This study evaluated the knowledge, attitudes and practices of 30 traditional birth attendants in Cameroon regarding danger signs in pregnancy and infection prevention. The average age of attendants was 49.6 years. Most had no formal education beyond primary school. While all attendants reported referring women in difficult deliveries, only 40% did so regularly. Common reasons for referral included convulsions, heavy bleeding, and large stomach size. Over 70% reported regularly washing hands, but few used other infection prevention measures consistently. The study found traditional birth attendants play an important role but could benefit from additional training to improve safety.
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Austin Journal of Women's Health is an open access, peer reviewed, scholarly journal dedicated to publish articles in all areas of women's healthcare including gynecology, obstetrics, and breast cancer and policies.
Austin Journal of Women's Health is committed to improving the health and health care of all women throughout the lifetime and in diverse communities with focus on the prevention, diagnosis and administration of fertility.
Austin Journal of Women's Health accepts original research articles, review articles, case reports, commentaries, clinical images and rapid communication on all the aspects of Women's Health.
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Austin Journal of Women's Health is an open access, peer reviewed, scholarly journal dedicated to publish articles in all areas of women's healthcare including gynecology, obstetrics, and breast cancer and policies.
Austin Journal of Women's Health is committed to improving the health and health care of all women throughout the lifetime and in diverse communities with focus on the prevention, diagnosis and administration of fertility.
Austin Journal of Women's Health accepts original research articles, review articles, case reports, commentaries, clinical images and rapid communication on all the aspects of Women's Health.
Maternal and Neonatal morbidity and MortalityBPKIHS
It deals with:
Introduction
International Perspectives
National Status
Complication during Pregnancy, Childbirth, Postpartum period including Neonatal Problems
Causes of Maternal and neonatal mortality
Framework of determinants of maternal mortality
Three delay model
Background: Maternal health remains today, one of the major public health concerns in developing countries. Maternal deaths and newborn deaths usually occur within 48 hours of delivery. In Cameroon, despite all the initiatives set up by the Ministry of Public Health to reduce the mortality rate, the situation remains alarming in terms of postnatal consultation; this is much more felt in the West region of Cameroon, which is one of the most affected regions because 43.1% of women who give birth in hospitals do not return to postnatal consultation and this rate is higher than the national average with a value of 21.5%. Objective:This work aims to determine the factors influencing postnatal follow-up in the Bafang Health District. Methodology: This is a cross-sectional descriptive study for analytical purposes, carried out in the Bafang Health District between January 1 to November 30, 2017. Our study population consisted of all women of childbearing age living in the Bafang Health District during the study period. The variables studied were sociodemographic characteristics, socio-cultural characteristics and the provision of care. Results: Analysis carried out during this study, it appears that, the person who informs the women on the dates of rendez-vous during the CPoN (OR = 2.92; [95%CI = 1.16-7,]; p-value = 0.02), women who think the appropriate period of postnatal follow-up is 6 weeks postpartum (OR = 4.27, [95%CI = 1.47-12.39], p-value = 0.00 ) and those who massage the abdomen after childbirth (OR = 2.62, [95%CI = 1.34 - 5.12], p-value = 0.00) are more likely to have knowledge about follow-up postnatal. While women who have no knowledge of postnatal follow-up (OR = 0.18, 95%CI = 0.07-0.45, p-value = 0.00) are less likely to have more knowledge. Conclusion: Lack of knowledge of the existence and importance of postnatal consultation (CPoN), traditional practices are the factors that influence postnatal follow-up in the Bafang Health District. A good and effective care for women after childbirth requires increased awareness campaigns at the hospital level as well as in community settings.
This topic contains Meaning and definitions of midwifery, obstetrics, obstetrical nursing, midwife, scope of midwifery, basic competencies of a midwife, history of midwifery in nursing and development of maternity services in India.
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Vital statistics related to maternal health in indiaPriyanka Gohil
This topic contains introduction of vital statistics, list of important statistics, birth rate, death rate, specific death rates, infant mortality rate, neonatal mortality rate, under five mortality rate, maternal mortality rate (detailed), perinatal mortality rate (detailed), expectation of life, general fertility rate and still births.
Health System Factors Affecting Uptake of Antenatal Care by Women of Reproduc...Premier Publishers
This study sought to determine how health system factors affect antenatal care services uptake. A descriptive cross-sectional study design was adopted. The population under study was selected household members of the community, facility in charges as well as community own resource persons in Kisumu county. The study used purposive sampling method in selecting the Key Informants. A total sample size of 300 respondents were interviewed. The study used an interview and questionnaires to collect data. Descriptive statistics and chi-square tests were used to analyse data with the help of Statistical Package for the Social Sciences. Chi-square analysis showed that distance to facility (p=0.043), waiting time (p=0.012), means of transport used (p=0.016), perceived quality of services (p=0.000) and perceived attitude of service provider (p=0.000) were significant as pertains to number of ANC visits. The study concluded that health system factors affect uptake of ANC. Specifically, lack long distance to hospital, long waiting time, poor quality of services, commodity stock outs and poor attitude of staff. The combination of these factors reduced uptake of ANC. The study recommended integration of traditional birth attendants, community health workers and health care workers services, regular ANC Outreaches and better equipping of rural health facilities.
Community Wellness Through Improved Maternity Practices By Drs Jose Gorrin and Ana Parilla. Given at the Puerto Rican Cultural Center in September of 2003
Relationship of Antenatal Care with the Prevention of Maternal Mortality amon...iosrjce
The purpose of this study was to examine the relationship of antenatal care with the prevention of
maternal mortality among pregnant women in Bauchi state. An ex-post facto research design was used to study
308 subjects drawn from six local government areas in Bauchi state. The subjects were drawn through stratified
random sampling techniques. A close ended questionnaire was used to obtain responses from the subjects. Data
collected for this study were analyzed using descriptive statistics of mean and standard deviation and inferential
statistics of person product moment correlation analysis, 0.05 level of significance was used for all tests of
significance. Two research questions were asked and two hypotheses were tested at 0.05 level of significance.
Findings showed that, significance relationship existed between level of awareness and the prevention of
maternal mortality among pregnant women in Bauchi state; significant relationship existed between level of
utilization of antenatal care services among pregnant women and prevention of maternal mortality in Bauchi
state. Based on the findings above, the following recommendations were made: health professionals should
intensify enlightenment campaign on the benefits of antenatal care in Bauchi state. Pregnant women should be
encouraged to attend antenatal care services regularly as soon as possible for early detection of risk factors,
resulting to maternal mortality. Government should provide adequate facilities and equipment of antenatal care
in Bauchi state
Latent Class Analysis of Adolescent Health Behaviorsasclepiuspdfs
Background: Behavior is one of the most important components in health. While the impacts of adolescent risky activities have been studied extensively, less attention has been paid to health. This study examines the patterning of health behaviors among adolescents age of 10–19 years. Methods: Latent class analysis identified homogeneous, mutually exclusive “classes” (patterns) of eight, leading health behaviors - sleep, alcohol consumption, cigarette smoking, physicians’ visits, meal autonomy, wearing braces, general health assessment, and having a permanent tattoo. Results: Resulting classes include (1) healthy, (2) moderately healthy, and (3) unhealthy. The characteristic behaviors and tendencies of each class differed by gender. Conclsion: This study attempts to classify adolescents by their own health behavior without including parental attributes. While adolescents do not typically prescribe to predictable behaviors and actions, the emphasis on healthy behaviors by some suggests an individual awareness of behavioral impacts and importance of healthy lifestyle choices
Taking place under the tagline ‘We can. I can.’, World Cancer Day 2016-2018 will explore how everyone – as a collective or as individuals – can do their part to reduce the global burden of cancer.
Just as cancer affects everyone in different ways, all people have the power to take various actions to reduce the impact that cancer has on individuals, families and communities.
World Cancer Day is a chance to reflect on what you can do, make a pledge and take action. Whatever you choose to do ‘We can. I can.’ make a difference to the fight against cancer.
WCD2016 website http://www.worldcancerday.org/ materials http://www.worldcancerday.org/materials and ways to help http://www.worldcancerday.org/get-involved
Does Utilization of Antenatal Care Reduces Reproductive Risk? A Case Study o...PRAKASAM C P
This paper examines the utilization of antenatal care and out come of pregnancy and delivery complications (Reproductive risk) among currently married women in Andhra Pradesh, India. Data for this study were collected from DLHS-RCH-3 for Andhra Pradesh. Pregnancy outcome has been collected for all deliveries from the currently married women and the utilisation of ANC, health seeing behavior, pregnancy problems during and problems during delivery which have been considered as reproductive risk and analysed for the last child data. Reproductive history of 19825 deliveries for Andhra Pradesh form data set. Analysis has been carried out in three stages. Initially Pregnancy loss and its ANC and treatment seeking behavior have been analysed. At the second stage pregnancy complications and delivery complications for the last delivery in relation to outcome has been analysed for Andhra Pradesh data. At the third stage interrelation between Pregnancy out come and reproductive risk has been analysed by using logistic regression. Further influence of background variables on reproductive loss and treatment seeking behavior has been analysed. The results revealed that women experience still birth in Andhra Pradesh found to be around 2.9. Further results revealed that women who had utilized antenatal care services found to have less risk in delivering last child than other. Maternal age and husband occupation played significant influence in utilization of health care services leading to safe delivery in these two selected states.
AIM AND OBJECTIVE: • To compare and assess the clinical features and outcome of pneumonia occurring in infants with traditional child rearing practices and in infants without traditional child rearing practices. • To assess the influence of individual traditional child rearing practices with the outcome of pneumonia occurring in infants. MATERIALS AND METHODS: : For this study detailed clinical history was taken. Infants with clinical and radiological evidence of pneumonia were selected as per the selection criteria The study. After eliciting necessary history some children were excluded using exclusion criteria. Detailed questionnaires were asked to mother / care taker which included details regarding various traditional child rearing practices. . RESULTS: On comparing and analyzing the clinical parameters and outcome of pneumonia in infants between traditional child rearing practices and without traditional child rearing practice. it is found that increased morbidity pattern of pneumonia in infants associated with traditional child rearing practices is high while comparing non traditional child rearing infants CONCLUSION: In my study increased morbidity in the infants is attributed to traditional child rearing practice, mortality was very less probably due to increased vaccination status and also due to increasing literacy rate in mothers.
Maternal and Neonatal morbidity and MortalityBPKIHS
It deals with:
Introduction
International Perspectives
National Status
Complication during Pregnancy, Childbirth, Postpartum period including Neonatal Problems
Causes of Maternal and neonatal mortality
Framework of determinants of maternal mortality
Three delay model
Background: Maternal health remains today, one of the major public health concerns in developing countries. Maternal deaths and newborn deaths usually occur within 48 hours of delivery. In Cameroon, despite all the initiatives set up by the Ministry of Public Health to reduce the mortality rate, the situation remains alarming in terms of postnatal consultation; this is much more felt in the West region of Cameroon, which is one of the most affected regions because 43.1% of women who give birth in hospitals do not return to postnatal consultation and this rate is higher than the national average with a value of 21.5%. Objective:This work aims to determine the factors influencing postnatal follow-up in the Bafang Health District. Methodology: This is a cross-sectional descriptive study for analytical purposes, carried out in the Bafang Health District between January 1 to November 30, 2017. Our study population consisted of all women of childbearing age living in the Bafang Health District during the study period. The variables studied were sociodemographic characteristics, socio-cultural characteristics and the provision of care. Results: Analysis carried out during this study, it appears that, the person who informs the women on the dates of rendez-vous during the CPoN (OR = 2.92; [95%CI = 1.16-7,]; p-value = 0.02), women who think the appropriate period of postnatal follow-up is 6 weeks postpartum (OR = 4.27, [95%CI = 1.47-12.39], p-value = 0.00 ) and those who massage the abdomen after childbirth (OR = 2.62, [95%CI = 1.34 - 5.12], p-value = 0.00) are more likely to have knowledge about follow-up postnatal. While women who have no knowledge of postnatal follow-up (OR = 0.18, 95%CI = 0.07-0.45, p-value = 0.00) are less likely to have more knowledge. Conclusion: Lack of knowledge of the existence and importance of postnatal consultation (CPoN), traditional practices are the factors that influence postnatal follow-up in the Bafang Health District. A good and effective care for women after childbirth requires increased awareness campaigns at the hospital level as well as in community settings.
This topic contains Meaning and definitions of midwifery, obstetrics, obstetrical nursing, midwife, scope of midwifery, basic competencies of a midwife, history of midwifery in nursing and development of maternity services in India.
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Vital statistics related to maternal health in indiaPriyanka Gohil
This topic contains introduction of vital statistics, list of important statistics, birth rate, death rate, specific death rates, infant mortality rate, neonatal mortality rate, under five mortality rate, maternal mortality rate (detailed), perinatal mortality rate (detailed), expectation of life, general fertility rate and still births.
Health System Factors Affecting Uptake of Antenatal Care by Women of Reproduc...Premier Publishers
This study sought to determine how health system factors affect antenatal care services uptake. A descriptive cross-sectional study design was adopted. The population under study was selected household members of the community, facility in charges as well as community own resource persons in Kisumu county. The study used purposive sampling method in selecting the Key Informants. A total sample size of 300 respondents were interviewed. The study used an interview and questionnaires to collect data. Descriptive statistics and chi-square tests were used to analyse data with the help of Statistical Package for the Social Sciences. Chi-square analysis showed that distance to facility (p=0.043), waiting time (p=0.012), means of transport used (p=0.016), perceived quality of services (p=0.000) and perceived attitude of service provider (p=0.000) were significant as pertains to number of ANC visits. The study concluded that health system factors affect uptake of ANC. Specifically, lack long distance to hospital, long waiting time, poor quality of services, commodity stock outs and poor attitude of staff. The combination of these factors reduced uptake of ANC. The study recommended integration of traditional birth attendants, community health workers and health care workers services, regular ANC Outreaches and better equipping of rural health facilities.
Community Wellness Through Improved Maternity Practices By Drs Jose Gorrin and Ana Parilla. Given at the Puerto Rican Cultural Center in September of 2003
Relationship of Antenatal Care with the Prevention of Maternal Mortality amon...iosrjce
The purpose of this study was to examine the relationship of antenatal care with the prevention of
maternal mortality among pregnant women in Bauchi state. An ex-post facto research design was used to study
308 subjects drawn from six local government areas in Bauchi state. The subjects were drawn through stratified
random sampling techniques. A close ended questionnaire was used to obtain responses from the subjects. Data
collected for this study were analyzed using descriptive statistics of mean and standard deviation and inferential
statistics of person product moment correlation analysis, 0.05 level of significance was used for all tests of
significance. Two research questions were asked and two hypotheses were tested at 0.05 level of significance.
Findings showed that, significance relationship existed between level of awareness and the prevention of
maternal mortality among pregnant women in Bauchi state; significant relationship existed between level of
utilization of antenatal care services among pregnant women and prevention of maternal mortality in Bauchi
state. Based on the findings above, the following recommendations were made: health professionals should
intensify enlightenment campaign on the benefits of antenatal care in Bauchi state. Pregnant women should be
encouraged to attend antenatal care services regularly as soon as possible for early detection of risk factors,
resulting to maternal mortality. Government should provide adequate facilities and equipment of antenatal care
in Bauchi state
Latent Class Analysis of Adolescent Health Behaviorsasclepiuspdfs
Background: Behavior is one of the most important components in health. While the impacts of adolescent risky activities have been studied extensively, less attention has been paid to health. This study examines the patterning of health behaviors among adolescents age of 10–19 years. Methods: Latent class analysis identified homogeneous, mutually exclusive “classes” (patterns) of eight, leading health behaviors - sleep, alcohol consumption, cigarette smoking, physicians’ visits, meal autonomy, wearing braces, general health assessment, and having a permanent tattoo. Results: Resulting classes include (1) healthy, (2) moderately healthy, and (3) unhealthy. The characteristic behaviors and tendencies of each class differed by gender. Conclsion: This study attempts to classify adolescents by their own health behavior without including parental attributes. While adolescents do not typically prescribe to predictable behaviors and actions, the emphasis on healthy behaviors by some suggests an individual awareness of behavioral impacts and importance of healthy lifestyle choices
Taking place under the tagline ‘We can. I can.’, World Cancer Day 2016-2018 will explore how everyone – as a collective or as individuals – can do their part to reduce the global burden of cancer.
Just as cancer affects everyone in different ways, all people have the power to take various actions to reduce the impact that cancer has on individuals, families and communities.
World Cancer Day is a chance to reflect on what you can do, make a pledge and take action. Whatever you choose to do ‘We can. I can.’ make a difference to the fight against cancer.
WCD2016 website http://www.worldcancerday.org/ materials http://www.worldcancerday.org/materials and ways to help http://www.worldcancerday.org/get-involved
Does Utilization of Antenatal Care Reduces Reproductive Risk? A Case Study o...PRAKASAM C P
This paper examines the utilization of antenatal care and out come of pregnancy and delivery complications (Reproductive risk) among currently married women in Andhra Pradesh, India. Data for this study were collected from DLHS-RCH-3 for Andhra Pradesh. Pregnancy outcome has been collected for all deliveries from the currently married women and the utilisation of ANC, health seeing behavior, pregnancy problems during and problems during delivery which have been considered as reproductive risk and analysed for the last child data. Reproductive history of 19825 deliveries for Andhra Pradesh form data set. Analysis has been carried out in three stages. Initially Pregnancy loss and its ANC and treatment seeking behavior have been analysed. At the second stage pregnancy complications and delivery complications for the last delivery in relation to outcome has been analysed for Andhra Pradesh data. At the third stage interrelation between Pregnancy out come and reproductive risk has been analysed by using logistic regression. Further influence of background variables on reproductive loss and treatment seeking behavior has been analysed. The results revealed that women experience still birth in Andhra Pradesh found to be around 2.9. Further results revealed that women who had utilized antenatal care services found to have less risk in delivering last child than other. Maternal age and husband occupation played significant influence in utilization of health care services leading to safe delivery in these two selected states.
AIM AND OBJECTIVE: • To compare and assess the clinical features and outcome of pneumonia occurring in infants with traditional child rearing practices and in infants without traditional child rearing practices. • To assess the influence of individual traditional child rearing practices with the outcome of pneumonia occurring in infants. MATERIALS AND METHODS: : For this study detailed clinical history was taken. Infants with clinical and radiological evidence of pneumonia were selected as per the selection criteria The study. After eliciting necessary history some children were excluded using exclusion criteria. Detailed questionnaires were asked to mother / care taker which included details regarding various traditional child rearing practices. . RESULTS: On comparing and analyzing the clinical parameters and outcome of pneumonia in infants between traditional child rearing practices and without traditional child rearing practice. it is found that increased morbidity pattern of pneumonia in infants associated with traditional child rearing practices is high while comparing non traditional child rearing infants CONCLUSION: In my study increased morbidity in the infants is attributed to traditional child rearing practice, mortality was very less probably due to increased vaccination status and also due to increasing literacy rate in mothers.
The relationship between prenatal self care and adverse birth outcomes in you...iosrjce
Birth outcomes refer to the end result of a pregnancy. The purpose of this study was to examine the
relationship between self care practices during pregnancy and adverse birth outcomes in young women aged 16
to 24 years at a provincial maternity hospital in Zimbabwel. A descriptive corelational design was used. Orem’s
Self Care theory was used to guide the study. Eighty pregnant women were selected using systematic random
sampling and, data was collected using interviews from the 1 March - 31 April 2012. Permission to carry out
the study was obtained from the provincial maternity hospital, the Department of Nursing Science and the
Medical and Research Council of Zimbabwe. Findings revealed such adverse birth outcomes as prematurity
(between 28-32 weeks) 10 (12.5%), still births, 3 (3.75%), low apgar 17 (21.2%) and low birth weight 16 (20%).
Adverse birth outcomes in the mothers included high blood pressure 32 (40%), HIV infection 20 (25%) and post
partum hemorrhage 7 (8.8%) Twenty-four (30%) participants had not booked for antenatal care, 1 (1.8%)
booked for antenatal care at less than 12 weeks while only 1 (1.8%) disclosed her pregnancy at above 29 weeks’
gestation. There was a moderate significant positive correlation between self care practices and adverse birth
outcomes, r=.340. This meant that birth outcomes improved as self care practices increased. Significant R2
. was
.115 meaning self care practices explained 11.5% of the variance observed in birth outcomes. Midwives should
advocate delay in sexual debut in young women to reduce adverse birth outcomes.
Apart from limited attempts to understand the sexual and reproductive health situations of street children in general, little is known about the overall psycho-social and health related circumstances surrounding pregnancy and child bearing practices of homeless women. The present research was at assessing the overall psycho-social circumstances surrounding Incidences of pregnancy and child bearing among homeless women in Shashemene town. A cross-sectional study design was used in which data were collected between December, 2018 and January, 2019. 163 homeless women, selected on the basis of purposive sampling procedure have participated in the study. Both qualitative and quantitative data were collected using survey and depth interview methods (methodical triangulation). While quantifi able data were entered in to SPSS version. 20 for further analysis, qualitative data were transcribed, organized, and narratively presented after fi nding themes in the data. Marriage between homeless women and their men counterparts is a common feature of social interaction in the study area. This social context may justify the fact that most (93.7%) women conceived their last babies intentionally. While respondents were relatively. better off in terms of receiving prenatal care (50.3%), the experience of attending postnatal health care services has been moderately low
(40.6%). Above all, street sides and religious compounds (2.8% & 2.8%, respectively) were also among the places where babies were delivered. Attendance of prenatal care was signifi cantly associated to education (-.284, P < 0.01) and postnatal care (.590, P < 0.01) while post-natal health care seeking behavior was signifi cantly associated to the number of children a woman have (.228, P < 0.01), age of respondents (.278, P < 0.01), experiences of attending prenatal care (.590, P < 0.01) and education (-.389, P < 0.01). Patterns of psycho-social relationships prevalent among the homeless women in Shashemene town hold similarity with the pattern existing in the mainstream society. The concerned governmental and non-governmental organizations should work to enhance the
awareness of the homeless women about contraceptive methods, its advantage, and how it is relevant to their living situations.
[[INOSR ES 11(2)108-121, 2023.Evaluation of Male partner participation in pre...PUBLISHERJOURNAL
Evaluation of Male partner participation in prevention of mother to child transmission of HIV/AIDs at Hoima Referral hospital
Sebwami Richard
School of Allied Health Sciences, Kampala International University Uganda.
________________________________________
ABSTRACT
The purpose of the study was to assess the knowledge and attitude, the level of male involvement and factors associated with male involvement in the prevention of mother-to-child transmission of HIV in Hoima municipality. This study was a descriptive cross section in which quantitative method of data collection was employed in collection of data from respondents. Questionnaires were distributed to participants to assess the knowledge and attitude, the level of male involvement and factors associated with male involvement in prevention of mother-to-child transmission of HIV (PMTCT) in Hoima municipality. Sample size of 200 participants were used, this included the Male partners who hard escorted their pregnant partners to the antenatal clinic aged between 20-50years.The predominant religion were Catholics 59% and seventh day Adventists. Regarding educational levels, majority of respondents had completed secondary level and above (61%) and the predominant ages were between 20-29 years. The study revealed that very few males partner were involved in the PMTCT program especially during HIV counseling and testing (HCT) because of being at old age group above 30years couples, couples not living together, high number of wife’s pregnancies four and above, having no knowledge on methods of MTCT, and husbands failure to discuss HCT with their wives. From the findings, majority of the respondents have ever had about the male involvement in the PMTCT but there was still low male involvement in PMTCT programs at antenatal clinics. There is a need to do an in-depth assessment of women’s experiences when tested HIV-positive in the presence of their partners at the ANC, as well as to develop strategies to improve male involvement. The study again recommends formative research on the use of incentives to promote male involvement in the PMTCT program and the government should train more of the health promoters and the Village Health Teams in order to reach even those that are deep in the village that are not having easy access to the health facility.
Keywords: HIV, Hoima municipality, Male partner, counseling
Knowledge of Cervical Cancer among Women of Reproductive Age in Ibadan North...GABRIEL JEREMIAH ORUIKOR
Nigeria has one of the highest rates of cervical cancer morbidity and mortality in Sub-Saharan Africa. Both the human
papillomavirus vaccine (HPV) and cervical screening are effective
prevention strategies against both HPV infection and cervical cancer. Lack
of awareness, limited knowledge, limited decision-making agency, lack of spousal support and stigma are barriers to uptake of these preventive
measures.
Cervical cancer is a deadly disease claiming the lives of many women in
developing countries due to late presentation which might be influenced by a lack of knowledge of the disease and its prevention.
This descriptive study examined the knowledge assessment of Cervical cancer among women of reproductive age (15-49), about cervical cancer, its prevention, and their utilization of Pap smear screening; using a convenience sample of 426 women in Ibadan North Local Government Area of Oyo State, Nigeria. Women voluntarily completed a structured questionnaire.
Results showed that women who participated in the study were
aware of cervical cancer (77%; n=328) but many (62.9%; n= 268) were
unaware of Pap smears as the screening tests for cervical cancer. Although 41.3% (n=176) were knowledgeable about cervical cancer, risk factors and prevention, only 9.4% (n=40) had Pap smear tests done.
Health care professionals, need to intensify efforts to increase
awareness about cervical cancer screening, and encourage women through the different clinics to use these services. The benefits of screening and early diagnosis of cervical cancer should be emphasized to enhance the utilization of cervical cancer screening services.
KNOWLEDGE GAPS IN MALARIA MANAGMENT IN CAMEROON.pptxFidelityP
Malaria is a vector borne infectious disease caused by protozoan parasites of the genus Plasmodium and is transmitted by an infected female Anopheles mosquito. Until the late 19th Century, the contributory agent for malaria was largely unknown.
Malaria is one of the commonest infections, disproportionately affecting children and pregnant women
In 2019, an estimated 409,000 people died of malaria. Most (274,000) were young children, and 94% of the infections and deaths occurred in Africa. (WHO, 2019)
Children under five years are one of the most vulnerable groups affected by malaria. Severe anaemia, hypoglycaemia and cerebral malaria are features of severe malaria more commonly seen in children than in adults.
According to the WHO 2016 report, the global prevalence of malaria among under-five children was 16%. In the same year, the prevalence in Ethiopia was 0.6%.
Malaria is the most widespread endemic disease in Cameroon, responsible for 2.7 million reported cases, and absenteeism from school and work annually. It continues to be a major public health problem and is the first cause of infant-child morbidity and mortality with a mortality rate in children under five, estimated at 40%.
Much is being done to curb and eradicate malaria infection by the government, USAID and more.
SOCIO-CULTURAL AND BEHAVIORAL FACTORS INFLUENCING CHILDHOOD IMMUNIZATION PR...GABRIEL JEREMIAH ORUIKOR
Abstract: Background: Immunization is one of the most cost-effective interventions with proven strategies to reach
the vulnerable populations. It is also a proven tool for controlling and eliminating life threatening infectious diseases.
It also prevents illness, disability and deaths from vaccine preventable diseases averting estimated 2-3 million deaths
each year.
Method: A descriptive survey research design was adopted, one hundred 100 nursing mothers were used for the
study. The instruments used for the study was a self-structured questionnaire. Simple random sampling technique
was used to select the sample for the study. Data collected were analysed using frequency, counts and percentage
table for demographic information.
Result: The findings of the study revealed that behaviour/attitude of healthcare workers and lack of enough
information were determinants of incomplete routine immunization, while life style, religion and belief were not
determinants of incomplete routine immunization. However, level of education, distance to health facility, life style,
religion and belief were jointly determinants of incomplete routine immunization among nursing mothers in Jericho
specialist hospital.
Conclusion: Based on the findings of the study; it is therefore recommended that State Government and
Philanthropists should assist in building more health care facilities close to the communities for easy accessibility.
Effort should be geared towards public campaign using local dialect to encourage them to complete routine
immunization. In addition, community mobilization should be strengthening especially among nursing mothers to
be fully informed about the merits of completing the routine immunization and to avert childhood morbidity and
mortality in our society.
ABSTRACT- Background: Malnutrition constitutes a major public health concern worldwide and serves as an indicator
of hospitalized patient’s prognosis. Nutritional support is an essential aspect of the clinical management of children
admitted to hospital. Malnutrition has been long associated with poor quality, poor diet and inadequate access to health
care, and it remains a key global health issue that both stems from and contributes to weakness, with 50% of childhood
deaths due to principal under nutrition.
Methods: The present hospital based cross sectional study was conducted in April to Dec 2015 among 300 rural
adolescents of 9-18 years age (146 boys and 154 girls) attending the outpatient department at Patna Medical College and
Hospital, Bihar, India, belonging to the all caste communities. The nutritional status was assessed in terms of under
nutrition (weight-for-age below 3rd percentile), stunting (Height-for-age below 3rd percentile) and thinness (BMI-for-age
below 5th percentile). Diseases were accepted as such as diagnosed by pediatrician, skin specialist and medical officer.
Results: The prevalence of underweight, stunting and thinness were found to be 31%, 22.3% and 30.7% respectively. The
maximum prevalence of malnutrition was observed among early adolescents (23% - 54%) and the most common
morbidities were diarrhoea (16.7%), carbuncle / furuncle (16.7%) and scabies (12%).
Conclusion: Malnutrition among hospitalized under five children and around suffers moderately high rates of
malnutrition. Present nutrition programs attention on education for at risk children and referral to regional hospitals for
malnourished children. Screening tools to classify children at risk of developing malnutrition might be helpful.
Key-words- Malnutrition, Hospitalized children, Morbidities, Prevalence, Stunting
Early Detection of Breast Cancer: Awareness and Practice of Self Breast Exami...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Similar to International Journal of Reproductive Medicine & Gynecology (20)
A 5-year old boy, with an established diagnosis of a topic
dermatitis, previously treated by topical corticosteroids and emollient cream with a good improvement, developed widespread papules on his legs, hands and forearm that appeared 5 months ago.
Methods: Retrospectively, the file records of the patients who underwent sleeve gastrectomy were examined. Demographic features, Body Mass Index (BMI), the mouth opening, Mallampati score, thyromental distance, sternomental distance, neck circumference measurements and videolaryngoscopic examination results were recorded Results: In a total of 140 consecutive patients (58 male, 82 female) were included in the study. The mean age of the study participants was 35.40 ± 9.78 and the mean BMI of the patients was 44.33 ± 7.52 kg/m2
. The mean mouth opening of the patients was 4.82 ± 0.54 cm
and the mean neck circumference was 43.52 ± 4.66 cm. The mean thyromental distance was 8.02 ± 1.00 cm and the mean sternomental distance was16.58 ± 1.53 cm. Difficult intubation was determined in 8 (5.7%) patients. In logistic regression analysis, age (p : 0.446), gender (p : 0.371), BMI (p : 0.947), snoring (p : 0.567), sleep apnea (p : 0.218), mouth opening (p : 0.687), thyromental distance (p :0.557), sternomental (p : 0.596) and neck circumference (p : 0.838) were not the independent predictors of difficult intubation. However, Mallampati score (p : 0.001) and preoperative direct laryngoscopy findings (p : 0.037) performed in outpatient clinic were the significant
predictors of difficult intubation. Interestingly, all patients with grade 4 laryngoscopy findings had difficult intubation.
Introduction: Laparoscopic surgery has been performed in Mexico since 1989, but no reports about training tendencies exist. We conducted a national survey in 2015, and here we report the results concerning training characteristics during the surgical residence of the respondents. Materials and Methods: A prospective study was conducted through a survey questioning demographic data, laparoscopic training during pre and post surgical residency and other of areas of laparoscopic practice. The sample was calculated and survey piloted before
application. Special interest in this report was placed on type and quality of training received. Data are reported in percentages.
Heterotopic Ossification (HO) is defined as pathological bone formation at locations where bone normally does not exist. The
presence of HO has been found to be a rare complication after stroke in several studies, whereas there are only sporadic references relating HO to Cerebral Palsy (CP) and few for CP and stroke. No effective treatment for HO has yet been found, whereas the cellular and molecular mechanisms have not been completely understood. Therefore, increased awareness among physicians is required, as a challenge for early diagnosis and treatment. A case of a male patient with CP, who developed HO on the paretichip joint following an ischemic stroke is presented.
Objectives: To assess the practice of food hygiene and safety, and its associated factors among street food vendors in urban areas of Shashemane, West Arsi Zone, Oromia Ethiopia, 2019.
Methods: Cross-sectional study design was applied from December 28, 2019 to January 27, 2020. Data was collected from 120 food handlers, which were selected by purposive sampling techniques. Information was gathered from interview and field observation by conducting food safety survey and using questionnaires via face to face interview. The collected data was entered using Epi Data 3.1 and finally, it was analyzed using SPSS VERSION 20.
A Division I football athlete experienced acute posterior leg pain while pushing off on the line of scrimmage. Ultrasound (US) showed a midsubstance plantaris tendon rupture, an injury that, to our knowledge, has only been described once before in the medical literature [1]. US was also used to assist with rehab progression and return to previous level of activity, which was achieved three weeks after the injury. While there currently are no guidelines regarding return to sport after this injury, this case demonstrates that once pain is controlled and ROM restored, progression through rehabilitation and return to elite level sport is simply based on symptoms.
Type 1 Diabetes (T1D), is a severe disease, representing 5-10% of all reported cases of diabetes worldwide. Fulminant Type 1 Diabetes Mellitus (FT1D) is a subtype of type 1 diabetes mellitus that is largely characterized by the abrupt onset of Diabetic Ketoacidosis (DKA) and severe hyperglycemia without insulin defi ciency. Viral infections have been hypothesized to play a major role in the pathogenesis of Fulminant Type 1 Diabetes Mellitus (FT1D) through the complete and rapid destruction of pancreatic beta cells. Coxsackie viral infection has been detected in islets of 50% of the pancreatic tissue recovered from recent-onset Type 1 Diabetes (T1D) patients. In this report we have highlighted a case where the patient developed a Group B Coxsackie virus infection culminating in the development of Fulminant Type 1 Diabetes Mellitus (FT1D).
Methods: Cercariae are released by infected water snails. To determine the occurrence of cercariae-emitting snails in SchleswigHolstein, 155 public bathing places were visited and searched for fresh water snails. Family and genus of the collected snails were determined and the snails were examined for the shedding of cercariae, using a standard method and a newly developed method.
Objective: To generate preliminary information about of enteroviruses and Enterovirus 71 (EV71) in patients with aseptic meningitis in Khartoum State, Sudan.
Method: Cerebrospinal fluid specimens were collected from 89 aseptic meningitis patients from different Khartoum Hospitals
(Mohammed Alamin Hamid Hospital, Soba Teaching Hospital, Omdurman Military Hospital, Alban Gadeed Teaching Hospital and Police Hospital) within February to May 2015. Among these 89 patients, 43 (48%) were males and 46 (52%) were females. The patient’s age ranged between 1 day and 30 years old. The collected specimens were assayed to detect enteroviruses and EV71 RNA using Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) technique
Femoral hernias, comprise 2% to 4% of all hernias in the inguinal region, and occur most commonly in women. Th ey present typically with a mass below the level of the inguinal ligament. The sac may contain preperitoneal fat, omentum, small bowel, or other structures and have a high rate of incarceration and strangulation due to the small size of the hernia neck orifice, requiring emergency surgery. We present the case of a 54-year-old female patient with intestinal occlusion due to incarcerated femoral hernia, repaired by laparoscopic approach, that gave the patient the opportunity to attend her daughter’s wedding the same day.
Small Supernumerary Marker Chromosome (sSMC) is a rare genetic condition marked by the presence of an extra chromosome to the 46 human chromosomes. This case report describes a 4 year old child with SSMC on the 46th chromosome. The child presented with delayed speech and language development, seizures and mild developmental delay. Speech and Language evaluation was carried out and management options are discussed.
A catheter is a thin tube made from medical grade materials that serve a broad range of functions, but mainly catheters are medical devices that can be inserted in the body to treat disease or perform surgical procedures. Catheters have been inserted into body cavities, ducts, or vessels to allow for drainage, administration of therapeutic fluids or gases, operational access for surgery. Catheters help perform tasks in various systems such as cardiovascular, urological, gastrointestinal, neurovascular, and ophthalmic systems. A dataset of 12 patients with varying “weights” and “heights” was recorded along with the lengths of their catheter tubes. This data set was found from two revered statistical textbooks on linear regression and the Department of Scientific Computing at Florida State University. This data set was not able to be linked to any particular clinical or experimental research studies, but the data set can be used to help catheter manufacturers and medical professionals better decide on what particular catheter lengths to use for patients knowing only their height & weight. These research insights could be helpful to healthcare professionals that have patients with incomplete or no healthcare records
to decide what catheter length to use. The main investigative inquiry that needed to be answered was how does patient weight & height influence catheter length together and separately? We conducted linear regression and other statistical analysis procedures in R program & Microsoft Excel and discovered that this data exhibited a quality called multi collinearity. With multi collinearity, all predictors (2 or more
independent variables) are not significant in an all encompassing linear aggression, but the predictors might be significant in their own individual linear regressions. Individual linear regression analyses were conducted for both patient height & weight to see how much they both contribute to varying catheter length. Patient weight was found to be more impatful than patient height in relationship to catheter length, even though height and weight are a classical example of multi collinearity predictors.
Bovine mastitis has a negative impact through economic losses in the dairy sector across the globe. A cross sectional study was carried out from September 2015 to July 2016 to determine the prevalence of bovine mastitis, associated risk factors and isolation of major causative bacteria in lactating dairy cows in selected districts of central highland of Ethiopia. A total of 304 lactating cows selected randomly from five districts were screened by California Mastitis Test (CMT) for subclinical mastitis. Based on CMT result and clinical examination, over all prevalence of mastitis at cow level was 70.62% (214/304).
Two hundred fourteen milk samples collected from CMT positive cows were cultured for isolation of major causative bacteria. From 214 milk samples,187 were culture positive and the most prevalent isolates were Staphylococcus aureus 42.25% (79/187) followed by Streptococcus agalactiae 14.43%
(27/187). Other bacterial isolates were included Coagulase Negative Staphylococcus species 12.83% (24/187), Streptococcus dysgalactiae 5.88% (11/187), Escherichia coli 13.38% (25/187) and Entrococcus feacalis 11.23% (21/187) were also isolated. Moreover, age, parity number, visible teat abnormalities,husbandry practice, barn fl oor status and milking hygiene were considered as risk factors for the occurrence of bovine mastitis and they were found significantly associated with the occurrence of mastitis (p < 0.05). The findings of this study warrants the need for strategic approach including dairy extension that focus on enhancing dairy farmers’ awareness and practice of hygienic milking, regular screening for subclinical mastitis, dry cow therapy and culling of chronically infected cows.
Kratom is an herbal product that is derived from Southeast Asian Mitragyna speciose tree leaves [1-10]. This compound is used for many purposes such as stimulation, euphoria, or analgesia [1-10]. It has been recently identified as a drug of abuse by the United States Drug Enforcement Administration [2,8]. Side-effects from this compound have not been well documented. We describe a case of a 36-year-old female who develop nephrotoxicity after taking an herbal supplement. She took kratom as an adjunctive therapy for back pain management. She developed right upper quadrant pain and nausea. Laboratory tests showed elevated liver enzymes without evidence of bile duct obstruction. Liver enzymes normalized several weeks after Kratom discontinuation. We advise clinicians to be vigilant about Kratom’s hepatotoxic potential on patient health.
The assessment, diagnosis and treatment of critically ill patients is extremely challenging. Patients often deteriorate whilst being
reviewed and their rapidly changing pathophysiology barrages healthcare professionals with new data. Furthermore, comprehensive assessments must be postponed until the patient has been stabilised. So, important data and interventions are often missed in the heat of the moment. In emergency situations, suboptimal management decisions may cause signifi cant morbidity and mortality. Fortunately, standardisation and careful design of documentation (i.e. proformas and checklists) can enhance patient safety. So, I have developed a series of checklist proformas to guide the assessment of critically ill patients. These proformas also promote the systematic recording and presentation of information to facilitate the retrieval of the precise data required for the management for critically ill patients. The proformas have been modifi ed extensively over the last twenty years based on my personal experience and extensive consultation with colleagues in several world-renowned centres of excellence. The proformas were originally developed for use in the intensive therapy unit
or high dependency unit. However, they have been adapted for use by outreach teams reviewing patients admitted outside of critical care areas. The use of these tools can direct eff orts to provide appropriate organ support and provides a framework for diagnostic reasoning.
Systemic Hypertension (HTN) accounts for the largest amount of attributable Cardiovascular (CV) mortality worldwide. There are several factors responsible for the development of HTN and its CV complications. Multicenter trials revealed that risk factors responsible for Micro Vascular Disease (MVD) are similar for those attributable to Coronary Artery Disease (CAD) which include tobacco use, unhealthy cholesterol levels, HTN, obesity and overweight, physical inactivity, unhealthy diet, diabetes, insulin resistance, increasing age and genetic predisposition. In addition, the defective release of Nitric Oxide (NO) could be a putative candidate for HTN and MVD. This study reviewed the risk stratification of hypertensive population employing cardiac imaging modalities which are of crucial importance
in diagnosis. It further emphasized the proper used of cardiac imaging to determine patients at increased CV risk and identify the management strategy. It is now known that NO has an important effect on blood pressure, and the basal release of endothelial Nitric Oxide (eNOS) in HTN may be reduced. Although there are different forms of eNOS gene allele, there is no solid data revealing the potential role of the polymorphism of the eNOS in patients with HTN and coronary vascular diseases. In the present article, the prevalence of eNOS G298 allele in hypertensive patients with micro vascular angina will be demonstrated. This review provides an update on appropriate and justified use of non-invasive imaging tests in hypertensive patients and its important role in proper diagnosis of MVD and CAD. Second, eNOS gene allele and its relation to essential hypertension and angina pectoris are also highlighted.
Methods: Two groups were selected by non-probability random sampling technique including case group of 154 patients with
suspected dengue (fever>2days and <10days) and control group of 146 patients with febrile illness other than dengue. Clinical,hematological and serologic markers of cases and control groups were analyzed. The frequency distribution was used to compare categorical serologic markers and paired sample T test was applied for hematologic variables before and after treatment of dengue using SPSS version 21.
Researchers from Utrecht recently published yet another paper on the use of Magnetic Resonance Imaging (MRI)demonstrating an additional failed attempt to understand the importance of qualitative versus quantitative imaging, and anatomic versus physiologic imaging. Th e implications of this failure here cannot be overstated.
Introduction: Stroke is an even more dramatic major public health problem in young people. Goal of the study: Contribute to the knowledge of strokes in young people. Methodology: This was a retrospective study carried out over a period of 02 years (January 2017 to December 2018) including the files of patients aged 18 to 49 years hospitalized for any suspected case of stroke in the Neurology department of the University Hospital
Center of the Sino-Central African Friendship (CHUSCA) of Bangui.
Background: This report describes a unique case of a patient that developed psychotic symptoms believed to be secondary
to a tentorial meningioma with associated hydrocephalus. These psychotic symptoms subsequently abated with placement of a
ventriculoperitoneal shunt. Case description: 60-year-old female was admitted to an inpatient psychiatric facility on a psychiatric involuntary commitment petition due to progressive paranoia, homicidal ideation and psychosis. The work up showed a calcified six cm tentorial meningioma with associated hydrocephalus. The patient initially rejected treatment but later became amenable to placement of Ventriculoperitoneal Shunt
(VPS).
More from SciRes Literature LLC. | Open Access Journals (20)
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. SCIRES Literature - Volume 3 Issue 2 - www.scireslit.com Page - 052
International Journal of Reproductive Medicine & Gynecology
INTRODUCTION
Traditional Birth Attendants (TBAs henceforth) or matrons
have been, over history, the main human resources for women who
deliver. With the passage of time, depending on cultures and customs,
and until today, they oversee most of the deliveries in rural areas of
emerging countries. Their role cannot be denied when it comes to
their cultural competence, comfort, empathy and psychological
support during delivery. TBAs are found in most communities all over
the world though their nature and function vary considerably. The
World Health Organisation (WHO) defines a TBA as “a person who
attends to a mother during delivery and who has initially acquired her
competences by delivering on her own or working with another TBA”
[1]. TBAs lack in formal training and their competences are initially
acquired either by delivering babies or by learning from other TBAs.
The aim of the KAP study on TBAs is to contribute in the reduction of
maternal/infant mortality and morbidity by identifying bad practices
that could be improved upon through training offered to matrons.
Such training offers centre around the training of TBAs to achieve
deliveries with more hygiene and security, discourage bad practices,
identify danger signs and refer women with complications to health
facilities where essential obstetrical cares are offered.
JUSTIFICATION OF THE STUDY
The reduction of maternal and infant mortality represents two
main targets of the Millennium Development Goals [2]. Almost four
million new-born babies die before the age of one month every year
and a similar number of stillborn babies is recorded. In the meantime,
more than half a million of mothers die of their pregnancy and the
majority of the cases occur in poor areas. Almost 43% of the sum
total of living births are taken care of by traditional birth attendants
(including their family members) in poor areas and this ratio is far
higher in some rural areas [3].
Traditional birth attendants are indeed a main component in
reducing maternal mortality. Hence, it is worth evaluating their
knowledge, attitudes and practices in a bid to better work out
trainings that could be offered.
RESEARCH HYPOTHESIS
Traditional birth attendants have knowledge, attitudes and bad
practices as far as recognizing danger signs of pregnancy and the
prevention of infections are concerned.
OBJECTIVES
General Objective
The general objective of our study was to evaluate knowledge,
attitudes and practices of traditional birth attendants with regard
to their ability to recognize danger signs of pregnancy and the
prevention of infections.
Specific Objectives
There were four:
-determine socio demographic characteristics of traditional birth
attendants.
-determine different danger signs of pregnancy identified by
traditional birth attendants.
-evaluate knowledge and practices of matrons with regard to
referring patients.
-evaluate knowledge and practices of matrons with regard to the
prevention of infections.
TOOLS AND METHODS
Location of the study
The study was carried out in Nkongsamba chief town of the
Moungo division. This was during a seminar on the training of
traditional birth attendants.
Type of the study
It was a Knowledge Attitudes and Practice study (KAP).
Duration of the study
The study took place between the 26 and the 30th of September
2011.
Population of the study
The population consisted of 30 traditional birth attendants.
They represented the Littoral region during a seminar on the
identification of danger signs in pregnancy and the prevention of
infectious risks. Matrons were selected from health districts relying
on the identification register and their intervention as traditional
birth attendants. All matrons who participated in the seminar were
interviewed for the study. Matrons who were not willing to participate
ABSTRACT
We report on the results of a survey carried out on 30 Traditional Birth Attendants (TBA) in the littoral region of the Republic of
Cameroon. The main objective of this survey was to evaluate knowledge, attitudes and practices of traditional birth attendants with
regard to their ability to recognize danger signs during pregnancies and the prevention of infections. The survey did not include trained
birth attendants who perform deliveries in homes. The mean age of traditional birth attendants was 49.6 years; the lowest age being 33
and the highest 69. 30% of the matrons were self-made. 19 of them, representing 63.3% had received a given training. All the informants
acknowledged having referred parturients even though the practice was only systematic with 40% of them. In all, 56.7 % of the matrons
referred parturients during labor and 27.7% before labor. 87% of the matrons interviewed referred patients for convulsions, 63.3% for
abundant bleeding, 26.7% for prior history of C-section, 23.3% for fever or when the abdomen was so large. A single matron referred
patients when the labor time rose up to 12 hours. No parturient was referred as a result of the loss of the amniotic fluid before labor.
Hand washing was systematic for 73.3% of the matrons. Six of them, representing 20% used barriers against infections. They only used
glove for this purpose. Generally, water and soap were used to sterilise tools (76.7%). Only 23.3% of TBA systematically directed their
patients to health centers upon delivery. Traditional birth attendants being an essential component in reducing maternal and neo-natal in
low-income countries ought to be empowered in recognizing danger signs of pregnancies and the prevention of infections.
Keywords: Traditional Birth Attendants; Infections; Pregnancy
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International Journal of Reproductive Medicine & Gynecology
in the survey and who did not work within the littoral region were
excluded from the study. Health personnel who performed delivery
at homes were also excluded from the survey.
Sampling
The sample size consisted of 30 participants. The survey was
carried out following a stratified sampling at two levels on different
health districts of the Littoral region of the Republic of Cameroon.
Method
A questionnaire was designed at the beginning of the training.
This questionnaire was about knowledge, attitudes and practices of
traditional obstetricians as concerns their recognition of danger signs
of pregnancy and the prevention of infections. The questionnaire was
made up of four parts; namely birth attendant’s socio demographic
characteristics, information on their activities, the recognition of
danger signs in pregnancy and practices with regard to prevention
of infections. The questionnaire was introduced to all participants
at the beginning of the training session. Training facilitators were
responsible for helping birth attendants who could not fill in the
questionnaire by themselves. Forms were collected at the end of the
training and later analyzed.
Tools used
- Individual data sheets
- Stationaries (pencils, pens, eraser…)
Statistical analysis
Data were analyzed with the computer. In order to calculate
means and percentages the epi info and excel software were used and
the obtained data presented in histograms and tables.
RESULTS
Socio demographic characteristics of birth attendants
The minimum age of traditional birth attendants stood at 49.6
years with the lowest age standing at 33 years and the highest at 69.
In total, 23.3% of the birth attendants were single woman. As low
as 16.7% were traditional healers. 17 of them, representing 56.6%,
practiced other income generating activities such as farming, selling
while 13 being 26.7 % had no other activities. As concerns the level
of education, 73.3% had not accessed secondary education. None of
the birth attendants had been to higher education. 30% of the birth
attendants confirmed they had obtained their skills on their own. 19
of them, representing 63.3% had undergone training from any third
party. Generally, birth attendants were paid in kind: soap, table birds,
and tubers. Those who received money would earn 2000 CFA francs
per delivery (table 1).
Referral practices
All the interviewees acknowledged having referred parturients.
40 % of them referred parturients to other health centers on a regular
basis. In total, 86.7% referred for convulsions, 63.3% for abundant
bleeding, 26.7% for prior history of caesarean section and 23.3% for
fever or when the stomach was too large. As low as 1 birth attendant
referred parturients when the labor duration was above 12 hours. No
parturient was referred because of fluid loss before labor. In total,
56.7% of the birth attendants referred parturients during labor and
26.7% before the beginning of labor (table 2).
Prevention of infectious risks
Hand washing was systematically observed by 73.3% of the birth
attendants. Six matrons, representing 20% used barriers against
infections. Gloves were the only barrier used. 60% used a new blade
for cutting the cord. Other risky and infectious gestures included: the
treatment of the placenta (46.7%), the administration of traditional
concoctions on the cord (46.7%), traditional cares to the new-born
baby (53.3%). Tools were generally sterilized with water and soap
(76.7%). Wastes were dumped in community rubbish dumps by
86.7% of the matrons. Only 23.3% of the matrons systematically
referred their patients to health centers upon delivery (table 3).
DISCUSSION
Thirty matrons, working in the littoral region of the republic
of Cameroon, were interviewed during a training seminar held by
the Ministry of Public Health on the recognition of danger signs
of pregnancies and the prevention of infections. The mean age of
matrons was 49.6 years. The youngest matron who was interviewed
was 33 years, the oldest being 69 years and still fully employed. Our
results are different from Thatte’s [4] findings whose informants’
mean age was 42 years with 35 and 60 years being the youngest and
Table 1: socio demographic characteristics of birth attendants.
variables Number /30 (%)
Matrimonial status
single 5(16.7)
Married 17(56.7)
widow 8(26.6)
Profession
Liberal Profession 17(56.7)
housewife 13(26.7)
healer 5(16.7)
Level of education
none 11(36.6)
Primary
Secondary
11(36.6)
8(26.8)
Higher education 0(0.0)
Acquisition of knowledge
After training 2(6.7)
Trained by a third party 19(63.3)
Self-trained 9(30)
Table 2: Referral practice.
variables Number/30 (%)
Referral Practice
Yes, often 12(40)
Yes, rarely 18(60)
Justification of the
referral practice
Prior history of C-section 8(26.7)
Prior history of peripartum death 4(13.3)
Too large stomach 7(23.3)
Abundant vaginal bleeding 19(63.3)
Breech presentation 9(30)
Feet oedema 6(20)
Convulsions 26(86.7)
jaundices 2(6.7)
headaches 5(16.7)
Great multiparity 3(10)
labor > 12 hours 1(3.30
loss of amniotic fluid 0(0.0)
fever 7(23.3)
unlimited contractions 3(10)
The moment of reference
During pregnancy 8(26.7)
During labor 17(56.7)
In post-partum 5(16.6)
post-partum check-up in
a hospital
yes 7(23.3)
No 23(76.7)
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oldest matrons. Tina [5], conversely, found out a mean age that stood
at 47.1 years that is close to our results. In general, matrons are adults
whose age falls between 40 and 50 years.
Most of the matrons who were interviewed, thus 83.7%, were
married or widows. 5 of them were single women. This contrasts with
Itina’s [6] series whereby 92.4% are either married or widow. All these
women started practicing as matrons when they were delivered by
themselves and others after menopause. But although there is no set
rule, it may be surprising to see a woman who has never given birth
to become a matron.
As concerns their profession, 5 matrons representing 16.7% were
in the meantime traditional healers and 56.6% were either traders or
farmers. Only 26.7% did not exercise any other activities. Our result
differs from Salako’s series [7] whereby almost half of the traditional
birth attendants (43.1%) were not involved in other activities. The
matrons that we interviewed argued that the low frequency of birth
prompted them to practice other trades so as to cater for their family
needs.
The majority of matrons (73.3%) had not undertaken secondary
education. In fact, 36.6% had not had access to education and the
same was true of the percentage of those who had not accessed basic
education. None of them had undertaken higher education. Similar
results were disclosed by Bassey, et al. [8]. with the following rates:
44.3% and 31.4% for women who did not attend any formal education
and those who had attended the basic education level; respectively.
Matrons are generally housewives without no genuine instruction [9].
The mean length of service stood at 12.1 years. The most experienced
matron had 30 years of experience and she is still practicing.
The average number of deliveries per month stood at 1.16; being
almost 576 deliveries per year for the 30 interviewees. This further
shows their contribution in the reduction of maternal mortality. Only
16.7% exclusively practiced deliveries in their homes. The remaining
83.35% would practice deliveries either at the parturient’s home or in
their own home.
The majority of matrons that is 19 of them; representing 63.3%
had learned the trade from a third party (mother, mother-in-law,
aunt). Nine matrons, representing 30%, declared having acquired
their competence on their own.
Most of them were multiparous women whose know-how was
developed gradually. In our series, irrespective of the learning path,
observation is the main path used to transmit and acquire a know-
how and not theoretical knowledge learned. In Tina’s series [5], all
of the matrons acknowledged having undertaken an initial training.
Her study dealt with the assessment of experiences and the change in
practices of TBAs who had an initial training.
TBAs were paid in kind. The most classical gifts consisted of some
soap, table birds, and tubers. Four matrons declared having perceived
money to the tune of 2000 CFA francs in average. In general, matrons
practice in rural areas whereby, assistance to delivery is rewarded
with presents following customs and traditions of people.
When there was a complicated delivery, matrons declared that
they referred mothers to the nearest hospital or health center. Their
attitude towards reference was not, however, always the same because
the most experienced matrons rarely referred mothers to such health
facilities. In our study, they represented 40% of our sample.
Such a practice accounts for the presence of a hybrid situation of
taking care of pregnant women that may certainly translate the impact
of trainings that are offered them in their daily practices. The same is
true in Tina’s [5] series whereby only 53% of matrons acknowledged
having referred patients. In fact, in this series, most of the TBAs had
benefitted from training. It is at this stage that we see the significance
of training matrons. The issue is rather to prompt matrons to refer
patients in time and not to limit the number of referred cases through
trainings.
Interviewed on referral indicators, participants listed situations
and signs that required the direction of pregnant women to health
services.Themostfrequentsituationswerethefollowing:Convulsions
(86.7%), Abundant vaginal bleeding (63.3%), breech presentation
(30%), large stomach (23.3%), prior history of C-Section (26.7%),
fever (23.3%), feet oedema (20%), jaundice (6.7%), great multiparity
(10%), and unlimited contractions (10%). None of the matrons
referred patients in case of water burst before the beginning of labor.
One matrons indicated that she referred patients who spent more
than 12 hours in labor. In this case, most of the matrons declared that
they could wait between 12 to 48 hours before referring. Even after
normal delivery, only 23.3% systematically directed their patients to
health units. In Keri’s [10] study, the mostly reported cases that were
referred include: the spacing of contractions or their rapprochement,
the water burst default despite contractions, the poor presentation of
the foetus, twin pregnancies, prior C-section history, and primipara.
The recognition of danger signs is diversely appreciated by matrons.
Nevertheless, matrons could improve on their referral practices [11].
In a case-control study dealing with the evaluation of the impact
of matrons on the recognition of danger signs of pregnancies and
referral practices, Akpala [12] discovers significant differences (p <
0.01) for the following criteria: pregnant women aged less than 16
years (74% vs 19%), and those aged more than 35 years (63% vs 16%),
minor size (72% vs 0), prior inter partal haemorrhage history (77% vs
13%), labor beyond 24 hours (95 vs 39 %), pregnancy oedema (67%
vs 19%). Concerning the maternal-foetal outcome, Sibley’s [13] meta-
analysis reports that the training of TBAs correlates with an 8 to 10
% of perinatal and neonatal asphyxia; respectively. The World Health
Organisation now recommends a qualified assistance to delivery
(including the midwife, the doctor and the nurse) while excluding
traditional birth attendants as well as trained ones.
Hand washing was systematically observed by 73.3% of matrons.
This finding is identical with that discovered by Tina [5] (73.3%).
Table 3: Prevention of infections.
variables Number/30 (%)
Hand washing
systematically 22(73.3)
occasionally 8(26.7)
Use of barriers
Yes 6(20)
No 24(80)
Use of new blade
yes 12(40)
no 18(60)
Risky and infectious gestures
Traditional cares for the cord 14(46.7)
Traditional cares for the
perineum
8(26.7)
Treatment of the placenta 14(46.7)
Cutting of the cord with scissors 12(40)
Traditional cares for the baby 16(53.3)
Means of sterilisation
Water and soap 23(76.7)
alcohol 1(3.3)
bleach 6(20)
Wastes disposal
Incineration 1(3.3)
Septic tank 3(10)
Community rubbish dump 26(86.7)
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Those who did not observe hand washing explained that they failed
to do so because they were called up when the new-born was at the
vulva.
Theuseofbarrierscontributesinthefightagainstthetransmission
of infections. As concerns the question to know if they used barriers,
6 matrons representing 20% gave a positive answer. Gloves remained
their only barrier. Masks, boots, eye glasses and blouses were not
used. The reason was that they were ignorant and some of the kits
were unavailable (gloves). The use of barriers does not fit into the
habits of matrons according to the existing literature. In fact, Bassey
reported a 10.7% rate of usage.
Forty percent of TBAs cut off the cord using scissors and 60% use
a new blade. Ahmed [14] reports 21.1% and 65.1 %; respectively. In
Bassey’s [8] series, a new blade was used in similar proportions. Other
risky and infectious practices were also recorded. These include; the
treatment of the placenta (46.7%), the administration of traditional
concoctions on the cord (46.7 %), traditional cares for the new-born
(53.3%), traditional cares of the perineum (26.7%). The treatment of
the placenta consisted in washing it up in water so as to get rid off
impurities. It is generally done without protecting the hands. These
practices are accounted for by a set of traditional values that endanger
the mother and the baby; therefore indicating the need for the training
of matrons. Similar practices are found in the literature [15].
The sterilization of tools is done with water and soap by 23 TBAs
representing 73.3%. Six TBAs use bleach whereas only one uses
alcohol. In Gary’s [15] series, 52 of the matrons used either boiled
water (29%) or alcohol (23%). This translates a high risk for the
spread of infections especially when they are called upon to perform
close deliveries. In fact, even in cases whereby alcohol is used, the risk
for infection remains because the latter is rather considered as a fixer
and would only have a limited action on certain positive and negative
gram germs. The use of boiled water on the other hand is beneficial
and recommended even though it is unable to destroy sporulated
forms and non conventional transmissible agents. The temperature
must be above 80°C for some bacteria, and 95°C for other viruses to
be effective within reasonable durations [16].
In the attempt to find out where wastes – gloves, blades, cloths
- were disposed, the majority; that is 86.7% stated that they used
community rubbish dumps. A single informant acknowledged
incinerating wastes. The matron in question was sensitized on the
positive aspects of incineration. Here, once again, the ignorance of
indirect contamination risks was voiced by matrons to justify their
practice.
Traditional birth attendants are an essential component in
reducing maternal and neo natal mortality especially in rural areas
whereby they are deeply involved in deliveries. However, they possess
knowledge and practices that put the wellbeing of the mother and her
foetus at risk. It is therefore important not to forbid their activities
in enclaved areas but, rather, to encourage and empower them so
that they can easily recognize danger risks in pregnancy and refer
patients within acceptable time. On the other hand, the prevention
of infections must be included in training modules because our
study proves that TBAs are not only exposed to infections but can
also prompt maternal foetal contamination. Nonetheless, if the main
expectation underlying the training of TBAs is to reinforce the link
between the community and the health system in place, it seems
necessary to implement this type of programme in a place where
there are effective SOUB and SOUC, and infrastructure that can
enable a rapid transfer of women towards centers. Yet, in the areas
concerned with high maternal mortality rates such conditions are
often questionable.
LIMITATIONS OF THE STUDY
This study has some limitations. The study was conducted during
a training seminar of matrons on the recognition of danger signs of
pregnancy and the prevention of infections. The sample was thus
defined by the central level. The questionnaire designed targeted the
two major axes of the training. From this, a study including a bigger
sample and that could be extended to other regions is recommended.
Other issues that could be interesting may include: how to conduct a
normal delivery, the prevention of post-partum haemorrhage, the use
of traditional oxytocic, and post-natal cares.
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