated Graphical Approaches Identify Hepatosplenic Multimorbidity In Individuals At Risk Of Schistosomiasis, Yin-Cong Zhi, Simon Mpooya, Narcis Kabatereine, Betty Nabatte, Christopher Opio, Narcis Kabatereine, Goylette Chami

Internal Medicine, East Africa

The global burden of multimorbidity is increasing yet poorly understood, owing to insufficient methods for modelling complex systems of conditions. In particular, hepatosplenic multimorbidity has been inadequately investigated. From 17 January to 16 February 2023, we examined 3186 individuals aged 5–92 years from 52 villages across Uganda within the SchistoTrack Cohort. Point-of-care B-mode ultrasound was used to assess 45 hepatosplenic conditions within the context of schistosomiasis (Schistosoma mansoni). Three graph learning methods for representing hepatosplenic multimorbidity were compared. Thresholds for including graph edges were found using graph kernels and tested with graph neural networks to assess predictive utility for unobserved …

Bibliometric Analysis Of Congenital Toxoplasmosis: A Ten-Year (2013-2023) Review Of Research Publications, Festus Mulakoli, Horatius Musembi, Ann Kimani

School of Nursing & Midwifery, East Africa

Background:Toxoplasma gondii, an obligate intracellular protozoan, infects more than one-third of the global population and causes toxoplasmosis, which can lead to severe fetal complications in pregnant women. The global prevalence of latent toxoplasmosis in pregnant women is 33.8%, with regional variations and risk factors, including the consumption of undercooked meat, exposure to cat feces, and consumption of contaminated water. Pregnant women lack sufficient awareness of these risk factors, necessitating enhanced education, regular screening, and counseling during antenatal care for early detection and management.

Aim: This study performed a comprehensive bibliometric analysis of research on congenital toxoplasmosis published between 2013 …

Clinico-Epidemiological Characteristics Of Cerebral Venous Sinus Thrombosis In Kenya: A Retrospective Case Series, Taby Siika, Jaskirat Sokhi, Juzar Hooker, Sheila Waa, Anne Mwirigi, Jasmit Shah, Dilraj Sokhi

Internal Medicine, East Africa

Background: Cerebral venous sinus thrombosis (CVST) is a rare cause of stroke that is more common in young, especially female, adults and can be challenging to diagnose due to its frequently non-specific presentation and diverse risk factors. Most cases are idiopathic, and international guidelines do not recommend routine investigations for underlying thrombophilia. Timely diagnosis, with prompt neuroimaging and guideline-based treatment, leads to good outcomes. However, in the literature on CVST from sub-Saharan Africa, the gap is substantial, with the few cases described as being related to systemic and/or brain infections. We describe here the largest cohort of CVST from the …

Higher Plasma Afb1 Concentration Is Associated With Increased Risk Of Hpv 16 And Hpv 18 Detection And Persistence Among Ugandan Women, Yan Tong, Miriam Nakalembe, Collins Mpamani, Carolyn Nakisige, Jane Namugga, Grace Banturaki, Philiph Tonui, Elkanah Orang'o

Obstetrics and Gynaecology, East Africa

Introduction: Aflatoxins are environmental hazards; potent carcinogenic and immunosuppressive agents that contaminates corn and other crops. A high proportion of hepatocellular carcinoma cases are caused by exposure to dietary aflatoxins. Cervical cancer is common among Ugandan women; this malignancy is caused by persistent infection with oncogenic HPV types. An analysis was performed to examine associations between plasma aflatoxin B1 (AFB1) detection and oncogenic HPV detection (HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) and persistence among Ugandan women.

Methods: Ugandan women were enrolled in a prospective cohort study. Annual cervical swabs …

Placental Transfer Of Sars-Cov-2 Antibodies In Mother-Neonate Pairs: A Prospective Nested Cohort Study, Alex Mugo, Angela Koech, Liberty Cantrell, Moses Mukhanya, Isaac Mwaniki, Joseph Mutunga, Merryn Voysey, Rachel Craik, Peter Dadelszen, Marleen Temmerman, Geoffrey Omuse

Centre of Excellence in Women and Child Health

Background

Newborns depend on the transfer of IgG across the placenta to acquire protection against pathogens. We assessed the placental transfer of SARS-CoV-2 antibodies, primarily derived from infection, from seropositive pregnant women enrolled in a pregnancy cohort in Kilifi, Kenya.

Methods

The study was nested within a prospective observational multi-country cohort study. All available paired maternal delivery and cord blood samples were selected. Maternal sera were tested for SARS-CoV-2 receptor binding domain (RBD) IgM/IgG total antibodies using the Wantai assay. For positive samples, maternal and corresponding cord blood samples were tested for SARS-CoV-2 IgG antibodies against the spike (anti-spike) and …

Covid-19 Vaccine Attitudes And Behaviors Among Pregnant Women In Nairobi, Kenya With Diverse Socio-Economic And Educational Backgrounds, Jessica Schue, Ferdinand Okwaro, Ingrid Gichere, Daizy Cherono, Mandeep Sura, Emilly Miller, Berhaun Fesshaye, Prachi Singh, Marleen Temmerman

Centre of Excellence in Women and Child Health

Introduction: Pregnant women are at increased risk of severe manifestations of COVID-19, resulting in ICU admission, mechanical ventilation, and death compared to non-pregnant women. COVID-19 vaccines were approved for use in pregnant women in early 2022 by the World Health Organization, but permissive policies toward vaccine women differed by country. As education has been associated with vaccine uptake, this study sought to examine the association between socio-economic or educational status and vaccination behaviors, including reasons for vaccination or non-vaccination among pregnant women seeking health care services in Nairobi, Kenya.

Methods: This study administered a survey to pregnant women at the …

Vitamin D Status And Risk For Breast Cancer In Kenya, Ronald Wasike, Victor Mobegi, Esther Maina, Francis Makokha, Robert Armstrong, Annastacia Mbithi

General Surgery, East Africa

Background: Vitamin D plays a critical role in bone metabolism, calcium regulation, and various cellular processes, including those linked to cancer. The biologically active form, 1,25-dihydroxyvitamin D [1,25(OH)2D], works through the Vitamin D Receptor (VDR). Polymorphisms in VDR and related genes have been associated with cancer risk, including breast cancer. This case-control study aimed to investigate the relationship between serum vitamin D levels and breast cancer among Kenyan women.

Methods: Serum 25-hydroxyvitamin D [25(OH)D] levels were measured in 112 breast cancer patients and 106 controls using electrochemiluminescence.

Results: Results indicated that 81.2% of participants had deficient or insufficient vitamin D …

Labrad : Vol 50, Issue 1 - July 2025, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• EDITORIAL
• ARTICLES
• Molecular Integration in Diagnostic Medicine: The Convergence of Laboratory and Imaging Disciplines Toward Precision Healthcare
• Diagnosis of Odontogenic Cysts: Integrated Approach; Radiology-Pathology Correlation
• Radiologic Correlation in Bone Pathology Diagnosis - Essential Aspect
• Integrated Diagnostics in Microbiology: A Comprehensive Approach to Tuberculosis Diagnosis
• Integrated Diagnostics in Multiple Myeloma
• Sweat and DNA: A Unified Approach to Diagnosing Cystic Fibrosis
• Integrated Breast Biopsy and Predictive Marker Testing: A New Era in Streamlined Cancer Diagnostics
• Unmasking the Hook Effect in Prolactinomas: A Diagnostic Trap Requiring an Integrated Approach
• Radiology-Pathology Correlation: A Cornerstone of Integrated Diagnostic Accuracy
• Integrated Diagnostic Assessment of von Willebrand …

Author Reply, Cyprian Mostert

Population Health, East Africa

No abstract provided.

Comparison Between Acute Leukemia Screening Tube And Lineage-Specific Panels For The Diagnosis Of Acute Leukemia In Kenya, Nancy Okinda, Geoffrey Omuse, Elizabeth Kagotho, Douglas Munga

Pathology, East Africa

Purpose: Acute leukemia is a group of hematologic malignancies categorized according to the immature cells that proliferate and replace the normal bone marrow. Flow cytometry has emerged as a cornerstone in the diagnosis of hematologic malignancies. Staged analysis with a screening tube containing specific lineage markers determines the need for subsequent testing if there is an abnormal population (blasts). The specific lineage panels to be analyzed are determined depending on the positive markers in the screening tube. This study aimed to determine the agreement of diagnosis using the acute leukemia screening tube (ALST) and the lineage-specific panel.

Methods: This was …

Exploring Covid-19 Vaccination Behavior: A Cross-Country Study Among Pregnant And Postpartum Women In Brazil, Ghana, Kenya, And Pakistan, Rupali Limaye, Berhaun Fesshaye, Emilly Miller, Prachi Singh, Saleem Jessani, Muhammad Asim, Ferdinand Okwaro, Caroline Badzi, Emefa Amoah, Marleen Temmerman

Centre of Excellence in Women and Child Health

Pregnant women infected with SARS-CoV2 are more likely to be hospitalized and require ventilation, compared to non-pregnant women. Although the development of the COVID-19 vaccine was regarded as a scientific breakthrough among many, the pace of development in combination with delayed and unclear recommendations for maternal vaccination led to slower vaccine uptake among this population. We explored the decision-making process for COVID-19 vaccination among pregnant and postpartum women in four countries: Brazil, Ghana, Kenya, and Pakistan through 201 in-depth interviews. A grounded theory approach was used for analysis, and a socio-ecological framework was used to synthesize emerging themes. Four levels …

Covid-19 Vaccine Attitudes And Behaviors Among Pregnant Women In Nairobi, Kenya With Diverse Socio-Economic And Educational Backgrounds, Jessica Schue, Ferdinand Okwaro, Ingrid Gichere, Daizy Cherono, Mandeep Sura, Emily Miller, Berhaun Fesshaye, Prachi Singh, Grace Belayneh Belayneh, Rupali Limaye, Marleen Temmerman

Centre of Excellence in Women and Child Health

Introduction

Methods

Placental Transfer Of Sars-Cov-2 Antibodies In Mother-Neonate Pairs: A Prospective Nested Cohort Study, Alex Mugo, Angela Koech, Liberty Cantrell, Moses Mukhanya, Isaac Mwaniki, Joseph Mutunga, Merryn Voysey, Rachel Craik, Marleen Temmerman, Geoffrey Omuse

Centre of Excellence in Women and Child Health

Background: Newborns depend on the transfer of IgG across the placenta to acquire protection against pathogens. We assessed the placental transfer of SARS-CoV-2 antibodies, primarily derived from infection, from seropositive pregnant women enrolled in a pregnancy cohort in Kilifi, Kenya.

Methods :The study was nested within a prospective observational multi-country cohort study. All available paired maternal delivery and cord blood samples were selected. Maternal sera were tested for SARS-CoV-2 receptor binding domain (RBD) IgM/IgG total antibodies using the Wantai assay. For positive samples, maternal and corresponding cord blood samples were tested for SARS-CoV-2 IgG antibodies against the spike (anti-spike) and …

Contribution Of Maternal Adherence To The Effect Of Multiple Micronutrient Supplementation During Pregnancy: A Systematic Review And Individual Participant Data Meta-Analysis, Emily R. Smith, Filomena Gomes, Seth Adu-Afarwuah, Victor M. Aguayo, Shams El Arifeen, Zulfiqar Ahmed Bhutta, Ellen C. Caniglia, Parul Christian, Arjumand Rizvi, Sajid Bashir Soofi

Centre of Excellence in Women and Child Health

Multiple micronutrient supplements (MMS) in pregnancy reduces risk of infant low birthweight (LBW) and improves other maternal and infant outcomes compared with iron and folic acid (IFA) supplements alone. However, the impact of timing of initiation and adherence on the MMS effectiveness in real-world programs remains unclear. To address this, we conducted a 2-stage individual participant data meta-analysis that included 15 randomized trials (61,204 pregnant women) and assessed whether the relative effect of MMS differed by the following: adherence alone; adherence in combination with gestational age at initiation; and the total number of tablets taken. We also evaluated the observational …

Anemia: An Uncommon Cause Of Cerebral Venous Sinus Thrombosis, Iqra Athar, Afrah Malik, Neelma Naz Khattak, Tashfain Shifa, Zukhruf Zayian

Pakistan Journal of Neurological Sciences (PJNS)

Cerebral venous sinus thrombosis (CVST) is a multifactorial illness seen more commonly in females as compared to males. Its diagnosis is often delayed due to variable clinical presentations. It is now identified more often due to advancements in neuroimaging modalities. We present an uncommon case of CVST caused by anemia in a 23-year-old female. Our patient presented with complaints of headache since the past two days and left sided hemiplegia since past one day. Later on during her hospital stay she developed generalized tonic clonic seizures. MRI and MRV brain with contrast revealed right cerebral venous (vein of Trolard) thrombosis. …

Role Of Rituximab In Autoimmune Encephalitis: A Report Of Two Cases, Salman Farooq, Shafaq Saleem, Muhammad Bilal Tariq

Pakistan Journal of Neurological Sciences (PJNS)

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a form of autoimmune encephalitis that predominantly affects young individuals and often presents with neuropsychiatric symptoms. It is frequently misdiagnosed as a primary psychiatric disorder due to its initial presentation. Although first-line immunotherapy typically includes corticosteroids, intravenous immunoglobulin (IVIG), or plasmapheresis, a subset of patients shows limited response and requires escalation to second-line agents such as Rituximab. We report two adult male patients, aged 35 and 41 years, who initially presented with behavioral disturbances, confusion, memory deficits, and speech abnormalities. Both were initially misdiagnosed with psychiatric illnesses, delaying appropriate treatment. Diagnostic workups including MRI, EEG, …