A study of maternal deaths from preeclampsia and eclampsia in a tertiary care centre

Background: Hypertensive disorders of pregnancy (HDPs) affect about 10% of all pregnant women around the world and are an important cause of maternal and perinatal mortality and morbidity. In Asia and Africa, nearly one tenth of all maternal deaths are associated with hypertensive disorders of pregnancy. Predicting the onset of these complications could aid in timely interventions such as increased surveillance, treatment of symptoms, transfer to higher care facility and delivery when necessary, which could reduce morbidity and mortality from the HDPs. Aim: It was to calculate the total number of women admitted with hypertensive disorders and eclampsia in the labor room and their case fatality rate, to calculate the number of mothers died from preeclampsia and eclampsia, to critically analyze all the mothers who died from preeclampsia in order to identify the root causes of substandard care leading to maternal deaths. Materials and methods: This prospective study was carried out in the labor room, Department of Obstetrics and Gynecology, King George Hospital, Andhra Medical College for a period of twelve months from November 2016 to October 2017. All the mothers who died from severe preeclampsia and eclampsia were included in the study and they were all analyzed modeled on the United Kingdom Confidential Enquiries into maternal deaths. Results: In one year there were 530 women admitted with hypertensive disorders and 144 with Chuppana Ragasudha, Atluri Phani Madhavi, Pulidindi Sanjana Sharon, Satyala Satya Priya, Syed Shehnaz. A study of maternal deaths from preeclampsia and eclampsia in a tertiary care centre. IAIM, 2018; 5(1): 6-10. Page 7 eclampsia giving a prevalence of 9.04% and 2.45% respectively. Case fatality rate of preeclampsia was 2.26% and eclampsia was 4.1%. During the study period there were 44 total maternal deaths. Out of 44 maternal deaths, 12 were from severe preeclampsia and eclampsia making it the second leading cause of maternal mortality in our institute. Conclusion: The majority of deaths related to hypertensive disorders can be avoided by providing timely and effective care to women presenting with complications. Thus, optimization of health care for women during pregnancy to prevent and treat hypertensive disorders of pregnancy is a necessary step towards achievement of the Millennium Development Goals

Comparison of perceptions regarding nutrition education between medical interns trained in the discipline-based and the integrated curriculum in gulf medical university Ajman

Gulf Medical University, Ajman has changed from a discipline-based curriculum to an organsystem based integrated curriculum. To compare perceptions of medical interns from the discipline based and the integrated curriculum regarding nutrition and nutrition education in the undergraduate medical curriculum. Questionnaire based study with medical interns from the discipline based curriculum [Batch 2007] and the organ-system based integrated curriculum [Batch 2008]. Respondents rated on a Likert-like [1-5] scale items spanning domains including attitudes to nutrition, perceptions regarding nutrition-related knowledge, competence in nutrition-related skills and nutrition education in the curriculum. 22 interns from the discipline-based and 33 from the integrated curriculum completed the survey. 61% were males. Both groups had positive attitudes to nutrition counseling [median score=4]. Total scores in the knowledge domain were significantly higher in the integrated curriculum group. Perceptions regarding knowledge and skills in most nutrition related topics was good in both groups [Median score=4]. Both groups of interns were uncertain [Median score=3] regarding the quantity and quality of nutrition education. Most interns felt a need for more nutrition education in the curriculum [Median score=4] however fewer interns from the integrated curriculum compared to the discipline-based curriculum felt the need for more nutrition education in [basic nutrition concepts] [48% vs. 69%], [nutrition in primary care settings] [44% vs. 75%], [nutritional assessment] [52 vs. 81%] and [evidence based nutrition][30 vs. 75%]. Similar numbers [55.6 and 56.3%] perceived the need for more 'clinical nutrition [nutrition in disease states]] in both groups. Changing the curriculum did not bring about significant changes in attitudes regarding nutrition or perceptions regarding nutrition-related competences. However a significant increase was seen in perceptions regarding nutrition knowledge. Interns from both groups perceived a need for more nutrition education especially Clinical nutrition [nutrition in disease states]

Prevalence and practice of self-medication among high school students in United Arab Emirates

Objective: Adolescence is a key period in the emergence of health practices which may persist even during the adulthood. One of the potentially hazardous health practices among adolescents is self- medication [SM]. In this context, the present study aimed to identify the prevalence and practice of SM and to assess the factors related to SM among high school students of UAE

Materials and Methods: A cross sectional survey of 324 high school students from Dubai, Sharjah and Ajman was conducted using a self-administered questionnaire. Data was analyzed using SPSS 19 version. The association between SM and different variables was tested with Chi square test

Results: The majority of the participating students were females aged 16-17 years. The prevalence rate of SM among the participants was 89%, which did not vary with age or gender. There was no association of SM with parents' educational level. The most common sources of drug and drug information were private pharmacies and parents respectively. Headache and fever were common self-medicated conditions and consequently, analgesics and antipyretics were most commonly used both in the previous two weeks and during the year before the survey. The average number drugs used in self-medication in the previous two weeks and during the past year were 2+/-1.5 and 3+/-3.5 respectively. The students indicated presence of mild illness and previous experiences with the medicines as the most common reason for SM. High risk practices like altering dosage [43%]; stopping medication [50%] and SM without adult guidance [25%] were also observed

Conclusion: The prevalence of SM among high school students in UAE is high. There is a need to create awareness about the risks and benefits of SM. Healthcare providers, pharmacists, educators and parents should be actively involved in health education strategies for establishing safe SM practices

Diabetes-related knowledge among university students

To assess the diabetes-related knowledge among the university students attending non-healthcare related professional courses. Study subjects were students enrolled in non-healthcare related professional courses in a reputed university in Ajman. A pre-tested questionnaire, assessing the knowledge of risk factors, symptoms and complications of diabetes and lifestyle practices, was administered and analyzed. 182 subjects [53 males and 129 females] of 23 nationalities, age group of < 24 years, participated in the study. Of the subjects, 11.2% were current smokers, 26% were overweight and obese, 8% were known diabetic, 14% were hypertensive and 11% had hypercholesterolemia. Only 29% of these university students exercised regularly. 37% thought that they have very good health. Regarding their general knowledge on diabetes mellitus [DM], 70% knew that it is a condition characterized by high blood sugar level, and identified family history as a major risk factor. Surprisingly, only 53% could link obesity and physical inactivity as risk factors for development of DM. Excessive feeling of thirst, urination and weight loss were identified as symptoms by approximately 55% of them. Knowledge on complications including loss of sensation and decaying limbs, oral and dental complications, recurrent infections and CVD risk were poorly identified. Only 55% thought that onset of diabetes can be delayed. Our results show surprisingly high health-related issues among the young adults studied. This study also highlights the poor level of knowledge related to diabetes among university students considering the availability of various sources of information to the modern day youth