Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Early referral for hospital delivery is important to reduce the risks during pregnancy and labor for 90% of the women in rural areas. Therefore, Tanzania has improved a record card for antenatal screening that would detect labor complications, indicate appropriate action, emphasize preventive treatment for pregnancy complications, and record labor outcome. A patient's obstetric history is obtained and the patient is examined with consideration given to height and limp or polio leg. Patients with raised blood pressure, signs of pre-eclamptic toxemia, or severe anemia are referred to the hospital and if breech, transverse lie, or twins are suspected, the patient is booked for a hospital delivery. Prevention of anemia, malaria, and neonatal tetanus are emphasized. Of 13,410 women screened, a height factor of 146 cm or less accounted for 41.6% of all risk factors, and 81% of all risk factors were detected from the patient's history and height measurement. By using the new antenatal cards there was a higher detection rate of risk cases an when used by different health workers, there was over 95% agreement in findings compared to 68% using the old cards.
 ...
PMID:Use of an action-orientated record for antenatal screening. 30 47

Before a long journey, the healthy pregnant woman should be advised by her doctor after a careful examination. Healthy pregnant women may consider traveling to any destination except tropical and subtropical regions, where a danger of infection with malaria or dysentery exists. Likewise she should not select a country where vaccination with living virus is required on entry. Pregnant women with a high risk (hemorrhages, toxemia of pregnancy, threatening premature birth) should be advised unconditionally against a long journey.
 ...
PMID:[Travel during pregnancy (author's transl)]. 82 11

Factors leading to acute renal failure (ARF) were analysed in 376 consecutive patients between January 1993 and December, 1994 in a Karachi centre. Two hundred and sixteen (57%) had medical conditions, 86 (24%) obstetrical, 28 (7%) obstructive, 18 (5%) surgical and in 28 (7%) the causes were uncertain. Within the medical group, the causes were diarrhoea 30%, drugs 23%, malaria 15% and liver disease 5%. In the obstetrical group majority of the patients had multiple etiologies. Sixty percent of patients had ante-partum haemorrhage, 33% post-partum haemorrhage, intrauterine deaths were seen in 31%, septic abortions in 20% and pre-eclamptic toxemia in 22% cases. In the obstructive group, most of the patients had stone disease, where bilateral ureteric calculi constituted 57% of the cases. In surgical group, 11 (61%) had ARF due to post-operative complications. This data confirms the pattern of ARF from other third world countries where obstetrical and obstructive causes are high as compared to western countries.
 ...
PMID:Analysis of factors causing acute renal failure. 868 43

In 1993, 2,008 deliveries were recorded at the Provincial Maternity Hospital at Franceville in Gabon. The frequency of cesarean section was 3%. The perinatal mortality of children born by cesaraean section was high, 213 per thousand. The principal indications for cesarean section were the baby being too large to pass through the pelvis, bicicatricial uterus, breech presentation and toxemia during pregnancy. The maternal mortality rate was 200 per 100,000, similar to the rates of most African countries, and 75% of the women that died had undergone cesarean section. The mortality rate for cesarean section was high (4.9%), so the indications for cesarean section in underdeveloped countries are limited. Malaria was the principal reason for the hospitalization of pregnant women, because it is endemic and is a serious condition for pregnant women. The next most frequent causes of hospitalization were a high risk of premature labor and hyperemesis gravidarum, the frequency of which is high among pregnant African women, particularly those of West Africa. Toxemia in pregnancy was the fourth most important cause of hospitalization. The rate of cesarean section rupture was 2.5 per thousand. Only 20% of these cases involved a cicatricial uterus, with no maternal deaths but a fetal mortality rate of 100%. The frequency of premature birth was 4.23% and the perinatal mortality rate was 48 per thousand, with 37 stillbirths per thousand and an early neonatal mortality rate of 11 per thousand. The perinatal mortality of breech presentations was high (330 per thousand), with 13.9 delivered by cesarean section. These levels are similar to those for other African countries. Maternal health could be improved by introducing several consultations during pregnancy, improving hospital hygiene and making antibiotics more widely available. Fetal survival could be improved by preventing premature births, providing more help with delivery, decreasing the time to intervention and improving neonatal resuscitation techniques.
 ...
PMID:[Precarious situation of obstetric practice in Gabon]. 985 7

Nearly 99% of maternal deaths in the world each year occur in developing countries. New efforts have recently been undertaken to combat maternal mortality through research and action. The medical causes of such deaths are coming to be better understood, but the social mechanisms remain poorly grasped. Maternal mortality rates in developing countries are difficult to interpret because they tend to exclude all deaths not occurring in health care facilities. The countries of Europe and North America have an average maternal mortality rate of 30/100,000 live births, representing about 6000 deaths each year. The developing countries of Asia, Africa, and Latin America have rates of 270-640/100,000, representing some 492,000 deaths annually. For a true comparison of the risks of maternal mortality in different countries, the risk itself and the average number of children per woman must both be considered. A Nigerian woman has 375 times greater risk of maternal death than a Swedish woman, but since she has about 4 times more children, her lifetime risk of maternal death is over 1500 times greater than that of the Swedish woman. The principal medical causes of maternal death are known: hemorrhages due to placenta previa or retroplacental hematoma, mechanical dystocias responsible for uterine rupture, toxemia with eclampsia, septicemia, and malaria. The exact weight of abortion in maternal mortality is not known but is probably large. The possible measures for improving such rates are of 3 types: control of fertility to avoid early, late, or closely spaced pregnancies; effective medical surveillance of the pregnancy to reduce the risk of malaria, toxemia, and hemorrhage, and delivery in an obstetrical facility, especially for high-risk pregnancies. Differential access to high quality health care explains much of the difference between mortality rates in urban and rural, wealthy and impoverished areas of the same country. The social determinants of high maternal mortality rates include political, geographic, and economic mechanisms of exclusion which affect the vast majority of the population in developing countries. Political power is concentrated in the hands of relatively small groups whose decisions about such expenditures as health care are usually more favorable to the privileged. A consequence of the very unequal regional development in most Third World countries is that health, educational, and most other resources are concentrated in large cities and perhaps 1 or 2 strategic regions, leaving most of the population underserved. The low social position of women leaves them doubly vulnerable. The social factors adding to risks of maternal mortality should be considered in programs of prevention if the causes and not just the consequences are to be addressed.
 ...
PMID:[Maternal death: unequal risks]. 1228 79

The Lady Dufferin Fund, founded in 1885 in India, had by 1940 established 400 hospitals to alleviate diseases and mortality related to childbirth. After independence 2328 community health centers and 21254 primary health centers were created in the country. During 1974-94 more than 131,000 subcenters were set up and about 620,000 auxiliary nurse midwives (ANMs) had been trained. The Ministry of Health introduced four health prevention schemes in 1969: 1) immunization of children against diphtheria, pertussis, and tetanus; 2) immunization of pregnant women against tetanus; 3) prophylaxis of mothers and children against nutritional anemia; and 4) prophylaxis of children against blindness caused by vitamin A deficiency. As a result, infant mortality declined from 146/1000 live births to 74/1000 in 1993; but maternal mortality still stayed around 4-5/1000. In 1993 an estimated 117,356 maternal deaths occurred out of a total of 26,057,000 births, equalling 4.5 deaths per 1000 live births. The main causes of maternal deaths are hemorrhage, anemia, abortion, toxemia, and puerperal sepsis. Only about 411 first referral units in community health centers are functioning properly. Prenatal care of mothers includes the administration of tetanus toxoid and iron-folic acid tablets. However, the prenatal coverage reached only about 50% of mothers; and the coverage was only 21.4% in Bihar, 23.8% in Nagaland, 29.3% in Rajasthan, and 29.6% in Uttar Pradesh. In these areas administrative inefficiency is widespread with nonavailability of essential drugs for malaria, infections, sepsis, dysentery, and colds. During 1992-93 the rate of hospital deliveries ranged from 6.1% in Nagaland to 88.4% in Kerala, with a national average of only 25.6%. 71% of deliveries in rural areas and 30% in urban areas were conducted by untrained assistants. Although there are 450 ANM training schools in the country, the level of training has deteriorated. The major causes of infant deaths are respiratory infections and diarrhea, responsible for 13.5% and 6.9% of mortality, respectively. Severe malnutrition and inadequate vaccination are other major causes of child deaths and morbidity.
 ...
PMID:Maternal and child health in India: a critical review. 1229 Sep 61

Pregnant women delivering in Sub-Saharan Africa (SSA) are dying from causes that are related to poverty rather than to ignorance: 1) hemorrhages; 2) infections due to the lack of sanitary conditions; 3) toxemia; 4) anemia resulting from malnutrition, intestinal parasites and malaria; and 5) too many pregnancies that are too closely spaced. Additional institutional problems are the lack of adequate health facilities, especially for maternity; the lack of personnel and services in the rural areas, and when they do exist, underutilization because of the of lack equipment, supplies and drugs, burdening the patient with such purchases. Pregnant women do not get prenatal care because health personnel are badly trained, they do not speak local languages nor know the local customs and their training is inadequate to provide crisis- intervention. The situation in the urban areas is somewhat better, with more than 2/3 of pregnant women getting prenatal care and delivering in maternity hospitals. However, the logistical problems are growing with up to 50 patients delivering per day, coupled with an insufficient number of badly trained health personnel and the unacceptable sanitary conditions in the hospitals. This situation had let to the inability of staff to diagnose and survey patients with pregnancy complications, the lack of professional assistance during deliveries, the lack of adequate health facilities and equipment to treat emergencies and the lack of ambulances to transport critical patients. The solutions require building maternity centers that are decentralized (near to people's homes in the villages) and near to hospitals; training traditional birth attendants in public health practices that are also practical for their own environments; increasing prenatal care in health centers and through home visits and providing post-partum follow-up visits that include family planning.
 ...
PMID:[Towards a lower maternity risk]. 1234 19

A study was carried out to investigate the causes of prolonged fever or onset of fever, after starting anti-tubercular treatment (ATT) in sputum smear positive, HIV negative patients admitted in a Tuberculosis (TB) Sanatorium for directly observed therapy (DOT). A total of 40 patients were studied. All were males with age ranging from 22-55 years (mean 43 years). There were 22 (55%) patients with radiological extensive disease, 12 (30%) of whom had toxemia of TB (any three of the following, <90% body weight, hypoalbuminemia, hyponatremia, severe normocytic anaemia, <5mm response on tuberculin testing). Radiologically, moderately extensive disease was seen in 9 (22.5%) cases, whereas focal disease was present in another 9 (22.5%) patients. There were 28 (70%) patients who had evidence of dissemination of disease to extra pulmonary organs. It was found that fever occurred because of direct complications of TB in 22.5%, TB hypersensitivity (cold abscess) in 12.5%, drug resistance in 10% and drug reactions in 22.5%. Other diseases were the cause of fever in 32.5%. These included superadded lung infections in 15%, malaria in 7.5% anaemia in 5%. Filariasis and amoebic liver abscess in another 2.5% each. It is concluded that such fevers require a systematic and detailed investigation rather than attributing fever to drug resistance or TB toxemia alone.
...
PMID:PROLONGED FEVER DURING THE TREATMENT OF PULMONARY TUBERCULOSIS. 2740 58