Search

Background: Patient satisfaction is one of the key outcome measures of healthcare services. Aim and Setting: To explore factors that influence women’s satisfaction with peri-partum care at Bertha Gxowa district hospital, South African primary care. Methods: A cross-sectional study involving 260 women was conducted. A structured questionnaire collected information from participants on pain relief, health education provided by healthcare providers, privacy, cleanliness of the ward and their participation in decision-making about care received in the peri-partum period. Results: Most respondents were co-habiting with their partners (100, 38%) and had completed only secondary school education (119, 46%). The average participant age was 27 years, with an average parity of two children. Most participants were satisfied with the privacy (218, 84%) and the general cleanliness of the wards (233, 90%). However, large proportions of women were dissatisfied with the information given to them by doctors (104, 55%) and nurses (89, 37%), and the rest were unsure. About 189 (73%) participants were dissatisfied with the extent of their participation in decision-making about their own care. The study had a caesarean rate of 53 (20%). Compared to normal vaginal delivery, participants who had caesarean section were significantly more likely to report being satisfied with pain relief during labour ( p < 0.001). Conclusion: The study findings showed varying levels of satisfaction with different aspects of peri-partum care and suggested the need for better pain relief during vaginal delivery, information sharing by doctors and patient emancipation for decision-making about their own care.

A verminose é um dos principais problemas sanitários da criação de pequenos ruminantes no Brasil e no mundo. Entretanto, pouco se conhece sobre a variação sazonal da contaminação parasitária e os efeitos da associação de um controle estratégico com um tático sobre ovinos criados em condições do Semiárido no norte de Minas. Este trabalho foi realizado com o objetivo de avaliar a variação sazonal da contaminação por helmintos gastrintestinais em borregos e matrizes ovinas em um sistema de controle integrado no norte de Minas Gerais, Brasil. Durante um ano, mensalmente, foram coletadas amostras de 30 borregos e 30 matrizes de uma propriedade. Durante o mês de abril de 2007, foram também avaliados 68 ovinos em uma segunda propriedade, período esse que correspondeu à época de parição nas duas fazendas. Amostras de fezes foram obtidas diretamente da ampola retal para determinação do número de ovos por gramas de fezes (OPG) e os dados submetidos à análise de variância. Os valores médios do OPG das matrizes apresentaram aumento significativo nos meses de maio e outubro de 2007, meses de parição na propriedade. Já para os borregos, ocorreu aumento significativo no OPG médio em março de 2007, coincidindo com o final da estação chuvosa. O controle integrado adotado foi eficiente na redução da contaminação após esses períodos relatados. Após o cultivo das larvas, os gêneros mais observados foram Trichostrongylus, Haemonchus e Strongyloides, tanto para o período seco, quanto para o chuvoso. A comparação das contaminações das matrizes das duas propriedades no mês de abril de 2007 indicou uma média de OPG significativamente maior na segunda propriedade, que não tratou esses animais antes do parto. The verminosis is one of the principal sanitary problems in ovine herds in Brazil and around the world. However, little is known about the seasonal variation of the helminth contamination and the effects of the combination of a strategy control and a tactical control in sheep raised under in the Northern Minas semiarid conditions. In this study, the objective was to evaluate the seasonal helminth contaminations in lambs and ewes under an integrated control in the North of Minas Gerais, Brazil. The research was carried through during December 2006 to November 2007. Monthly faecal samples from 30 lambs and 30 ewes of one farm were collected. During April 2007, 68 sheep of a second farm were also evaluated, corresponding to the peri-partum time to both farms. The samples were collected directly from the recto and the faecal egg count (FEC) was determined and evaluated by variance analysis. The ewe FEC increased significantly in May and October ,which were peri-partum periods. Lamb FEC increased significantly in March , which coincided with the rainy season end. The integrated control was efficient to reduce the contaminations after these related periods. After the larvae culture, the genus Trichostrongylus, Haemonchus and Strongyloides were the most observed to both dry and rainy periods. During April 2007 the ewe contamination was significantly higher in the second farm that did not treat these animals in the pre-partum.

Peripartum Cardiomyopathy is insufficient congestive heart occurring in the last month of pregnancy and 5 months after delivery, in the absence of preexisting heart disease and identified etiology. This heart disease is associated with echocardiography systolic dysfunction and left ventricular dilatation. Its incidence ranges from 1/3000 to 1/15000, depending on the region, including much higher in some African countries, it particularlyconcern women over 30 years, multiparous and multiple pregnancies. The pathogenesis remains unclear, the prognosis is closely related to the complete recovery of cardiac function. We report through the clinical case of a woman aged 33 years admitted to the ICU for acute pulmonary edema of sudden onset of a term pregnancy and what to do before this critical situationKey words: Peri-partum, cardiomyopathy, acute pulmonary edema

INTRODUCTION: La cardiomyopathie du péripartum (CMPP) est une défaillance cardiaque dont l'étiologie demeure encore méconnue. METHODES: Il s'agit d'une étude prospective descriptive réalisée dans le service de cardiologie du CHU Sylvanus olympio de Lomé du 1er janvier 2010 au 30 avril 2012. Elle a concerné 41 patientes ayant présenté une insuffisance cardiaque entre le 8eme mois de la grossesse et les 5 premiers mois du post-partum. RESULTATS: L'âge moyen des patientes était de 31,47 ans (extrêmes 21 et 44ans). L'incidence de la CMPP était de 1/362 grossesses. La parité moyenne était de 3,07 (extrêmes 1 et 6). Les symptômes étaient apparus dans le post-partum dans 90,24% des cas. Un retard important de diagnostic était observé. L'insuffisance cardiaque globale était le mode de décompensation dans 65,85%. Les signes électrocardiographiques étaient essentiellement la tachycardie sinusale (97,56%) et l'hypertrophie ventriculaire gauche (97,56%). L'échographie cardiaque a montré dans tous les cas une cardiomyopathie dilatée. Quatre cas de thrombus intraventriculaire gauche étaient notés. La FEVG était sévèrement altérée. L'HTAP était importante dans 56,09%. CONCLUSION: La cardiomyopathie du péripartum est une complication cardiaque grave de la grossesse de cause inconnue, fréquente dans la population africaine.