Deep Infiltrating Endometriosis Influence of Endometriosis and Progestin Therapy on the Course of COVID Infection: A Prospective Study at a University Endometriosis Center in Germany

Morva Tahmasbi Rad, Lisa Marie Wilhelm , Denis Brachmann, Sven Becker, Sophie Simon

Objective: Endometriosis is a chronic immune-related inflammatory disease. As progestin therapy modulates estrogen and progesterone pathways it may also influence antiviral immune response. This study aimed to evaluate the impact of deep infiltrating endometriosis (DIE) and progestin therapy on the clinical course of SARS-CoV-2 infection. Methods: This prospective, single-center cohort study included 30 women with confirmed deep infiltrating endometriosis (DIE). Clinical data and standardized questionnaires were used to assess SARS-CoV-2 infection status, symptom severity, duration of PCR positivity, vaccination status, and endometriosis symptoms. Patients were stratified according to progestin therapy use versus no hormonal treatment. Results: Seventeen women (56.7%) were receiving progestin therapy, while 13 (43.3%) did not. The mean age was 34.0 ± 7.2 years, with no significant baseline differences between the groups. All patients contracted SARS-CoV-2. The mean time to PCR negativity was significantly longer in the progestin group (10.76 ± 4.1 vs. 8.00 ± 2.2 days; p = 0.026). Moderate COVID-19 symptoms were more frequent among progestin users (47.1% vs. 7.7%; p = 0.042), whereas mild disease predominated in non-users (92.3%). No hospitalizations or thromboembolic events were observed. Endometriosis-related symptoms remained stable following both SARS-CoV-2 infection and vaccination. Conclusion: In women with DIE, progestin therapy was associated with prolonged viral clearance and a higher frequency of moderate COVID-19 symptoms. Although causality cannot be established in this small cohort, the findings suggest a potential interaction between hormonal therapy and the immune response to SARS-CoV-2. As current evidence in this area remains scarce, these preliminary observations provide a basis for future larger, adequately powered prospective studies aimed at elucidating the immunological mechanisms underlying these associations and determining their clinical relevance.

Impact of Maternal Anaemia on neonatal Packed Cell volume among neonates of placental malaria parasitaemic Mothers in Imo State, Nigeria

Maria-Joannes K. Uzoma, Chukwudi O. Okani, Frank C. Akpuaka, Kingsley C. Madubuike, Peter Ughachukwu, Osita Chiaghanam, Ikechukwu V. Ogoke, Samson D Ejikunle, Agu Pius Okechukwu, Onughara Anderson, Onyegbula Onyema

Introduction: Malaria remains endemic in many tropical African countries and continues to pose a significant public health challenge. Pregnant women and children are particularly vulnerable to malaria infection due to pregnancy-related immunological changes. Placental malaria is associated with adverse maternal and neonatal outcomes.

Objective: This study aimed to determine the correlation between Maternal anaemia and Neonatal Packed Cell Volume among placental malaria parasitaemic mothers in Owerri, the capital city of Imo State, Nigeria.

Methodology: This was a descriptive correlational study conducted among consenting term parturient who delivered at the Labour and Delivery units of the Federal Teaching Hospital, Owerri; the Claretian University of Nigeria Hospital; and the Holy Family Sisters of the Needy Hospital, all located in Owerri, Imo State. Women with pre-existing medical conditions such as hypertension, cardiac or renal disease, diabetes mellitus, sickle cell anaemia, retroviral disease, as well as preterm parturient, were excluded.

Data were obtained using interviewer-administered questionnaires and patients’ case notes to collect information on socio-demographic characteristics, parity, gestational age, antenatal clinic attendance, and use of intermittent preventive treatment (IPT) and insecticide-treated nets (ITNs). Immediately after delivery, placental blood samples were obtained from the maternal surface of the placenta for malaria parasite detection. Neonatal heel-prick blood samples were collected for malaria parasitaemia. In contrast, cord blood samples were used to estimate neonatal packed cell volume. Neonatal outcome measures assessed included birth weight, Apgar scores, jaundice, malaria parasitaemia, packed cell volume, and perinatal mortality. Data were analyzed using Chi-square and Fisher’s exact with statistical significance set at p ≤ 0.05.

Results/Findings: Out of 431 term parturients initially assessed, 400 were included in the final analysis. The prevalence of maternal peripheral malaria and placental malaria parasitaemia were 69% (276/400) and 14.0% (56/400) respectively. There was no significant association between maternal anaemia and neonatal anaemia (p=0.386).

Placental malaria parasitaemia showed a statistically significant correlation with neonatal malaria parasitaemia (p =0.0001), neonatal anaemia (p = 0.010), low birth weight (p = 0.0001) and neonatal mortality (p = 0.002). There was no significant association with Apgar scores (p = 0.425).

Assessment of Injury-Related Chief Complaints Among School Children Managed by School Nurses in Nepal

Bimal Singh Bist, Puspa Raj Pant, Sanu Krishna Shrestha, Pavan Sah, Lokendra Sherchan, Subash Neupane, Dipendra Gautam, SujanAdhikari, Ashis Thapa, Ram Prasad Neupane

Background: In Low- and Middle-Income Countries (LMICs) like Nepal, school nurses serve as the first point of contact for managing childhood injuries and acute illnesses. However, the actual pattern of complaints they manage remains poorly documented. This study aimed to assess the prevalence and types of chief complaints, particularly injuries, among school children presenting to school nurses in rural Nepal and to identify demographic and temporal associations.Methods: A cross-sectional study was conducted using secondary data from five schools with qualified school nurses in Dhading district. Records of 1,167 students (aged 5–18 years) who presented with a chief complaint during school hours across three fiscal years (2022–2024) were analyzed. Complaints were categorized into ten clinical groups. Descriptive statistics, chi-square tests for associations, and trend analyses were performed. Results: The majority of students were female (58.4%) and aged 11–15 years (57.8%). The most common chief complaints were neurological (28.0%, primarily headache), musculoskeletal/injury (23.9%), and gastrointestinal (21.0%). Within injuries, cut injuries (34.8%) and fall injuries (15.1%) predominated. Significant associations were found between complaint type and age (p < 0.001) and gender (p < 0.001), but not ethnicity (p = 0.204). Male students had higher injury rates (30.5% vs. 19.2%), while females reported more neurological and reproductive complaints. Injury related consultations peaked during the monsoon months. Conclusions: Musculoskeletal injuries account for nearly one in four school nurse consultations, with distinct demographic and seasonal patterns. These findings provide an evidence base for strengthening school nurse training in acute injury management, developing gender-sensitive services, and implementing seasonally-targeted prevention programs in rural Nepal.