Résumé
Background: Since 1990, the maternal mortality significantly decreased at global scale as well as the North Africa and Middle East. However, estimates for mortality and morbidity by cause and age at national scale in this region are not available. Method(s): This study is part of the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019. Here we report maternal mortality and morbidity by age and cause across 21 countries in the region from 1990 to 2019. Result(s): Between 1990 and 2019, maternal mortality ratio (MMR) dropped from 148.8 (129.6-171.2) to 94.3 (73.4-121.1) per 100 000 live births in North Africa and Middle East. In 1990, MMR ranged from 6.0 (5.3-6.8) in Kuwait to 502.9 (375.2-655.3) per 100 000 live births in Afghanistan. Respective figures for 2019 were 5.1 (4.0-6.4) in Kuwait to 269.9 (195.8-368.6) in Afghanistan. Percentages of deaths under 25 years was 26.0% in 1990 and 23.8% in 2019. Maternal hemorrhage, indirect maternal deaths, and other maternal disorders rank 1st to 3rd in the entire region. Ultimately, there was an evident decrease in MMR along with increase in socio-demographic index from 1990 to 2019 in all countries in the region and an evident convergence across nations. Conclusion(s): MMR has significantly declined in the region since 1990 and only five countries (Afghanistan, Sudan, Yemen, Morocco, and Algeria) out of 21 nations didn't achieve the Sustainable Development Goal (SDG) target of 70 deaths per 100 000 live births in 2019. Despite the convergence in trends, there are still disparities across countries.Copyright © 2022 Academy of Medical Sciences of I.R. Iran. All rights reserved.
Résumé
Background: COVID-19 has become the global pandemic incapacitating the health systems and demanding investigation of possible pharmacotherapeutic options against SARS CoV-2. Although social distancing, hand sanitizing and supportive care remain as the preventive and management measures of COVID-19, clinical efficacy of various therapeutic agents is being tried out simultaneously to reduce the mortality associated with the disease. Objective: To ascertain the potential drugs/treatment for COVID 19 from the published literature across the world from its origin until June 2020. Methods: A literature search was done in CINAHL, Pub Med, Google Scholar, Science Direct, Springer, Wiley, EEEE, and Medline computerized repositories for complete texts from December 2019 until June 2020. The search terms used were COVID-19, treatment, antimalarial, antibiotics, antiretroviral, antiviral, plasma, immunoglobulin, heparin and immunosuppressant. The inclusion criteria adopted in the study were original research articles with current treatment process and potential drugs used in COVID 19 patients, primary data, published in English and full article available for free download. Results: There is no absolute single pharmacotherapeutic measure identified till date to cure this disease. The studies reviewed reported that the clinical improvement of the disease could be due to the result of other supportive measures and the results are inconclusive as the disease is impacted by various coexisting medical conditions. More clinical trials at large scales are needed to tackle this crisis at the earliest. Conclusion: Inventing a new vaccine or drug against coronavirus may take years to fully develop. However, clinicians are trying to treat this disease with already prescribed drugs for other diseases like H1N1, malaria, HIV, and SARS. It is important to note that there may be emergence of new clinical characteristics, treatment trials and outcome of COVID-19 as the disease evolves.