Saumya Pandey | Indira IVF Hospital, India
Abstract
Objectives: Infertility is a major public health problem globally, including India; the etiopathogenesis of reproductive disorders amongst ethnically disparate populations is indeed complex. Cost-effective, evidence-based intervention strategies are essential for infertility control/prevention. My pilot study aimed to assess the in vitro fertilization success trends and neonatal developmental defects/neonatal deaths amongst Mycobacterium tuberculi and Human Papillomavirus positive infertile women of Asian-Indian ethnicity. Methods: A prospective clinical research study enrolling 1380 infertile women undergoing Assisted-Reproductive-Technology procedures at Indira-IVF Hospital, Udaipur, India was rigorously conducted; inclusion criteria: age<35 years, Indian ethnicity, Body Mass Index (kg/m2)<25, Anti-Mullerian Hormone (AMH)1.5-2.5 ng/ml, and exclusion criteria: prior ≥2 IVF failures, fibroids, adenomyosis, cervical cancer, thin endometrium, endometriosis. IVF success was determined by assessing total frozen embryos transferred per month, average oocyte yield per donor, oocyte quality, and pregnancy/beta-Human Chorionic Gonadotrophin (HCG) positivity. M. tb.-positivity was assessed using Gene-Expert/TB-Gold-PCR- testing and endometrial thickness using Color-Doppler-imaging. HPV-positivity was evaluated using FDA-approved hybrid capture (hc)-2 assay. Psycho-sexual interventions incorporated marital-relationship counseling-sessions/therapy, clinical referrals for neuropsychiatric assessments (cognitive impairment/schizophrenia/depression). Written informed consent of patients was taken at initial enrollment. Results and Conclusions: Total embryos transferred were 248/April, 240/May, 201/June, 254/July, 230/August, 207/September; number of pregnancies/β-hCG positivity: 171,171, 139, 179, 176, 163. Subgroup-stratification demonstrated that M-II vs total oocytes retrieved were 72.7%, 66.6%, 83.1%, 73.0%, 72.1% and 74.2%. Overall IVF success rates were 71%/April, 72%/May, 71%/June, 72%/July, 78%/August and 84%/September, and frozen embryo-transfer success was 68%, 75%, 74%, 85%, 77%, 83%. M. tb. (55.6%), HPV-positivity (12.0%) and self- reported tobacco-usage (100% response rate) were significantly associated with aberrant fetal cardiac activity, higher trends of intrauterine growth restriction and neonatal deaths (P<0.05). My maternal-fetal-neonatology innovative study highlights promising IVF success rates in Asian-Indian infertile women; future public health research, awareness-campaigns, psychosocial interventions and pharmacogenetic/genomics epidemiological causal association studies are warranted for successful development of predictive biomarkers for infertility management in ethnically disparate populations, and identifying aberrant microbiome at the maternal-fetal interface tilting the “embryonic/fetal fate” towards still-births and/or autophagy-mediated neonatal cell death. Mary Anbarasi Johnson Christian Medical College, India Title : Trends in pediatric nursing Abstract: Pediatric nursing is growing with many trends in terms of education , practice research.Pediatric nurses need to be updated with the current trends in order to translate the knowledge in to practice.Some of the trends in pediatric nursing are discussed in the presentation.Technology Integration:The integration of technology in pediatric nursing continues to advance, with the use of electronic health records (EHRs), telehealth, and mobile health applications. These technologies enhance communication, streamline documentation, and improve patient care.Specialized Pediatric Nursing Certification,Pediatric nurses are increasingly obtaining specialized certifications to enhance their knowledge and skills in specific areas such as pediatric critical care, pediatric oncology, and pediatric emergency nursing.Family- Centered Care:There is a growing emphasis on family-centered care in pediatric nursing. This approach involves collaboration between healthcare providers and families to make decisions that impact the child's health and well-being.Cultural Competence in Pediatric Nursing:Pediatric nurses are recognizing the importance of cultural competence to provide care that respects and addresses the diverse needs of children and their families.Research and Evidence-Based Practice: Pediatric nursing is increasingly focused on evidence-based practice, with nurses engaging in research to improve outcomes for pediatric patients. This involves applying the best available evidence to inform clinical decision-making.
