Risk Factors for Immediate Postpartum Hemorrhages in the Maternity of the University Teaching Hospital of Parakou

2015 ◽  
Vol 05 (04) ◽  
Author(s):  
Awade Afoukou Achille Obossou
2019 ◽  
Author(s):  
PRISCILLA KAPOMBE ◽  
LUNGOWE SITALI ◽  
PATRICK MUSONDA

Abstract Background Neisseria gonorrhea, the causative agent of Gonorrhea, has developed antibiotic resistance to the “last-line” Cephalosporin’s, Quinolones and Macrolides which is cause for concern. In Zambia, despite recommendations of discontinued use, Ciprofloxacin is used for treatment. The lack of an active surveillance system, appropriate and structured data management and analysis tools magnifies the problem because resistance patterns cannot be monitored. The study aimed to ascertain effectiveness of Ciprofloxacin a Quinolone in comparison with Ceftriaxone a Cephalosporin, in treatment of Gonorrhea using Susceptibility testing; and to identify possible risk factors associated with resistance. Methods Study design was parallel non-inferior quasi experimental study. Patients at the University Teaching Hospital with discharge and Gonorrhea symptoms who gave consent, were recruited. Fishers Exact Test for associations was used. Data was analyzed using Ordinal logistic regression as the Susceptibility was at 3 levels; Susceptible, Intermediate or Resistant with an assumed Ordinal nature. Proportionality assumption was checked, and when violated Partial Proportional Odds Model was used instead. Results A total of 104 isolates were obtained. The overall proportion of patients who had Susceptible, Intermediate and Resistant results were: 49 (47.1%), 55 (52.9%) and 0 (0) for Ceftriaxone and 70 (68.0%), 10 (9.7%) and 22 (22.3%) for Ciprofloxacin respectively. Adjusted estimates in partial Proportional Odds model showed that, Males were 4.1 (95% CI; 1.8, 9.4, p-value=0.001) times more likely to have Intermediate or Susceptible results compared to Resistance than females, or they were more likely to have Susceptible compared to Resistance or Intermediate result compared to females. Ciprofloxacin was 70% less likely than Ceftriaxone of having susceptible or intermediate results compared to resistance and this could be as high as 90% and as high as 40% p-values <0.001). Conclusion Level of Ciprofloxacin resistance detected from the Susceptibility testing, shows it is not an effective treatment for Gonorrhea. Ceftriaxone remains a satisfactory option for first-line treatment of Gonorrhea at UTH. Risk factors identified to be associated with resistance in this study were being female and use of Ciprofloxacin. Ethical Clearance Ethical clearance was obtained from University of Zambia Biomedical Ethics Research Committee (UNZABREC Ref # 033-06-17).


Author(s):  
Nchimunya Machila ◽  
◽  
Chishala Chabala ◽  
Chisambo Mwaba ◽  
Catherine Chunda-Liyoka ◽  
...  

Background: Improved medical care has led to the improved life expectancy of sickle cell anaemia (SCA) patients hence complications associated with SCA such as chronic kidney disease (CKD) are being seen more frequently. Globally, nephropathy of varying severity occurs in 5 to 18 % of the SCA population across all age groups with a third of the adults proceeding to develop CKD while over 30 % of paediatric SCA patients have CKD in Africa. The mortality rate in SCA patients CKD is high. This study sought to determine the prevalence and risk factors of CKD in SCA, information that was not available in Zambia prior to this study. This information will guide in targeting and timing of screening for CKD in SCA in children in our population. Objectives: To determine the prevalence of haematuria, proteinuria, abnormal estimated glomerular filtration rate (eGFR), CKD, and risk factors of CKD among the steady-state SCA patients aged 5 to 16 years at the University Teaching Hospital (UTH), Lusaka. Methodology: This was a prospective cross-sectional study of 197 children aged 5 to 16 years with SCA at the UTH - Lusaka conducted from August 2014 to July 2015. Demographic and clinical data were collected using a structured questionnaire. Urine and blood samples were used to determine the urine albumin creatinine ratio (ACR) and full blood count /blood biochemistry respectively. CKD was defined and determined using the Kidney Disease Outcome Quality Initiative 2012 guidelines employing urine ACR, dipstick urinalysis and eGFR. In this study, spot urine ACR and dipstick urinalysis were done and repeated three months later if initial tests were abnormal. Data was analysed using SPSS version 21. Chi-square and t-test were used to compare proportions between groups. Relation between study variables and CKD were examined using logistic regression. Results: The mean age of the participants was 9.6 years (SD ±3.6). Male to female ratio was 1:1. The median age at diagnosis of SCA was 22 months (IQR = 44). The prevalence of haematuria, proteinuria and CKD among the study participants was 14.2%, 36% and 36 % respectively. Low haemoglobin and elevated mean corpuscular volume (MCV) were associated with CKD-AOR 0.62, 95% CI; 0.46-0.84 and 1.04, 95% CI; 1.01 – 1.08 respectively. Recurrent admissions (due to VOCs, severe anaemia and febrile illness) were also risk factors associated with CKD- AOR 0.52, 95% CI; 0.27-0.98. CKD was not associated with age at enrolment, sex, age at diagnosis of SCA, recurrent Vaso-occlusive crisis (VOCs) or abnormal liver function tests. Conclusion: The prevalence of CKD among the SCA patients at UTH- Lusaka is high (36%) with lower Haemoglobin, elevated MCV and recurrent admissions being risk factors for developing CKD. SCA patients should be screened for CKD routinely at least once a year. Interventions such as the early introduction of hydroxyurea, proactive blood transfusions and ACE inhibitors can reduce the risk of CKD and its progression to end-stage renal disease.


2016 ◽  
Vol 3 (4) ◽  
pp. 199-203 ◽  
Author(s):  
Moono Silitongo ◽  
◽  
Dailesi Ndlovu ◽  
Kasonde Bowa ◽  
Krikor Erzingatsian ◽  
...  

Author(s):  
Marialuz Arántzazu García-González ◽  
Fermín Torrano ◽  
Guillermo García-González

The aim of this paper is to analyze the primary stress factors female professors at online universities are exposed to. The technique used for the prospective and exploratory analysis was the Delphi method. Two rounds of consultations were done with fourteen judges with broad experience in health and safety at work and university teaching who reached a consensus of opinion regarding a list of nine psychosocial risk factors. Among the most important risk factors, mental overload, time pressure, the lack of a schedule, and emotional exhaustion were highlighted. These risk factors are related to the usage and expansion of information and communication technology (ICT) and to the university system itself, which requires initiating more research in the future in order to develop the intervention programs needed to fortify the health of the affected teachers and protect them from stress and other psychosocial risks.


2013 ◽  
Vol 5 ◽  
pp. OED.S12672
Author(s):  
Kagmeni Giles ◽  
Moukouri Ernest ◽  
Domngang Christelle ◽  
Nguefack-Tsague Georges ◽  
Cheuteu Raoul ◽  
...  

We assessed the outcomes of the use of anterior chamber foldable lens for unilateral aphakia correction at the University Teaching Hospital of Yaounde. In this retrospective, non-comparative, consecutive case series study, we reviewed the records of patients who underwent an operation for aphakia correction by the means of injection of an angular supported foldable lens between January 2009 and December 2011 in the University Teaching Hospital Yaounde. Student's paired t-test was carried out to compare preoperative and postoperative visual acuity (VA) and intraocular pressure (TOP). P-values less than 0.05 were considered statistically significant. Twenty-one patients were included in the study; twelve were male (57.1%) and nine were female (42.9%). The mean age was 55.38 ± 17.67 years (range 9–75 years). The mean follow-up duration was 5.95 ± 3.14 months (range 2–12 months). The mean logMAR visual acuity was 1.26 ± 0.46 pre-operatively and 0.78 ± 0.57 post-operatively ( P = 0.003). The change in intraocular pressure was not statistically significant. Complications included intraocular hypertension (over 21 mmHg) in 3 patients (14.3%) and macular edema, pupillar ovalization, and retinal detachment in one patient each. The results indicate that injection of an angular support foldable lens in the anterior chamber is a useful technique for the correction of aphakia in eyes without capsular support. More extended follow-up, however, and a larger series of patients are needed to ascertain the effectiveness and safety of this procedure.


2018 ◽  
Vol 1 (2) ◽  
pp. 142-147
Author(s):  
S K Hembah-Hilekaan ◽  
A O Ojabo ◽  
O Audu ◽  
P E Onche ◽  
M T Maanongun

Episiotomy is an incision on the introitus and the perineum to increase pelvic outlet to facilitate childbirth and prevent trauma to fetal and maternal tissues. Episiotomy and perineal laceration may predispose the woman to short and long term complications. The objective of this study was to determine the prevalence of episiotomy and perineal lacerations and their associated risks factors at Benue State University Teaching Hospital, Makurdi, Nigeria. Retrospective data of all women who had spontaneous vagina delivery over a 3 year period with perineal laceration/episiotomy were reviewed. Data was obtained from the records and information on the socio-demographic variables, episiotomies, lacerations and the birth weight of infants. The associated risk factors were recorded using Statistical Package for Social Sciences version 22.Of the 636 vaginal deliveries, 85(13.4%) had lacerations with 65(10.2%) first degree, 19(3.0%) second degree and 1(0.2%) major laceration. Episiotomy rate was 132(20.8%). The mean parity and birth weight of infants were 2.62(SD= ± 1.83) and 3.1 kg (SD= ± 0.767) respectively. The highest number of perineal tears 69(10.8%) were in the lower age group (≤ 30 years). A similar observation was noted in respect of episiotomies which rate however decreased with parity. The relationship between maternal age, parity, booking status, fetal weight and the perineal status at delivery was statistically significant (P≤ 0.05). Episiotomy and perineal laceration rates in our institution were low. The major risk factors were low parity, young maternal age and increasing fetal weight at birth and their presence should be an early warning sign. We advise perineal support for all women during delivery.


Sign in / Sign up

Export Citation Format

Share Document