Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa: a systematic review of literature

ConclusionsA number of factors were found to hamper access to and utilization of emergency obstetric care among women in sub-Saharan Africa. These barriers are inter-dependent and occurred at multiple levels either at home, on the way to health facilities, or at the facilities. Therefore, country-specific holistic strategies including improvements to healthcare systems and the socio-economic status of women need to be strengthened. Further research should focus on the assessment of the third delay, as little is known about facility-readiness.Systematic review registrationPROSPERO CRD42017074102
Source: Systematic Reviews - Category: International Medicine & Public Health Source Type: research

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Conclusion: VEGFR-TKIs are associated with a small increase in risk of patients developing hypertension, arterial thrombotic events, thrombocytopenia, and bleeding. Previous studies overestimated the actual risk associated with VEGFR-TKIs by analyzing the outcome with the lower baseline risk. PMID: 31698959 [PubMed - as supplied by publisher]
Source: Expert Opinion on Drug Safety - Category: Drugs & Pharmacology Tags: Expert Opin Drug Saf Source Type: research
Portal hypertension is associated with many of the known complications of cirrhosis and has an enormous impact on patients ’ prognosis. Ascites and hepatic encephalopathy represent the most common complications of cirrhosis; both are associated with a significantly worse prognosis, with 50% survival over 1–2 years. Acute variceal bleeding is a life-threatening complication, and despite significant improvements in th e management it remains a leading cause of death in patients with cirrhosis. Advances in variceal bleeding management, including empirical antibiotic use, vasoactive drugs, early endoscopy and thera...
Source: Medicine - Category: Internal Medicine Authors: Tags: Management problems in liver disease Source Type: research
Abstract Background: Mitral valve repair in paediatric patients with chronic rheumatic heart disease is superior to valve replacement and has been used with good results. Objective: To identify predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplasty secondary to rheumatic heart disease. Methods: Retrospective study of 54 patients under the age of 16 operated at a tertiary paediatric hospital between March 2011 and January 2017. The predictors of risk for unfavourable outcomes were: age, ejection fraction, degree of mitral insufficiency, degree of pulmonary hypertension, pr...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research
Abstract Background: Mitral valve repair in paediatric patients with chronic rheumatic heart disease is superior to valve replacement and has been used with good results. Objective: To identify predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplasty secondary to rheumatic heart disease. Methods: Retrospective study of 54 patients under the age of 16 operated at a tertiary paediatric hospital between March 2011 and January 2017. The predictors of risk for unfavourable outcomes were: age, ejection fraction, degree of mitral insufficiency, degree of pulmonary hypertension, pr...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research
Abstract AIM: Periodontitis is a relapsing-remitting disease. Compared to bleeding on probing (BoP), expression of disease activity, periodontal inflamed surface area (PISA) incorporates chronic disease parameters. We tested the association of PISA and BoP with blood pressure (BP) in NHANES III. MATERIALS AND METHODS: 8,614 subjects (≥30y) with complete periodontal and BP examinations were enrolled. PISA was derived from periodontal probing depth and BoP. The association of PISA and BoP with high/uncontrolled BP was examined by multiple-adjusted models. Inflammatory markers were tested as possible mediator...
Source: Journal of Clinical Periodontology - Category: Dentistry Authors: Tags: J Clin Periodontol Source Type: research
This study is also a reminder that the health impact of a particular intervention (such as diet) may not be easy to predict or explain. In most cases, the risk of stroke and heart disease tend to rise or fall together, but that wasn’t the case in this research. Beware the study’s limitations This study linking a vegetarian diet with a higher risk of hemorrhagic stroke has a number of important limitations that should temper the concerns of vegetarians. The study was observational. That means it simply observed what happened among different people who followed different diets over time, without being able to ac...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Healthy Eating Heart Health Hypertension and Stroke Source Type: blogs
In this study we aim to identify factors associated with adverse events in VSB surgery.MethodsWe queried the database of the American College of Surgeons National Surgical Quality Improvement Program for cases of VSB surgery during the period 2005 ‐2014. Patients with complications, readmissions, reoperations, or mortality were compared to those without adverse events.ResultsNine hundred patients were included; 253 (28.1%) had complications, underwent reoperation, were readmitted, or died. These patients were older (42.6% vs 32.8,p = 0.032) and had higher rates of congestive heart failure (CHF) (3.2% vs 0.2%,p
Source: International Forum of Allergy and Rhinology - Category: Allergy & Immunology Authors: Tags: ORIGINAL ARTICLE Source Type: research
The severe form of CF liver disease, multilobular biliary cirrhosis (MBC) is associated with the almost invariable development of portal hypertension (PH) and the complications of variceal bleeding [1 –4] and unusually hepatic encephalopathy [5] or liver failure requiring transplantation [6]. These features in combination with splenomegaly and laboratory evidence of hypersplenism facilitate a diagnosis of MBC/PH which can be confirmed with non-invasive ultrasonography [2,7–9] and magnetic res onance imaging.
Source: Journal of Cystic Fibrosis - Category: Respiratory Medicine Authors: Source Type: research
We present the case of a 77-year-old man with retroperitoneal fibrosis obstructing the splenic vein and causing recurrent episodes of upper gastrointestinal bleeding. Computed tomography showed a retroperitoneal mass as being responsible for the obstruction of the splenic vein, splenomegaly, and diffuse varices around the gastrosplenic and gastrohepatic ligaments. An oesophagus preserving, modified Sugiura procedure was performed with disconnection of the gastric vessels on the lesser curve of the stomach, preserving the pylorus branches of the nerves of Latarjet. PMID: 31660755 [PubMed - as supplied by publisher]
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Tags: Ann R Coll Surg Engl Source Type: research
Publication date: Available online 26 October 2019Source: Clinics and Research in Hepatology and GastroenterologyAuthor(s): Manon Allaire, Aurélie Walter, Olivier Sutter, Pierre Nahon, Nathalie Ganne-Carrié, Roland Amathieu, Jean-Charles NaultSummaryPortal hypertension is primarily due to liver cirrhosis, and is responsible for complications that include variceal bleeding, ascites and hepatorenal syndrome. The transjugular intrahepatic portosystemic shunt (TIPS) is a low-resistance channel between the portal vein and the hepatic vein, created by interventional radiology, that aims to reduce portal pressure. T...
Source: Clinics and Research in Hepatology and Gastroenterology - Category: Gastroenterology Source Type: research
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