Study of maternal near miss and mortality in obstetrics in a tertiary care hospital

Background: Maternal health is an important aspect for the development of any country in terms of increasing equity and reducing poverty. In 2009, WHO came up with clinical, laboratory and management criteria for identification of the maternal near miss cases. Aim of the current study was to determine the level of near-miss maternal morbidity and mortality due to severe obstetrical complications or maternal disease in a tertiary care hospital. Objectives of the study were to compare the relation of near miss events with that of maternal mortality and to see the trend of near miss events.Methods: Cases were defined based on WHO criteria 2009. Study was conducted at GMERS Medical College and Hospital, Sola, Ahmedabad from 2020 to 2021. The study population were near miss cases and maternal deaths.Results: During the period of audit there were a total of 6776 deliveries, 6434 live birth, 145 near miss and 36 maternal deaths.Conclusions: Haemorrhage and hypertension are the leading cause of maternal near miss and maternal mortality in our hospital. As near miss indices represent quality of health care it should be represented in the national indices

Traditional Medicine Practices among Community Members with Diabetes Mellitus in Northern Tanzania: An ethnomedical Survey.

Diabetes is a growing burden in sub-Saharan Africa where traditional medicines (TMs) remain a primary form of healthcare in many settings. In Tanzania, TMs are frequently used to treat non-communicable diseases, yet little is known about TM practices for non-communicable diseases like diabetes. Between December 2013 and June 2014, we assessed TM practices, including types, frequencies, reasons, and modes, among randomly selected community members. To further characterize TMs relevant for the local treatment of diabetes, we also conducted focus groups and semi-structured interviews with key informants. We enrolled 481 adults of whom 45 (9.4 %) had diabetes. The prevalence of TM use among individuals with diabetes was 77.1 % (95 % CI 58.5-89.0 %), and the prevalence of using TMs and biomedicines concurrently was 37.6 % (95 % CI 20.5-58.4 %). Many were using TMs specifically to treat diabetes (40.3 %; 95 % CI 20.5-63.9), and individuals with diabetes reported seeking healthcare from traditional healers, elders, family, friends, and herbal vendors. We identified several plant-based TMs used toward diabetes care: Moringa oleifera, Cymbopogon citrullus, Hagenia abyssinica, Aloe vera, Clausena anisata, Cajanus cajan, Artimisia afra, and Persea americana. TMs were commonly used for diabetes care in northern Tanzania. Individuals with diabetes sought healthcare advice from many sources, and several individuals used TMs and biomedicines together. The TMs commonly used by individuals with diabetes in northern Tanzania have a wide range of effects, and understanding them will more effectively shape biomedical practitices and public health policies that are patient-centered and sensitive to TM preferences

Knowledge, Attitudes, and Practices Associated with Chronic Kidney Disease in Northern Tanzania: A Community-Based Study.

Non-communicable diseases (NCDs) are a leading cause of death among adults in sub-Saharan Africa, and chronic kidney disease (CKD) is a growing public health threat. Understanding knowledge, attitudes, and practices associated with NCDs is vital to informing optimal policy and public health responses in the region, but few community-based assessments have been performed for CKD. To address this gap, we conducted a cross-sectional survey of adults in northern Tanzania using a validated instrument. Between January and June 2014, we administered a structured survey to a random sample of adults from urban and rural communities. The validated instrument consisted of 25 items designed to measure knowledge, attitudes, and practices associated with kidney disease. Participants were also screened for CKD, diabetes, hypertension, and human immunodeficiency virus. We enrolled 606 participants from 431 urban and rural households. Knowledge of the etiologies, symptoms, and treatments for kidney disease was low (mean score 3.28 out of 10; 95% CI 2.94, 3.63). There were no significant differences by CKD status. Living in an urban setting and level of education had the strongest independent associations with knowledge score. Attitudes were characterized by frequent concern about the health (27.3%; 20.2, 36.0%), economic (73.1%; 68.2, 77.5%), and social impact (25.4%; 18.6, 33.6%) of kidney disease. Practices included the use of traditional healers (15.2%; 9.1, 24.5%) and traditional medicines (33.8%; 25.0, 43.9%) for treatment of kidney disease as well as a willingness to engage with mobile-phone technology in CKD care (94.3%; 90.1, 96.8%). Community-based adults in northern Tanzania have limited knowledge of kidney disease. However, there is a modest knowledge base upon which to build public health programs to expand awareness and understanding of CKD, but these programs must also consider the variety of means by which adults in this population meet their healthcare needs. Finally, our assessment of local attitudes suggested that such public health efforts would be well-received

CLINICAL FEATURES AND PATTERN OF PRESENTATION OF BREAST DISEASES IN SURGICAL OUTPATIENT CLINIC OF A TERTIARY HOSPITAL

Objective: The objective of thedu was to characterize the clinical features and pattern of presentation of breast diseases as observed in our practice. Materials and Methods: A prospective study of 121 consecutive patients with breast complaints presenting in our Surgical Outpatient Clinics. The relevant data were collected using the prescribed forms and was analyzed using Epi Info 2003, Mann–Whitney (test of two groups) Chi-squared and Fishers exact test was used to compare parameters of benign and malignant groups. P value <0.05 was considered as significant. Results: One hundred and nineteen patients were females, two were males. The age range was 14–70 years. Forty two (34.7%) patients were in the 21–30 year age group. The commonest symptoms were breast lump in 111 (91.7%) patients, and breast pain in 28 (23.1%) patients. Breast pain was a significant presenting complaint in patients with breast malignancy (P=0.026). On clinical examination 103 (85.1%) patients had palpable lumps, and seven patients were normal. Forty four patients (36.3%) had malignant disease, seventy patients (57.8%) had benign breast diseases and seven were normal. Fifty nine of the 70 benign diseases were fibroadenoma. One hundred and three patients (85%) had appropriate therapy, while 18 patients (14.8%), including eight with malignant disease absconded. Conclusion: In the study, a breast lump was the commonest clinical feature of breast disease. Over 60% of these were benign. Breast pain was a statistically significant presentation in patients with malignant breast disease. One in seven of the patients absconded

Agronomic Performance and Genetic Variability of \u3cem\u3ePanicum Maximum\u3c/em\u3e Accessions in the Cerrado of Federal District, Brazil

In the last three decades, the Brazilian Savanna (locally called Cerrado ) became the most important beef cattle production region in Brazil. Around 90% of all beef produced in the region comes from pasture-based systems. Intensively-managed and fertilised Panicum maximum pastures can be highly productive and economic. As a result, farmers are demanding new P. maximum cultivars for using in well-fertilised pastures or in crop-pasture rotation systems. This study aimed to evaluate the agronomic performance and the genetic variability of P. maximum accessions in the Brazilian Cerrado

Repeatability, number of harvests, and phenotypic stability of dry matter yield and quality traits of Panicum maximum jacq.

Selection of superior forage genotypes is based on agronomic traits assayed in repeated measures. The questions are how repeatable the performance of individual genotypes is and how many harvests are needed to select the best genotypes. The objectives were to estimate repeatability coefficients of dry matter yield (DMY) and forage quality, their phenotypic stability and the number of harvests needed for an accurate selection. Two randomized complete block design experiments data with 24 genotypes each, undergoing 12 and 16 harvests, over a period of 2 and 3 years, respectively, were used. The DMY repeatability estimates ranged from 0.42 to 0.55, suggesting a low heritability. The mean numbers of repeated measures were 5 and 7 harvests for 0.80 and 0.85 accuracy, respectively. The inclusion of the first two harvests negatively affects the estimates. Repeatability for quality traits ranged from 0.30 to 0.69, indicating low to moderate heritability.Título em português: Repetibilidade, número de colheitas e estabilidade fenotípica da produção de matéria seca e de características de qualidade de Panicum maximum jacq