Background: The World Health Organization (WHO) 'near miss' tool has been extensively used to audit maternal morbidity in low- and middle-income countries. Analysis of the cases of 'near miss' enables a better understanding of the associated factors, identifies deficiencies in the provision of maternity services and lays a foundation for better preventive measures in the future.
Aims: To understand the epidemiology, aetiology and determine the aspects of preventability of maternal 'near miss' (MNM) at Kathmandu Medical College.
Materials And Methods: A prospective audit of MNM and maternal deaths (MD) was undertaken at Kathmandu Medical College over a period of 12 months. The cases were identified using WHO 'near miss' criteria and areas of preventability in the provision of care determined using the modified Geller's criteria.
Results: The total number of deliveries and live births in the study period were 2747 and 2698 respectively. A total of 34 'near misses' and two MDs were identified. The common direct aetiologies of MNM and MDs identified were obstetric haemorrhage followed by hypertensive disorders with one-third of cases being of indirect aetiology. Fifty-five percent of cases had some aspects of provider- or system-related preventability with the leading delays being lack of diagnosis and recognition of high-risk status among patients and lack of interdepartmental communication.
Conclusion: The WHO near miss rate at Kathmandu Medical College was 12.5/100 live births. Significant aspects of preventability, especially at the level of the provider, were noted among cases of MNM and MDs.
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http://dx.doi.org/10.1111/ajo.13679 | DOI Listing |
Proc Natl Acad Sci U S A
January 2025
Department of Biology, Faculty of Science and Technology, Mount Royal University, Calgary, AB T3E 6K6, Canada.
With over 14 million people living above 3,500 m, the study of acclimatization and adaptation to high altitude in human populations is of increasing importance, where exposure to high altitude (HA) imposes a blood oxygenation and acid-base challenge. A sustained and augmented hypoxic ventilatory response protects oxygenation through ventilatory acclimatization, but elicits hypocapnia and respiratory alkalosis. A subsequent renally mediated compensatory metabolic acidosis corrects pH toward baseline values, with a high degree of interindividual variability.
View Article and Find Full Text PDFPLOS Glob Public Health
January 2025
Britain Nepal Medical Trust, United Kingdom of Great Britain and Northern Ireland (UK), London, United Kingdom.
Cervical cancer is the leading cancer among women in Nepal, but the country has very low screening rate, with only 8.2% of women being screened. In recent years, a self-sampling kit for testing for the human papillomavirus (HPV) has been developed to allow self-sampling and enable early detection of cervical abnormalities.
View Article and Find Full Text PDFA A Pract
January 2025
Department of Anesthesiology and Therapy Intensive, Semen Padang Hospital, Padang, Indonesia.
Numerous barriers hinder the effective delivery of neurologic care as well as the education of health care professionals in the low-income and middle-income countries (LMICs). This study assessed the knowledge of the participants after Comprehensive Neurocritical Care Course (CN3C) in the LMICs. Data from 177 participants were collected and analyzed.
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January 2025
Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Introduction: Electronic decision-support systems (EDSSs) aim to improve the quality of antenatal care (ANC) through adherence to evidence-based guidelines. We assessed the potential of the mHealth integrated model of hypertension, diabetes, and ANC EDSS and the World Health Organization EDSS to improve the quality of ANC in primary-level health care facilities in Nepal.
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PLoS One
January 2025
IMU University Centre for Education, IMU University, Kuala Lumpur, Malaysia.
Introduction: Antimicrobial resistance (AMR) is a significant problem in developing, low- and middle-income countries like Nepal. Community engagement can be an important means to address the problem. Knowledge, attitude, practice, and adherence of women regarding antibiotics and AMR was studied.
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