Search

Emergency Obstetric and Newborn Care services will impact on the mortality and morbidity of Mother and newborn. Factors like education, socio economic status and linkages between community and health facility will adversely affects the availability of EMOC services. Aim: To assess the relation between socio economic factors and availability of EMOC services. Material and methods: A quantitative study was conducted among 761 pregnant women of Badwani district of Madhya Pradesh who were admitted in District Hospital Badwani and availed EMOC services, through pretested interview schedule. Analysis of collected data was done using Microsoft excel. Results: Among the study group, (761 pregnant women respondent in this study), appox 50 % (58.87 %) had received education till high school, including 16.95 % of illiterate category. Literacy level among their husbands is slight better, as approx. 66.62 % had educated till intermediate level. Strong linkages between community and health facility is very crucial element is saving the life of pregnant women and newborn, 62% of pregnant women received emergency obstetric care services in average time of 90 - 120 mins. As far as family income is concerned, approx. 45 % pregnant women have family income of 1-2 lakhs annually. Conclusion: Socio economic factors like literacy level of pregnant women and her husband, family annual income and linkages between community and health institutions are directly proportional to the availability of emergency obstetric and newborn care services. [ABSTRACT FROM AUTHOR]

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used for refractory cardiogenic shock and is still associated with frequent morbidities and high mortality. Many risk scores have been used to stratify the patients for rapid decision making. The recent studies using the risk scores during VA-ECMO support were reviewed and the conflicting results were addressed. The Survival After VA-ECMO (SAVE), modified SAVE, Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology score II (SAPS II), REMEMBER, ENCOURAGE scores were used in retrospective studies without validation prospective studies. The risk scores used in evaluation of adult patients with VA-ECMO support for refractory cardiogenic shock help in clinical judgment but should not affect decision making for withdrawal of support. [ABSTRACT FROM AUTHOR]

This cross-sectional study was conducted to evaluate the prevalence of oral sub-mucous fibrosis among male school going children in a low socio-economic class and to analyze the relationship between oral submucous fibrosis and the use of various form of tobacco and areca nut. It was conducted on 54 male school going children aged between 10-19 years studying in classes VI to X of a public school in the catchment area of Hamdard University Dental Hospital Block-L North Nazimabad, Karachi. Results of the study showed that 50% of the study subjects used tobacco and its related products and amongst them 7.4% of Oral Submucous Fibrosis cases were identified. Tobacco and its related products have flooded the Pakistani market being cheap and convenient and have become popular in school age groups. They have been identified as a high risk for occurrence of the precancerous lesion (oral submucous fibrosis). Screening system in all schools must be introduced to identify precancerous lesion at an early stage. [ABSTRACT FROM AUTHOR]

Background: Emergent peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been used frequently to support patients with refractory cardiogenic shock with variable rates of complications. We retrospectively analyzed adult patients who received peripheral VA-ECMO support between 2015 and 2019 at our tertiary care hospital. Results: Sixty five patients with a mean age of 37.9±14.9 years, mostly males (70.8%), were supported with femoral VA-ECMO with a median duration of 8 (IQR: 3-40) days. Hospital mortality occurred in 29 (44.6%) patients. Complications included acute kidney injury (AKI) in 39 (60%), acute cerebral strokes in 13 (20%), gastrointestinal bleeding in 14 (21.5%) and acute limb ischemia in 21 (32.3%) patients. Non-survivors had significantly higher mean Sequential Organ Failure Assessment (SOFA) scores and significantly increased rates of acute kidney injury, renal replacement therapy, ischemic cerebral strokes, cannulation site exploration for bleeding, atrial fibrillation and anticoagulation discontinuation. Multivariable regression analysis revealed significant Odds Ratios (OR), 95% Confidence Intervals (CI) of hospital mortality with: increasing SOFA scores after 48 hours (2.15, 1.441-3.214, p < 0.001), atrial fibrillation (11.351, 1.354-83.222, p = 0.025) and hyperlactatemia (2.74, 1.448-6.719, p = 0.016). Conclusion: High mortality and frequent morbidities due to emergent peripheral VA-ECMO should be considered before initiation for cardiogenic shock. According to our results, increasing trend of SOFA scores, atrial fibrillation and progressive hyperlactatemia are independent predictors of hospital mortality of peripheral VAECMO. [ABSTRACT FROM AUTHOR]