East African medical journal
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To review the findings of safe motherhood intervention studies conducted in African settings. ⋯ More than a decade after the launching of the Safe Motherhood Initiative, there exists little evidence regarding which interventions will reduce maternal mortality levels in African settings. Intervention studies conducted in Africa have identified several low-tech improvements in emergency obstetric services which improve maternal outcomes and deserve replication and testing in a variety of settings. Further operational research should be conducted to identify and test other promising safe motherhood interventions, in particular interventions designed to reduce the important proportion of maternal mortality associated with unsafe termination of pregnancy.
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Sinus of Valsalva aneurysms are uncommon. Aortic sinus aneurysm may be complicated by endocarditis or rupture. A 26 year old native Ghanaian presented with dyspnoea, raised jugular venous pressure (JVP), tender hepatomegaly, peripheral oedema, a thrill and a continuous murmur at the upper left sternal edge. ⋯ Colour flow revealed left to right shunting of blood from the aortic root into the right atrium. A year later he presented with a febrile illness, weight loss, night sweats and was diagnosed as having culture negative infective endocarditis. Following a course of antibiotics, he underwent successful cardiopulmonary bypass surgery with repair of the ruptured aneurysm of the right sinus of Valsalva.