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Vaginal dehiscence after pelvic surgery is an extremely rare gynecological emergency world over. Without a high index of suspicion, it can easily be missed with grave consequences. We present an extremely rare case of this post abdominal hysterectomy case for which if immediate suspicion and timely intervention were not ensured, the patient would have suffered serious morbidity and/or death.
RESUMO
Background: Toxoplasmosis is an infection caused by a parasite called Toxoplasma gondii and is progressively increasing in pregnancy mainly with age and if left undiagnosed and untreated, can result into several adverse pregnancy outcomes. In Uganda, there is a paucity of information about toxoplasmosis in pregnancy. This study aimed to determine the seroprevalence and factors associated with toxoplasmosis among pregnant women attending antenatal care clinic at a Tertiary hospital in Uganda.Methods: This was a cross-sectional study carried out from July 2022 to October 2022. 165 pregnant women were consecutively enrolled. Data gathered for analysis were collected using a pre-tested structured questionnaire. Blood samples were taken and test of Toxoplasma gondii specific IgG and IGM was done using EUROIMMUN ELISA test kits as instructed by manufacturer. Data was analyzed using STATA version 14.2. A bivariate and multivariate analysis were used to show the association between the dependent and independent variables considering p?0.05 at 95% confidence interval.Results: The overall seroprevalence of toxoplasmosis in pregnancy was 16.4%. Age >35 years old (aOR: 8.36; 95% CI: 1.809-38.71; p=0.007), having contact with cats (aOR: 3.55; 95% CI: 1.258-10.01; p=0.017), drinking untreated water (aOR=4.08; 95% CI:1.237-13.46; p=0.021) and HIV status (aOR=8.91; 95% CI: 1.419-56.03; p=0.020) were independently associated with toxoplasmosis infection.Conclusions: The overall seroprevalence of toxoplasmosis in pregnancy was low as compared to the global seroprevalence. There is a need to educate pregnant women about the transmission routes and preventive measures of toxoplasmosis at antenatal care.
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Background: Short birth interval continues to increase in sub-Sahara Africa of which Uganda is part. If all birth-to-pregnancy intervals were spaced at least 2 years apart as recommended by the world health organization, most under-five deaths would be avoided. We aim at determining the predictors of short birth interval among women of reproductive age at tertiary hospitals, Uganda.Methods: A cross-sectional study involving 325 women of reproductive age attending the young child clinic at Fortportal Regional Referral Hospital was conducted from July 2022 to October 2022. Interviewer-administered questionnaires were used to obtain data used for analysis. Descriptive statistics followed by binary logistic regression were conducted to achieve the study objectives using SPSS version 22.0.Results: Out of 325 participants, 94 (29%) had short birth interval. Maternal age (OR=3.4, 95% CI: 1.15-10.13; p=0.02), no previous pregnancy planning (OR=3.4, 95% CI: 1.23-9.41; p=0.01), duration of breastfeeding less than 12 months (OR=1.9, 95% CI: 0.06-0.58; p=0.003), less or equal to 4 antenatal care visits (OR=8.7, 95% CI: 3.19-23.80; p?0.001) and not using postpartum contraceptives (OR=5.7, 95% CI: 1.64-19.81; p=0.006) were independently associated with short birth interval.Conclusions: The prevalence of short birth interval is still high in Uganda as compared to global report. The predictor factors of short birth interval include maternal lack of pregnancy planning, low number of antenatal care visits, breastfeeding for less than 12 months and lack of postpartum contraceptive use. Women of reproductive age should routinely be educated about child spacing by healthcare workers.