ABSTRACT
Background: Eclampsia remains a leading cause of maternal and perinatal morbidity and mortality often in settings of poor health seeking behaviour and services. Objective of this study was to determine the incidence, investigate the risk factors, obstetric outcomes and suggest ways of improving the impact of eclampsia.Methods: An analytical observational study on consecutive cases of eclampsia managed in a tertiary hospital setting from 2014 to 2019. For each case of eclampsia recruited the next gestational hypertensive and normotensive cases managed in the period were recruited to serve as controls. Computer statistical software, Chi square for test of associations were used for analysis with statistical significance set at p<0.05.Results: Among 3625 deliveries within the study period were 57 cases of eclampsia; an incidence of 1.57%. Most (74.4%) were antepartum eclampsia. Majority of the eclamptic mothers were unbooked (81.4%), of lower social class (86.0%), poorly educated (81.4%) and nulliparous (58.1%). Eclamptic mothers were more likely to be youth ≤24 years (39.5%), teenagers (25.6%), and unmarried. Twenty-four (55.8%) had abdominal delivery, anaemia (23.3%) and were transfused. Three women died from eclampsia; a case fatality of 6.98%. Twenty-four (55.8%) neonates were preterm, low birth weight (48.8%), intrauterine growth restriction (25.6%), special care baby unit admission (32.6%) and perinatal mortality 13 (30.2%).Conclusions: Eclampsia is still an un-mitigating malady in this study settings with increased maternal and perinatal complications. Nulliparity, low social status, young age and lack of prenatal care appeared significant risk factors. Quality prenatal care, early detection and management of pre-eclampsia will mitigate eclampsia occurrence and severity. Women empowerment is proffered.
ABSTRACT
Timor-Leste faces an urgent set of challenges in oral health. The impact of oral diseases in terms of reduced quality of life and cost of treatment is considerable. This paper reviews progress on policy recommendations since the National Oral Health Survey in 2002, the first such national survey. Few proposals have been implemented to date, owing to (i) lack of local support for the recommendations, particularly on promotion of oral health; (ii) lack of financial and budgetary provisions for oral health; (iii) lack of focus on services, human resources and dental personnel; (iv) poor focus, design and implementation of policy and planning in oral health; and (v) lack of transport to facilitate health-care workers’ access to remote areas. Based on this assessment, the present paper presents a reconfigured set of policies and recommendations for oral health that take into consideration the reasons for low uptake of previous guidance. Key priorities are promotion of oral health, legislative interventions, education of the oralhealth workforce, dental outreach programmes, targeted dental treatment, dental infrastructure programmes, and research and evaluation. Interventions include promotion of oral health for schoolchildren, salt fluoridation, fluoride toothpaste and banning sweet stalls and use of tobacco and betel nut in, or near, schools. Timor-Leste should strengthen the availability and quality of outreach programmes for oral health. Dental therapists and dental nurses who can supply preventive and atraumatic restorative dental care should continue to be trained, and the planned dentistry school should be established. Ongoing research and evaluation is needed to ensure that the approach being used in Timor-Leste is leading to improved outcomes in oral health.
Subject(s)
Adult , Bone Neoplasms/diagnosis , Female , Humans , Humerus/surgery , Neurilemmoma/diagnosisABSTRACT
Se reporta nuestra experiencia inicial con el Bypass gástrico por laparoscopia para la obesidad mórbida en 5 pacientes. Todos los casos fueron del sexo femenino con edad promedio de 36 años y un IMC promedio de 43 Kg/m². El procedimiento se completó vía laparoscopica en cuatro pacientes con un tiempo quirúrgico promedio de 6 horas y sin morbilidad intraoperatoria. La evolución fue favorable, presentándose en un caso una complicación menor (infección de un portal), tratada con éxito de manera ambulatoria. El Bypass gástrico por laparoscopia ofrece a los pacientes con obesidad mórbida una nueva opción para lograr excelentes resultados reduciendo la morbilidad y el tiempo de recuperación del procedimiento abierto. Sin embargo es una cirugía exigente que debe ser abordada por cirujanos que posean entrenamiento tanto en cirugía bariátrico como en técnicas laparoscópicas avanzadas
Subject(s)
Humans , Female , Gastric Bypass , Laparoscopy , Obesity, Morbid , General Surgery , Medicine , VenezuelaABSTRACT
A mortalidade por câncer de próstata é 2 a 3 vezes maior entre os negros americanos (African-American) do que entre os brancos (Caucasian) para as mesmas faixas etárias. As razöes para esta diferença näo säo conhecidas, porém estudos tem demonstrado que os negros säo portadores de tumores em estágio mais avançado do que os brancos, quando do diagnóstico. A definiçäo de raça negra näo é clara e apesar de näo haver uma definiçäo genética para raça existe uma clara heterogeneidade fenotípica. Há evidências indicando uma maior porcentagem de lipídios bioativos no sistema biológico dos negros sugerindo que estes consomem uma taxa mais alta de gordura. Também, a grande maioria dos negros faz parte de um grupo econômico e social distinto nos Estados Unidos. Desta maneira, a discussäo sobre o comportamento do câncer de próstata em negros e brancos deve ser levada näo só a nível biológico, mas precisa-se considerar as diferenças sócio-econômicas. Neste manuscrito, iremos comentar e comparar evidências e características epidemiológicas, biológicas, clínicas e patológicas do câncer de próstata em ambas as raças