Emergency Contraception Among Women With Abortion At University Teaching Hospital In Lusaka, Zambia

Background: The maternal mortality ratio for Zambia is 591/100 000 live births. Globally between 15 – 30% of the maternal deaths are due to unsafe abortions. According to the Zambian demographic health survey (ZDHS), the contraceptive prevalence rate was 34% (CSO, 2003). The unmet need for family planning was 27%. Emergency contraception pill (ECP) was officially launched in Zambia in 1998 by the Ministry of Health with the aim of strengthening reproductive health. It can be obtained free of charge at public health institutions and also as an over the counter drug.Objective: To determine knowledge, Practice and attitude towards Emergency Contraception (EC) among women with abortion at the University Teaching Hospital (UTH), Lusaka, Zambia.Design: A cross-sectional descriptive study design and an interview schedule were administered to 200 women admitted to UTH with abortion aged between 18 – 49 years old.Main outcome measure: Emergency contraception awareness among women with abortions at UTH, Lusaka.Results: The median age of the participants was 19 years. Only 7.5% had ever heard of emergency contraceptive pills (ECPs). Majority (70%) were married with the majority reporting being married for less than 5 years. The contraceptive ever use rate was 78.5%and 58% the participants had their first pregnancies as teenagers. Almost a third (31%) was nulliparous. The most common sources of information about EC were friends (80%). Level of education was significantly associated with the outcome of EC awareness (OR = 9.5; 95% CI [3.06 – 29.87] (P value 0.001). Another factor that was significantly associated with the outcome of EC awareness was the level of EC knowledge (OR = 0.00; 95% CI [0.00 – 0.02](P value 0.001). Other factors such as age, place of residence and marital status were not significantly associated with EC awareness.Conclusion: Knowledge about Emergency Contraception (EC) among women with abortions admitted to UTH is low. Friends are an important source of EC information. Awareness and knowledge of EC should be increased

Expression Profiling of Non-Aflatoxigenic Aspergillus parasiticus Mutants Obtained by 5-Azacytosine Treatment or Serial Mycelial Transfer

Aflatoxins are carcinogenic secondary metabolites produced by the fungi Aspergillus flavus and Aspergillus parasiticus. Previous studies found that repeated serial mycelial transfer or treatment of A. parasiticus with 5-azacytidine produced colonies with a fluffy phenotype and inability to produce aflatoxins. To understand how these treatments affect expression of genes involved in aflatoxin production and development, we carried out expressed sequence tag (EST)-based microarray assays to identify genes in treated clones that are differentially expressed compared to the wild-type. Expression of 183 genes was significantly dysregulated. Of these, 38 had at least two-fold or lower expression compared to the untreated control and only two had two-fold or higher expression. The most frequent change was downregulation of genes predicted to encode membrane-bound proteins. Based on this result we hypothesize that the treatments cause changes in the structure of cellular and organelle membranes that prevent normal development and aflatoxin biosynthesis

The sudden change phenomenon of quantum discord

Even if the parameters determining a system's state are varied smoothly, the behavior of quantum correlations alike to quantum discord, and of its classical counterparts, can be very peculiar, with the appearance of non-analyticities in its rate of change. Here we review this sudden change phenomenon (SCP) discussing some important points related to it: Its uncovering, interpretations, and experimental verifications, its use in the context of the emergence of the pointer basis in a quantum measurement process, its appearance and universality under Markovian and non-Markovian dynamics, its theoretical and experimental investigation in some other physical scenarios, and the related phenomenon of double sudden change of trace distance discord. Several open questions are identified, and we envisage that in answering them we will gain significant further insight about the relation between the SCP and the symmetry-geometric aspects of the quantum state space.Comment: Lectures on General Quantum Correlations and their Applications, F. F. Fanchini, D. O. Soares Pinto, and G. Adesso (Eds.), Springer (2017), pp 309-33

Global, regional, and national burden of epilepsy, 1990 - 2016 : a systematic analysis for the Global Burden of Disease Study 2016

Background: Seizures and their consequences contribute to the burden of epilepsy because they can cause health loss (premature mortality and residual disability). Data on the burden of epilepsy are needed for health-care planning and resource allocation. The aim of this study was to quantify health loss due to epilepsy by age, sex, year, and location using data from the Global Burden of Diseases, Injuries, and Risk Factors Study. Methods: We assessed the burden of epilepsy in 195 countries and territories from 1990 to 2016. Burden was measured as deaths, prevalence, and disability-adjusted life-years (DALYs; a summary measure of health loss defined by the sum of years of life lost [YLLs] for premature mortality and years lived with disability), by age, sex, year, location, and Socio-demographic Index (SDI; a compound measure of income per capita, education, and fertility). Vital registrations and verbal autopsies provided information about deaths, and data on the prevalence and severity of epilepsy largely came from population representative surveys. All estimates were calculated with 95% uncertainty intervals (UIs). Interpretation: Despite the decrease in the disease burden from 1990 to 2016, epilepsy is still an important cause of disability and mortality. Standardised collection of data on epilepsy in population representative surveys will strengthen the estimates, particularly in countries for which we currently have no or sparse data and if additional data is collected on severity, causes, and treatment. Sizeable gains in reducing the burden of epilepsy might be expected from improved access to existing treatments in low-income countries and from the development of new effective drugs worldwide

Global, regional, and national burden of neurological disorders during 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Background Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level. Methods We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer's disease and other dementias, Parkinson's disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, medication overuse headache, brain and nervous system cancers, and a residual category of other neurological disorders. We also analysed results based on the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility, to identify patterns associated with development and how countries fare against expected outcomes relative to their level of development. Findings Neurological disorders ranked as the leading cause group of DALYs in 2015 (250.7 [95% uncertainty interval (UI) 229.1 to 274.7] million, comprising 10.2% of global DALYs) and the second-leading cause group of deaths (9.4 [9.1 to 9.7] million], comprising 16.8% of global deaths). The most prevalent neurological disorders were tensiontype headache (1505 9 [UI 1337.3 to 1681.6 million cases]), migraine (958.8 [872.1 to 1055.6] million), medication overuse headache (58.5 [50.8 to 67.4 million]), and Alzheimer's disease and other dementias (46.0 [40.2 to 52.7 million]). Between 1990 and 2015, the number of deaths from neurological disorders increased by 36.7%, and the number of DALYs by 7.4%. These increases occurred despite decreases in age-standardised rates of death and DALYs of 26.1% and 29.7%, respectively; stroke and communicable neurological disorders were responsible for most of these decreases. Communicable neurological disorders were the largest cause of DALYs in countries with low SDI. Stroke rates were highest at middle levels of SDI and lowest at the highest SDI. Most of the changes in DALY rates of neurological disorders with development were driven by changes in YLLs. Interpretation Neurological disorders are an important cause of disability and death worldwide. Globally, the burden of neurological disorders has increased substantially over the past 25 years because of expanding population numbers and ageing, despite substantial decreases in mortality rates from stroke and communicable neurological disorders. The number of patients who will need care by clinicians with expertise in neurological conditions will continue to grow in coming decades. Policy makers and health-care providers should be aware of these trends to provide adequate services.Peer reviewe

The Process of Producing the Modified Ministry of Health (MOH) TBA Training Curriculum

Background: The MOH TBATraining Curriculum has been in Draft form since its documentation in 1996. This curriculum does not state when it was reviewed last or when it needs to be reviewed again in-order to incorporate new trends and concepts in infection prevention practices. The purpose of the modification is to facilitate task–shifting (a component of knowledge management) from the health professionals to non-professionals in the health care systems.Methods: We conducted a desk review, training needs assessment, focus group discussion and, analysing baseline data on maternal and infant morbidity and mortality rates.Results: The Desk review showed non-uniform TBA training curricula being used, infection prevention omissions, inadequate integration of positive socio-cultural and traditional beliefs in the curriculum, training needs assessment showed poor knowledge and practice among existing TBAs, focus group discussions showed inadequate resource and support supervision of the TBAs while the baseline data showed high maternal and infant morbidity and mortality rates in Chongwe District.Conclusion: Policy implications advocates that Low-income resource countries may need to formulate Primary Health Care (PHC) oriented Reproductive Health Policy that supports the training of TBAs through task-shifting anchored on evidence-based modified curriculum in the interim period until there are sufficient skilled birth attendants to service the hardest-to reach rural settings

Nanning – Perils and promise of a frontier city

[No abstract available