scholarly journals Undiagnosed Ectopic Pregnancy among Unsupervised use of Medical Abortion pills

2017 ◽  
Vol 11 (2) ◽  
pp. 12-15
Author(s):  
Arun Prasad Joshi ◽  
NS Chitrakar ◽  
J Pariyar ◽  
I Shrestha ◽  
R Maharjan ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Lower Abdominal Pain ◽  
Medical Practitioner ◽  
Medical Abortion ◽  
World Health ◽  
History Of ◽  
One Year ◽  
Health Organization ◽  
Operative Findings ◽  
A Prospective Study

Aims: To identify and share the experience of clinical presentation and management of ectopic pregnancy (EP) in women who presented with unsupervised use of Medical abortion (MA) pills.Methods: A prospective study was conducted in department of Obstetrics and Gynaecology of Civil Service Hospital over one year (March 2015- February 2016). Women with a history of unsupervised use of MA pills were taken into study group as there has been a trend of taking theses pills without consultation in recent days. Detail clinical, menstrual, obstetrics and MA history were taken. Relevant investigations and Ultrasonography were done. Women diagnosed to have ectopic pregnancy were followed and their operative findings were recorded. Results: Ninety-six women presented with unsupervised use of MA, among which 8 (8.33%) diagnosed to have EP. Most women were 20-30 years of age and 37.5% were unmarried.  They gave history of taking MA from pharmacy. Among eight women, 37.5 % had taken MA at the period of gestation <5 weeks, 37.5% between 5-7 weeks and 25% >7-9 weeks. Fifty percent attended hospital after seventy- two hours of MA. Majority (50%) presented with lower abdominal pain and ruptured EP with hemoperitoneum (>one litre) requiring blood transfusion. History of easy availability and social reasons for MA intake were given by 37.5% each.Conclusions: Even though medical abortion is easily accessible, affordable and available, it should also be safer. It is of utmost importance to take it from health facility or a registered medical practitioner following World Health Organization (WHO) guidelines, one of which is excluding extra-uterine pregnancy.

scholarly journals Evaluation of Uterine Scar on Repeat Second Cesarean Section in Patients with Previous Cesarean Section

1970 ◽  
Vol 3 (1) ◽  
pp. 16-19
Author(s):  
N Nargis ◽  
AK Al-Mahmood ◽  
D Akhter
Keyword(s):  
Cesarean Section ◽  
Tertiary Care ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
History Of ◽  
Uterine Scar ◽  
One Year ◽  
Operative Findings ◽  
A Prospective Study ◽  
Previous Cesarean

To evaluate the safety and integrity of uterine scar at repeat cesarean section in patients with previous one cesarean section (C/S). A prospective study was Carried out in a tertiary care, obstetric unit over a period of one year, 2010. All pregnant mothers who underwent cesarean section either emergency or elective with history of previous one cesarean sections were included in this study. The variables noted were age, parity, socioeconomic status, residential area, location of previous cesarean section, previous wound infection and associated complaints. Data was analyzed on SPSS 11 Operative findings during cesarean sections were recorded in terms of thinning of scar, dehiscence or rupture. One hundred and twenty cesarean section patients were included in the study. Out of all patients, extreme thinning of scar was noted in 28 (23.33%) patients. Four patients (3.33%) had scar dehiscence,only 3( 2.5%) patients with scar dehiscence had associated complaint of scar tenderness, while 17 (14.16%) of 120 cases of scar thinning were having scar tenderness. All 4 cases of scar dehiscence had their previous c/s at peripheral hospitals. No patient underwent hysterectomy and all patients with scar dehiscence had successful repair. Our findings shows relatively inadequate scar thickness rate but at the same time relatively acceptable scar dehiscence rate. Thus it seems to be a safe approach to make trial of labour after meticulous scrutinization and individualization. DOI: http://dx.doi.org/10.3329/akmmcj.v3i1.10108 AKMMCJ 2012; 3(1): 16-19

scholarly journals A prospective study on causality, severity and preventability assessment of adverse drug reactions in a tertiary care hospital in India

2018 ◽  
Vol 8 (1) ◽  
pp. 104
Author(s):  
Mahesh N. Belhekar ◽  
Sweta B. Tondare ◽  
Prasad R. Pandit ◽  
Kiran A. Bhave ◽  
Tejal C. Patel
Keyword(s):  
Tertiary Care ◽  
World Health ◽  
Care Hospital ◽  
Antimicrobial Drugs ◽  
Related Information ◽  
Cutaneous Reactions ◽  
One Year ◽  
Health Organization ◽  
A Prospective Study ◽  
The Cost

Background: The present study was undertaken to evaluate the incidence and pattern of adverse drug reaction (ADRs), causality, severity and preventability of ADRs.Methods: Data was collected and analyzed with the information such as patients’ demographic details, associated co-morbid conditions and detailed drug related information gathered from ADR reporting forms. World Health Organization (WHO) scale was used for assessing causality, modified Hartwig scale was used for assessing severity and modified Schumock and Thorntons scale were used for assessing preventability of ADRs. Data was analyzed using descriptive statistics.Results: Total 154 ADRs were reported in a period of one year (August 2016- July 2017). Out of 154 ADRs analyzed, 120 (77.9%) were in adults, 33 (21.4%) pediatric and 01 (0.7%) in geriatric patients. The most common ADR recorded was cutaneous reactions (43.5%) and the most common causative class of drugs for the same was found to be antimicrobials (46.7%) followed by non-steroidal anti-inflammatory drugs (15.6%). Causality assessment scale indicated 68.8% ADRs possible and 24% ADRs as probable. Severity assessment revealed that 45.5 % were mild, 50.6% moderate and 3.9% ADRs severe. Preventability assessment showed 84.4% of the cases were probably non-preventable.Conclusions: In this study it was found that, most of the ADRs were of possible category with mild to moderate severity and majority being non-preventable. Antimicrobial drugs being the most common offending drug class causing ADRs. Strategies targeting appropriate and cautious use of this class of drugs may benefit in reducing the number of ADRs and therefore the cost involved in the treatment.

Preventing Premature Weaning: Management Options for Common Lactation Conditions, Including OMT

2020 ◽  
pp. 20-25
Author(s):  
Denise Sackett ◽  
Tala Dajani ◽  
David Shoup ◽  
Uzoma Ikonne
Keyword(s):  
Postpartum Depression ◽  
Family Physician ◽  
Treatment Options ◽  
World Health ◽  
Management Options ◽  
Pharmacological Management ◽  
Control And Prevention ◽  
Lactational Mastitis ◽  
One Year ◽  
Health Organization

The benefits of breastfeeding are well established. The World Health Organization and the Centers for Disease Control and Prevention recommend that mothers breastfeed infants for at least one year, but most children are not breastfed that long because of many factors. Breastfeeding mothers face many challenges to continued breastfeeding, including medical conditions that arise during this period, such as postpartum depression and lactational mastitis. Because of a perceived lack of consistent guidance on medication safety, it can be difficult for the family physician to treat these conditions while encouraging mothers to continue breastfeeding. The purpose of the current review is to summarize and clarify treatment options for the osteopathic family physician treating lactating mothers. We specifically focus on the pharmacological management of contraception, postpartum depression, and lactational mastitis.

Organization of restrictive quarantine measures to prevent especially dangerous infections

2020 ◽  
pp. 6-11
Author(s):  
Petr Ilyin
Keyword(s):  
Infectious Diseases ◽  
Clinical Symptoms ◽  
International Health ◽  
World Health ◽  
The World ◽  
History Of ◽  
Entire History ◽  
Health Organization ◽  
Former Ussr ◽  
Health Regulations

Especially dangerous infections (EDIs) belong to the conditionally labelled group of infectious diseases that pose an exceptional epidemic threat. They are highly contagious, rapidly spreading and capable of affecting wide sections of the population in the shortest possible time, they are characterized by the severity of clinical symptoms and high mortality rates. At the present stage, the term "especially dangerous infections" is used only in the territory of the countries of the former USSR, all over the world this concept is defined as "infectious diseases that pose an extreme threat to public health on an international scale." Over the entire history of human development, more people have died as a result of epidemics and pandemics than in all wars combined. The list of especially dangerous infections and measures to prevent their spread were fixed in the International Health Regulations (IHR), adopted at the 22nd session of the WHO's World Health Assembly on July 26, 1969. In 1970, at the 23rd session of the WHO's Assembly, typhus and relapsing fever were excluded from the list of quarantine infections. As amended in 1981, the list included only three diseases represented by plague, cholera and anthrax. However, now annual additions of new infections endemic to different parts of the earth to this list take place. To date, the World Health Organization (WHO) has already included more than 100 diseases in the list of especially dangerous infections.

Gambaran Pengetahuan Remaja Tentang Ca Serviks Dan Perilaku Pencegahan Ca Serviks Di Sma Negeri Tebing Tinggi Empat Lawang Tahun 2016

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Yuni Kurniati Yuni Kurniati
Keyword(s):  
Cervical Cancer ◽  
World Health Organization ◽  
Cancer Incidence ◽  
World Health ◽  
Cervical Cancer Incidence ◽  
Cross Sectional ◽  
History Of ◽  
Unhealthy Diet ◽  
Birth Control Pills ◽  
Health Organization

ABSTRACT   According to the World Health Organization (WHO), every two minutes a woman dies of cervical cancer in develoving countries. In Indonesia, new cases of cervical cancer is 40-45 cases of day. It is estimated every hour, a women died of cervical center. At the general hospital center Dr. Mohammad Hoesin Palembang, the incidence of women who had cervical cancer incidence year 2011 women who had cervical cancer incidence are 34 people (48,2%). The following factors increase the chance of cervical cancer in women is infection of Human Papilloma Virus (HPV), sexsual behavior, family history of cervical cancer, age, mechanism of how oral contraceptives, smoking, income or socioeconomic status, race , unhealthy diet, the cell abnormal, parity, use of the drug DES (Dietilsbestrol), and birth control pills. The purpose of this study is known of adolescents about cervical cancer in SMA Tebing Tinggi Empat Lawang year 2016. This study used Analytic Survey with Cross Sectional approach. The population in this study were all young women students in SMA Tebing Tinggi Empat Lawang with the number of 171 respondents. The results showed there were 171 respondents (37.5%) of respondents were knowledgeable, and (62.52%) of respondents who are knowledgeable unfavorable. These results indicate that knowledgeable either less than those less knowledgeable in both the SMA Tebing Tinggi Empat Lawang Year 2016. From these results, it is expected that more teens can know about cervical cancer so that it can add a lot of insight and knowledge.     ABSTRAK   Menurut data World Health Organization (WHO), setiap dua menit wanita meninggal dunia karena kanker serviks dinegara berkembang. Di Indonesia, kasus baru kanker serviks 40-45 kasus perhari. Di perkirakan setiap satu jam, seorang perempuan meninggal dunia karena kanker serviks. Di rumah sakit umum pusat Dr. Mohammad Hoesin Palembang, angka kejadian ibu yang mengalami kanker serviks pada tahun 2011 ibu yang mengalami kejadian kanker serviks terdapat 34 orang (48,2%). Faktor-faktor berikut meningkat kan peluang kanker serviks pada wanita yaitu infeksi Human Papiloma virus (HPV), perilaku seks, riwayat keluarga kanker serviks, umur ,mekanisme bagaimana kontrasepsi peroral, merokok, pendapatan atau status social ekonomi, ras, diet tidak sehat, adanya sel abnormal, paritas, menggunakan obat DES (Dietilsbestrol),dan pil KB. Tujuan penelitian ini adalah Diketahuinya pengetahuan remaja tentang Ca Cerviks di SMA Negeri Tebing Tinggi Empat Lawang Tahun 2016. Penelitian ini menggunakan metode survey  analitik dengan pendekatan cross sectional. Populasi pada penelitian ini adalah semua siswi remaja putri di SMA Negeri Tebing Tinggi Empat Lawang dengan jumlah 171 responden.Hasil penelitian menunjukkan dari 171 responden terdapat(37.5 %) responden yang berpengetahuan baik, dan (62.52  %) responden yang berpengetahuan kurang baik. Hasil penelitian ini menunjukan bahwa yang berpengetahuan baik lebih sedikit dibandingkan dengan  yang berpengetahuan kurang baik di SMA Negeri Tebing Tinggi Empat Lawang Tahun 2016. Dari hasil penelitian ini, Diharapkan remaja bisa lebih banyak mengetahui tentang caserviks sehingga dapat menambah banyak wawasan dan pengetahuan.    

scholarly journals Ectopic pregnancy in a tertiary care centre of Jharkhand, India

2019 ◽  
Vol 8 (8) ◽  
pp. 2969
Author(s):  
Meetali Parashar ◽  
Meena Mehta
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Previous History ◽  
First Trimester ◽  
Near Miss ◽  
Obstetrics And Gynaecology ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
Β Hcg ◽  
A Prospective Study

Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions:Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions: Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.

scholarly journals Pulmonary tuberculosis screening in anti-retroviral treated adults living with HIV in Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jill K. Gersh ◽  
Ruanne V. Barnabas ◽  
Daniel Matemo ◽  
John Kinuthia ◽  
Zachary Feldman ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Preventive Therapy ◽  
World Health ◽  
People Living With Hiv ◽  
Tuberculosis Screening ◽  
Hiv Positive Adults ◽  
Health Organization ◽  
A Prospective Study ◽  
Living With Hiv ◽  
Tuberculosis Prevalence

Abstract Background People living with HIV (PLHIV) who reside in high tuberculosis burden settings remain at risk for tuberculosis disease despite treatment with anti-retroviral therapy and isoniazid preventive therapy (IPT). The performance of the World Health Organization (WHO) symptom screen for tuberculosis in PLHIV receiving anti-retroviral therapy is sub-optimal and alternative screening strategies are needed. Methods We enrolled HIV-positive adults into a prospective study in western Kenya. Individuals who were IPT-naïve or had completed IPT > 6 months prior to enrollment were eligible. We evaluated tuberculosis prevalence overall and by IPT status. We assessed the accuracy of the WHO symptom screen, GeneXpert MTB/RIF (Xpert), and candidate biomarkers including C-reactive protein (CRP), hemoglobin, erythrocyte sedimentation rate (ESR), and monocyte-to-lymphocyte ratio for identifying pulmonary tuberculosis. Some participants were evaluated at 6 months post-enrollment for tuberculosis. Results The study included 383 PLHIV, of whom > 99% were on antiretrovirals and 88% had received IPT, completed a median of 1.1 years (IQR 0.8–1.55) prior to enrollment. The prevalence of pulmonary tuberculosis at enrollment was 1.3% (n = 5, 95% CI 0.4–3.0%): 4.3% (0.5–14.5%) among IPT-naïve and 0.9% (0.2–2.6%) among IPT-treated participants. The sensitivity of the WHO symptom screen was 0% (0–52%) and specificity 87% (83–90%). Xpert and candidate biomarkers had poor to moderate sensitivity; the most accurate biomarker was CRP ≥ 3.3 mg/L (sensitivity 80% (28–100) and specificity 72% (67–77)). Six months after enrollment, the incidence rate of pulmonary tuberculosis following IPT completion was 0.84 per 100 person-years (95% CI, 0.31–2.23). Conclusions In Kenyan PLHIV treated with IPT, tuberculosis prevalence was low at a median of 1.4 years after IPT completion. WHO symptoms screening, Xpert, and candidate biomarkers were insensitive for identifying pulmonary tuberculosis in antiretroviral-treated PLHIV.

A Framework Convention on Alcohol Control: Getting Concrete about Its Contents

2020 ◽  
pp. 1-11
Author(s):  
Robin ROOM ◽  
Jenny CISNEROS ÖRNBERG
Keyword(s):  
Public Health ◽  
World Health ◽  
Alcohol Industry ◽  
Alcohol Control ◽  
The World ◽  
Draft Convention ◽  
History Of ◽  
Supplementary Material ◽  
Health Organization ◽  
Narcotic Drugs

This article proposes and discusses the text of a Framework Convention on Alcohol Control, which would serve public health and welfare interests. The history of alcohol’s omission from current drug treaties is briefly discussed. The paper spells out what should be covered in the treaty, using text adapted primarily from the Framework Convention on Tobacco Control, but for the control of trade from the 1961 narcotic drugs treaty. While the draft provides for the treaty to be negotiated under the auspices of the World Health Organization, other auspices are possible. Excluding alcohol industry interests from the negotiation of the treaty is noted as an important precondition. The articles in the draft treaty and their purposes are briefly described, and the divergences from the tobacco treaty are described and justified. The text of the draft treaty is provided as Supplementary Material. Specification of concrete provisions in a draft convention points the way towards more effective global actions and agreements on alcohol control, whatever form they take.

scholarly journals COVID-19 PANDEMIC UPDATES AND PERSPECTIVES. NEED FOR AN INTEGRATED AND EQUITABLE APPROACH.

2021 ◽  
Author(s):  
Grigoris Gerotziafas ◽  
Mariella Catalano ◽  
Ioannis Theodorou ◽  
Patrick van Dreden ◽  
Vincent Marechal ◽  
...  
Keyword(s):  
Mitigation Strategies ◽  
World Health ◽  
Learning Technology ◽  
Pharmacological Interventions ◽  
Health Crisis ◽  
Patients At Risk ◽  
Physical Barriers ◽  
Risk Of Disease ◽  
One Year ◽  
Health Organization

One year after the declaration of the COVID-19 pandemic by the World Health Organization (WHO) and despite the implementation of mandatory physical barriers and social distancing, humanity remains challenged by a long-lasting and devastating public health crisis. Non-pharmacological interventions (NPI) are efficient mitigation strategies. The success of these intense NPI is dependent on the approval and commitment of the population. The launch of a mass vaccination program in many countries in late December 2020 with mRNA vaccines, adenovirus-based vaccines, and inactivated virus vaccines has generated hope for the end of the pandemic. Current issues: The continuous appearance of new pathogenic viral strains and the ability of vaccines to prevent infection and transmission raise important concerns as we try to achieve community immunity against SARS-CoV-2 and its variants. The need of a second and even third generation of vaccines and the possibility of potentially harmful side-effects of the vaccines (i.e. venous thromboembolism ) have already been acknowledged. Perspectives: There is a critical and urgent need for a balanced and integrated strategy for the management of the COVID-19 outbreaks organized on three axes: (1) Prevention of the SARS-CoV-2 infection, (2) Detection and early diagnosis of patients at risk of disease worsening, and (3) Anticipation of medical care (PDA). Conclusion: The “PDA strategy” integrated into state policy for the support and expansion of health systems and introduction of digital organization (i.e. telemedicine, artificial intelligence and machine learning technology) is of major importance for the preservation of citizens’ health and life world-wide.

scholarly journals Death of the King: The Introduction of Vaccination into Nepal in 1816

2018 ◽  
Vol 63 (1) ◽  
pp. 24-43 ◽  
Author(s):  
Susan Heydon
Keyword(s):  
Communicable Disease ◽  
World Health ◽  
Smallpox Vaccination ◽  
Communicable Disease Control ◽  
Eradication Programme ◽  
Early Appearance ◽  
Colonial Authority ◽  
History Of ◽  
Global Eradication ◽  
Health Organization

This article explores the introduction of smallpox vaccination into Nepal in 1816 at the request of the Nepalese government; the king, however, was not vaccinated, contracted the disease and died. British hopes that vaccination would be extended throughout the country did not eventuate. The article examines the significance of this early appearance of vaccination in Nepal for both Nepalese and British, and relates it to the longer history of smallpox control and eventual eradication. When the Nepalese requested World Health Organization (WHO) assistance with communicable disease control in the mid-twentieth century little had changed for most Nepalese. We know about the events in 1816 through the letters of the newly imposed British Resident after Nepal’s military defeat in the Anglo-Nepal War (1814–16). By also drawing on other sources and foregrounding Nepal, it becomes possible to build up a more extensive picture of smallpox in Nepal that shows not only boundaries and limits to colonial authority and influence but also how governments may adopt and use technologies on their own terms and for their own purposes. Linking 1816 to the ultimately successful global eradication programme 150 years later reminds us of the need to think longer term as to why policies and programmes may or may not work as planned.

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