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Abstract:The present study has been undertaken to investigate plasma creatinine, folate and vitamin B 12 as underlying factors in the reduction of plasma homocysteine concentration in different trimesters of pregnancy. Under a cross-sectional design, 30 healthy nonpregnant as well as 130 pregnant women, at 3 different trimesters of pregnancy (43 in 1 st trimester, 44 in 2 nd trimester and 43 in 3 rd trimester) were sampled for plasma levels of folate, vitamin B 12, homocysteine and creatinine. Plasma homocysteine and creatinine level were significantly (p<0.014) lower in pregnant women at different trimester (1 st , 2 nd and 3 rd trimester) compared to nonpregnant women. Plasma folate was significantly higher in different groups of pregnant women compared to nonpregnant women. Significant negative correlation was found between plasma homocysteine and folate in nonpregnant (r=-0.453, p<0.012) and pregnant women at 2 nd trimester (r=-0.681, p<0.001). There was found significant negative correlation between plasma homocysteine and vitamin B 12 at 1 st trimester group (r=-0.322, p<0.035) and 2 nd trimester group (r=-0.394, p<0.008) but not in 3 rd trimester. In present study, reduction of plasma total homocysteine appears to be a physiological response in pregnancy, and the level of plasma folate and vitamin B 12 , but can not be explained by renal homodynamic changes.

Objective: This study assessed the health status and explored the perception of health care management among those with cardiovascular conditions in rural counties in China where the ability to pay is dominant. Method:We performed a cluster random sampling to select patients (aged ≥50 years) at rural health infirmaries in eight villages from three countries in Guangdong province, China. Information on clinical parameters measured on-site and morbidity history from medical records were obtained. The presence of hypertension, diabetes, and dyslipidemia were examined from clinically-diagnosed parameters (including triglycerides, ≥1.69 mmol/L; total cholesterol, ≥5.69 mmol/L; and lowdensity lipoprotein cholesterol, ≥3.62 mmol/L) according to clinical guidelines. A validated questionnaire to assess the perception of health care management (in a 10point Likert-type scale) was administered by trained researchers to study subjects. Multiple linear regression analysis was conducted to explore factors associated with the willingness to pay for health care management. Result:The study population (N = 4,670 out of 4,800) had an average age of 65.3 years (standard deviation 7.1). Nearly one-third of subjects (31.9%) were illiteracy. The most prevalent condition was hypertension (54.6%), followed by dyslipidemia (43.3%) and diabetes (25.3%). Two-thirds of patients had multiple chronic conditions, with an average score ≤2 (out of 10) on the perception of health care management. Single-living (p = 0.018), higher education level (p = 0.034), and higher income level (p = 0.001) were independently associated with higher willingness of participating in health care management among the study subjects. Conclusion:The prevalence of cardiovascular conditions was high among middleaged and older adults in China's rural health infirmary setting. The low-level perception of health care management might be explained by the unaffordablility of patients.Background: Pregnancy-Induced-Hypertension (PIH) is claimed to create greater risk of hypertension (HTN) and chronic-kidney-diseases (CKD) at later life of the women. Objective:To explore what proportion of women with history of PIH develop HTN and CKD in later stages after delivery and, to study the interrelation of HTN and CKD with socio-demographic, anthropometric and biochemical risk factors. Methods:Under an observational case-control design 133 women with previous history of PIH [PIH group; Age(yrs), Median(range) 31(25-45), and BMI [(kg/m 2 , (Mean ± SD)(25.2 ± 2.1)] were compared with 113 women without history of PIH (Non-PIH group), Age(yrs) Median(range) 34(25-45), and BMI [(kg/m 2 , Mean ± SD) (25.8 ± 2.9)] for the development of HTN (SBP > 130 mmHg; DBP > 90 mmHg; or MBP > 105 mmHg) and CKD [as measured by totalurinary-protein and elevated urinary-protein-creatinine ratio (UPCR)]. Clinical and anthropometric parameters were measured by standard techniques, lipids by enzymatic-colorimetric method, urinary total protein by pyrogallol-red method, urinary-protein by strip method and uri...

Introduction Cardiovascular disease is common in woman of all age, including child bearing age. In this study, we aim to compare maternal and fetal outcome in pregnant woman with and without preexisting cardiovascular disease. Methods This case control single center study was conducted by Obstetrics & Gynecology department and Cardiology department Shaikh Zayed Medical College/Hospital Rahimyar Khan from 1 st March 2020 to 30 th June 2020. Results Pregnant woman with preexisting cardiovascular disease had more preterm births and newborn with lower birth weight. Maternal and fetal deaths were numerical higher in pregnant women with preexisting cardiovascular disease but statistically non-significant compared to woman without preexisting cardiovascular disease. Conclusion It is important to identify underlying cardiovascular disease in pregnant woman. Proper counselling throughout pregnancy is needed and efforts should be made to minimize risk of maternal and fetal complications.