Obstetrics fistula is one of the most serious and tragic childbirth injuries. It is a hole between the birth canal and bladder or rectum caused by prolonged, obstructed labour, without access to timely, high-quality medical treatment. It leaves women leaking urine, faeces or both and often leads to chronic medical problems, depression, social isolation and deepening poverty. The goal of this research is to develop a Fuzzy logic means for intelligent diagnosis of Obstetrics fistula disease. In the study we presented the architecture of the FCM system for the diagnosis of Obstetrics Fistula. It comprises of knowledge base system, fuzzy c-means inference engine and decision support system. The knowledge base system holds the symptoms for Obstetrics Fistula. The expert system is developed in an environment characterized by Microsoft XP Professional operating system, Microsoft Access Database Management System, Visual BASIC Application Language and Microsoft Excel.
Women in Burkina Faso who experienced life-threatening complications during childbirth faced significant financial and social hardships even if they survived. The costs of emergency care often plunged families deeper into poverty, as women had to pay at least part of the bills and missed work during their recovery. While Burkina Faso adopted a policy in 2006 to subsidize delivery and emergency obstetric care costs, many poor women did not benefit due to lack of awareness about the policy and which women qualified for full exemption from fees. Surviving such complications compromised women's social status and roles within their families and communities.
Determinants of Maternal mortality in SomaliaOmar Osman Eid
This document analyzes the determinants of maternal mortality in Somalia from 1990-2015. It finds that socioeconomic factors like poverty and lack of education, as well as cultural factors like gender inequality, contribute significantly to maternal deaths in Somalia. Physical barriers like limited transportation and long distances to health facilities also restrict access to prenatal and postnatal care. The document concludes that increasing GDP, lowering fertility rates, reducing HIV prevalence, expanding education for girls, discouraging early pregnancies, and increasing access to healthcare can help reduce Somalia's high maternal mortality ratio.
This document discusses the public health consequences of abortion in Myanmar. It notes that abortion is illegal except to save a woman's life, and many women resort to unsafe methods performed by traditional birth attendants. This can result in incomplete abortions, bleeding, infections and even death. While some emergency treatment services exist in hospitals, they are difficult to access. Introducing misoprostol or manual vacuum aspiration at primary health centers could help manage abortion complications since these methods are effective, easy to use, and don't require physicians. Overall, reducing unwanted pregnancies through family planning and counseling, as well as expanding post-abortion care, could help address the health impacts of unsafe abortion in Myanmar.
This document discusses abortion and post-abortion care. It defines abortion and classifies the different types. It also discusses the magnitude of abortion globally and in Africa and Ethiopia. It then covers spontaneous abortion, including risk factors and potential causes. It discusses the clinical features and diagnosis of abortion. It defines post-abortion care and its five key elements. It notes that unsafe abortion is a major cause of maternal mortality worldwide and in East Africa.
Maternal mortality and morbidity are serious issues globally. Maternal mortality is defined as the death of a woman during pregnancy or within 42 days of termination from any cause related to the pregnancy. Maternal deaths are classified as direct, indirect, or fortuitous. Direct deaths result from obstetric complications while indirect deaths result from pre-existing or pregnancy-aggravated conditions. Major causes of maternal mortality include obstetric complications like hemorrhage and infections as well as social factors like poverty, illiteracy, and lack of access to medical care. Preventive measures include antenatal care, treatment of medical conditions, institutional deliveries, and promotion of family planning. Nurses play an important role in providing anten
Risk Factors and Pregnancy Outcome of Preterm Laboriosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Maternal mortality remains a significant issue worldwide, with over 500,000 deaths annually. Through initiatives like the Confidential Enquiries into Maternal Deaths system, Malaysia has significantly reduced its maternal mortality rate from 540/100,000 live births in 1950 to 28.1/100,000 in 2000. Postpartum hemorrhage is a leading cause of death in Malaysia, while medical conditions, sepsis, and hypertensive disorders also contribute substantially. Recommendations focus on increasing access to emergency care and transportation, improving provider training, and expanding family planning programs.
Maternal mortality refers to the death of a woman during pregnancy, childbirth or within 42 days of termination of pregnancy. Some key points:
- Causes of maternal mortality include hemorrhage, sepsis, unsafe abortion, obstructed labor, eclampsia, and complications from existing medical conditions.
- Maternal mortality is highest in Sub-Saharan Africa, where 1 in 16 women face the risk of dying from pregnancy or childbirth-related causes.
- In India, an estimated woman dies every seven minutes from pregnancy or childbirth complications. The maternal mortality ratio in India is around 200 per 100,000 live births.
- Prevention strategies focus on increasing access to antenatal
Women in Burkina Faso who experienced life-threatening complications during childbirth faced significant financial and social hardships even if they survived. The costs of emergency care often plunged families deeper into poverty, as women had to pay at least part of the bills and missed work during their recovery. While Burkina Faso adopted a policy in 2006 to subsidize delivery and emergency obstetric care costs, many poor women did not benefit due to lack of awareness about the policy and which women qualified for full exemption from fees. Surviving such complications compromised women's social status and roles within their families and communities.
Determinants of Maternal mortality in SomaliaOmar Osman Eid
This document analyzes the determinants of maternal mortality in Somalia from 1990-2015. It finds that socioeconomic factors like poverty and lack of education, as well as cultural factors like gender inequality, contribute significantly to maternal deaths in Somalia. Physical barriers like limited transportation and long distances to health facilities also restrict access to prenatal and postnatal care. The document concludes that increasing GDP, lowering fertility rates, reducing HIV prevalence, expanding education for girls, discouraging early pregnancies, and increasing access to healthcare can help reduce Somalia's high maternal mortality ratio.
This document discusses the public health consequences of abortion in Myanmar. It notes that abortion is illegal except to save a woman's life, and many women resort to unsafe methods performed by traditional birth attendants. This can result in incomplete abortions, bleeding, infections and even death. While some emergency treatment services exist in hospitals, they are difficult to access. Introducing misoprostol or manual vacuum aspiration at primary health centers could help manage abortion complications since these methods are effective, easy to use, and don't require physicians. Overall, reducing unwanted pregnancies through family planning and counseling, as well as expanding post-abortion care, could help address the health impacts of unsafe abortion in Myanmar.
This document discusses abortion and post-abortion care. It defines abortion and classifies the different types. It also discusses the magnitude of abortion globally and in Africa and Ethiopia. It then covers spontaneous abortion, including risk factors and potential causes. It discusses the clinical features and diagnosis of abortion. It defines post-abortion care and its five key elements. It notes that unsafe abortion is a major cause of maternal mortality worldwide and in East Africa.
Maternal mortality and morbidity are serious issues globally. Maternal mortality is defined as the death of a woman during pregnancy or within 42 days of termination from any cause related to the pregnancy. Maternal deaths are classified as direct, indirect, or fortuitous. Direct deaths result from obstetric complications while indirect deaths result from pre-existing or pregnancy-aggravated conditions. Major causes of maternal mortality include obstetric complications like hemorrhage and infections as well as social factors like poverty, illiteracy, and lack of access to medical care. Preventive measures include antenatal care, treatment of medical conditions, institutional deliveries, and promotion of family planning. Nurses play an important role in providing anten
Risk Factors and Pregnancy Outcome of Preterm Laboriosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Maternal mortality remains a significant issue worldwide, with over 500,000 deaths annually. Through initiatives like the Confidential Enquiries into Maternal Deaths system, Malaysia has significantly reduced its maternal mortality rate from 540/100,000 live births in 1950 to 28.1/100,000 in 2000. Postpartum hemorrhage is a leading cause of death in Malaysia, while medical conditions, sepsis, and hypertensive disorders also contribute substantially. Recommendations focus on increasing access to emergency care and transportation, improving provider training, and expanding family planning programs.
Maternal mortality refers to the death of a woman during pregnancy, childbirth or within 42 days of termination of pregnancy. Some key points:
- Causes of maternal mortality include hemorrhage, sepsis, unsafe abortion, obstructed labor, eclampsia, and complications from existing medical conditions.
- Maternal mortality is highest in Sub-Saharan Africa, where 1 in 16 women face the risk of dying from pregnancy or childbirth-related causes.
- In India, an estimated woman dies every seven minutes from pregnancy or childbirth complications. The maternal mortality ratio in India is around 200 per 100,000 live births.
- Prevention strategies focus on increasing access to antenatal
Maternal mortality remains a significant global issue, with nearly 830 women dying daily from preventable causes related to pregnancy and childbirth. The majority (99%) of maternal deaths occur in developing countries, where access to skilled healthcare is limited. Key factors that influence a woman's risk include her location (rural areas pose higher risk), economic status (poorer communities at higher risk), and age (adolescents at highest risk). While the global maternal mortality ratio has declined 44% between 1990-2015, many countries still show no progress. Reliable data remains scarce but interventions like skilled birth attendance and access to family planning can significantly reduce maternal deaths.
Maternal mortality is defined as the death of a woman during pregnancy or within 42 days of termination of pregnancy from pregnancy-related causes. The three main causes of maternal death globally are hemorrhage, sepsis, and hypertensive disorders. In India, maternal mortality rates are highest in rural areas where access to healthcare is limited. The three delay model explains that maternal deaths are often due to delays in seeking care, reaching care, and receiving adequate care. Reducing maternal mortality requires improving access to emergency obstetric care, family planning services, and addressing social determinants like gender inequality and poverty.
Prevention of Maternal Mortality_StantonCORE Group
This document summarizes USAID's Maternal Health Vision for Action plan to end preventable maternal mortality globally by 2030. The plan focuses on 10 key strategies: 1) improving individual and community behaviors, 2) increasing access to services for vulnerable groups, 3) integrating family planning and maternal services, 4) scaling quality maternal/fetal care, 5) treating indirect causes of mortality, 6) addressing morbidity, 7) respectful maternity care, 8) strengthening health systems, 9) using data for decisions, and 10) promoting innovation. Financial incentives, community mobilization, addressing disparities, and strengthening health systems are emphasized as ways to achieve the vision.
Female Infertility can be caused by physical obstructions like endometriosis or pelvic inflammatory disease blocking the fallopian tubes, hormonal issues interfering with ovulation, or problems with fertilization or early development. Around 12% of women experience infertility, which is generally treated through fertility drugs, surgery, artificial insemination or assisted reproductive technologies like in vitro fertilization. Coping strategies include considering other family planning options, seeking counseling or support groups, and maintaining a healthy lifestyle to potentially overcome infertility issues.
Maternal Mortality is a concern for the government of India and hence it is important to know the various aspects of it. Government of India has introduced various programs to look upon it.
The maternal mortality rate is the number of maternal deaths in a population divided by the number of women of reproductive age. It captures the likelihood of both becoming pregnant and dying during pregnancy (including deaths up to six weeks after delivery).
1) Maternal mortality in India remains a significant problem, with 212 deaths per 100,000 live births according to 2009 data.
2) The main medical causes of maternal death are postpartum hemorrhage (24%), hypertension/eclampsia (12%), and infection (15%).
3) Addressing the "three delays" - delay in deciding to seek care, reaching a facility, and receiving care at the facility - is critical to reducing maternal mortality through strategies like community education, improving transportation and emergency services, and upgrading health facilities.
26th International Papillomavirus Conference: Satellite Symposium
Enhancing HPV Prevention among Indigenous Populations: International Perspectives on Health and Well-Being
Montreal, Quebec
July 5, 2010
Panel 2: Primary and Secondary Prevention of HPV Diseases, Cervical and other cancers among Indigenous Populations: Promising Interventions and Wise Practices.
A powerpoint presentation on maternal mortality during a resident's presentation at Komfo Anokye Teaching Hospital, obstetrics and gynecology directorate.
definitions, causes, prevention and way forward for maternal mortality in Ghana
This study investigated the association between night work and breast cancer risk using data from a large population-based case-control study in France. The study found that 13% of breast cancer cases and 11% of controls had a history of night shift work, corresponding to a 27% increased risk of breast cancer among night shift workers. The risk was highest for women who worked overnight shifts or had worked night shifts for over 4 years. Notably, women who worked night shifts for over 4 years before their first full-term pregnancy had nearly double the risk of breast cancer compared to those without such a history, suggesting that incompletely differentiated breast tissue may be particularly susceptible to circadian disruption from night work.
Trichomoniasis in the women is usually asymptotic however the disease might be manifested as vaginitis, cervicitis, urethritis, pelvic inflammatory disease (PID), and adverse birth outcomes. Methods: A case-control hospital based study conducted at Kassala Hospitals, eastern Sudan during the period from 1st January 2015 to 30th June 2015 to investigate the prevalence rate of Trichomoniasis during pregnancy and its impact on neonatal outcome. Results: During the study period there were 199 infected women with T vaginalis among 2374 deliveries yielding a prevalence rate of 8.3%. The vast majority (140/199, 70.4%) was asymptomatic while the rest presented with vaginal discharge (33/199, 16.6%), itching (16/199, 8%) and dysuria (10/199, 5%). With regard to membranes status and neonatal outcome higher proportion of infected women presented with premature ruptured membranes (30, 15.1% Vs 6, 3%; P = 0.000) and gave preterm birth (31, 15.6% Vs 7, 3.5%; P= 0.000). Using logistic regression analysis the study showed significant association between Trichomoniasis, preterm birth (CI= 1.1 � 13.6, OR= 3.9, P= 0.030) and premature rupture of the amniotic sac before 4 centimeter dilatation (CI= 1.0 3.2, OR= 1.8, P= 0.025). Conclusion: Trichomoniasis is highly prevalent among parturient women in eastern Sudan, and there is significant association between Trichomoniasis, preterm birth and premature ruptured membranes.
The document discusses infant and child mortality rates in Paraguay using data from various sources. It reports that the infant mortality rate in Paraguay is estimated to be 33.8 per 1000 live births but that reported data diverges significantly from estimates. The main causes of neonatal death are identified as birth injuries and preterm birth. The health sector response is described as fragmented and lacking coordination. Strategies to reduce infant mortality discussed include improving prenatal care, professional care during childbirth, and expanding access to healthcare.
Understanding Maternal Mortality using the medical and social contexts. In explaining the social contexts, the presentation will present a case of the Zuellig Family Foundation on Maternal Death Reviews.
Barriers to Adoption of Family Planning among Women in Eastern Democratic Rep...MEASURE Evaluation
This study assessed barriers to family planning among women in Butembo, Eastern Democratic Republic of Congo. The researchers surveyed 572 women and found high knowledge of family planning methods but low usage of modern contraceptives. Only 36% used modern methods such as male condoms, pills, injectables, and implants while 64% relied on traditional methods like calendar-based family planning and withdrawal. Major barriers included lack of knowledge, fear of side effects, religious views, and husband opposition. The researchers recommend improving access to family planning in health facilities, advocating for modern methods, training health workers, and promoting family planning to women at health encounters.
Maternal mortality remains a significant global issue, with one woman dying every minute from pregnancy or childbirth complications. This document defines maternal mortality and classifications, and provides data on maternal mortality ratio (MMR) in various regions. Key findings include: the state's MMR declining from 30.8 in 2008 to 21.7 in 2011 but rising again to 26.6 in 2012; the principal causes of death being obstetric embolism, medical disorders during pregnancy, and postpartum hemorrhage; and over 60% of deaths occurring postnatally. Remediable factors contributing to deaths include delays in seeking or receiving care, failure to diagnose or treat appropriately, and inadequate adherence to protocols.
Final Presentation - TPS MCH Team on July 21, 2011 in Chennai on the Concluding Day of the Trans Disciplinary Problem Solving Course: co-taught by Washington University in St. Louis and ICTPH.
Maternal mortality refers to deaths due to complications from pregnancy or childbirth. Globally, almost 800 women die daily from preventable causes related to pregnancy and childbirth. The vast majority (99%) of maternal deaths occur in developing countries, particularly in sub-Saharan Africa and South Asia. The three leading causes of maternal death in the United States are postpartum hemorrhage, preeclampsia and eclampsia, and cardiomyopathy. Preventing unwanted pregnancies and ensuring access to skilled care before, during, and after childbirth can significantly reduce maternal mortality worldwide.
This ppt contains all information about Health statistics-Vital Statistics. It is useful for students of medical field learning preventive and social medicine, Swasthavritta (Ayurved), nursing and everyone who is interested in knowing about it.
Assess the Prevalence of Self Reported Vaginal Discharge, Perceived Causes an...ijtsrd
Introduction Womens health is often suffering from gynaecological problems between puberty and post menopause. This will have an impression on their sexual and reproductive health. Many ladies find that persistent discharge is often uncomfortable. Objectives The purpose of this study was to determine the prevalence of self reported vaginal discharge, its perceived causes, and any associated symptoms among reproductive aged women.Methods A community based cross sectional study was conducted among women of the reproductive age group 15 45 years from the village of Kondancherry who met the inclusion criteria and were recruited using an appropriate sampling method Convenient . Formal approval was obtained from the village authorities and received approval from the institutions ethics committee. A self structured questionnaire was wont to collect data during a face to face interview. Descriptive and inferential statistics were used to analyse the data.Result Out of a total of 140 women who were interviewed for the presence of abnormal vaginal discharge, 100 71 were found to possess abnormal discharge. The prevalence of discharge was discovered to be quite high. Most of the ladies had a whitish vaginal discharge 76 , 59 had odourless discharge and 43 of women experience cheesy sticky in consistency of discharge. A majority of respondents 26 attributed the cause to excessive body heat, 22 said it was due to eating hot food, and about 13 of women cited stress. The foremost coexisting associated symptoms with vaginal discharge were itching, lower abdominal pain, and backache.Conclusion The stigma, shame, and embarrassment related to with any genital disorder deter many women and girls from seeking medical help. It must be identified and given great importance. Cecyli. C | Yogalakshmi. S "Assess the Prevalence of Self-Reported Vaginal Discharge, Perceived Causes and Associated Symptoms among Reproductive Aged Women" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-7 | Issue-5 , October 2023, URL: https://www.ijtsrd.com/papers/ijtsrd59988.pdf Paper Url: https://www.ijtsrd.com/medicine/other/59988/assess-the-prevalence-of-selfreported-vaginal-discharge-perceived-causes-and-associated-symptoms-among-reproductive-aged-women/cecyli-c
Maternal mortality remains a significant global issue, with nearly 830 women dying daily from preventable causes related to pregnancy and childbirth. The majority (99%) of maternal deaths occur in developing countries, where access to skilled healthcare is limited. Key factors that influence a woman's risk include her location (rural areas pose higher risk), economic status (poorer communities at higher risk), and age (adolescents at highest risk). While the global maternal mortality ratio has declined 44% between 1990-2015, many countries still show no progress. Reliable data remains scarce but interventions like skilled birth attendance and access to family planning can significantly reduce maternal deaths.
Maternal mortality is defined as the death of a woman during pregnancy or within 42 days of termination of pregnancy from pregnancy-related causes. The three main causes of maternal death globally are hemorrhage, sepsis, and hypertensive disorders. In India, maternal mortality rates are highest in rural areas where access to healthcare is limited. The three delay model explains that maternal deaths are often due to delays in seeking care, reaching care, and receiving adequate care. Reducing maternal mortality requires improving access to emergency obstetric care, family planning services, and addressing social determinants like gender inequality and poverty.
Prevention of Maternal Mortality_StantonCORE Group
This document summarizes USAID's Maternal Health Vision for Action plan to end preventable maternal mortality globally by 2030. The plan focuses on 10 key strategies: 1) improving individual and community behaviors, 2) increasing access to services for vulnerable groups, 3) integrating family planning and maternal services, 4) scaling quality maternal/fetal care, 5) treating indirect causes of mortality, 6) addressing morbidity, 7) respectful maternity care, 8) strengthening health systems, 9) using data for decisions, and 10) promoting innovation. Financial incentives, community mobilization, addressing disparities, and strengthening health systems are emphasized as ways to achieve the vision.
Female Infertility can be caused by physical obstructions like endometriosis or pelvic inflammatory disease blocking the fallopian tubes, hormonal issues interfering with ovulation, or problems with fertilization or early development. Around 12% of women experience infertility, which is generally treated through fertility drugs, surgery, artificial insemination or assisted reproductive technologies like in vitro fertilization. Coping strategies include considering other family planning options, seeking counseling or support groups, and maintaining a healthy lifestyle to potentially overcome infertility issues.
Maternal Mortality is a concern for the government of India and hence it is important to know the various aspects of it. Government of India has introduced various programs to look upon it.
The maternal mortality rate is the number of maternal deaths in a population divided by the number of women of reproductive age. It captures the likelihood of both becoming pregnant and dying during pregnancy (including deaths up to six weeks after delivery).
1) Maternal mortality in India remains a significant problem, with 212 deaths per 100,000 live births according to 2009 data.
2) The main medical causes of maternal death are postpartum hemorrhage (24%), hypertension/eclampsia (12%), and infection (15%).
3) Addressing the "three delays" - delay in deciding to seek care, reaching a facility, and receiving care at the facility - is critical to reducing maternal mortality through strategies like community education, improving transportation and emergency services, and upgrading health facilities.
26th International Papillomavirus Conference: Satellite Symposium
Enhancing HPV Prevention among Indigenous Populations: International Perspectives on Health and Well-Being
Montreal, Quebec
July 5, 2010
Panel 2: Primary and Secondary Prevention of HPV Diseases, Cervical and other cancers among Indigenous Populations: Promising Interventions and Wise Practices.
A powerpoint presentation on maternal mortality during a resident's presentation at Komfo Anokye Teaching Hospital, obstetrics and gynecology directorate.
definitions, causes, prevention and way forward for maternal mortality in Ghana
This study investigated the association between night work and breast cancer risk using data from a large population-based case-control study in France. The study found that 13% of breast cancer cases and 11% of controls had a history of night shift work, corresponding to a 27% increased risk of breast cancer among night shift workers. The risk was highest for women who worked overnight shifts or had worked night shifts for over 4 years. Notably, women who worked night shifts for over 4 years before their first full-term pregnancy had nearly double the risk of breast cancer compared to those without such a history, suggesting that incompletely differentiated breast tissue may be particularly susceptible to circadian disruption from night work.
Trichomoniasis in the women is usually asymptotic however the disease might be manifested as vaginitis, cervicitis, urethritis, pelvic inflammatory disease (PID), and adverse birth outcomes. Methods: A case-control hospital based study conducted at Kassala Hospitals, eastern Sudan during the period from 1st January 2015 to 30th June 2015 to investigate the prevalence rate of Trichomoniasis during pregnancy and its impact on neonatal outcome. Results: During the study period there were 199 infected women with T vaginalis among 2374 deliveries yielding a prevalence rate of 8.3%. The vast majority (140/199, 70.4%) was asymptomatic while the rest presented with vaginal discharge (33/199, 16.6%), itching (16/199, 8%) and dysuria (10/199, 5%). With regard to membranes status and neonatal outcome higher proportion of infected women presented with premature ruptured membranes (30, 15.1% Vs 6, 3%; P = 0.000) and gave preterm birth (31, 15.6% Vs 7, 3.5%; P= 0.000). Using logistic regression analysis the study showed significant association between Trichomoniasis, preterm birth (CI= 1.1 � 13.6, OR= 3.9, P= 0.030) and premature rupture of the amniotic sac before 4 centimeter dilatation (CI= 1.0 3.2, OR= 1.8, P= 0.025). Conclusion: Trichomoniasis is highly prevalent among parturient women in eastern Sudan, and there is significant association between Trichomoniasis, preterm birth and premature ruptured membranes.
The document discusses infant and child mortality rates in Paraguay using data from various sources. It reports that the infant mortality rate in Paraguay is estimated to be 33.8 per 1000 live births but that reported data diverges significantly from estimates. The main causes of neonatal death are identified as birth injuries and preterm birth. The health sector response is described as fragmented and lacking coordination. Strategies to reduce infant mortality discussed include improving prenatal care, professional care during childbirth, and expanding access to healthcare.
Understanding Maternal Mortality using the medical and social contexts. In explaining the social contexts, the presentation will present a case of the Zuellig Family Foundation on Maternal Death Reviews.
Barriers to Adoption of Family Planning among Women in Eastern Democratic Rep...MEASURE Evaluation
This study assessed barriers to family planning among women in Butembo, Eastern Democratic Republic of Congo. The researchers surveyed 572 women and found high knowledge of family planning methods but low usage of modern contraceptives. Only 36% used modern methods such as male condoms, pills, injectables, and implants while 64% relied on traditional methods like calendar-based family planning and withdrawal. Major barriers included lack of knowledge, fear of side effects, religious views, and husband opposition. The researchers recommend improving access to family planning in health facilities, advocating for modern methods, training health workers, and promoting family planning to women at health encounters.
Maternal mortality remains a significant global issue, with one woman dying every minute from pregnancy or childbirth complications. This document defines maternal mortality and classifications, and provides data on maternal mortality ratio (MMR) in various regions. Key findings include: the state's MMR declining from 30.8 in 2008 to 21.7 in 2011 but rising again to 26.6 in 2012; the principal causes of death being obstetric embolism, medical disorders during pregnancy, and postpartum hemorrhage; and over 60% of deaths occurring postnatally. Remediable factors contributing to deaths include delays in seeking or receiving care, failure to diagnose or treat appropriately, and inadequate adherence to protocols.
Final Presentation - TPS MCH Team on July 21, 2011 in Chennai on the Concluding Day of the Trans Disciplinary Problem Solving Course: co-taught by Washington University in St. Louis and ICTPH.
Maternal mortality refers to deaths due to complications from pregnancy or childbirth. Globally, almost 800 women die daily from preventable causes related to pregnancy and childbirth. The vast majority (99%) of maternal deaths occur in developing countries, particularly in sub-Saharan Africa and South Asia. The three leading causes of maternal death in the United States are postpartum hemorrhage, preeclampsia and eclampsia, and cardiomyopathy. Preventing unwanted pregnancies and ensuring access to skilled care before, during, and after childbirth can significantly reduce maternal mortality worldwide.
This ppt contains all information about Health statistics-Vital Statistics. It is useful for students of medical field learning preventive and social medicine, Swasthavritta (Ayurved), nursing and everyone who is interested in knowing about it.
Assess the Prevalence of Self Reported Vaginal Discharge, Perceived Causes an...ijtsrd
Introduction Womens health is often suffering from gynaecological problems between puberty and post menopause. This will have an impression on their sexual and reproductive health. Many ladies find that persistent discharge is often uncomfortable. Objectives The purpose of this study was to determine the prevalence of self reported vaginal discharge, its perceived causes, and any associated symptoms among reproductive aged women.Methods A community based cross sectional study was conducted among women of the reproductive age group 15 45 years from the village of Kondancherry who met the inclusion criteria and were recruited using an appropriate sampling method Convenient . Formal approval was obtained from the village authorities and received approval from the institutions ethics committee. A self structured questionnaire was wont to collect data during a face to face interview. Descriptive and inferential statistics were used to analyse the data.Result Out of a total of 140 women who were interviewed for the presence of abnormal vaginal discharge, 100 71 were found to possess abnormal discharge. The prevalence of discharge was discovered to be quite high. Most of the ladies had a whitish vaginal discharge 76 , 59 had odourless discharge and 43 of women experience cheesy sticky in consistency of discharge. A majority of respondents 26 attributed the cause to excessive body heat, 22 said it was due to eating hot food, and about 13 of women cited stress. The foremost coexisting associated symptoms with vaginal discharge were itching, lower abdominal pain, and backache.Conclusion The stigma, shame, and embarrassment related to with any genital disorder deter many women and girls from seeking medical help. It must be identified and given great importance. Cecyli. C | Yogalakshmi. S "Assess the Prevalence of Self-Reported Vaginal Discharge, Perceived Causes and Associated Symptoms among Reproductive Aged Women" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-7 | Issue-5 , October 2023, URL: https://www.ijtsrd.com/papers/ijtsrd59988.pdf Paper Url: https://www.ijtsrd.com/medicine/other/59988/assess-the-prevalence-of-selfreported-vaginal-discharge-perceived-causes-and-associated-symptoms-among-reproductive-aged-women/cecyli-c
This document summarizes presentations on maternal near miss in Sudan. It defines maternal near miss as a severe life-threatening complication during pregnancy, childbirth, or postpartum that requires urgent intervention to prevent death. The document discusses how analyzing near miss cases can provide insights into health system failures in obstetric care. It notes that the leading causes of near miss in Sudan are hemorrhage, infection, hypertensive disorders, and anemia. The document also outlines Sudan's policy on identifying near miss criteria and qualitative research examining determinants of maternal morbidity and mortality in post-conflict areas.
This document discusses a case report of a woman who suffered intestinal injury from an illegal abortion. The key points are:
1. The 28-year-old woman underwent an unsafe, illegal abortion by an untrained nurse, which perforated her uterus and injured her intestine, leading to sepsis.
2. She required an emergency laparotomy where a 2cm rent was found in her posterior uterine wall and faecal matter was leaking from her bowel. Her intestine was repaired and a loop ileostomy was performed.
3. Unsafe abortions frequently occur in developing countries due to lack of education, social stigma around abortion, and restrictive abortion laws. This can lead to serious complications like infection, hemor
This is an individual project showing strategies of addressing pregnant women labor delays in St. Paul's Hospital Millennium Medical College , Addis Ababa, Ethiopia
This document discusses abortion, including definitions, types, causes, and management. It begins by defining abortion and providing statistics on incidence. It then describes types of abortion, differentiating between spontaneous abortion (miscarriage) and induced abortion. Biological causes of spontaneous abortion are outlined, including fetal factors like genetic abnormalities and maternal factors like infections, endocrine issues, and anatomical abnormalities. The document also discusses legal issues surrounding abortion, challenges with access to services, and consequences of unsafe abortion. Approaches to addressing unsafe abortion, such as ensuring availability of services and training of health workers, are presented. Causes and management of unintended pregnancy as well as post-abortion care are also summarized.
Obstetric Fistula Community Based Assessment Tool (OF-COMBAT)paperpublications3
OF-COMBAT is a community-based screening tool developed to identify potential cases of obstetric fistula in remote areas with weak health systems. The tool consists of 27 questions in 4 categories addressing clinical presentation, causes, and time between cause and effect. It was tested on 153 women in Kenya, correctly identifying most fistula cases while minimizing referrals of women with other conditions. The tool provides a tentative diagnosis to help determine if a woman needs to travel for facility-based confirmation and potential treatment. It aims to improve identification and access to care for fistula patients in a cost-effective manner.
MATERNAL AND FETAL OUTCOME AMONG OBSTETRIC REFERRALS: A CASE STUDY OF THE BA...GABRIEL JEREMIAH ORUIKOR
Abstract: Background: maternal/foetal mortality and morbidity could be reduced by making use of timely
consultations, an efficient referral system, basic and comprehensive emergency obstetric care to pregnant women
and their new-borns. This study was carried out in other to compare maternofoetal outcome and to evaluate the
types of delays experienced by women.
The main objective was to evaluate maternal and foetal outcome of obstetric referrals.
Method: A case control study was carried out. All pregnant women that were referred, consented and met with the
inclusion criteria were recruited as cases, while those who came to deliver on their own were recruited as the controls.
Data were collected on pretested questionnaires. The chi square test was used as nonparametric test.
Result: Most of the participants 75.4% (n=49) were found between 15-30 years. The majority (n=35, 53.8%) of
pregnant women were referred from health centres. Cases with at least one delay was twice that of the controls (cases
42, 64.6% controls 22, 33.8% p value =0.00). 6.2 %and 9.8 %babies delivered from cases and control group
respectively were born dead. Admission in the Neonatal intensive care unit was in greater proportion for the babies
delivered from cases than the controls (cases 15, 23.1% controls 9, 13.8% p value=0.175). Most of the women
delivered through ceserian section (cases 27, 41.5% controls 32, 49.2% p value =0.378). No maternal mortality was
recorded. 60% of the women spent 7-14days in the hospital.
Conclusion: for non-referred pregnant women, maternal outcome is poor but foetal outcome is better.
MATERNAL AND FETAL OUTCOME AMONG OBSTETRIC REFERRALS: A CASE STUDY OF THE BA...GABRIEL JEREMIAH ORUIKOR
Background: maternal/foetal mortality and morbidity could be reduced by making use of timely
consultations, an efficient referral system, basic and comprehensive emergency obstetric care to pregnant women
and their new-borns. This study was carried out in other to compare maternofoetal outcome and to evaluate the
types of delays experienced by women.
The main objective was to evaluate maternal and foetal outcome of obstetric referrals.
Method: A case control study was carried out. All pregnant women that were referred, consented and met with the
inclusion criteria were recruited as cases, while those who came to deliver on their own were recruited as the controls.
Data were collected on pretested questionnaires. The chi square test was used as nonparametric test.
Result: Most of the participants 75.4% (n=49) were found between 15-30 years. The majority (n=35, 53.8%) of
pregnant women were referred from health centres. Cases with at least one delay was twice that of the controls (cases
42, 64.6% controls 22, 33.8% p value =0.00). 6.2 %and 9.8 %babies delivered from cases and control group
respectively were born dead. Admission in the Neonatal intensive care unit was in greater proportion for the babies
delivered from cases than the controls (cases 15, 23.1% controls 9, 13.8% p value=0.175). Most of the women
delivered through ceserian section (cases 27, 41.5% controls 32, 49.2% p value =0.378). No maternal mortality was
recorded. 60% of the women spent 7-14days in the hospital.
Conclusion: for non-referred pregnant women, maternal outcome is poor but foetal outcome is better.
Keywords: Obstetrics, Referrals, Haemorrhage, Infection, Outcome.
Obstetric fistula is an abnormal opening between a woman's vagina and bladder or rectum caused by prolonged obstructed labor without medical care. In Sudan, it is estimated that 5,000 new cases occur annually. Sudan has specialized fistula centers, most notably the Dr. Abbo National Fistula Center in Khartoum, which treats over 700 patients per year. Developing a national fistula prevention and treatment strategy involves collecting data, developing prevention strategies like increasing access to emergency obstetric care, and monitoring programs through clinical audits and key performance indicators.
The document discusses maternal health and outcomes in Burkina Faso. It finds that the maternal mortality ratio in Burkina Faso is 400 deaths per 100,000 live births, which is higher than the global average but has declined 49% since 1990. Pregnancy-related crises can have long-term health, social, and economic impacts on women and their families due to costs of care, lost productivity, and risk of impoverishment. Investing in access to emergency obstetric care and family planning can help reduce maternal mortality and its adverse effects in Burkina Faso.
GIRHL's mission is to increase access and quality of reproductive health care globally through research, development, and implementation of innovative solutions. They identify problems through collaboration with local healthcare workers and engineers. Their programs focus on obstetric fistula and maternal health in developing countries. For obstetric fistula, they develop new evaluation techniques and devices to manage incontinence. For maternal health, they are developing a device called the Prenabelt to prevent stillbirth and low birthweight.
This document discusses obstetric fistula (OF), including its definition, epidemiology, causes, and strategies for prevention and treatment. Some key points:
- OF is an abnormal opening caused by prolonged obstructed labor without medical care that causes urine and/or feces to continuously leak. It can be repaired surgically for $300.
- An estimated 2 million women live with OF, with 50,000-100,000 new cases annually in sub-Saharan Africa including 5,000 cases estimated in Sudan.
- Causes include lack of emergency obstetric care, early marriage and childbirth, female genital mutilation, and poverty. Prevention strategies focus on increasing access to
This document is a certificate for a 12th grade biology project on infertility completed by Navneet Srivastava. It was guided by Mr. Deepak Rastogi and fulfills the biology practical curriculum requirements for CBSE, New Delhi for the 2021-2022 academic year. The project includes an acknowledgment, index, abstract, theory on infertility definitions and causes, sections on infertility in females and males, treatment options, and a conclusion on the lack of fertility treatment availability in developing nations.
Millennium Development Goal 5: Maternal Health InterventionsSolveij Praxis
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Dấu hiệu, nguyên nhân của mãn kinh sớm và cách điều trị | Venus GlobalVENUS
Trong những năm gần đây, mãn kinh sớm đang là một vấn đề khiến nhiều chị em lo lắng. Có rất nhiều nguyên nhân gây ra tình trạng mãn kinh sớm nó có thể do thói quen ăn uống, sinh hoạt ảnh hưởng đến nội tiết tố nữ và tứ đó gây ra mãn kinh. Trong bài viết này Venus sẽ cung cấp cho bạn toàn bộ thông tin về nguyên nhân, biểu hiện gây ra căn bệnh này để bạn đọc có cách phòng tránh cũng như điều trị kịp thời.
Nguồn: Trích https://venusglobal.com.vn/man-kinh-som/
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Obstetric Fistula Post Repair Follow Up: An Outreach Worker’s Perspectivepaperpublications3
Abstract: Obstetric Fistula is a childbirth injury caused by prolonged obstructed labour leaving a woman incontinent of urine or faeces or both. The stigma associated with the condition keeps many women hidden away. A woman with obstetric fistula is too often rejected by her husband and pushed out of her village due to her foul smell. Without treatment, fistula often leads to social, physical, emotional and economic decline. Although some women with fistula display amazing courage and resilience, many others succumb to illness and despair. Kenya is estimated to have 1000-3000 new fistula cases every year where as the national treatment capacity is only 500 clients per year. With the understanding of the impact this condition has not only to the affected clients but also to the community at large, several local and international organizations are currently supporting the fistula repairs in Kenya. Review of relevant literature reveals inconsistent findings about the need for the post repair follow up for this client. This leaves program designers and their funding partners to handle the issue according to their discretion. Most projects focus on identifying fistula clients supporting them to get the surgery document the number repaired but do very little to follow up on this client. This paper gives the perspective on an outreach worker who has supported fistula clients for the last 11 years. The author looks at what is currently happening in Kenya and brings out the need for establishing post repair follow up in the programs. The paper gives case studies in the client either benefited from post repair follow up to show an amazing outcome or lost life in unclear circumstances. The paper demonstrates the effect of this follow up to the client their significant other, the community and the effectiveness of the project. It finally gives recommendation on how this can be integrated in fistula management.
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Abortion can have serious physical and psychological complications. It is linked to increased risks of cancer, uterine damage, cervical lacerations, ectopic pregnancy, and complications in future pregnancies like preterm birth. Multiple abortions further increase these risks. Abortion is also associated with negative health behaviors and poorer overall health and well-being afterwards. It is a traumatic experience for many women that can be perceived as a violation, especially if the pregnancy was wanted or the abortion was forced.
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The smart irrigation system represents an innovative approach to optimize water usage in agricultural and landscaping practices. The integration of cutting-edge technologies, including sensors, actuators, and data analysis, empowers this system to provide accurate monitoring and control of irrigation processes by leveraging real-time environmental conditions. The main objective of a smart irrigation system is to optimize water efficiency, minimize expenses, and foster the adoption of sustainable water management methods. This paper conducts a systematic risk assessment by exploring the key components/assets and their functionalities in the smart irrigation system. The crucial role of sensors in gathering data on soil moisture, weather patterns, and plant well-being is emphasized in this system. These sensors enable intelligent decision-making in irrigation scheduling and water distribution, leading to enhanced water efficiency and sustainable water management practices. Actuators enable automated control of irrigation devices, ensuring precise and targeted water delivery to plants. Additionally, the paper addresses the potential threat and vulnerabilities associated with smart irrigation systems. It discusses limitations of the system, such as power constraints and computational capabilities, and calculates the potential security risks. The paper suggests possible risk treatment methods for effective secure system operation. In conclusion, the paper emphasizes the significant benefits of implementing smart irrigation systems, including improved water conservation, increased crop yield, and reduced environmental impact. Additionally, based on the security analysis conducted, the paper recommends the implementation of countermeasures and security approaches to address vulnerabilities and ensure the integrity and reliability of the system. By incorporating these measures, smart irrigation technology can revolutionize water management practices in agriculture, promoting sustainability, resource efficiency, and safeguarding against potential security threats.
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Fuzzy Logic means for Intelligent Diagnosis of Obstetrics Fistula Disease
1. International Journal of Electrical, Electronics and Computers (EEC Journal) [Vol-2, Issue-5, Sep-Oct 2017]
https://dx.doi.org/10.24001/eec.2.6.1 ISSN: 2456-2319
www.eecjournal.com Page | 1
Fuzzy Logic means for Intelligent Diagnosis of
Obstetrics Fistula Disease.
Amosa Babalola1
, Hameed Aderemi2
, Kawonise Kayode2
, Ekuewa Jacob2
1
Department of Computer Science, San Juan de la Cruz University, San Jose, Costa Rica
2
Department of Computer Science, Federal Polytechnic, Ede, Nigeria
Abstract - Obstetrics fistula is one of the most serious and
tragic childbirth injuries. It is a hole between the birth canal
and bladder or rectum caused by prolonged, obstructed
labour, without access to timely, high-quality medical
treatment. It leaves women leaking urine, faeces or both and
often leads to chronic medical problems, depression, social
isolation and deepening poverty. The goal of this research is
to develop a Fuzzy logic means for intelligent diagnosis of
Obstetrics fistula disease. In the study we presented the
architecture of the FCM system for the diagnosis of
Obstetrics Fistula. It comprises of knowledge base system,
fuzzy c-means inference engine and decision support system.
The knowledge base system holds the symptoms for
Obstetrics Fistula. The expert system is developed in an
environment characterized by Microsoft XP Professional
operating system, Microsoft Access Database Management
System, Visual BASIC Application Language and Microsoft
Excel.
Keywords-fuzzy Logic, intelligent diagnosis, childbirth
injuries, obstetrics fistula.
I. INTRODUCTION
Obstetrics fistula is one of the most serious and tragic
childbirth injuries. It is a hole between the birth canal and
bladder or rectum caused by prolonged, obstructed labour,
without access to timely, high-quality medical treatment. It
leaves women leaking urine, faeces or both and often leads
to chronic medical problems, depression, social isolation and
deepening poverty. Obstetric fistula is a condition that most
frequently affects women living in resource poor countries
where, for a variety of reasons, access to emergency obstetric
care (EmOC) is difficult. In such settings, women living in
rural areas and those from low socioeconomic households
have fewer opportunities to obtain EmOC (specifically, a
cesareansection) and are therefore more vulnerable to fistula.
When not repaired, vaginal fistula causes incontinence, and
for some women it can result in an inability to carry and bear
children. Because of the physical consequences, fistula
stigmatizes women, often forcing them to isolate themselves
and remain silent about their condition [1]. The World
Health Organization has estimated that more than 2 million
women have untreated obstetric fistula and some 50,000 TO
100000 new cases develop annually. Globally, there were an
estimated 289,000 maternal deaths in 2013[2]. Further
statistical figures on obstetric fistula mortality are presented
in [3-4]. However, this figure is thought to be an
underestimate, because many women with fistula do not seek
treatment. The overall rate of obstetric fistula in Africa is
three to five cases per 1,000 deliveries; in rural Africa,
however, the rate is five to 10 cases per 1,000 deliveries. The
United Nations Population Fund estimates that, worldwide,
fistulas occur in one or two of every 1,000 deliveries. The
actual prevalence of fistula, however, is not known. Fistula
from prolonged or obstructed labour can strike any pregnant
woman, regardless of her age or gravidity. However,
adolescents who marry early have unique characteristics that
put them at increased risk for obstetric fistula. Most of these
adolescents become pregnant before the pelvis is fully
developed for childbearing[5].
The five types of obstetric fistula are: Vesicovaginal (VVF)
fistula: Between the bladder and vagina,Rectovaginal fistula
(RVF): Between the rectum and vagina, Urethrovaginal
fistula: Between the urethra and the vagina, Ureterovaginal
fistula: Between the distal ureter and vagina, Vesicouterine
fistula: Between the uterus and the bladder, Vesicovaginal
(VVF) is the most common type of obstetric fistula, A client
may have both vesicovaginal and rectovaginal fistula at the
same time—the combination of VVF and RVF is the second
most commonly encountered type of obstetric fistula.The
most common cause of obstetric fistula in developing
countries is prolonged or obstructedlabour. Other physical
causes of fistula include: Trauma caused by sexual violence,
Accidental surgical injury, Unsafe abortions, Harmful
traditional practices, Diseases or radiotherapy treatments,
Most women who develop obstetric fistula during childbirth
do so because they did not receive the health care they
needed.
The problems in accessing timely obstetric care, which can
lead to maternal death or complications (including fistula),
are commonly referred to as the “Three Delays”: Delay in
2. International Journal of Electrical, Electronics and Computers (EEC Journal) [Vol-2, Issue-5, Sep-Oct 2017]
https://dx.doi.org/10.24001/eec.2.6.1 ISSN: 2456-2319
www.eecjournal.com Page | 2
deciding to seek care, Delay in reaching a health care
facility, and Delay in receiving adequate care/attention at the
facility. Other societal factors that contribute to obstetric
fistula include: Poverty, Early marriage and childbirth,
Gender discrimination, Poor nutrition and compromised
development and Inadequate family planning information.
Symptoms of Obstetrics fistula are; Flatulence, Foul-
smelling, Repeated virginal/urinary infections, Irritation or
pains in vagina areas and Pains during sexual activity [6-8].
1.1 Consequence of Obstetric fistula
Obstetric fistula, in conjunction with prolonged or obstructed
labour, can lead to a range of physicaland mental health
complications,[9-11]including: Gynecologic sequelae, Nerve
damage, Dermatologic injuries, Bone abnormalities, Anxiety
and Depression, Ancillary medical conditions (such as
dehydration, bladder stones, malnutrition, anemia, urinary,
tract infections, and kidney disease), The social
consequences for women living with obstetric fistula
include: Stigma related to stillbirth, Subjection to myths and
misconceptions about fistula, Social isolation (Because of the
unpleasant odour, women with fistula may be perceived as
unclean and are often excluded, or exclude themselves, from
participating in communityactivities), Marital
breakdown/divorce, Shame, Self-esteem issues, and other
psychological problems, Inability to make a living (Many
women with fistula live for years without any financial or
socialsupport and fall into extreme poverty),Suicide, “The
understanding that one must treat the ‘whole person’ with the
fistula—not just her injuredbladder or rectum—is the single
most important concept in fistula care”[9]. The record of
high mortality presented by WHO, coupled with the
aforementioned consequences of Obstetrics fistula beckons
for an intelligence system for early diagnosis of obstetrics
fistula. The goal of this research is to develop a Fuzzy logic
means for intelligent diagnosis of Obstetrics fistula disease.
II. RELATED WORKS
Studies on obstetric fistula closely follows maternal
mortality; a recent longitudinal study of 230 parturient
women in Nigeria found a cumulative prevalence rate of 12.2
%, 13.5% and 3% for urinary, anal and combined urinary
and anal incontinence respectively [12].
Risk factors associated with Epidemiology of Obstetric
Fistula in [13] can be caused by delay.Once a woman arrives
at the facility, she may not have access to adequate care, due
to a lack of staff or unfriendly staff, supplies, or electricity.
Furthermore, insufficiently skilled staff may mean that the
woman may not get the care that is needed or when provided,
and which results in complications [14].
Factors that can lead to Obstetric fistula arepresented in [15].
A condition exclusive to women and gender has a big role in
its genesis. Gender inequality and oppression of women are
known to persist in regions where obstetric fistula occurs. In
these regions, forced adolescent and teen marriages, low
education levels for girls, male control of money, and the
need for women in obstructed labor to get the permission of
their husband or mother-in-law to seek care are common
findings
Obstetric Fistula Community Based Assessment Tool (OF-
COMBAT) is an enhanced verbal screening tool presented
in[16]. The tool was designed to minimize the number of
clients referred to treatment centres with conditions other
than obstetric fistula. OF-COMBAT helps health facilities to
minimize the screening of resources required and improvethe
efficiency and cost-effectiveness of fistula programs by
limiting transport and logistics costs for ineligible clients.
Importantly, the tool enables the woman to receive a
tentative diagnosis within the comfort of her home or
community before she travels a very long distance, only to at
times be turned back because her condition may not be
covered through charitable fistula programs. OF-COMBAT
is best used by a community outreach worker who has
received basic training on verbal screening for fistula. The
outreach worker is encouraged to listen to the client’s story
before he/she takes the client through the set of up to 27
questions, depending on the type of injury described by the
client. The responses are then tallied and rated on the given
scale to provide a tentative diagnosis. The OF-COMBAT is
unique in that in utilizes a set of confirmatory questions in
order to improve the rates of correctly diagnosing a fistula
case. The limitation of the tool is that, it is a verbal screening
tool.
Medical diagnosis involves identifying illness or disorder in
a patient through physical examination, medical tests or
other procedures while therapy is the treatment of physical,
mental or behavioral problems and it is meant to cure or
rehabilitate the sick [17-18]. However, the system lacks the
capabilityfor global access due to its offline nature and could
not handle vague (imprecise) data which are inherent in
medical records.
The authors in [19] proposed a Fuzzy Expert System for the
Management of Malaria which has been identified as a
predominant environmental health problem in several parts
of the world. While the authors in [20]presented a model for
the diagnosis of Liver problems, both systemswere suitable
to act as a decision support platform to researchers,
physicians and other healthcare practitioners in malaria
endemic and liver diseases respectively. The limitations of
the conventional methods for the diagnosis of diseases call
for the development of expert systems which will aid
medical practitioners in delivering effective and efficient
medical services to patients at affordable prices (cost)
3. International Journal of Electrical, Electronics and Computers (EEC Journal) [Vol-2, Issue-5, Sep-Oct 2017]
https://dx.doi.org/10.24001/eec.2.6.1 ISSN: 2456-2319
www.eecjournal.com Page | 3
irrespective of their geographical location. Due to the
strength of Fuzzy Logic (FL) in the provision of accurate
solutions to difficult real life problems and the advancement
in Internet technology, there has been an increasing need to
incorporate FL concept into medical diagnosis for a
successful development of Internet-based expert system that
will have a human-like reasoning capability[21].
III. RESEARCH METHODS
The process for the medical diagnosis of Obstetrics Fistula
begins when an individual consults a medical expert (doctor)
and presents a set of complaints (symptoms). The medical
expert thenrequests further information that will further aid
in the proper diagnosis of the disease. Data collected include
patient’s previous state of health, living condition and other
medical conditions. During the diagnosis of Obstetrics
Fistula, the medical expert looks at the patient’s symptoms
after which he conducts a physical examination. From the
symptoms presented by the patient, the Medical expert
narrows down the possibilities of the illness that corresponds
to the apparent symptoms and make a list of the conditions
that could account for what is wrong withthe patient. These
are usually ranked in possibility order (Low, Moderate and
High). When the list has been narrowed down to a single
condition, it is called differential diagnosis and provides the
basis for a hypothesis of what is ailing the patient. The
examining physician accounts for possibilities of having
Obstetrics Fistula through physical examination, interview,
or laparoscopic test.
The expert system is developed in an environment
characterized by Microsoft XP Professional operating
system, Microsoft Access Database Management System,
Visual BASIC Application Language and Microsoft Excel.
The research was carried out at the University Teaching
hospital (UCH), Ibadan, Nigeria. Verbal informed consent
was administered to all respondents before they participated
in the study. International ethical standards were followed to
ensure the confidentiality of the information collected and
the anonymity of the respondents. Our dataset is made up of
5 clinical symptoms and 5 types of Obstetrics fistula
diseases. We also performed training, testing and validation.
The correct classified records are stored in the knowledge
base. Rule extraction with the correct classified data was also
performed.
3.1 Fuzzy C-Means Clustering (FCM)
The FCM algorithm is one of the most widely used fuzzy
clustering algorithms. The FCM algorithm
attempts to partition a finite collection of elements X={X1,
X2,...,Xn} into a collection of c fuzzy clusters withrespect to
some given criterion. Given a finite set of data, the algorithm
returns a list of c cluster centers V, such that;
V =Vi, i=1, 2,..., c
and a partition matrix U such that
U = Uij , i =1,..., c , j =1,..., n
whereUij is a numerical value in [0, 1] that tells the degree to
which the element Xj belongs to the i-th cluster.
The fuzzy logic linguistic description of the typical FCM
algorithm is presented below:
Start
Step 1: Select the number of clusters c (2≤c≤n),
exponential weight μ (1<μ<∞), initialpartition matrix U0,
and the termination criterion ε. Also, set the iteration index i
to 0.
Step 2: Calculate the fuzzy cluster centers
{Vi 1| i=1, 2,..., c} by usi n g U1 .
Step 3: Calculate the new partition matrix U1+1 by using
{Vi 1| i=1, 2,. .., c}.
Step 4: Calculate the new partition matrix = || U1+1 - U1|| = |
Uij 1+1 – Uij 1 |. If >ε, then set l = l+ 1 and go to step 2. If
≤ε, then stop.
Stop
IV. MODEL OF FCM FOR OBSTETRICS
FISTULA DISEASES
In this work, we present an architecture model of the fuzzy
C-means expert system for the diagnosis of obstetrics fistula
diseases as shown in Fig. 1. It consists of a Knowledge base
system, Fuzzy C-means inference engine and decision
support module. The knowledge base is made of the
demographic details of the patients, the observed clinical
symptoms and data. The values of the clinical symptoms are
vague and imprecise hence the adoption of fuzzy logic as a
means of analyzing these information. These values therefore
constitute the fuzzy parameters of the knowledge base. The
fuzzy set of the clinical symptoms characteristics is
represented by ‘P’ which is defined as: P = {p1, p2… pn}
where pi represents the jth parameter and n is the total
number of parameters (in this study, n= 5).Neural network
provides the structured intelligent learning for all forms of
the symptoms of obstetrics fistula diseases, which serves as a
platform for the inference engine. The inference engine
consists of reasoning algorithms, driven by production rules.
These production rules are evaluated by using the forward
chaining approach of reasoning. The fuzzy logic and Fuzzy
C-means algorithm provides the rules for the partitioning of
patients into a number of homogenous clusters with respect
to a suitable similarity measure. The patients were classified
according to 5 types of obstetrics fistula diseases as given by
a gynecologist (medical expert).
Fuzzy logic is a superset of the conventional Boolean logic
with capability for handling imprecise (vague) and
incomplete data that are commonly found in medical records.
4. International Journal of Electrical, Electronics and Computers (EEC Journal) [Vol-2, Issue-5, Sep-Oct 2017]
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It resembles human decision making with its ability to work
from approximate reasoning and ultimately find a precise
solution to a given problem. The process of diagnosing
obstetrics fistula by the fuzzy logic involves the following
stages:
a) Fuzzification of input variables (values of signs,
symptoms, and laboratory test results).
b) Establishment of the fuzzy rule base.
c) Building the decision making logic of the fuzzy
logic component (inference engine).
d) Defuzzification of the output of the inference engine
into crisp values.
A fuzzy set of healthy, mild, moderate, severe, very severe
for the input variables (signs, symptoms, and laboratory test
results) are defined.The input variables are fuzzified and the
membership functions defined for them are applied to their
actual values to determine the degree of truth for each rule
antecedent.
Fig 1: Architecture of Fuzzy Logic for Diagnosis of Obstetrics Fistula
V. RESULTS AND DISCUSSIONS
To design the FCM Knowledge Base System for diagnosis of
Obstetrics Fistula, we design a system which consists of a set
of parameters needed for diagnosis presented in Table 1,
while types of Obstetrics Fistula is in Table 2.
Table.1: Clinical Symptoms of Obstetrics Fistula
SN Input Field Code
1 Flatulence FT
2 Foul-smelling FS
3 Repeated virginal/urinary
infections
RF
4 Irritation or pains in
vagina areas
IV
5 Pains during sexual
activity
PS
In Figure 1 we presented the architecture of the FCM system
for the diagnosis of Obstetrics Fistula. It comprises of
knowledge base system, fuzzy c-means inference engine and
decision support system. The knowledge base system holds
the symptoms for Obstetrics Fistula. The values of the
parameters are vague and imprecise hence the adoption of
fuzzy logic as a means of analyzing these information. Those
parameters therefore constitute the fuzzy parameter of the
knowledge base.
The fuzzy set of parameters is represented by ‘P’ which is
defined as P= P1, P2,…,Pn Where Pi represents the jth
parameter and n is the total number of parameter (in
this case n = 5). The set of linguistic values which is
modeled as a linker scale denoted by ‘L’ is given as L =
(Low, Average and High).
Table.2: Types of Obstetrics Fistula
No
Types of
Obstetrics
Fistula
Description
Cluster
code
1 Vesicovaginal
Between
the bladder
and vagina
VV
2 Rectovaginal
Between
the rectum
and vagina
RV
5. International Journal of Electrical, Electronics and Computers (EEC Journal) [Vol-2, Issue-5, Sep-Oct 2017]
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3 Urethrovaginal
Between
the urethra
and the
vagina
HV
4 Ureterovaginal
Between
the distal
ureter and
vagina
TV
5 Vesicouterine
Between
the uterus
and the
bladder
VT
The clustering of the data is achieved using the typical FCM
algorithm presented in Fig. 2. Neural networks provide the
structure for the parameters which serves as a platform for
the inference engine. The inference engine consists of
reasoning algorithms driven by production rules. These
production rules are evaluated by using the forward chaining
approach of reasoning. The inference mechanism is fuzzy
logic driven. The cognitive filter of the decision support
engine takes as input the output report of the inference
engine and applies the objective rules to rank the individual
on the presence or absence of Obstetrics Fistula disease. The
emotional filter takes as input the output report of the
cognitive filter and applies the subjective rules in the domain
of Obstetrics Fistula studies in order to rank individuals on
the extent of the Obstetrics Fistula disease.
Table.3: FCM membership grade of all patients in all
clusters
PNO
C1
(VV)
C2
(RV)
C3
(HV)
C4
(TV)
C5
(VT)
P1 0.10 0.35 0.25 0.47 0.08
P2 0.63 0.40 0.17 0.57 0.71
P3 0.09 0.27 0.46 0.62 0.78
P4 0.51 0.44 0.00 0.88 0.05
P5 0.70 0.21 0.82 0.14 0.12
A typical FCM membership grade table (Table3) using 5
parameters and 5 clusters which shows thedegree of
membership of each parameter of Obstetrics Fistula is
represented in Figure 3. From Table3, it could be observed
that from the various degrees of membership there are no
unitary (crisp) coefficients, indicating that each data point
belongs to more than one cluster. For example P3 = (0.10/c1
+0.03/c2+0.30/c3+0.52/c4+0.05/c5) where c1, c2, …, c5 are
clusters, and in this study represents Vesicovaginal fistula
(VV), Rectovaginal fistula (RV), Ureterovaginal fistula
(TV),Urethrovaginal fistula (HV) and Vesicouterine
fistula(VT) respectively. Each of the symptoms highlighted
in Table1 is represented with P (starting from 1 – 5, i.e., P1-
P5).
Fig. 2: Membership Clusters of Obstetrics fistula Disease
Finally, Table 3 presents membership grades of parameters
in all clusters and the degree of membership of the clusters is
presented in Figure 2.Cluster 1 has the highest degree (0.78)
for symptom P3, Cluster 2 has the highest degree (0.88) for
symptom P4, Cluster 3 has the highest degree (0.82) for
symptom P5,and Cluster 4 has the highest degree (0.44) for
symptom P4 while Cluster 5 has the highest degree (0.70) for
symptom P5.
VI. CONCLUSIONS
The end to the problems associated with the medical
diagnosis of Obstetrics fistula diseases is in view, with this
research work where the application of fuzzy logic concept
to medical diagnosis of Obstetrics fistula disease has been
explored. The paper presents a diagnostic fuzzy cluster
platform to help in diagnosis of Obstetrics fistula diseases
using a set of symptoms and demonstrates the practical
application of soft computing in the domain of diagnostic
pattern appraisal by determining the extent of membership of
individual symptoms. The classification, verification and
matching of symptoms to the five groups of clusters was
necessary especially in some complex scenarios. The
proposed model as experimented can assist the medical
experts in the diagnosis of Obstetrics fistula.
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