Tuesday, July 19, 2016

Herbal therapy: Popular Herbal Myrrh (Commiphora myrrha)

Kyle J. Norton(Scholar and Master of Nutrients, all right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

         Herbal Myrrh (Commiphora myrrha)

Myrrh, is resin made from dried tree sap of Commiphora myrrha, which is the genus Commiphora, belonging to the family Burseraceae, native to the Yemen, Somalia, and eastern Ethiopia. The herb has been used traditional medicine to treat sore and spongy gums, rheumatoid arthritis, the tissues congestion, etc. In tradition Chines medicine, the herb has been used over thousands odf year to invigorate the blood to reduce blood stasis causes of pain and swelling, etc.

Health benefits
1. Anti-inflammatory and analgesic properties
In the determination of the effects of individual herbal extracts and combined extract on anti-inflammatory and analgesic activities from Commiphora myrrha, and Boswellia carterii in vivo found that that myrrh water extract (MWE) and the combined extract (CWE) at the 3.9g/kg, and 5.2g/kg showed inhibition of formalin-induced paw edema with inhibition rate of 30.44%, and 23.50%, respectively. The PGE(2) production was inhibited significantly by all samples (P<0.01 or P<0.05). CWE showed stronger suppression on carrageenan-induced mice paw edema at 2 and 3h after administration of drugs. The inhibitory effect of CWE on nitrite production was between that of MWE and water extract of frankincense (FWE) at 5.2g/kg. The dysmenorrhea mice test showed MWE could remarkably reduce the writhing times (P<0.05) and prolong the latency period, while FWE showed no obvious effects on the writhing times. CWE significantly reduced the writhing times and prolong the latency period (P<0.01), according to "Evaluation of the anti-inflammatory and analgesic properties of individual and combined extracts from Commiphora myrrha, and Boswellia carterii" by Su S, Hua Y, Wang Y, Gu W, Zhou W, Duan JA, Jiang H, Chen T, Tang Y.(1)

2. Neuroprotective Effects
In the testing the neuroprotective effects of ten new furanosesquiterpenoids, myrrhterpenoids A-J ( 1- 10), together with eight known analogues ( 11- 18),isolated from the resinous exudates of COMMIPHORA MYRRHA, found that all isolated furanosesquiterpenes showed neuroprotective effects against MPP (+)-induced neuronal cell death in SH-SY5Y cells, according to "Sesquiterpenoids from the Resinous Exudates of Commiphora myrrha and Their Neuroprotective Effects" by Xu J, Guo Y, Li Y, Zhao P, Liu C, Ma Y, Gao J, Hou W, Zhang T.(2)

3. Anti cancer activities
In the identification of the effects of Aqueous extracts of 12 Chinese medicinal herbs, including Commiphora myrrha on antiproliferative activity on eight cancer cell found that All the crude aqueous extracts demonstrated growth inhibitory activity on some or all of the cancer cell lines, but only two showed activity against the normal mammary epithelial cells. and concluded that these results indicate the potential use of traditional Chinese medicinal herbs as antineoplastic agents and suggest that further studies evaluating their mechanism(s) of action and the isolation of active antitumor compounds are warranted, according to "In vitro anticancer activity of twelve Chinese medicinal herbs" by Shoemaker M, Hamilton B, Dairkee SH, Cohen I, Campbell MJ.(3)

4. Prostate cancer
In the examination whether two naturally occurring sesquiterpenoids (ST1 and ST2) from myrrh with anti-proliferative activity in prostate cancer cells found that that suppression of AR transactivation by ST1 and ST2 may be mediated, in part, by inhibiting AR nuclear translocation and/or interfering with the interaction between AR and its coactivators ARA70 and SRC-1. Therefore, sesquiterpenoids could be developed as novel therapeutic agents for treating prostate cancer, according to "Sesquiterpenoids from myrrh inhibit androgen receptor expression and function in human prostate cancer cells" by Wang XL, Kong F, Shen T, Young CY, Lou HX, Yuan HQ.(4)

5. Antibacterial activity
In the evaluation of the antimicrobial activity from chemical composition of essential oils of cabreuva, including Commiphora myrrha, found that The volatile oils exhibited considerable inhibitory effects against all tested organisms, except Pseudomonas, using both test methods. Higher activity was observed against Gram-positive strains in comparison with Gram-negative bacteria. Cabreuva oil from Brazil showed similar results, but in comparison with the other oils tested, only when higher concentrations of oil were used, according to "Chemical composition and antibacterial activity of selected essential oils and some of their main compounds" by Wanner J, Schmidt E, Bail S, Jirovetz L, Buchbauer G, Gochev V, Girova T, Atanasova T, Stoyanova A.(5)

6. Anti parasites
In the identification of the effect of myrrh, divided into three main groups: GI (control group), GII (infected group) and GIII (infected-treated group) on Schistosoma mansoni found that the maximum effect of the drug was observed in SGs IIIB and IIIC as detected by significant decrease in the mean number and size of granulomas, paucity of eosinophils, decreased fibrosis and reticular fibers and the restoration of the glycogen content in the hepatocytes, according to "Evaluation of "Myrrh extract" against Schistosoma mansoni: a histological study" by Massoud AM, El Ebiary FH, Ibrahim SH, Saleh HA, Khalil HH.(6)

7. Gingival fibroblasts
In the study of myrrh oil (MO) effect on human gingival fibroblasts and epithelial cellsfound that that gingival epithelial cells and fibroblasts may differ in the magnitude of NF-kappaB activation after IL-1beta stimulation, and that MO inhibition of IL-1beta-stimulated IL-6 production in fibroblasts is due in part to inhibition of PGE(2), but not NF-kappaB activation, according to "Effect of myrrh oil on IL-1beta stimulation of NF-kappaB activation and PGE(2) production in human gingival fibroblasts and epithelial cells" by Tipton DA, Hamman NR, Dabbous MKh(7)

8. Anti-ulcer activity
In the investigation of botanical compounds with anti-ulcer activity include flavonoids, including gums and mucilages (i.e. gum guar and myrrh) found that Despite progress in conventional chemistry and pharmacology in producing effective drugs, the plant kingdom might provide a useful source of new anti-ulcer compounds for development as pharmaceutical entities or, alternatively, as simple dietary adjuncts to existing therapies, according to "The plant kingdom as a source of anti-ulcer remedies" by Borrelli F, Izzo AA.(8)

9. Etc.

Side effects
1. Do not use the herb in children or if you are pregnant or breast feeding without approval from the related field specialist.
2. Myrrh may cause irritation of the eyes and mucous membranes, if it is contacted.
3. Etc.


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The Best Way to prevent, treat your disease, including Obesity
and restore your health naturally with Chinese diet

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Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/22178177
(2) http://www.ncbi.nlm.nih.gov/pubmed/21830185
(3) http://www.ncbi.nlm.nih.gov/pubmed/16161030
(4) http://www.ncbi.nlm.nih.gov/pubmed/21372825
(5) http://www.ncbi.nlm.nih.gov/pubmed/20922991
(6) http://www.ncbi.nlm.nih.gov/pubmed/20503602
(7) http://www.ncbi.nlm.nih.gov/pubmed/16112536
(8) http://www.ncbi.nlm.nih.gov/pubmed/11113992
                        

Traditional Chinese Medicine Herbal Therapy - Popular Chinese Herbs - Hai Ma (Hippocampus)

Kyle J. Norton(Scholar and Master of Nutrients, all right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.


                     Hai Ma (Hippocampus) 

Hai Ma is also known as Sea Horse. The sweet and warm herb has been used in TCM as sex hormone enhancing, anti aging, anti breast cancer agent, etc. and to treat asthma, impotence, unable to conceive, sleepiness and lack of strength, infection of throat, skin diseases, insomnia , etc. as it tonifies the Kidneys, strengthens the Yang, moves Blood, etc., by enhancing the functions of liver and kidney channels.

Ingredients
Depending to the types of sea horse, it can contain the following
1. γ-carotene
2. Astaxanthin
3. Astacene
4. Melanin
5. Acetylcholinesterase
6. Cholinesterase
7. Stearic acid
8. Etc.

Health Benefits
1. Antioxidants
In the determination of the radical scavenging and antioxidant activities of the water extracts of Hippocampus japonicus Kaup and the developed HPLC method applied to quantify hypoxanthine in different H. japonicus, H. kuda and S. acus samples. found that the developed HPLC method is simple and reliable for the quantification of hypoxanthine with a detection limit at 0.002 µg mL(-1), and a high recovery from 96.3% to 102.1%. This method provides a powerful tool for rapid identification and quantification of free radical scavenging compounds in complex marine natural products, according to “Rapid finding and quantification of the major antioxidant in water extracts of three marine drug organisms from China by online HPLC-DAD/MS-DPPH” by Zheng L, Chen J, Zhao H, Shi Q, Yang B, Cheng H, Zang J, Wang X.(1).

2. Antimicrobial peptide
In the examination of the novel gene encoding 55 amino-acid residues identified from the brooding pouch cDNA library of Hippocampus kuda Bleeker, found that the dominant contents are anti-parallel and parallel sheets, which may have β-sheet or β-strand motif. It is inferred that HKPLP participates in the host defense during egg fertilization and embryo development as an antimicrobial peptide in brooding pouch, according to “ Identification, synthesis and characterization of a novel antimicrobial peptide HKPLP derived from Hippocampus kuda Bleeker” by Sun D, Wu S, Jing C, Zhang N, Liang D, Xu A.(2).

3. Immune system
In the identification of a cDNA library of male Chinese seahorse (Hippocampus kuda Bleeker) which was constructed to investigate the molecular profile of seahorse as one of the most famous traditional Chinese medicine materials, and to reveal immunological and physiological mechanisms of seahorse as one of the most primitive vertebrates at molecular level, found that a lectin-complement pathway might exert a more dominant function in the innate immune system of teleost than mammal. Carbohydrate recognition domain (CRD) without a collagen-like region in the lectins of seahorse was likely an ancient characteristic of lectins similar to invertebrates, according to “Molecular profile of the unique species of traditional Chinese medicine, Chinese seahorse (Hippocampus kuda Bleeker)” by Zhang N, Xu B, Mou C, Yang W, Wei J, Lu L, Zhu J, Du J, Wu X, Ye L, Fu Z, Lu Y, Lin J, Sun Z, Su J, Dong M, Xu A.(3).

4. Etc.

Side effects
1. Do not use the herb in newborn, children or if you are pregnant or breast feeding without consulting first with the related field specialist.
2. Not not use the herb in case of yin deficiency with heat
3. Overdoses or prolonged period of using can cause kidney damage
4. Etc.


Chinese Food Therapy
The Best Way to prevent, treat your disease, including Obesity 
and restore your health naturally with Chinese diet

Ovarian Cysts And PCOS Elimination

Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/21995368
(2) http://www.ncbi.nlm.nih.gov/pubmed/22252202
(3) http://www.ncbi.nlm.nih.gov/pubmed/12935898



Most Common Diseases of 50 Plus: Thyroid disease: Thyroid adenoma Treatments In conventional medicine perspective

Kyle J. Norton(Scholar and Master of Nutrients, all right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.


                         Thyroid disease


Thyroid disease is defined as a condition of malfunction of thyroid. Hyperthyroidism is a condition in which the thyroid gland is over active and produces too much thyroid hormones.



                       Thyroid adenoma

Thyroid adenoma is a benign tumor started in the layer of cell lined the inner surface of the thyroid gland. The disease are relatively common among adults living in the United States. According to the study by the Mayo Clinic and Mayo Foundation, there is a report of 4 patients described in whom a follicular carcinoma developed following thyroidectomy for a benign follicular neoplasm. Most thyroid nodules are Thyroid adenoma.


                          The 
Treatments



F.1. In conventional medicine perspective
1, Watchful waiting
In most cases of a benign thyroid nodule, as a result of fine-needle aspiration biopsy differentiating benign from malignant thyroid nodules, your doctor may suggest only simply watching your condition with regular interval physical exam and thyroid function tests(39).

2. Thyroid hormone suppression therapy such as Levoxyl, Synthroid
In the valuation of the effect of THST on the clinical outcomes of papillary and/or follicular ThyrCa, showed that out of 4, 174 patients with ThyrCa, 2, 880 (69%) were reported as being on THST. Meta-analysis showed that the group of patients who received THST had a decreased risk of major adverse clinical events (RR = 0.73; Cl = 0.60-0.88; P < 0.05). Further, by applying a Likert scale, 15/17 interpretable studies showed either a 'likely' or 'questionable' beneficial effect of THST. Assessment of causality between TSHT and reduction of major adverse clinical events suggested a probable association(40).

3. Radiofrequency ablation
adiofrequency ablation is an effective and well tolerated treatment option for benign thyroid nodules. Radiofrequency ablation of recurrent thyroid cancers may be an alternative to surgery in patients at high surgical risk(41).

4. Surgery
If the tumor is growth large enough to interfere with function of nearby tissues or organs, surgery may be necessary.

5. In case of nodules that cause hyperthyroidism
a. Radioactive iodine
In the study of the thyroid glands from 20 euthyroid patients and 20 hyperthyroid patients, all of which had been treated with radioactive iodine, showed that almost all the euthyroid glands displayed a fibrotic atrophic pattern, whereas the glands from the Graves' disease patients showed more adenomatous and Hashimoto lesions than atrophy(42).
b. Medication such as methimazole (MMI) and propylthiouracil (PTU)
The aim of the medication is to reduce the symptoms of the disease with serious side effect
c. Surgery
In some case, if treatment with radioactive iodine or anti-thyroid medications has not been effective or an option, surgery may be necessary.


The Best Weight Loss and Healthy Lunch Box recipe: Corn and edamame

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

 The Best Weight Loss and Healthy Lunch Box recipe:  Corn and edamame
The Lunch Box recipes , Packed with fun, healthy meals that keep them smiling, by Kate McMillan and Sarah Putman Clegg, published by Weldonowen.

Stealth side salad: Chunky salad perfect for youngsters who have never to let a shred of lettuce pass their lips

In a small container with tight-fitting lid, combine 2 teaspoons fresh lime juice and 1 tablespoon olive oil. Add equal parts cooked corn kernels; cooked shelled edamame; halved cherry tomatoes; and avocado cubes. Sprinkle with minced cilantro, if you like. Cover and shake to combine. Season with salt and pepper.

General Health: Bladder Stone (Vesical calculi) - The Symptoms

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

                     Bladder Stones (calculus)

Bladder Stones (calculus) is a composed of mineral masses formed in the bladder as a result of Concentrated, stagnant urinary, dehydrated causes of crystallization. Small bladder stones in most cases, pass on their own in the flow of urine.

                        The Symptoms

The symptoms are as results of irritation of bladder wall or the stones have blocked the flow of the urine causes of infection and complications. In most cases, Bladder stone large and small do not cause any symptoms at all.
1. Inability to walk, constipation and urinary incontinence
There is a report of a case of massive irreducible procidentia with a hard palpable mass in the anterior vaginal wall mimicking an impacted faecal mass in a 57-year-old multiparous, post-menopausal woman with symptoms of Inability to walk, constipation and urinary incontinence as her primary complaints. targeted plain X-ray and ultrasound of the prolapsed mass disclosed the existence of multiple vesical calculi(1).

2. Lower abdominal pain, pain during micturation and pollakuria
There is a report of a 48-year-old man hospitalized with the chief complaints oflower abdominal pain, pain during micturation and pollakuria, plain radiography showed 2 giant bladder stone shadows: one as 6.0 × 5.0 cm and the other one 5.0 × 5.0 cm in size(2).


3. Voiding symptoms (Poor stream, Hesitancy, Terminal dribbling, Incomplete voiding, Overflow incontinence) and hematuria (Blood in your urine)
There is a report of a case of 43 year old man with the diagnosis of giant bladder stone (more than 10 cm diameter) with symptoms of voiding symptoms and hematuria(3).

4. Others symptoms
a. Repeated cloudy or abnormally dark-colored urine as a result of infection of the urinary track.
b. In men, pain or discomfort in the penis due to blockage or infection
c. Etc.

Women Health: Overcome Infertility (Menstrual Modification for Optimal Conception) The Normal Menstrual Cycle In Traditional Chinese Medicine Perspective

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Infertility is defined as inability of a couple to conceive after 12 months of unprotected sexual intercourse or can not carry the pregnancy to full term. It effects over 5 millions couple alone in the U. S. and many times more in the world, because of unawareness of treatments, only 10% seeks help from professional specialist. In fact, More than 40% of infertility of a couple is caused by male inability to fertilize.

The Normal Menstrual Cycle In Traditional Chinese Medicine

A normal menstrual cycle is normally from 28- 35 days, without any symptom that causes discomfort (excluding dull pain) and menstrual discharge is red and last from 3- 5 days without spotting. Not all women with abnormal menstrual cycle are infertile, but if you are diagnosed with the unexplained cause of infertility, then your abnormal menstrual cycle may be the cause. Traditional Chinese medicine, before treating any cause of infertility would like to restore your normal menstrual cycle so you can conceive quickly. Girls in southest Asia has learnt early from the grandmother wisdoms, that maintaining the normal menstrual cycle is the main objective for easy conception and any menstrual disorder should be looked after immediately.
Depending to how the Chinese practitioner divides the menstrual cycle, it may be 4 or 5 phrases.
I would like to make it easily for the reader, by dividing it to 4 phrase (it is still the same).

I. Phase I -the yin phase (about 12 - 14 days)
At the beginning of the yin phrase, yin surges (the rise of estrogen) that leads to the growth of fluids in the uterus, that not only helps to moisten the uterus, but also thickens the endometriosis in order to prepare the uterus for normal conception. The increasing yin also supports the production of blood and produces sperm friendly mucus which is important for sperm invasion.
In conventional medicine as the estrogen rise, the brain signals the hypothalamus to secret gonadotrophin-releasing hormone (FSH), which in turn stimulates the pituitary gland to produce the follicle stimulating hormone that initiates the growth and recruitment of immature follicles in the ovary.

II. Phase II - ovulation phase (about 4 days)
As the yin (estrogen) at its peak, liver triggers the start the ovulation phrase by extruding the mature follicle into the fallopian tube. In this phrase, uterus continues producing sperm friendly mucus as qi and blood move downward to warm the uterus and promote the implantation of the egg.

III. Phase III - the yang or luteal phase (about 12 -14 days)
When the egg is extruded into fallopian tube, liver transform yin energy to yang that trigger the yang ( progesterone) phrase. At this phrase, blood and qi move down ward, the endometrial lining become softer to prepare the implantation of the fertilized egg, if occurs.
In conventional medicine, at this phase corpus luteum starts to produce progesterone that triggers the softening of endometrial lining for fertilized egg implantation.

IV. Phase IV- menstruation phrase (about 3-5 days)
If there is no conception occurred, the yang drops that cause the shedding of the uterus lining. The menstrual discharge is bright red and profuse and only last between 3 - 5 days ( spotting does not count).
I will continue to provide more information that contributes to the causes of abnormal menstrual cycle, including prolonged and shortened phases in each phrase and how you can treat them. The aim of this series is to provide the information of how you can modify your menstrual cycle for easy conception. I believe, it is helpful for women diagnosed with the unexplained causes of infertility or any women who would like to stop symptoms of menstruation disorders.

Pregnancy Miracle
Reverse Infertility And Get Pregnant Naturally
Using Holistic Ancient Chinese Medicine
                   

Women Health: The Obesity and Pregnancy' Research and Studies of Reduce or Prevent Obesity in Pregnant Women

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Obesity is a medical condition of excess body fat accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

You can calculate your BMI index BMI= weight (kg)/ height (m2)

The Studies of Reduce or Prevent Obesity in Pregnant Women


The prevalence of childbearing age obesity is wide spreading in US, approximately, 50% of them are either overweight [body mass index (BMI) 25-29.9 kg/m(2)] or obese (BMI ≥ 30 kg/m(2)). In the study toevaluate the effectiveness of dietary and lifestyle interventions in reducing or preventing obesity in pregnancy and to assess the beneficial and adverse effects of the interventions on obstetric, fetal and neonatal outcomes, posted in PubMed, indicated that interventions in pregnancy to manage weight result in a significant reduction in weight gain in pregnancy (evidence quality was moderate). Dietary interventions are the most effective type of intervention in pregnancy in reducing gestational weight gain and the risks of pre-eclampsia, gestational hypertension and shoulder dystocia. There is no evidence of harm as a result of the dietary and physical activity-based interventions in pregnancy. Individual patient data meta-analysis is needed to provide robust evidence on the differential effect of intervention in various groups based on BMI, age, parity, socioeconomic status and medical conditions in pregnancy(1).