VALIDATION OF A PRE-ECLAMPSIA MONITORING TOOL (PETOGRAPH) AMONG PREGNANT MOTHERS IN JINJA REGIONAL REFERRAL HOSPITAL: A CROSS-SECTIONAL STUDY. Presented at the Association of Obstetricians and Gynaecologists Uganda ANNUAL SCIENTIFIC CONFERENCE 2017.
Evaluation of factors that contributes to post-partum haemorrhage in Pregnant...PUBLISHERJOURNAL
Postpartum haemorrhage (PPH) is the world’s leading cause of maternal death and accounts for an estimated 127,000 deaths each year. Identification of some of the risk factors such as; previous postpartum haemorrhage, multiple pregnancies, macrosomia, induction of labour, operative vaginal deliveries and cesarean section would help in preventing PPH. The aim of this research was to assess the factors contributing to postpartum haemorrhage (PPH) among pregnant women who attend delivery services in Kampala International University Teaching Hospital (KIU-TH). This study used a cross-sectional descriptive design where by a cross-section of respondents involving 68 respondents were sampled to represent the target population, in these case women who received maternity service from KIU-TH. Only quantitative methods of data collection using questionnaires with closed ended questions were employed for both mothers and health workers. During the study period, 58 women who delivered in the unit and 20 women developed postpartum haemorrhage giving the frequency of postpartum haemorrhage 34.6%. The majority of the women 30% were between 30-34 years of age. Among the women who developed PPH retained placental tissues was the most common cause 50% followed by uterine atony which was 30%. The rest of the causes of PPH were laceration 20%. Postpartum haemorrhage is still a leading but preventable cause of maternal morbidity and mortality in our country due to underutilization of health facilities, the major cause is retained placental tissues followed by uterine atony.
Keywords: post-partum haemorrhage, pregnant women, delivering, Uganda
Evaluation of factors that contributes to post-partum haemorrhage in Pregnant...PUBLISHERJOURNAL
Postpartum haemorrhage (PPH) is the world’s leading cause of maternal death and accounts for an estimated 127,000 deaths each year. Identification of some of the risk factors such as; previous postpartum haemorrhage, multiple pregnancies, macrosomia, induction of labour, operative vaginal deliveries and cesarean section would help in preventing PPH. The aim of this research was to assess the factors contributing to postpartum haemorrhage (PPH) among pregnant women who attend delivery services in Kampala International University Teaching Hospital (KIU-TH). This study used a cross-sectional descriptive design where by a cross-section of respondents involving 68 respondents were sampled to represent the target population, in these case women who received maternity service from KIU-TH. Only quantitative methods of data collection using questionnaires with closed ended questions were employed for both mothers and health workers. During the study period, 58 women who delivered in the unit and 20 women developed postpartum haemorrhage giving the frequency of postpartum haemorrhage 34.6%. The majority of the women 30% were between 30-34 years of age. Among the women who developed PPH retained placental tissues was the most common cause 50% followed by uterine atony which was 30%. The rest of the causes of PPH were laceration 20%. Postpartum haemorrhage is still a leading but preventable cause of maternal morbidity and mortality in our country due to underutilization of health facilities, the major cause is retained placental tissues followed by uterine atony.
Keywords: post-partum haemorrhage, pregnant women, delivering, Uganda
EFFECTIVENESS OF INTERMITTENT PREVENTIVE TREATMENT IN PREGNANCY WITH SULPHADO...oyepata
EFFECTIVENESS OF INTERMITTENT PREVENTIVE TREATMENT IN PREGNANCY WITH
SULPHADOXINE-PYRIMETHAMINE AGAINST MALARIA IN NORTHERN NIGERIA
Builder MI*1, Anzaku SA2 and Joseph SO1
This document summarizes a study on the clinical spectrum and risk factors of cerebral palsy in children. The study was conducted from 2013-2015 in India and included 100 children diagnosed with cerebral palsy. Key findings include: (1) Spastic cerebral palsy was the most common type seen in 81% of cases. (2) Quadriplegia was the most common topographical type. (3) Major risk factors for cerebral palsy included birth asphyxia (44%), low birth weight (33%), preterm birth (19%), and neonatal seizures (23%). This study provides insight into the types and causes of cerebral palsy affecting children in India.
— This study was conducted to find out if AFI ≤ 5 cms has any clinical significance in identifying the subsequent fetal distress & associated maternal & perinatal outcomes, in pregnancies beyond 37 weeks. Methodology: This is a prospective case control study done from July 2010 to July 2012 (24 months) at Dr Vasantrao Pawar Medical College, Hospital and Research Center. Adgaon, Nashik. It study the pregnancy outcome comparison of 58 Anenatal Cases(ANCs)as Study Group with diangosis of oligohydramnios (AFI ≤ 5 cms) by ultrasound after 37 completed weeks of gestation w e r e compared with 58 ANCs (Control Group) with no oligohydramnios (AFI > 5 cms). These two groups were matched for other variables like age, parity, gestational age and any pregnancy complication. Results: There was significant difference between two groups. Hypertension and Preeclampsia were found significantly more in ANCs with oligohydramnios. FHR deceleration was also significantly higher in women with oligohydramnios. Women require LSCS were also significantly more in women with oligohydramnios. Newborn borned by women with oligohydramnios had significantly more chances to admit in NICU than in newborn born by women without oligohydramnios. Conclusion: It can be concluded from this study that women with oligohydramnios poor pregancy outcomes. Determination of AFI can be used as an adjunct to other fetal surveillance methods. Determination of AFI can be used as valuable screening test for predicting fetal distress in labour, requiring caesarean section.
This document presents a proposal for a study to examine the prevalence of anemia and associated risk factors among pregnant women attending antenatal care at Shebel Berenta Primary Hospital in Ethiopia. The study will use a cross-sectional design to collect data from 283 pregnant women over 6 months using questionnaires, hemoglobin tests, and stool samples. The proposal describes the background, objectives, methodology, work plan, budget, and ethics of the study. Key objectives are to determine the prevalence of anemia during pregnancy and identify associated risk factors.
Medical Breakthroughs from the "Baliw na Baliw sa (Biotechnology) Research"Ourlad Alzeus Tantengco
This talk was given during the pre-event Symposium on Biotechnology in Healthcare by the Food and Development Administration of the Philippines.
Almost all of the medical innovations (i.e. medicine, vaccines, diagnostic tests etc) that are available to us are products of years of basic science and clinical research. Medical innovations have resulted in improved health and quality of life worldwide. These medical breakthroughs do not happen overnight. They require years of research and discovery and a huge amount of financial support to fund research facilities and human resources. This talk will introduce the long process of how biotechnology research is translated into clinics and public health. Current medical biotechnology researches in the Philippines and abroad will also be discussed. Some of the current medical biotechnology researches being conducted in the Philippines include rapid dengue diagnostic kits, Philippine herbal medicines, and Filipino cardiovascular genetics. These researches continuously revolutionize healthcare in the Philippines. Likewise, groundbreaking biotechnology researches from all other countries also open up new treatment and prevention for different diseases such as HIV, cancer, and metastases. These researches continue to advance modern medicine to address health and development issues worldwide. Continuous partnership and collaboration among the academe, industry, and the government is crucial in supporting more medical biotechnology researches that will provide cheaper and more efficient diagnostics, vaccines and medicines.
Evaluation of factors that contributes to post-partum haemorrhage in Pregnant...PUBLISHERJOURNAL
Postpartum haemorrhage (PPH) is the world’s leading cause of maternal death and accounts for an estimated 127,000 deaths each year. Identification of some of the risk factors such as; previous postpartum haemorrhage, multiple pregnancies, macrosomia, induction of labour, operative vaginal deliveries and cesarean section would help in preventing PPH. The aim of this research was to assess the factors contributing to postpartum haemorrhage (PPH) among pregnant women who attend delivery services in Kampala International University Teaching Hospital (KIU-TH). This study used a cross-sectional descriptive design where by a cross-section of respondents involving 68 respondents were sampled to represent the target population, in these case women who received maternity service from KIU-TH. Only quantitative methods of data collection using questionnaires with closed ended questions were employed for both mothers and health workers. During the study period, 58 women who delivered in the unit and 20 women developed postpartum haemorrhage giving the frequency of postpartum haemorrhage 34.6%. The majority of the women 30% were between 30-34 years of age. Among the women who developed PPH retained placental tissues was the most common cause 50% followed by uterine atony which was 30%. The rest of the causes of PPH were laceration 20%. Postpartum haemorrhage is still a leading but preventable cause of maternal morbidity and mortality in our country due to underutilization of health facilities, the major cause is retained placental tissues followed by uterine atony.
Keywords: post-partum haemorrhage, pregnant women, delivering, Uganda
Evaluation of factors that contributes to post-partum haemorrhage in Pregnant...PUBLISHERJOURNAL
Postpartum haemorrhage (PPH) is the world’s leading cause of maternal death and accounts for an estimated 127,000 deaths each year. Identification of some of the risk factors such as; previous postpartum haemorrhage, multiple pregnancies, macrosomia, induction of labour, operative vaginal deliveries and cesarean section would help in preventing PPH. The aim of this research was to assess the factors contributing to postpartum haemorrhage (PPH) among pregnant women who attend delivery services in Kampala International University Teaching Hospital (KIU-TH). This study used a cross-sectional descriptive design where by a cross-section of respondents involving 68 respondents were sampled to represent the target population, in these case women who received maternity service from KIU-TH. Only quantitative methods of data collection using questionnaires with closed ended questions were employed for both mothers and health workers. During the study period, 58 women who delivered in the unit and 20 women developed postpartum haemorrhage giving the frequency of postpartum haemorrhage 34.6%. The majority of the women 30% were between 30-34 years of age. Among the women who developed PPH retained placental tissues was the most common cause 50% followed by uterine atony which was 30%. The rest of the causes of PPH were laceration 20%. Postpartum haemorrhage is still a leading but preventable cause of maternal morbidity and mortality in our country due to underutilization of health facilities, the major cause is retained placental tissues followed by uterine atony.
Keywords: post-partum haemorrhage, pregnant women, delivering, Uganda
EFFECTIVENESS OF INTERMITTENT PREVENTIVE TREATMENT IN PREGNANCY WITH SULPHADO...oyepata
EFFECTIVENESS OF INTERMITTENT PREVENTIVE TREATMENT IN PREGNANCY WITH
SULPHADOXINE-PYRIMETHAMINE AGAINST MALARIA IN NORTHERN NIGERIA
Builder MI*1, Anzaku SA2 and Joseph SO1
This document summarizes a study on the clinical spectrum and risk factors of cerebral palsy in children. The study was conducted from 2013-2015 in India and included 100 children diagnosed with cerebral palsy. Key findings include: (1) Spastic cerebral palsy was the most common type seen in 81% of cases. (2) Quadriplegia was the most common topographical type. (3) Major risk factors for cerebral palsy included birth asphyxia (44%), low birth weight (33%), preterm birth (19%), and neonatal seizures (23%). This study provides insight into the types and causes of cerebral palsy affecting children in India.
— This study was conducted to find out if AFI ≤ 5 cms has any clinical significance in identifying the subsequent fetal distress & associated maternal & perinatal outcomes, in pregnancies beyond 37 weeks. Methodology: This is a prospective case control study done from July 2010 to July 2012 (24 months) at Dr Vasantrao Pawar Medical College, Hospital and Research Center. Adgaon, Nashik. It study the pregnancy outcome comparison of 58 Anenatal Cases(ANCs)as Study Group with diangosis of oligohydramnios (AFI ≤ 5 cms) by ultrasound after 37 completed weeks of gestation w e r e compared with 58 ANCs (Control Group) with no oligohydramnios (AFI > 5 cms). These two groups were matched for other variables like age, parity, gestational age and any pregnancy complication. Results: There was significant difference between two groups. Hypertension and Preeclampsia were found significantly more in ANCs with oligohydramnios. FHR deceleration was also significantly higher in women with oligohydramnios. Women require LSCS were also significantly more in women with oligohydramnios. Newborn borned by women with oligohydramnios had significantly more chances to admit in NICU than in newborn born by women without oligohydramnios. Conclusion: It can be concluded from this study that women with oligohydramnios poor pregancy outcomes. Determination of AFI can be used as an adjunct to other fetal surveillance methods. Determination of AFI can be used as valuable screening test for predicting fetal distress in labour, requiring caesarean section.
This document presents a proposal for a study to examine the prevalence of anemia and associated risk factors among pregnant women attending antenatal care at Shebel Berenta Primary Hospital in Ethiopia. The study will use a cross-sectional design to collect data from 283 pregnant women over 6 months using questionnaires, hemoglobin tests, and stool samples. The proposal describes the background, objectives, methodology, work plan, budget, and ethics of the study. Key objectives are to determine the prevalence of anemia during pregnancy and identify associated risk factors.
Medical Breakthroughs from the "Baliw na Baliw sa (Biotechnology) Research"Ourlad Alzeus Tantengco
This talk was given during the pre-event Symposium on Biotechnology in Healthcare by the Food and Development Administration of the Philippines.
Almost all of the medical innovations (i.e. medicine, vaccines, diagnostic tests etc) that are available to us are products of years of basic science and clinical research. Medical innovations have resulted in improved health and quality of life worldwide. These medical breakthroughs do not happen overnight. They require years of research and discovery and a huge amount of financial support to fund research facilities and human resources. This talk will introduce the long process of how biotechnology research is translated into clinics and public health. Current medical biotechnology researches in the Philippines and abroad will also be discussed. Some of the current medical biotechnology researches being conducted in the Philippines include rapid dengue diagnostic kits, Philippine herbal medicines, and Filipino cardiovascular genetics. These researches continuously revolutionize healthcare in the Philippines. Likewise, groundbreaking biotechnology researches from all other countries also open up new treatment and prevention for different diseases such as HIV, cancer, and metastases. These researches continue to advance modern medicine to address health and development issues worldwide. Continuous partnership and collaboration among the academe, industry, and the government is crucial in supporting more medical biotechnology researches that will provide cheaper and more efficient diagnostics, vaccines and medicines.
Exploring women's preferences for attributes of long-acting reversible contr...Olutosin Ademola Otekunrin
There is low LARC uptake in Nigeria and not much is documented about Nigerian women‟s preferences for these products and how these preferences affect women‟s choices. Therefore, the purpose of this study is to provide empirical evidence on the decision-making behavior of Nigerian women regarding LARCs. Three hypothetical LARCs were presented. Informed by results obtained from the review of relevant literature and focus group discussion held with selected family planning services providers, the identified attributes were effect on weight, cost, LARC effectiveness and effect on bleeding patterns, each at three levels. A D-optimal design was used to construct nine choice sets. An additional choice set was included to conduct the testretest stability test. The choice sets and other socio-demographic questions formed the discrete choice experiment questionnaire. A random sample of 150 eligible women was selected from women who enrolled and attended family planning clinics in public healthcare facilities in Ibadan, Nigeria through a three-stage sampling technique. Mixed logit modelling was used to obtain estimates of the parameters and willingness to pay (WTP) for each attribute was calculated. The test-retest stability result showed that 76.7% of the respondents responded in a consistent and rational manner. The women preferred LARCs that have no effect on their weights compared to LARCs that cause either slight weight loss or gain. Also, they preferred LARCs that offer 1/1000 level of effectiveness in a year. The most preferred attribute level, „women experience infrequent bleeding‟, increases WTP by NGN 13,984.584 (USD 33.68) while the least preferred level, „women experience frequent/prolonged bleeding‟, has a negative mean WTP (-NGN 19,598.378 (-USD 47.20)) indicating dispreference for the level. Furthermore, women derived higher utilities from very cheap LARCs. Evidence-based information on women‟s preferences regarding LARC usage would help policymakers in the deployment of strategies that would ensure that preferred LARCs are procured and made readily available to women.
Multicenter screening for pre-eclampsia by maternal factors and biomarkers at 11–13 weeks' gestation: comparison with NICE guidelines and ACOG recommendations
N. O'Gorman, D. Wright, L. C. Poon, D. L. Rolnik, A. Syngelaki, M. de Alvarado, I. F. Carbone, V. Dutemeyer, M. Fiolna, A. Frick, N. Karagiotis, S. Mastrodima, C. de Paco Matallana, G. Papaioannou, A. Pazos, W. Plasencia, K. H. Nicolaides
Volume 49, Issue 6, Pages 756–760
Slides prepared by Dr Fiona Brownfoot (UOG Editor-for-Trainees)
Read the free-access article: http://onlinelibrary.wiley.com/doi/10.1002/uog.17455/full
Community Midwifery and Prevention of Postpartum Hemorrhage_Kate Brickson_5.8.14CORE Group
This document summarizes information from a meeting on preventing postpartum hemorrhage (PPH). It discusses:
1) The leading causes of maternal death globally based on a WHO study, with severe bleeding during and after childbirth accounting for 27% of deaths.
2) MCHIP's comprehensive approach to PPH prevention, which promotes a package of interventions before, during, and after birth to prevent and manage PPH at both health facilities and in the community.
3) New WHO guidelines from 2012 that focus on uterotonic use immediately following birth to prevent PPH and allow misoprostol administration by community health workers.
This study analyzed 558 Pap smear reports from women ages 20-70 who presented to a gynecology clinic in Bangladesh from 2015-2016. Most women (70.2%) presented with chronic white discharge and itching. The majority (92.4%) of Pap smears showed inflammatory changes. Premalignant lesions were found in 3.7% of smears, including low-grade squamous intraepithelial lesions (LSIL) in 3% and high-grade squamous intraepithelial lesions (HSIL) in 0.7%. Suggestive of squamous cell carcinoma was seen in 0.7% of smears. The study concludes that Pap smear screening can effectively detect premalign
Neonatal and Obstetric Risk Assessment (NORA) Pregnancy Cohort Study in Singa...Premier Publishers
The Neonatal and Obstetric Risk Assessment (NORA) pregnancy cohort study was set up to assess clinical, biochemical and biophysical markers for risk assessment and prediction of the outcomes early in pregnancy. A total of 3271 patients who were in KK Women’s and Children’s Hospital between September 2010 and October 2014 were screened and 1013 patients consented to participate in the study. Women were followed at 18 to 22 weeks, 28 to 32 weeks and 34 weeks and above, till their postnatal discharge from the hospital. Finally, 926 patients remained for studying the outcome. In NORA study, we established locally derived and gestational age-specific reference intervals for the five thyroid hormone parameters. Higher serum progesterone levels at 28–32 weeks of pregnancy were observed in women who had preterm deliveries compared with women with term deliveries in the cohort. We also found that extracellular vesicle (EV) biomarkers enhanced the predictive robustness of an existing pre-eclampsia (PE) biomarker sufficiently to justify PE screening in a low-risk general obstetric population. We plan to further conduct a range of serial assessments from the biosamples which will provide a comprehensive and valuable information of the dynamics of maternal conditions and fetal development during pregnancy.
This study evaluated the pharmacokinetics of dapivirine, an antiretroviral drug, in lactating women using a dapivirine vaginal ring for 14 days. The study found:
1) Dapivirine was present at low concentrations in breast milk and plasma compared to cervicovaginal fluid.
2) The median estimated daily infant exposure to dapivirine through breast milk was 74.3 ng/kg/day (less than 1 microgram per day).
3) Use of the dapivirine vaginal ring was generally well-tolerated with few adverse events reported.
This study evaluated the pharmacokinetics of dapivirine, an antiretroviral drug, in lactating women using a dapivirine vaginal ring for 14 days. The study found:
1) Dapivirine was present at low concentrations in breast milk and plasma compared to cervicovaginal fluid.
2) The median estimated daily infant exposure to dapivirine through breast milk was 74.3 ng/kg/day (less than 1 microgram per day).
3) Use of the dapivirine vaginal ring was well-tolerated with few adverse events reported, none requiring ring removal.
Need assesment of obstetric fisutla in NepalWOREC Nepal
This document provides a summary of a needs assessment report on obstetric fistula in Nepal that was conducted from November 1st to December 16th, 2011. Some key findings include:
1. It is estimated that there are 200-400 new cases of obstetric fistula in Nepal each year, leading to an overall prevalence of 4,300 cases.
2. The assessment found that obstetric fistula surgery is performed at three sites but none of the sites address all five pillars of prevention, management, reintegration, training, and research.
3. While surgery is available, there remains a need for improved training, nursing care, and surgical protocols. Coordination of efforts to address obst
This study examined maternal and fetal outcomes in term premature rupture of membranes (PROM) using medical records from a hospital in Ethiopia between 2011-2013. The study found that 22.2% of women experienced unfavorable maternal outcomes like puerperal sepsis. 33.5% of neonates experienced unfavorable outcomes like stillbirth. Factors associated with unfavorable outcomes included residing in a rural area, duration of PROM over 12 hours, latency over 24 hours, and birth weight under 2500g. The study aims to identify factors that can help reduce complications from term PROM and improve outcomes.
Pregnancy outcome in women presenting with reduced fetal movements.
The study aims to evaluate maternal and perinatal outcomes in pregnant women presenting primarily with reduced fetal movements in the third trimester. Women experiencing reduced fetal movements will undergo assessments including CTG, ultrasound, and Doppler to evaluate fetal well-being. Pregnancy outcomes such as gestational age at delivery, mode of delivery, birthweight, and complications will be analyzed. The results could help improve management of reduced fetal movement cases in the future.
This study compared the cost-effectiveness of Giemsa and Field's staining techniques for malaria diagnosis among 243 children in Uganda. The study found that Field's staining technique was more cost-effective, correctly diagnosing 93.4% of cases at a cost of $0.030 per test, while Giemsa correctly diagnosed 94.7% of cases but at a higher cost of $0.769 per test. The incremental cost-effectiveness ratio of using Giemsa over Field's was $0.35 per additional correctly diagnosed case. Based on these findings, the study recommends continued use of the more cost-effective Field's staining technique for malaria diagnosis in resource-limited settings with high malaria burdens like Uganda
Making long term family planning methods accessible to rural communities to r...John Bako
The document summarizes a project in Nigeria that aimed to increase access to long-term family planning methods in rural communities to reduce the country's high maternal mortality rate. The project was implemented in 3 local government areas over 5 years. It trained community members and healthcare providers on family planning. Over 1,000 people received counseling and chose methods like IUDs, implants or pills. IUD uptake was highest at 57.1%. The project revealed a need for increased education on family planning and the safety of methods, in order to address issues like high fertility rates, abortion being used as contraception, and lack of male involvement in rural areas. Increasing access to affordable, long-acting methods could significantly improve maternal and child
Making long term family planning methods accessible to rural communities to r...John Bako
The document summarizes a project in Nigeria that aimed to increase access to long-term family planning methods in rural communities to reduce the country's high maternal mortality rate. The project was implemented in 3 local government areas over 5 years. It trained community members and healthcare providers and provided counseling and family planning services. Over 1,000 people received information on methods like IUDs, implants, and pills. Uptake of IUDs was highest at 57.1%, while 11.1% chose implants and 31.8% pills. The recommendations emphasize the need for increased access to family planning education, methods, and services especially in rural areas through public education programs, affordable options, and consistent contraceptive supplies.
HWANG Chung Cheng Jordan, RN, MN, Adv. Dip. (Oncology),
Advanced Practice Nurse – Haematology
Division of Nursing
Department of Haematology
Singapore General Hospital, Singapore
30th October 2016
This research article examines alterations in reproductive hormones during pregnancy and the risk of preeclampsia. The study followed 79 preeclamptic women and 80 healthy pregnant controls longitudinally from the third trimester through 6 weeks postpartum. Blood samples were taken at each visit and analyzed for beta-hCG, oestriol, progesterone and prolactin levels. Results showed beta-hCG and oestriol levels were significantly altered in the preeclamptic group compared to controls in the first and third trimesters respectively, indicating these hormones may help identify risk of preeclampsia earlier in pregnancy. The study aims to determine the gestational age at which hormonal changes occur that are associated with developing preecl
Diagnostic accuracy of placental growth factor and ultrasound parameters to predict the small-for-gestational-age infant in women presenting with reduced symphysis–fundus height
M. Griffin, P. T. Seed, L. Webster, J. Myers, L. MacKillop, N. Simpson, D. Anumba, A. Khalil, M. Denbow, A. Sau, K. Hinshaw, P. von Dadelszen, S. Benton, J. Girling, C. W. G. Redman, L. C. Chappell and A. H. Shennan
Volume 46, Issue 2, pages 182–190, August 2015
Link to free-access article: http://onlinelibrary.wiley.com/doi/10.1002/uog.14860/full
Study of Incidence and Etiology of Prolapse at Rural Based Teaching Hospitaltheijes
In our country as large number of woman deliver at home, usually conducted by untrained dias, incidence of prolapse is higher. The etiology of prolapse was discussed by ARETAEUS, a Greek physician who believed procedentiato be result of weakness of ligaments of the uterus. There are multiple etiological factors in the developed of prolapse. Diagnosis of prolapse at the earliest will help to reduce the complications of prolapse as well as continue child bearing function of the young woman.
Observational and laboratory studies suggest that some hormonal contraceptive methods, particularly
intramuscular depot medroxyprogesterone acetate (DMPA-IM), might increase women’s susceptibility to HIV
acquisition.
Incidence of Neonatal Septicemia in Babies Admitted in Pediatric Ward of KIU...PUBLISHERJOURNAL
This research was done to determine factors that influence the occurrence of neonatal septicemia among babies admitted in Kampala international university teaching hospital. This study was guided by the following objectives: to assess the maternal related factors associated with occurrence of neonatal septicemia among babies admitted in Pediatric ward of Kampala international university teaching hospital; to determine neonatal related factors associated with occurrence of neonatal septicemia among babies admitted in Pediatric ward of Kampala international university teaching hospital and to determine the social-economic factors associated with occurrence of neonatal septicemia among babies admitted in Pediatric ward of Kampala international university teaching hospital. A cross sectional study design was used in this study; A sample of 134 respondents were studied which included neonates/caretakers and health workers; data was collected with the use of observation, interview guide and questionnaires; data analysis and interpretation were done using Statistical package for social sciences (SPSS) to generate descriptive statistics and Chi-square p-values that were used to draw conclusion of the study. The results from this research showed that; - the maternal factors that influenced the occurrence of neonatal septicemia among babies admitted in pediatric ward of Kampala international university teaching hospital were inadequate Antenatal Care (ANC) attendance, prolonged rupture of membrane, bathing neonates with herbal medicines and place of delivery whereby a significant number of mothers delivered from home. On the neonatal factors the researcher found out that birth weight had a significant influence on the occurrence of neonatal septicemia among babies admitted in pediatric ward of Kampala international university teaching hospital. Finally, the study identified the socio-economic factors responsible for the occurrence of neonatal septicemia among babies admitted in pediatric ward of Kampala international university teaching hospital as washing hands before handling the neonates, low level of monthly household income and low level of education among caretakers. Based on the findings of this study, the researcher recommends that the Government through the DHOs offices should embark on health education by educating the pregnant women on the dangers of giving birth from their homes and also being helped by unqualified midwives. Also, the government through district sensitization programs should encourage pregnant women to seek antenatal care at the health facilities where they can be health educated, comprehensively screened and treated of infections to prevent spread of infections to newborns.
Keywords: Pediatric, Septicemia, Pregnant Women, Health Education, Antenatal care.
________________________________________
The document discusses the Indian Council of Medical Research's (ICMR) efforts to strengthen health research capacity and support innovation to improve health systems in India. Some key points:
1) ICMR aims to translate research into actions to improve population health and achieve universal healthcare by developing cost-effective technologies and innovations.
2) Its strategic framework focuses on strengthening research capacity, organizing data systems, leveraging traditional medicine, enabling evidence-based policy, and using research to strengthen health programs.
3) ICMR supports research on priority health issues like non-communicable diseases, maternal and child health, and infectious diseases through various initiatives and collaborations.
4) It develops and showcases indigenous medical
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
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Exploring women's preferences for attributes of long-acting reversible contr...Olutosin Ademola Otekunrin
There is low LARC uptake in Nigeria and not much is documented about Nigerian women‟s preferences for these products and how these preferences affect women‟s choices. Therefore, the purpose of this study is to provide empirical evidence on the decision-making behavior of Nigerian women regarding LARCs. Three hypothetical LARCs were presented. Informed by results obtained from the review of relevant literature and focus group discussion held with selected family planning services providers, the identified attributes were effect on weight, cost, LARC effectiveness and effect on bleeding patterns, each at three levels. A D-optimal design was used to construct nine choice sets. An additional choice set was included to conduct the testretest stability test. The choice sets and other socio-demographic questions formed the discrete choice experiment questionnaire. A random sample of 150 eligible women was selected from women who enrolled and attended family planning clinics in public healthcare facilities in Ibadan, Nigeria through a three-stage sampling technique. Mixed logit modelling was used to obtain estimates of the parameters and willingness to pay (WTP) for each attribute was calculated. The test-retest stability result showed that 76.7% of the respondents responded in a consistent and rational manner. The women preferred LARCs that have no effect on their weights compared to LARCs that cause either slight weight loss or gain. Also, they preferred LARCs that offer 1/1000 level of effectiveness in a year. The most preferred attribute level, „women experience infrequent bleeding‟, increases WTP by NGN 13,984.584 (USD 33.68) while the least preferred level, „women experience frequent/prolonged bleeding‟, has a negative mean WTP (-NGN 19,598.378 (-USD 47.20)) indicating dispreference for the level. Furthermore, women derived higher utilities from very cheap LARCs. Evidence-based information on women‟s preferences regarding LARC usage would help policymakers in the deployment of strategies that would ensure that preferred LARCs are procured and made readily available to women.
Multicenter screening for pre-eclampsia by maternal factors and biomarkers at 11–13 weeks' gestation: comparison with NICE guidelines and ACOG recommendations
N. O'Gorman, D. Wright, L. C. Poon, D. L. Rolnik, A. Syngelaki, M. de Alvarado, I. F. Carbone, V. Dutemeyer, M. Fiolna, A. Frick, N. Karagiotis, S. Mastrodima, C. de Paco Matallana, G. Papaioannou, A. Pazos, W. Plasencia, K. H. Nicolaides
Volume 49, Issue 6, Pages 756–760
Slides prepared by Dr Fiona Brownfoot (UOG Editor-for-Trainees)
Read the free-access article: http://onlinelibrary.wiley.com/doi/10.1002/uog.17455/full
Community Midwifery and Prevention of Postpartum Hemorrhage_Kate Brickson_5.8.14CORE Group
This document summarizes information from a meeting on preventing postpartum hemorrhage (PPH). It discusses:
1) The leading causes of maternal death globally based on a WHO study, with severe bleeding during and after childbirth accounting for 27% of deaths.
2) MCHIP's comprehensive approach to PPH prevention, which promotes a package of interventions before, during, and after birth to prevent and manage PPH at both health facilities and in the community.
3) New WHO guidelines from 2012 that focus on uterotonic use immediately following birth to prevent PPH and allow misoprostol administration by community health workers.
This study analyzed 558 Pap smear reports from women ages 20-70 who presented to a gynecology clinic in Bangladesh from 2015-2016. Most women (70.2%) presented with chronic white discharge and itching. The majority (92.4%) of Pap smears showed inflammatory changes. Premalignant lesions were found in 3.7% of smears, including low-grade squamous intraepithelial lesions (LSIL) in 3% and high-grade squamous intraepithelial lesions (HSIL) in 0.7%. Suggestive of squamous cell carcinoma was seen in 0.7% of smears. The study concludes that Pap smear screening can effectively detect premalign
Neonatal and Obstetric Risk Assessment (NORA) Pregnancy Cohort Study in Singa...Premier Publishers
The Neonatal and Obstetric Risk Assessment (NORA) pregnancy cohort study was set up to assess clinical, biochemical and biophysical markers for risk assessment and prediction of the outcomes early in pregnancy. A total of 3271 patients who were in KK Women’s and Children’s Hospital between September 2010 and October 2014 were screened and 1013 patients consented to participate in the study. Women were followed at 18 to 22 weeks, 28 to 32 weeks and 34 weeks and above, till their postnatal discharge from the hospital. Finally, 926 patients remained for studying the outcome. In NORA study, we established locally derived and gestational age-specific reference intervals for the five thyroid hormone parameters. Higher serum progesterone levels at 28–32 weeks of pregnancy were observed in women who had preterm deliveries compared with women with term deliveries in the cohort. We also found that extracellular vesicle (EV) biomarkers enhanced the predictive robustness of an existing pre-eclampsia (PE) biomarker sufficiently to justify PE screening in a low-risk general obstetric population. We plan to further conduct a range of serial assessments from the biosamples which will provide a comprehensive and valuable information of the dynamics of maternal conditions and fetal development during pregnancy.
This study evaluated the pharmacokinetics of dapivirine, an antiretroviral drug, in lactating women using a dapivirine vaginal ring for 14 days. The study found:
1) Dapivirine was present at low concentrations in breast milk and plasma compared to cervicovaginal fluid.
2) The median estimated daily infant exposure to dapivirine through breast milk was 74.3 ng/kg/day (less than 1 microgram per day).
3) Use of the dapivirine vaginal ring was generally well-tolerated with few adverse events reported.
This study evaluated the pharmacokinetics of dapivirine, an antiretroviral drug, in lactating women using a dapivirine vaginal ring for 14 days. The study found:
1) Dapivirine was present at low concentrations in breast milk and plasma compared to cervicovaginal fluid.
2) The median estimated daily infant exposure to dapivirine through breast milk was 74.3 ng/kg/day (less than 1 microgram per day).
3) Use of the dapivirine vaginal ring was well-tolerated with few adverse events reported, none requiring ring removal.
Need assesment of obstetric fisutla in NepalWOREC Nepal
This document provides a summary of a needs assessment report on obstetric fistula in Nepal that was conducted from November 1st to December 16th, 2011. Some key findings include:
1. It is estimated that there are 200-400 new cases of obstetric fistula in Nepal each year, leading to an overall prevalence of 4,300 cases.
2. The assessment found that obstetric fistula surgery is performed at three sites but none of the sites address all five pillars of prevention, management, reintegration, training, and research.
3. While surgery is available, there remains a need for improved training, nursing care, and surgical protocols. Coordination of efforts to address obst
This study examined maternal and fetal outcomes in term premature rupture of membranes (PROM) using medical records from a hospital in Ethiopia between 2011-2013. The study found that 22.2% of women experienced unfavorable maternal outcomes like puerperal sepsis. 33.5% of neonates experienced unfavorable outcomes like stillbirth. Factors associated with unfavorable outcomes included residing in a rural area, duration of PROM over 12 hours, latency over 24 hours, and birth weight under 2500g. The study aims to identify factors that can help reduce complications from term PROM and improve outcomes.
Pregnancy outcome in women presenting with reduced fetal movements.
The study aims to evaluate maternal and perinatal outcomes in pregnant women presenting primarily with reduced fetal movements in the third trimester. Women experiencing reduced fetal movements will undergo assessments including CTG, ultrasound, and Doppler to evaluate fetal well-being. Pregnancy outcomes such as gestational age at delivery, mode of delivery, birthweight, and complications will be analyzed. The results could help improve management of reduced fetal movement cases in the future.
This study compared the cost-effectiveness of Giemsa and Field's staining techniques for malaria diagnosis among 243 children in Uganda. The study found that Field's staining technique was more cost-effective, correctly diagnosing 93.4% of cases at a cost of $0.030 per test, while Giemsa correctly diagnosed 94.7% of cases but at a higher cost of $0.769 per test. The incremental cost-effectiveness ratio of using Giemsa over Field's was $0.35 per additional correctly diagnosed case. Based on these findings, the study recommends continued use of the more cost-effective Field's staining technique for malaria diagnosis in resource-limited settings with high malaria burdens like Uganda
Making long term family planning methods accessible to rural communities to r...John Bako
The document summarizes a project in Nigeria that aimed to increase access to long-term family planning methods in rural communities to reduce the country's high maternal mortality rate. The project was implemented in 3 local government areas over 5 years. It trained community members and healthcare providers on family planning. Over 1,000 people received counseling and chose methods like IUDs, implants or pills. IUD uptake was highest at 57.1%. The project revealed a need for increased education on family planning and the safety of methods, in order to address issues like high fertility rates, abortion being used as contraception, and lack of male involvement in rural areas. Increasing access to affordable, long-acting methods could significantly improve maternal and child
Making long term family planning methods accessible to rural communities to r...John Bako
The document summarizes a project in Nigeria that aimed to increase access to long-term family planning methods in rural communities to reduce the country's high maternal mortality rate. The project was implemented in 3 local government areas over 5 years. It trained community members and healthcare providers and provided counseling and family planning services. Over 1,000 people received information on methods like IUDs, implants, and pills. Uptake of IUDs was highest at 57.1%, while 11.1% chose implants and 31.8% pills. The recommendations emphasize the need for increased access to family planning education, methods, and services especially in rural areas through public education programs, affordable options, and consistent contraceptive supplies.
HWANG Chung Cheng Jordan, RN, MN, Adv. Dip. (Oncology),
Advanced Practice Nurse – Haematology
Division of Nursing
Department of Haematology
Singapore General Hospital, Singapore
30th October 2016
This research article examines alterations in reproductive hormones during pregnancy and the risk of preeclampsia. The study followed 79 preeclamptic women and 80 healthy pregnant controls longitudinally from the third trimester through 6 weeks postpartum. Blood samples were taken at each visit and analyzed for beta-hCG, oestriol, progesterone and prolactin levels. Results showed beta-hCG and oestriol levels were significantly altered in the preeclamptic group compared to controls in the first and third trimesters respectively, indicating these hormones may help identify risk of preeclampsia earlier in pregnancy. The study aims to determine the gestational age at which hormonal changes occur that are associated with developing preecl
Diagnostic accuracy of placental growth factor and ultrasound parameters to predict the small-for-gestational-age infant in women presenting with reduced symphysis–fundus height
M. Griffin, P. T. Seed, L. Webster, J. Myers, L. MacKillop, N. Simpson, D. Anumba, A. Khalil, M. Denbow, A. Sau, K. Hinshaw, P. von Dadelszen, S. Benton, J. Girling, C. W. G. Redman, L. C. Chappell and A. H. Shennan
Volume 46, Issue 2, pages 182–190, August 2015
Link to free-access article: http://onlinelibrary.wiley.com/doi/10.1002/uog.14860/full
Study of Incidence and Etiology of Prolapse at Rural Based Teaching Hospitaltheijes
In our country as large number of woman deliver at home, usually conducted by untrained dias, incidence of prolapse is higher. The etiology of prolapse was discussed by ARETAEUS, a Greek physician who believed procedentiato be result of weakness of ligaments of the uterus. There are multiple etiological factors in the developed of prolapse. Diagnosis of prolapse at the earliest will help to reduce the complications of prolapse as well as continue child bearing function of the young woman.
Observational and laboratory studies suggest that some hormonal contraceptive methods, particularly
intramuscular depot medroxyprogesterone acetate (DMPA-IM), might increase women’s susceptibility to HIV
acquisition.
Incidence of Neonatal Septicemia in Babies Admitted in Pediatric Ward of KIU...PUBLISHERJOURNAL
This research was done to determine factors that influence the occurrence of neonatal septicemia among babies admitted in Kampala international university teaching hospital. This study was guided by the following objectives: to assess the maternal related factors associated with occurrence of neonatal septicemia among babies admitted in Pediatric ward of Kampala international university teaching hospital; to determine neonatal related factors associated with occurrence of neonatal septicemia among babies admitted in Pediatric ward of Kampala international university teaching hospital and to determine the social-economic factors associated with occurrence of neonatal septicemia among babies admitted in Pediatric ward of Kampala international university teaching hospital. A cross sectional study design was used in this study; A sample of 134 respondents were studied which included neonates/caretakers and health workers; data was collected with the use of observation, interview guide and questionnaires; data analysis and interpretation were done using Statistical package for social sciences (SPSS) to generate descriptive statistics and Chi-square p-values that were used to draw conclusion of the study. The results from this research showed that; - the maternal factors that influenced the occurrence of neonatal septicemia among babies admitted in pediatric ward of Kampala international university teaching hospital were inadequate Antenatal Care (ANC) attendance, prolonged rupture of membrane, bathing neonates with herbal medicines and place of delivery whereby a significant number of mothers delivered from home. On the neonatal factors the researcher found out that birth weight had a significant influence on the occurrence of neonatal septicemia among babies admitted in pediatric ward of Kampala international university teaching hospital. Finally, the study identified the socio-economic factors responsible for the occurrence of neonatal septicemia among babies admitted in pediatric ward of Kampala international university teaching hospital as washing hands before handling the neonates, low level of monthly household income and low level of education among caretakers. Based on the findings of this study, the researcher recommends that the Government through the DHOs offices should embark on health education by educating the pregnant women on the dangers of giving birth from their homes and also being helped by unqualified midwives. Also, the government through district sensitization programs should encourage pregnant women to seek antenatal care at the health facilities where they can be health educated, comprehensively screened and treated of infections to prevent spread of infections to newborns.
Keywords: Pediatric, Septicemia, Pregnant Women, Health Education, Antenatal care.
________________________________________
The document discusses the Indian Council of Medical Research's (ICMR) efforts to strengthen health research capacity and support innovation to improve health systems in India. Some key points:
1) ICMR aims to translate research into actions to improve population health and achieve universal healthcare by developing cost-effective technologies and innovations.
2) Its strategic framework focuses on strengthening research capacity, organizing data systems, leveraging traditional medicine, enabling evidence-based policy, and using research to strengthen health programs.
3) ICMR supports research on priority health issues like non-communicable diseases, maternal and child health, and infectious diseases through various initiatives and collaborations.
4) It develops and showcases indigenous medical
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One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
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1. VALIDATION OF A PRE-ECLAMPSIA MONITORING TOOL
(PETOGRAPH) AMONG PREGNANT MOTHERS IN JINJA
REGIONAL REFERRAL HOSPITAL: A CROSS-SECTIONAL STUDY
Presented at
AOGU ANNUAL SCIENTIFIC CONFERENCE 2017
By
Abubakar Suleiman Tsamiya
Principal Director GPI
2. Suleiman Abubakar-Tsamiya1,2, Shilpy Chakraborty3, Nirav Hitesh Kumar
Valand3; Marta Vicente-Crespo2, 3, #
1School of Clinical Medicine, Kampala International University Western
Campus, Ishaka, Uganda;
2Global Pre-Eclampsia Initiative, Kampala, Uganda;
3School of Medicine, St. Augustine International University, Kampala,
Uganda;
#corresponding author: mvicentecrespo@saiu.ac.ug
3. TOP 10 COUNTRIES IN THE WORLD
WITH THE HIGHEST MATERNAL DEATH 13% CAUSED BY PRE-ECLAMPSIA
Nigeria
33%
India
25%
DR CONGO
12%
Ethiopia
6%
Pakistan 5%
Tanzania 5%
Kenya 5%
Uganda
3%
Bangladesh
3%
Chad 3%
MDG MORTALITY REVIEW 2015
4. BOTTLE NECKS TO
REDUCING PRE-ECLAMPSIA BURDEN
EXTERNAL BOTTLE NECKS
SCARCE
DATA
POOR FUNDING
FEW
RESEARCHES
INTERNAL BOTTLE NECKS
Maternal
Morbidity
and Mortality
from Pre-
eclampsia
Delay in
Detection
Late
Referral
Poor
Manage
ment
Inefficient
Follow-up
5. BACKGROUND
Pre-eclampsia: 1st cause of preventable maternal death in developed countries, 2nd
in developing countries.
pre-eclampsia claims the lives of more than 70,000 women per year (1 per 6min)
and more than 500,000 of their fetuses and newborns.
Complicates 2-10% of All Pregnancies
key variables that need improvement (FIGO report 2016):
early detection;
timely referral;
appropriate management;
efficient follow up.
We propose a series of measures to address the identified four stages in the clinical
course of the disease reporting.
In this paper: preliminary validation of the Petograph™ form, a monitoring tool for
appropriate management of pre-eclampsia in low resource environments.
6. METHODS
A cross-sectional study was carried out using a systematic
sampling for a period of 1 year (between July 2016 and
June 2017).
At Jinja Regional Referral Hospital Uganda in July 2017
169 pre-eclamptic mothers out of 4987 deliveries
A checklist was used to correlate the information found on
the PETOGRAPH™ to that of the existing patient records.
8. Current records vs Petograph™
100 100 100 100
16
33
27.5
4
0
20
40
60
80
100
120
Clinical Presentations Feto-maternal wellbeing Management Modalities &
Outcome
Baseline Investigations
Percentage
Coverage
Record Parameter
PETOGRAPH EXISTING RECORD SYSTEM Linear (PETOGRAPH)
9. CONCLUSIONS
1. There were big gaps in the medical records available for the pre-
eclampsia patients that received attention at the Jinja Regional
Referral Hospital.
2. Most of the records are missing key information about the
management and outcome of the disease, which would be most
helpful in investigations about risk factors and disease progression
markers.
3. The Petograph™ form would provide a clear template to guide the
data recording exercise and facilitate appropriate management of
the disease as it is developing and more inquisitive research on the
disease afterwards.
10. RECOMMENDATIONS
1. Holistic Approach to tackle hypertensive disorders in pregnancy
2. Ensure inter-professional collaboration (E.g. Ugandan Heart
Institute, “National Kidney Institute”)
3. Technical collaboration with relevant Organizations Like Global
Preeclampsia Initiative (GPI)- PETOGRAPH™
4. Design, Develop and Dedicate to an “African Roadmap” that is
non external donor dependent to combat the threat of Pre-
eclampsia in Uganda, Africa and the world in collaboration with
GPI (African Centre for Preeclampsia Research)
11. WAY FORWARD USING PETOGRAPH
Poor
Management and
Inefficient
Follow-up
• PETOGRAPH Form
• PETOGRAPH Desktop Application
• PETOGRAPH Android Application
Delay in
Detection
• PETOGRAPH
Android Application Late
Referral
• PETOGRAPH Android
Application
13. SUMMARY
• Uganda is the 8th Country with highest Maternal Death in the World
• A mother dies of Pre-eclampsia every 6 minutes
• External and Internal Bottle Neck towards reduction of maternal Mortality
and Morbidity identified
• A cross-sectional study carried out At Jinja Regional Referral Hospital
Uganda in July 2017 to validate an innovative tool the PETOGRAPH™
• Significant gaps were identified in the existing medical record.
• The Petograph™ innovation could be used to address the global mystery of
preeclampsia.
• Holistic Approach, inter-professional collaboration, strategic partnerships
and “African Approach” Identified as key players in Achieving SDG 3.1
(From 366 to 70 per100,000 live Birth).
14. ACKNOWLEDGMENT
GPI BOARD
Professor Sadiq Yusuf
Professor Ahmed Adedeji
Dr Marta Vicente-Crespo
Dr Aluonzi Burhan
Lucy Den Teuling
Immaculate Tusiime
Abubakar Suleiman Tsamiya
PETOGRAPH TEAM
Professor Ivan Bonet Fonseca
Dr Marta Vicente-Crespo
Mugasho Lincoln,
Saviour Muzoora
Aliyu Usman Muhammad
Mugizi Maurice
Mukhaye Miria Viveca
Abubakar Suleiman Tsamiya