4,342 research outputs found
Ruptured tubal pregnancy: predictors of delays in seeking and obtaining care in a Nigerian population
Get PDFPurpose: Morbidity and mortality from ruptured tubal pregnancies (RTPs) have been linked with delays in seeking and receiving care. Evaluation of the reasons for these delays and their contributions to maternal deaths is rarely done for women with RTPs in resource-constrained settings.Patients and methods: This was a 3-year retrospective review of the case records of women with tubal pregnancies managed at the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. Clinical and sociodemographic parameters were obtained, including information on onset of symptoms and intervals between the symptoms and when help was sought and obtained at the hospital.Results: There were 92 cases of tubal pregnancies, giving an incidence of 18 per 1,000 births. Most of the patients were married (74.7%), parous (64.9%), and urban dwellers (76.9%), and 11% were severely anemic on arrival. The case-fatality rate was 1.1% and 74.7% had delay in seeking care, while 82.4% of the women spent more than 2 hours after admission before surgical intervention. Rural dwellers (adjusted odds ratio 2.96, 95% confidence interval 1.08–8.36) and those without formal education (adjusted odds ratio 6.39, 95% confidence interval 1.06–67.30) had delays in seeking help, while problems with funds (?2=7.354, P=0.005) and initial misdiagnosis (?2=5.824, P=0.018) predicted delay in obtaining help at the hospital.Conclusion: RTPs are common gynecological emergencies in our environment that are often associated with delayed decisions to seek help and obtain care. Efforts should be geared toward women’s education and financial independence, improved hospital accessibility, and better diagnostic skills
Baird-pattinson aetiological classification and phases of delay contributing to stillbirths in a Nigerian Tertiary Hospital
Get PDFPurpose. This study aims to identify triggers of stillbirth in the study setting and to make suggestions to reduce the prevalence. Method. A three-year retrospective case-control study of stillbirths at Ekiti State University Teaching Hospital. Results. The stillbirth rate was 33 per 1000 births. Based on Baird-Pattinson classification of the primary obstetric causes of stillbirth, adverse intrapartum events, hypertensive diseases, and unexplained intrapartum fetal deaths were topmost causes of stillbirths. In comparison with the controls, other identified predictors of SB were grand multiparity (p = 0.016), delays in seeking medical care and/or in receiving treatment (p = 0.0001), wrong initial diagnosis (p = 0.0001), inadequate intrapartum monitoring (p = 0.0001), and inappropriate clinical management (p = 0.0001). Conclusion. Stillbirth rate remains high in our setting. Elimination of obstacles to accessing care, effective management of hypertensive disorders in pregnancy, updated health facilities, improved dedication to duty, and retraining of health workers will reduce the prevalence
Awareness and practice of emergency contraception at a private university in Nigeria
Get PDFThe pursuit of formal education now causes many people in developing countries to marry later in life, thereby leading to increased premarital sex and unintended pregnancies. Efforts have been made to characterize awareness and use of emergency contraception (EC) among undergraduate students in public universities in Nigeria; however, it is not known if students in private tertiary institutions adopt different practices or if having an affluent family background plays a role. This pilot study therefore aimed to assess the awareness and use of EC among students at a private Nigerian university toward assisting education planners in developing strategies in improving students’ reproductive well-being.ResultsOut of 94 female students, 42 (44.7%) had sexual experience, but only 32 (34.0%) were currently sexually active. Six students (6.4%) had had unwanted pregnancies, of which all but one were terminated. Fifty-seven respondents (60.6%) were aware of EC, though only 10 (10.6%) ever practiced it. The greatest source of EC information was from health workers and peers; the lowest source was family or relatives. Most respondents desired orientation and availability of EC on campus. EC awareness among the students was predicted by upper social class background (adjusted odds ratio [OR], 2.73; 95% confidence interval [CI], 1.06–7.45) and upbringing in the Federal Capital Territory (adjusted OR, 4.45; 95% CI, 1.56–14.22).ConclusionsThough awareness of EC was higher among the private university students in this study than at most public universities, there was no difference in EC usage. A high pregnancy termination rate was observed; dilatation and curettage were mainly adopted. In Nigeria, youth-friendly reproductive health information and access should not be limited to government-owned tertiary institutions but also extended to private ones.<br/
Antenatal drug consumption: the burden of self-medication in a developing world setting
No full textThis institutional-based cross-sectional study examines the burden of self-medication during pregnancy in a middle-income country setting and the impact on fetal wellbeing. Using a blend of open-ended and indication-oriented questionnaires, 346 pregnant women at term were interviewed about their pregnancy complaints and drug intake. Inferential statistical data analysis was employed with level of significance (?) set at 0.05. Excluding routine supplements and vaccinations, 251 (72.5%) women used medicines, of whom 79 (31.5%) had self-medicated. Consuming drugs without prescription was associated with increased US Food & Drug Administration (FDA) risk category (?(2)?=?8.375; P?=?0.015). There is therefore a need to scale up efforts towards educating women about the dangers of self-medication, while also introducing effective restrictive policies on over-the-counter drug sale
Clinical suspicion, management and outcome of intrapartum foetal distress in a public hospital with limited advanced foetal surveillance
No full textObjectives: To determine the basis for the clinical suspicion of foetal distress, the instituted managements and delivery outcome in a tertiary hospital in sub-Saharan Africa with limited capability for advanced foetal monitoring.Methods: It is a 3-year retrospective analysis of all the obstetrics cases with intrapartum foetal distress.Results: There were 301 cases reviewed. The birth asphyxia incidence rate was 233/1000 live births and the perinatal death rate was 47/1000 live births. Suspicion of foetal distress was premised on the presence of persistent tachycardia or bradycardia during intermittent auscultation. Main resuscitative measures were left lateral repositioning of patient, fast saline infusion, intranasal oxygen administration and discontinuation of oxytocin infusion, if any. Only 124 (41.2%) of all the cases had delivery achieved within 2?h of diagnosis. Mean decision-delivery interval by caesarean section was 2.93?±?2.05?h. Socio-demographic factors (p=?0.001) and pregnancy risk category (p?=?0.002) influenced incidence of birth asphyxia.Conclusion: To reduce subsisting high perinatal morbidity and mortality in sub-Saharan Africa, it is best that at the least referral hospitals should have advanced facilities for foetal monitoring and shortened surgical intervention time
Jacob of Sarug's Homily on Tamar (Gen 38)
No full textThis small volume contains an edition (from Vatican ms. 117) of Jacob of Sarug’s homily on Tamar (420 lines long). The full title is “On Tamar and on the Mystery of the Church.” The biblical narrative on which the poem is based (Gen 38) gives Jacob the opportunity to discuss various women in the early part of biblical history and in Jesus’ lineage, as well as the fact that a woman who is called a prostitute is in that lineage. Jacob explains how Scripture’s language is used in this regard
Jacob Wassermann.
No full textOne of several renderings of the German author Jacob Wassermann by the painter and illustrator Suzanne Carvallo-Schülein.Digital ImageArtwork
Jacob of Serugh's Homilies on the Spectacles of the Theatre
No full textThis fascinating volume contains excerpts from four otherwise unedited (and untranslated) homilies from Jacob of Sarug on the theatre. These homilies, extant only in a single manuscript (BM Add. 17158), which is unfortunately poorly preserved, are unique for the light they cast on the Greek theatre in the Byzantine period. In this article, originally published in Le Muséon 48 (1935), Moss gives a substantive introduction to the selections presented from these homilies, and then presents the texts in Syriac and in English translation. Scholars and readers interested in Syriac literature, and in Jacob of Sarug in particular, as well as students of the history of the theatre, will find this work of great interest.Translated into English from the Syriac text
Jacob Viner’s Reminiscences from the New Deal (February 11, 1953)
Get PDFThis paper presents and reproduces an unpublished oral history interview given by Jacob Viner in 1953. The interview released by Viner for the Columbia Oral History Project gives us a valuable opportunity to throw light on his advisory activity during the New Deal Era. In our introduction we attempt to make a critical appraisal of Viner's reminiscences and to state the contribution they can provide to our general knowledge of the period. In addition, we also attempt to find out some biographical and interpretative elements useful to understand Viner’s own vision and his contribution to important economic policy processes during the New Deal.
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