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Khan W, Jebanesan B, Ahmed S, Trimmer C, Agic B, Safa F, Ashraf A, Tuck A, Kavic K, Wadhawan S, Abbott M, Husain O, Husain I, Akhter Hamid M, McKenzie K, Quintana Y, Naeem F. Stakeholders' views and opinions on existing guidelines on "How to Choose Mental Health Apps". Front Public Health 2023; 11:1251050. [PMID: 38074730 PMCID: PMC10703154 DOI: 10.3389/fpubh.2023.1251050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Background Mental health Applications (Mhealth Apps) can change how healthcare is delivered. However, very little is known about the efficacy of Mhealth Apps. Currently, only minimum guidance is available in Assessment and Evaluation Tools (AETs). Therefore, this project aims to understand AET developers' perspectives and end users' experiences and opinions on "how to choose a Mhealth App". Objective The primary objectives were: (1) obtaining stakeholder's opinions and experiences of development and use of AETs for Mhealth Apps, their weaknesses and strengths, and barriers in their implementation of Mhealth Apps; (2) the experiences of App users, their analyzation and, obstacles in the use of apps; and (3) to quantify themes related to choosing a Mhealth App. Methods This qualitative study, used a sampling method to recruit six stakeholders (one App developer, two AET developers, an individual with lived experience of mental health illness, and two physicians) who were interviewed using a topic guide. These were examined by researchers (CT, WK, & FN) using thematic content analysis. Additionally, an anonymous online survey of 107 individuals was conducted. Findings Our analyses revealed six main themes: (a) needs and opportunities; (b) views on Mhealth apps; (c) views & opinions on AETs; (d) implementation barriers; (e) system of evaluation and; (f) future directions. The first key concept was, all stakeholders agreed that Apps could significantly impact mental health and that end-users were unaware of mental health AETs and Apps. Secondly, due to commercial interests, end-users reliability of App evaluations requires clear conflict-free guidelines. Thirdly, AETs should be evaluated and developed through a rigorous methodology. Finally, stakeholders shared insights into future developments for AETs and Mhealth Apps. Additionally, online survey respondents chose a "health professional" as their preferred source of guidance in selecting a Mhealth app (84%) and best suited to develop guidelines (70%). Conclusion The interviews and survey highlight the need for Mhealth Apps to be regulated and the importance of health professionals' engagement in the implementation process. Similarly, without well-defined roles for App evaluations within the health care system, it is unlikely that AETs will have wider spread use and impact without risk.
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Affiliation(s)
- Wishah Khan
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | | | - Sarah Ahmed
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Chris Trimmer
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Branka Agic
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Farhana Safa
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Aamna Ashraf
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Andrew Tuck
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Kelsey Kavic
- Mental Health Commission of Canada, Ottawa, ON, Canada
| | | | | | - Omair Husain
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ishrat Husain
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Muhammad Akhter Hamid
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
- Scarborough Health Network, Scarborough, ON, Canada
| | - Kwame McKenzie
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Yuri Quintana
- Department of Medicine, Harvard University, Boston, MA, United States
- Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Farooq Naeem
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Buchman DZ, Wadhawan S. A Global Vision for Neuroethics Needs More Social Justice: Brain Imaging, Chronic Pain, and Population Health Inequalities. AJOB Neurosci 2019; 10:130-132. [PMID: 31329077 DOI: 10.1080/21507740.2019.1632966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Persaud N, Jiang M, Shaikh R, Bali A, Oronsaye E, Woods H, Drozdzal G, Rajakulasingam Y, Maraj D, Wadhawan S, Umali N, Wang R, McCall M, Aronson JK, Plüddemann A, Moja L, Magrini N, Heneghan C. Comparison of essential medicines lists in 137 countries. Bull World Health Organ 2019; 97:394-404C. [PMID: 31210677 PMCID: PMC6560372 DOI: 10.2471/blt.18.222448] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 03/07/2019] [Accepted: 03/08/2019] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To compare the medicines included in national essential medicines lists with the World Health Organization's (WHO's) Model list of essential medicines, and assess the extent to which countries' characteristics, such as WHO region, size and health care expenditure, account for the differences. METHODS We searched the WHO's Essential Medicines and Health Products Information Portal for national essential medicines lists. We compared each national list of essential medicines with both the 2017 WHO model list and other national lists. We used linear regression to determine whether differences were dependent on WHO Region, population size, life expectancy, infant mortality, gross domestic product and health-care expenditure. FINDINGS We identified 137 national lists of essential medicines that collectively included 2068 unique medicines. Each national list contained between 44 and 983 medicines (median 310: interquartile range, IQR: 269 to 422). The number of differences between each country's essential medicines list and WHO's model list ranged from 93 to 815 (median: 296; IQR: 265 to 381). Linear regression showed that only WHO region and health-care expenditure were significantly associated with the number of differences (adjusted R2 : 0.33; P < 0.05). Most medicines (1248; 60%) were listed by no more than 10% (14) of countries. CONCLUSION The substantial differences between national lists of essential medicines are only partly explained by differences in country characteristics and thus may not be related to different priority needs. This information helps to identify opportunities to improve essential medicines lists.
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Affiliation(s)
- Nav Persaud
- Centre for Urban Health Solution, St. Michael’s Hospital, 80 Bond Street, Toronto, Ontario, M5B 1X2, Canada
| | - Maggie Jiang
- Centre for Urban Health Solution, St. Michael’s Hospital, 80 Bond Street, Toronto, Ontario, M5B 1X2, Canada
| | - Roha Shaikh
- Centre for Urban Health Solution, St. Michael’s Hospital, 80 Bond Street, Toronto, Ontario, M5B 1X2, Canada
| | - Anjli Bali
- Centre for Urban Health Solution, St. Michael’s Hospital, 80 Bond Street, Toronto, Ontario, M5B 1X2, Canada
| | - Efosa Oronsaye
- Centre for Urban Health Solution, St. Michael’s Hospital, 80 Bond Street, Toronto, Ontario, M5B 1X2, Canada
| | - Hannah Woods
- Centre for Urban Health Solution, St. Michael’s Hospital, 80 Bond Street, Toronto, Ontario, M5B 1X2, Canada
| | - Gregory Drozdzal
- Centre for Urban Health Solution, St. Michael’s Hospital, 80 Bond Street, Toronto, Ontario, M5B 1X2, Canada
| | - Yathavan Rajakulasingam
- Centre for Urban Health Solution, St. Michael’s Hospital, 80 Bond Street, Toronto, Ontario, M5B 1X2, Canada
| | - Darshanand Maraj
- Centre for Urban Health Solution, St. Michael’s Hospital, 80 Bond Street, Toronto, Ontario, M5B 1X2, Canada
| | - Sapna Wadhawan
- Centre for Urban Health Solution, St. Michael’s Hospital, 80 Bond Street, Toronto, Ontario, M5B 1X2, Canada
| | - Norman Umali
- Centre for Urban Health Solution, St. Michael’s Hospital, 80 Bond Street, Toronto, Ontario, M5B 1X2, Canada
| | - Ri Wang
- Centre for Urban Health Solution, St. Michael’s Hospital, 80 Bond Street, Toronto, Ontario, M5B 1X2, Canada
| | - Marcy McCall
- Centre for Evidence-Based Medicine, University of Oxford, Oxford, England
| | - Jeffrey K Aronson
- Centre for Evidence-Based Medicine, University of Oxford, Oxford, England
| | - Annette Plüddemann
- Centre for Evidence-Based Medicine, University of Oxford, Oxford, England
| | - Lorenzo Moja
- Department of Essential Medicines and Health Products, World Health Organization, Geneva, Switzerland
| | - Nicola Magrini
- Department of Essential Medicines and Health Products, World Health Organization, Geneva, Switzerland
| | - Carl Heneghan
- Centre for Evidence-Based Medicine, University of Oxford, Oxford, England
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Sabharwal V, Dharmavaram S, Bhadoria P, Wadhawan S, Sethi A. Use of two tracheal tubes and fibreoptic bronchoscope for intubation through a LMA Pro-Seal®in a difficult paediatric airway. Anaesthesia 2011; 66:843-4. [DOI: 10.1111/j.1365-2044.2011.06810.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chakravarty A, Wadhawan S. A novel technique of flexible reinforced laryngeal mask airway insertion. Anaesth Intensive Care 2009; 37:669-670. [PMID: 19685581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Anand R, Gupta K, Kumar R, Wadhawan S. Two-person capnography-cum-vision-guided endotracheal intubation in a case of laryngeal growth covering the glottic opening. Acta Anaesthesiol Scand 2008; 52:580-1. [PMID: 18339177 DOI: 10.1111/j.1399-6576.2007.01548.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sinha VR, Singla AK, Wadhawan S, Kaushik R, Kumria R, Bansal K, Dhawan S. Chitosan microspheres as a potential carrier for drugs. Int J Pharm 2004; 274:1-33. [PMID: 15072779 DOI: 10.1016/j.ijpharm.2003.12.026] [Citation(s) in RCA: 569] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2002] [Revised: 12/02/2003] [Accepted: 12/12/2003] [Indexed: 11/30/2022]
Abstract
Chitosan is a biodegradable natural polymer with great potential for pharmaceutical applications due to its biocompatibility, high charge density, non-toxicity and mucoadhesion. It has been shown that it not only improves the dissolution of poorly soluble drugs but also exerts a significant effect on fat metabolism in the body. Gel formation can be obtained by interactions of chitosans with low molecular counterions such as polyphosphates, sulphates and crosslinking with glutaraldehyde. This gelling property of chitosan allows a wide range of applications such as coating of pharmaceuticals and food products, gel entrapment of biochemicals, plant embryo, whole cells, microorganism and algae. This review is an insight into the exploitation of the various properties of chitosan to microencapsulate drugs. Various techniques used for preparing chitosan microspheres and evaluation of these microspheres have also been reviewed. This review also includes the factors that affect the entrapment efficiency and release kinetics of drugs from chitosan microspheres.
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Affiliation(s)
- V R Sinha
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh 160014, India.
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Affiliation(s)
- S Wadhawan
- Renal Unit, Noida Medicare Centre, Noida, India
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Vasdev S, Ford CA, Longerich L, Parai S, Gadag V, Wadhawan S. Aldehyde induced hypertension in rats: prevention by N-acetyl cysteine. Artery 2000; 23:10-36. [PMID: 10846614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Methylglyoxal, a highly reactive endogenous aldehyde is formed in the tissue of humans and animals as an intermediate of glucose and fructose metabolism. N-acetyl cysteine (NAC), an analogue of the dietary amino acid cysteine, binds aldehydes thus preventing their damaging effect on physiological proteins. We measured systolic blood pressure (SBP), platelet [Ca2+]i, circulating nitric oxide levels, tissue aldehyde conjugates and renal vascular changes in chronic methyglyoxal treated Wistar-Kyoto (WKY) rats and examined the effect of NAC in the diet on these parameters. Animals, age seven weeks, were divided into three groups of six animals each and were treated as follows: WKY-control (chow diet and normal drinking water); WKY-methylglyoxal (chow diet and methyglyoxal in drinking water); WKY-methyglyoxal + NAC (1.5% NAC in diet and methylglyoxal in drinking water) for the next 18 weeks. Methylgyoxal in drinking water was given at a concentration of 0.2% during weeks 0-5; 0.4%, weeks 6-10; and 0.8%, weeks 11-18. After 18 weeks systolic blood pressure, platelet [Ca2+]i and kidney aldehyde conjugates were significantly higher and serum nitric oxide levels lower in methylglyoxal treated rats. Methylglyoxal treated rats also showed smooth muscle cell hyperplasia in the small artery and arterioles of the kidney. N-acetyl cysteine, an aldehyde binding thiol compound, prevented these changes.
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Affiliation(s)
- S Vasdev
- Department of Medicine, Memorial University of Newfoundland St. John's, Newfoundland Canada
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Jauhari H, Wadhawan S, Kumar A. Cyclosporine trough levels in renal graft recipients. J Indian Med Assoc 1999; 97:476-7. [PMID: 10638120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Blood Trough Levels (TL) of cyclosporine (CyA) [the drug panimun bioral cyclosporine oral solution USP--modified. Panacea Biotec Ltd], were monitored in 103 renal transplant patients who were receiving CyA orally. Two hundred and sixty-two blood concentrations of CyA were determined using a validated HPLC assay over a period of two years. Mean dose from week 1 until 2 years ranged from 7.65 +/- 0.9 to 2.73 +/- 0.8 mg/kg. Mean blood CyA levels ranged from 197.4 +/- 87.5 to 205.9 +/- 113.5. The TL concentration changes versus dose reduction were not markedly different after 2-4 weeks and remained within therapeutic range. Stabilised concentrations were achieved after first month. We conclude that the blood TL of CyA were in the nominal therapeutic range suitable for renal transplant patients.
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Affiliation(s)
- H Jauhari
- Renal Transplant Unit, NOIDA Medicare Center
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Vasdev S, Wadhawan S, Ford CA, Parai S, Longerich L, Gadag V. Dietary vitamin B6 supplementation prevents ethanol-induced hypertension in rats. Nutr Metab Cardiovasc Dis 1999; 9:55-63. [PMID: 10726110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND AND AIMS All known pathways of ethanol metabolism result in the production of acetaldehyde, a highly reactive compound. Acetaldehyde has been shown to deplete vitamin B6 in chronic alcoholics. It also binds with sulfhydryl groups of membrane proteins, altering membrane Ca2+ channels and increasing vascular cytosolic free calcium, peripheral vascular resistance and blood pressure. The aldehyde-binding thiol compound, N-acetyl cysteine, attenuates elevated blood pressure and associated adverse changes in ethanol-induced hypertensive rats. Vitamin B6 supplementation increases the level of endogenous cysteine. Aim of this work was thus to investigate whether a dietary supplementation of vitamin B6 can prevent ethanol-induced hypertension and associated changes in Wistar-Kyoto (WKY) rats. METHODS AND RESULTS Starting at 7 weeks of age, WKY rats were divided into three groups of six animals each. The control group received a normal vitamin B6 diet (regular chow) and normal drinking water, the ethanol group, the same diet plus 1% ethanol in the drinking water, and the ethanol + vitamin B6 group a high vitamin B6 diet (20 times normal diet) and 1% ethanol in the drinking water. After 14 weeks, systolic blood pressure, platelet [Ca2+]i and kidney and aortic aldehyde conjugate levels were significantly higher in the ethanol group. These rats also showed smooth muscle cell hyperplasia in the small arteries and arterioles of the kidneys. Dietary vitamin B6 supplementation prevented these changes. CONCLUSIONS Dietary vitamin B6 supplementation prevented ethanol-induced hypertension and associated changes in WKY rats by normalizing tissue aldehyde conjugate levels.
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Affiliation(s)
- S Vasdev
- Department of Medicine, Memorial University of Newfoundland, St. John's, Canada
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Abstract
Aldehydes are formed in tissues of humans and animals as intermediates of glucose and fructose metabolism and due to lipid peroxidation. N-acetyl cysteine (NAC), an analogue of the dietary amino acid cysteine, binds aldehydes thus preventing their damaging effect on physiological proteins. We measured systolic blood pressure (SBP), platelet cytosolic free calcium [Ca2+]i and tissue aldehyde conjugates in fructose induced hypertensive Wistar-Kyoto (WKY) rats and examined the effect of NAC in the diet on these parameters. Animals age 7 weeks were divided into three groups of 6 animals each and were treated as follows: WKY-control (chow diet and normal drinking water); WKY-Fructose (chow diet and 4% fructose in drinking water); WKY-Fructose+NAC (1.5% NAC in chow diet and 4% fructose in drinking water). After 11 weeks, systolic blood pressure, platelet [Ca2+]i and kidney aldehyde conjugates were all significantly higher in fructose treated rats. NAC treatment prevented these changes. These results suggest that aldehydes may be the cause of fructose induced hypertension and elevated cytosolic free calcium.
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Affiliation(s)
- S Vasdev
- Department of Medicine, Health Sciences Centre, Memorial University of Newfoundland, St. John's, Canada
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Kar P, Jandwani P, Khurana V, Kumar V, Gupta RK, Sama S, Wadhawan S. Seroconversion with rDNA hepatitis B vaccine of Cuban origin. Indian J Gastroenterol 1997; 16:161. [PMID: 9357198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Abstract
An 8-year study of urinary fistulae from 1974 to 1981 was done in the University Teaching Hospital, Lusaka, Zambia. The analysis revealed no significant decrease in the number of urinary fistulae referred to the Department of Obstetrics and Gynaecology of the University during the period. Of 61 cases reviewed, 54 were consequent to obstetrical trauma of prolonged labor and superimposed operation or instrumentation. Four fistulae occurred as a complication of gynecologic surgery, while three originated from advanced malignancy of the cervix. Operative management of fistulae is discussed. Further reorganization of rural maternity services in Zambia is suggested as a preventive measure.
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Abstract
Four hundred fifty-one patients who had had previous lower segment cesarean section were studied for subsequent pregnancy outcome at the University Teaching Hospital, Lusaka, Zambia. Of 319 who were allowed to go into labor, 63% succeeded in delivering vaginally, while 37% had to undergo repeat intrapartum cesarean delivery. No maternal death occurred. Scar dehiscence occurred in one case only. Parturition in otherwise obstetrically normal patients seems to be safe, and the trial of labor approach is desirable as it results in a lower number of repeat cesarean deliveries.
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Wadhawan S, Narone RK, Narone JN. Obstetric problems in the adolescent Zambian mother studied at the University Teaching Hospital, Lusaka. Med J Zambia 1982; 16:65-8. [PMID: 7186722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The Obstetric performance of teenage primigravida aged 12-15 years was studied retrospectively and analysed in the local population attending the University Teaching Hospital, Lusaka. The leading Obstetric complications were cephalo-pelvic disproportion (3.6%) and acute toxeamia (2.2%). The caesarean section rate (7.5%) and operative vaginal delivery rate (11%) were both high. There was one maternal death due to Obstetric shock. The rates for prematurity (154/1,000), still births (30.8/1000), and neonatal death (101.9/1,000) were increased. Perinatal mortality rate was 123/1,000. The incidence of pregnancy between 12-15 years was 1.2%. Overall incidence of teenage pregnancy (12-19 years) was 22.5% and parity of 5 was observed at the age of 18 and 19. The study concluded that early teenage pregnancy carried obstetrical risks and was associated with a high perinatal loss.
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Narone JN, Wadhawan S, Narone RK, Wacha DS. Role of cervical cytology in gynaecological practice. Med J Zambia 1981; 16:18-20. [PMID: 7186715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Exfoliative cytopathology is a potent tool for the early detection and thereby eradication of cervical cancer and reducing mortality for many others. Besides, it has a vital role to play in diagnosis and therapy of infections specially trichomoniasis for which it gives a permanent record. The simplicity and rapidity of the technique is the greatest advantage for screening a wider group of population and thus guide us toward further diagnostic procedures.
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Narone JN, Narone RK, Wadhawan S, Chatterjee TK. Maternal and foetal morbidity associated with caesarean section. Med J Zambia 1981; 15:53-6. [PMID: 7347478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Wadhawan S, Narone RK, Narone JN, Wacha DS. Obstetrical performance in elderly Zambian parturients. Med J Zambia 1981; 15:37-40. [PMID: 7052887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The Obstetrical performance of elderly parturients (aged 40 and above) who delivered at the University Teaching Hospital, Lusaka during 1979 and 1980, has been analysed. There were 39,109 deliveries in the two years period, out of which 391 mothers were of 40 years or above, giving an incidence of 1.0%. There were 32 mothers above the age of 45, an incidence of 0.08%. Analysis of these mothers revealed that 87.2% of them were grand multipara with maximum parity of 16. Incidence of breech, toxaemia, malpresentation and multiple pregnancy were observed in the series but there was no maternal death recorded in the present study. History of abortion in previous pregnancies ranging from 1 to 5 was noted in 43 cases. Operative deliveries were noted in 22% cases, out of which 13% were delivered by caesarean section and 9% had to undergo operative vaginal interference. In the foetal outcome, high rates of prematurity (71/1,000) and perinatal death (138/1,000) were noted. Relations of birth weights, age and parity of mothers with preventable factors are discussed.
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Wadhawan S. Unilateral tubal twin pregnancy. Med J Zambia 1980; 14:90-1. [PMID: 7053011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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