The Central African journal of medicine
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Postpartum Haemorrhage (PPH) is the most common cause of maternal mortality globally, leading to a woman's death every seven minutes. In Zimbabwe, there has been a 300% increase in the Maternal Mortality Ratio (MMR) between 1994 and 2010 and the MMR was estimated at 960 maternal deaths per 100,000 live births in 2012.2-3 Overall, 14% of all maternal deaths in Zimbabwe are due to PPH. Ensuring prompt access to high-quality prevention and treatment of PPH for all women who deliver is an essential strategy to combat PPH-related morbidity and mortality and to make progress toward reaching Millennium Development Goal 5, the reduction of maternal mortality by three-quarters by 2015.
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Multicenter Study Observational Study
Negative appendicectomy: evaluation of ultrasonography and Alvarado score.
High negative appendicectomy rates are no longer acceptable with improvements in imaging techniques and clinical prediction rules. The use of ultrasound and CT scan in addition to clinical assessment and blood investigations has greatly reduced the negative appendicectomy rate to less than 10%. ⋯ The negative appendicectomy rate (16.5%) at the two University Teaching Hospitals in Harare is relatively high when compared with modern trends. Alvarado score had a high sensitivity (95.3%) and predictive value (90.3%). Ultrasound scan had a high sensitivity (89.5%) and a relatively low predictive value (77.2%) in diagnosing acute appendicitis. Regular use of these assessment modalities should contribute substantially to reduction in the negative appendicectomy rate in our practice.
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Acid base alterations occur during laparoscopy with carbon dioxide insufflation. The purpose of this study was to investigate the effects of low tidal volume ventilation on acid base status during pneumoperitonium. ⋯ Ventilation with low tidal volume during pneumoperitoneum causes a mixed respiratory and metabolic acidosis. EtCO2 is still a good non-invasive monitor for estimation of PaCO2 during low tidal volume ventilation during pneumoperitoneum.
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The International Classification of Functioning, Disability and Health (ICF) is a framework that provides a detailed outline of the information that should be included in patient records. Whilst the World Federation of occupational therapists and the World Confederation of Physiotherapists have recommended use of this framework in clinical practice, the extent to which Zimbabwean therapists are applying this framework in patients' assessment and treatment is unknown. ⋯ Standard guidelines for evaluating patients with different conditions derived from the ICF checklist should be designed for occupational therapists and physiotherapists to standardise information recorded during management of patients seeking rehabilitation services.
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To collect, analyse and compare prices of medicines in different sectors and parts of the country and to compare them with the medicine prices in other countries. ⋯ Medicine prices in Zimbabwe are high, a scenario that may compromise affordability and accessibility to medicines especially by the poor. Urgent steps are needed to reduce the level and effect of the high prices on the population, especially the poor.