Educational Program for Pregnant Women Regarding Obstetrics Dangerous Signs in Rural Areas

Background: Complications linked to postpartum & pregnancy are one of the major causes of female death. In order to understand the causes of complications and encourage women to take sufficient action in order to receive emergency treatment, a critical step should therefore be taken to minimize complications related to pregnancy, in order to ensure the safety of both women and newborns. Aim of the work: Evaluate the effectiveness of the education programs for pregnant women on obstetric danger signs in rural areas and help minimize the incidence of pregnancy loss and comorbidities. Methods: A quasi-experimental design on 70 women from a population of through 372 women in six-month in antenatal clinics recruited from the previously mentioned settings with pre- and post-test was conducted at antenatal clinics (M.C.H centers) affiliated to the available geographical health zones in EL-fayoum rural area including: Al-sheikh hassan at sanorse. We collected the data of women characteristics by a self-administered interview questionnaire & a structured reported knowledge and practices checklist to evaluate pregnant women practices and knowledge. Follow up was done to the studied groups & histopathology assessments of the product of conception in cases of abortion secondary to the complications to compare between effect of antenatal care program on the woman who followed the program and those who did not. Results: There is an improvement in 63% of pregnant women knowledge and practices after educational program in all aspects. The most common danger signs that may occur during pregnancy were miscarriage and vaginal bleeding, intrauterine fetal death as reported by women & confirmed by the histopathology reports. Conclusion: The educational program had an efficient improving women knowledge and practice regarding danger signs for pregnant women in rural areas, with highly statically significant differences in all the tested items between pre/post program implementation (P < 0.001). Recommendations: Establishment of in-service training programs and continuous supervision in rural areas to a raise women knowledge and practice regarding educational pregnant women and developing antenatal classes for all pregnant women about obstetric danger signs.

Peripheral and Tissue Lymphocytes as Predictors of Pathological Response in Locally Advanced Rectal Cancer Post Neoadjuvant Chemoradiotherapy

Background: Tailoring therapy is the target in the management of any cancer;if factors which can predict response to treatment are identified, we can individualize treatment. Locally advanced rectal cancer studies reported that tumor microenvironment and host immune response played roles in sensitivity to chemoradiotherapy (CRT) by proving that both peripheral circulating lymphocytes and tumor infiltrating lymphocytes (TILs) strongly correlated with the response rate to CRT and it impacted disease outcome. Aim of the work: We aimed to assess the predictive value of peripheral blood lymphocytes and tumor infiltrating lymphocytes by correlation with regression rate post chemo-radiotherapy in patients with rectal cancer, and to find correlation between peripheral and tissue lymphocytes. Method: Before neoadjuvant, CRT venous blood samples were obtained from 40 patients with rectal cancer, and prior to surgery. Blood cell counts in the samples were analyzed using an automated hematology analyzer and flowcytometry used to analyze lymphocyte subsets. Colonscopic biopsies were obtained before the CRT;the numbers and distributions of T cells (CD4 & CD8) were evaluated by immunostaining. Results: Pre CRT peripheral total lymphocytes, T lymphocytes, T helper, T cytotoxic lymphocytes significantly correlated with tumor regression rate (p = 0.04, 0.05, 0.06, 0.04 respectively). The density of tissue CD4(+) and CD8(+) T cells was highly correlated with tumor regression post CRT (p = 0.01 for both). The high expressions of tissue CD4 & CD 8 were significantly correlated with high number of pretreatment peripheral total lymphocytes, T lymphocytes, T helper, and T cytotoxic lymphocytes with significant p value for all. Conclusion: We concluded that peripheral lymphocytic count and its subsets have significant correlation to tissue CD4, CD8 and both can predict pathological response to CRT;enhancement of lymphocytes mediated immune response can help for outcome improvement.