ABSTRACT
Afghans comprise one of the largest groups of refugees in the world, with the majority living in Pakistan. The objective of this study was to identify commonly-occurring reproductive tract infections (RTIs), describe knowledge of women about RTIs, and assess physical and behavioural factors contributing to the development of RTIs. Afghan women presenting at Basic Health Units in refugee camps in Haripur, Pakistan, with reproductive health-related complaints, were included in the study (n=634). Data collection included implementation of an interviewer-administered questionnaire, along with a physical examination and laboratory tests. A descriptive analysis was conducted first. Qualitative data were coded and analyzed using predetermined themes. Chi-square test was used for determining the possible relationships between a binary outcome and categorical risk factors. Over three-fourths (76.7%) of those who reported to the health clinics with reproductive complaints had an RTI. Nearly half (49.5%) of these women were diagnosed with some form of vaginitis, and 14.7% were diagnosed with clinical suspicion of pelvic inflammatory disease (PID). Women with cervical prolapse (p=0.033) or who cleansed after intercourse (p=0.002) were more likely to have vaginitis. There was a significant difference (p=0.017) in the prevalence of suspected PID among women who used mud only (11.1%), any water (18.8%), and an old cloth or toilet paper (9.8%) for cleansing after defaecation. Specific physical and behavioural contributors to the high prevalence of RTIs in this population were identified, and recommendations to ameliorate these factors are offered.
ABSTRACT
É descrita a experiência inicial do Instituto do Coraçäo de Pernambuco, na unidade de terapia intensiva neonatal, com realizaçäo de septostomia Rashkind, sob monitorizaçäo ecocardiográfica, através de acesso percutâneo (punçäo da veia femoral), sob anestesia local, constando dos três primeiros casos, sendo dois neonatos com transposiçäo das grandes artérias e um com atresia tricúspide. Em dois pacientes, obteve-se sucesso tanto na técnica quanto na melhora hemodinâmica após o procedimento. No 3§ paciente com 36 dias de vida, o septo atrial encontrava-se rijo näo permitindo ampliaçäo satisfatória. Nenhum dos procedimentos apresentou complicaçöes significantes durante a sua realizaçäo. Apesar da pequena amostragem, nossa experiência demonstrou que esta nova abordagem para a realizaçäo da atrioseptostomia Rashkind é exeqüível, sem maiores complicaçöes para o neonato, e com benefícios sobre a técnica convencional