Ministry Of Health

This study examined nuanced preferences and unmet needs for bereavement care of mothers who experienced stillbirth or neonatal death. Cross-sectional survey. The Philippines. A total of 169 bereaved mothers aged 18 years or older who had experienced stillbirth or neonatal death on or after 30 January 2020 in the Philippines. Response patterns to nine self-administered questions about desired bereavement care and the care they received were analysed using latent class analysis. Measurement invariance was assessed across participant types and urbanicity. Multinomial logistic regression was used to examine the associations between latent classes, demographics and perinatal loss information. Desired type of bereavement care and unmet need for bereavement care. We identified three mutually exclusive stable latent classes related to desired care and unmet needs. For desired bereavement care, one class was characterised by a strong preference for seeing, holding, spending time with, and naming the baby, but low desire in memory making (25.1%). This preference was more common among mothers from urban areas (aOR = 3.04) and those who experienced stillbirth (aOR = 3.07), compared to those from rural areas and who experienced neonatal death, respectively. Regarding unmet need for bereavement care, one class reported unmet needs for memory making (28.3%), with preterm mothers (aOR = 3.11) three times more likely to belong to this class than those who delivered full-term. This study offers novel insights into the complex bereavement care preferences and needs of mothers who experienced perinatal loss. The findings can inform future frameworks and guide the development of culturally appropriate, context-specific interventions for mothers and families.

This study aimed to evaluate effects of calcium carbonate (CaCO3) and anhydrous strontium carbonate polyelectrolyte-cation complexes on dentin adhesive bonding, mechanical properties and intrafibrillar mineralization of dentinal collagen fibers. Dentin discs were prepared from collected human premolars and treated with 1%SrF₂CaCO3, 0.5%SrF₂CaCO3, 2% SrF₂CaCO3 and distilled water for 15 days under controlled pH. Raman spectroscopy, transmission and scanning electron microscopy were performed to evaluate intrafibrillar mineralization and topographical changes. Diffusional coefficient and density functional theory were calculated. Resin-dentin bond specimens were prepared and microtensile bond strength was measured. Statistical analysis was performed using a one-way ANOVA with subsequent post-hoc comparisons, with significance of p < 0.05. Raman spectroscopy demonstrated a concentration-dependent increase in dentin mineralization, with enhanced phosphate and organic matrix signatures following SrF₂CaCO3 treatment. TEM and HRTEM confirmed organised intra- and extrafibrillar hydroxyapatite deposition, particularly in the 2% SrF₂CaCO3 group, showing aligned crystallites along the collagen axis and well-defined D-periodicity. SEM revealed progressive crystal elongation and surface densification with increasing concentration. Diffusion analysis indicated higher ionic mobility in modified groups, supported by DFT calculations showing increased Ca and P occupancy and crystallographic stability. µ-tensile testing demonstrated significantly improved bond strength in the 1% SrF₂CaCO3 and 2% SrF₂CaCO3 groups without compromising adhesive performance. The present study demonstrated the modification of dentinal surface using a range of concentrations of SrF₂CaCO3 as a multifunctional modifier indicating favourable bond strength and extensive crystallisation capability. The 2% SrF₂CaCO3 polyelectrolyte formulation has a significant potential for clinical application and offers a novel potential solution to address significant challenges in adhesive dentistry. Strontium/fluoride/calcium carbonate polyelectrolyte complexes promote biomimetic dentin remineralization, enhance crystal organisation, and improve resin-dentin bond strength. This strategy offers a biologically guided approach to reinforce compromised dentin, potentially increasing the longevity and reliability of adhesive restorative procedures.

Women with pre-existing diabetes remain at increased risks of adverse pregnancy complications. Optimising glycaemic control before and during pregnancy could reduce risk but data from Asian countries are limited. This study evaluates maternal glycaemia, management strategies and pregnancy outcomes in women with diabetes in a multiethnic cohort. We retrospectively studied pregnancies with pre-existing diabetes or prediabetes at a Singapore tertiary hospital from 01/01/2022 to 31/12/2024. Maternal data and pregnancy outcomes were analysed by diabetes subtype. Multivariate logistic regression identified factors linked to adverse outcomes, including fetal overgrowth (macrosomia and large-for-gestational-age [LGA]) using local birthweight standards. Of 289 pregnancies (75.8% Type 2 diabetes mellitus [T2DM], 19.0% prediabetes, 5.2% Type 1 diabetes mellitus [T1DM]), median maternal age was 33 years and pre-pregnancy body mass index (BMI) was 29.3 kg/m2. HbA1c improved from 7.0% to 6.1% across trimesters (p < 0.00). Macrosomia (≥ 4 kg) occurred in 4.2% of infants, while preterm birth was more frequent in T1DM (33.3%) than in T2DM (5.0%) or prediabetes (1.8%). Retinopathy screening was completed in 67.6% of patients and continuous glucose monitoring (CGM) or pump devices were not utilised. Using Singapore LGA reference, third trimester HbA1c < 6.5% was associated with lower odds of LGA. Multidisciplinary care enhanced glycaemic control and reduced macrosomia, but women with T1DM remain at increased risk of preterm delivery and neonatal morbidity. Enhanced preconception care, retinopathy screening and adoption of real-time CGM may improve outcomes in Asian women with pre-existing diabetes in pregnancy.

Background: Dengue fever (DF) has emerged as a significant global health threat and has become a serious public health concern in Oman. This study aims to investigate the risk factors associated with the current dengue outbreak and to offer recommendations for its prevention and management. Methods: An unmatched case–control study involving 63 cases and 63 controls (1:1 ratio) was conducted on the outbreak that occurred between May and June 2024 in South Batinah, Oman. The cases were laboratory-confirmed dengue patients, while the controls were individuals from the same community who tested negative for dengue. Data were collected on demographic, environmental, behavioral, and socioeconomic factors. Logistic regression was used to assess the association between predictor variables and the probability of dengue infection. Results: A total of 126 cases and controls were included. Males accounted for 86% of cases and 59% of controls. Among the cases, 33% were aged ≥55 years, whereas 41% of controls were aged 25–39 years. Male gender was a significant predictor of dengue infection, with an adjusted odds ratio (AOR) of 6.59 (95% CI: 1.04–41.76; p = 0.046). Patients notified 3–6 days after symptom onset had an AOR of 8.64 compared to those reported within &lt;3 days. Joint pain (AOR: 0.02; 95% CI: 0–0.27; p = 0.004) and leukopenia (AOR: 12.89; 95% CI: 2.54–65.5; p = 0.002) were significantly associated with dengue infection. Houses less than 10 years old were protective against dengue infection, with an AOR of 0.05 (95% CI: 0.01–0.63; p = 0.02) compared to houses over 30 years old. Conclusion: The study indicated that males, patients presenting 3–6 days after symptom onset, and those with leukopenia were at higher risk of dengue infection, while residing in newly built houses is associated with a lower risk. Mosquito control, particularly around older and poorly maintained homes, along with continuous vector surveillance, is essential.