Assessment of Maternal Near Miss at Debre Markos Referral Hospital, Northwest Ethiopia: Five Years Experience

Maternal mortality in Ethiopia is one of the highest in the world. Data on maternal near miss cases and events among mothers who received care at health institutions is lacking. The main aim of this study was, therefore, to assess trend and correlates of maternal near miss case at a referral hospital. Case notes of clients who received care in obstetric and gynecologic ward of Debre Markos Referral Hospital from 1st January 2008 to 30th December 2012 were reviewed. Case notes were selected using systematic random sampling technique. Tailored format was data collection tool. SPSS version 16 was used to analyze the data. Logistic regression was fitted to determine possible association, and strength of associations was measured using odds ratio at 95% confidence interval. A total of 1355 case notes were reviewed. Of them, 403 (29.7%) were near miss cases. The data showed that maternal near miss ratio over the study period was decreasing (X2 = 7.4, p = 0.007). Distance from the hospital, history of difficult labor, and antenatal care (ANC) utilization were found to be major determinates of maternal near miss cases. The most common types of near miss events were obstructed labor and hemorrhage. Majority of maternal near miss cases brought referral letter to hospital. Although maternal near miss ratio is still high, it appears to decrease over the last five years period. This may reflect success of the government’s Endeavour to decrease maternal mortality. However, this effort needs to continue in a sustainable manner to avoid preventable causes of maternal mortality in Ethiopia.

Phytochemical screening of the exudate of Aloe otallensis and its effect on Leishmania donovani

Objective:To evaluate the antileishmanial activity of methanolic extract of Aloe otallensis(A.otallensis)on the promastigote stage of Leishmania donovani(L.donovani)as compared to standard drugs and to screen its phytochemical constituents.Methods:Phytochemical screening was done by using the method mentioned by Evans and Trease on methanolic extract of the exudates of Aloe otallensis leaves.The extract was also evaluated for in vitro antileishmanial activity against L.donavani which is found from the Parasitology Unit of Black Lion Hospital.The result was compared to standard drugs of sodium stibogluconate,milfostin and paramomycin.Results:The extract has a good antileishmanial activity with an IC_(50)of 0.1230μg/mL on L.donovani(AM 563).The experimental data showed that relatively it had better activity than paramomycin and milfostin but less activity than sodium stibogluconate.The data analyses were done by GraphPad Prism version 5 software after it was read by ELISA reader at the wave length of 650 nm.The phytochemical screening of the exudates of A.otallensis showed the presence of phenol,alkaloid and saponin.Conclusions:The methanol extract of the exudates of A.otallensis has a good anti-leishmaniasis activity and this may be attributed to phenol,alkaloid and saponin present in the plant.But it needs further analysis for the conformation of which constituent presents in high concentration to know which one has the strongest effect.