Maternal mortality rate (MMR) Number

Maternal mortality rate (MMR)                                                        Home

Rationale for use

Complications during pregnancy and childbirth are a leading cause of death and disability among women of reproductive age in developing countries. The maternal mortality ratio represents the risk associated with each pregnancy, i.e. the obstetric risk. It is also a MDG indicator.

Definition

Maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. To facilitate the identification of maternal deaths in circumstances in which cause of death attribution is inadequate, a new category has been introduced: Pregnancy-related death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death.


Live birth refers to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of the pregnancy, which, after such separation, breathes or shows any other evidence of life - e.g. beating of the heart, pulsation of the umbilical cord or definite movement of voluntary muscles - whether or not the umbilical cord has been cut or the placenta is attached. Each product of such a birth is considered live born
is the annual number of female deaths per 100,000 live births from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes).

 South Sudan         2,054.00
2 Chad         1,100.00
3 Somalia         1,000.00
4 Central African Republic          890.00
5 Sierra Leone          890.00
6 Burundi          800.00
7 Guinea-Bissau          790.00
8 Liberia          770.00
9 Sudan          730.00
10 Cameroon          690.00
11 Nigeria          630.00
12 Lesotho          620.00
13 Guinea          610.00
14 Niger          590.00
15 Zimbabwe          570.00
16 Congo, Republic of the          560.00
17 Congo, Democratic Republic of the          540.00
18 Mali          540.00
19 Mauritania          510.00
20 Mozambique          490.00
21 Laos          470.00
22 Afghanistan          460.00
23 Tanzania          460.00
24 Malawi          460.00
25 Angola          450.00
26 Zambia          440.00
27 Cote d'Ivoire          400.00
28 Senegal          370.00
29 Gambia, The          360.00
30 Kenya          360.00
31 Haiti          350.00
32 Ghana          350.00
33 Ethiopia          350.00
34 Benin          350.00
35 Rwanda          340.00
36 Swaziland          320.00
37 Uganda          310.00
38 South Africa          300.00
39 Burkina Faso          300.00
40 Togo          300.00
41 Timor-Leste          300.00
42 Comoros          280.00
43 Guyana          280.00
44 Pakistan          260.00
45 Cambodia          250.00
46 Eritrea          240.00
47 Equatorial Guinea          240.00
48 Madagascar          240.00
49 Bangladesh          240.00
50 Gabon          230.00
51 Papua New Guinea          230.00
52 Indonesia          220.00
53 Namibia          200.00
54 Burma          200.00
55 India          200.00
56 Djibouti          200.00
57 Yemen          200.00
58 Bolivia          190.00
59 Bhutan          180.00
60 Nepal          170.00
61 Botswana          160.00
62 Dominican Republic          150.00
63 Suriname          130.00
64 Guatemala          120.00
65 Jamaica          110.00
66 Tonga          110.00
67 Ecuador          110.00
68 Vanuatu          110.00
69 Honduras          100.00
70 Morocco          100.00
71 Micronesia, Federated States of          100.00
72 Samoa          100.00
73 Paraguay           99.00
74 Philippines           99.00
75 Algeria           97.00
76 Nicaragua           95.00
77 Solomon Islands           93.00
78 Panama           92.00
79 Venezuela           92.00
80 Colombia           92.00
81 El Salvador           81.00
82 Korea, North           81.00
83 Cabo Verde           79.00
84 Argentina           77.00
85 Cuba           73.00
86 Kyrgyzstan           71.00
87 Syria           70.00
88 Sao Tome and Principe           70.00
89 Turkmenistan           67.00
90 Peru           67.00
91 Georgia           67.00
92 Egypt           66.00
93 Tajikistan           65.00
94 Gaza Strip           64.00
95 West Bank           64.00
96 Mongolia           63.00
97 Jordan           63.00
98 Iraq           63.00
99 Mauritius           60.00
100 Maldives           60.00
101 Vietnam           59.00
102 Libya           58.00
103 Brazil           56.00
104 Tunisia           56.00
105 Belize           53.00
106 Barbados           51.00
107 Kazakhstan           51.00
108 Mexico           50.00
109 Saint Vincent and the Grenadines           48.00
110 Thailand           48.00
111 Bahamas, The           47.00
112 Trinidad and Tobago           46.00
113 Azerbaijan           43.00
114 Moldova           41.00
115 Costa Rica           40.00
116 China           37.00
117 Saint Lucia           35.00
118 Sri Lanka           35.00
119 Russia           34.00
120 Latvia           34.00
121 Ukraine           32.00
122 Oman           32.00
123 Armenia           30.00
124 Uruguay           29.00
125 Malaysia           29.00
126 Uzbekistan           28.00
127 Romania           27.00
128 Albania           27.00
129 Fiji           26.00
130 Lebanon           25.00
131 Chile           25.00
132 Brunei           24.00
133 Saudi Arabia           24.00
134 Grenada           24.00
135 Hungary           21.00
136 United States           21.00
137 Iran           21.00
138 Bahrain           20.00
139 Turkey           20.00
140 Puerto Rico           20.00
141 Luxembourg           20.00
142 Croatia           17.00
143 Korea, South           16.00
144 New Zealand           15.00
145 Kuwait           14.00
146 United Arab Emirates           12.00
147 Canada           12.00
148 United Kingdom           12.00
149 Serbia           12.00
150 Slovenia           12.00
151 Denmark           12.00
152 Bulgaria           11.00
153 Macedonia           10.00
154 Cyprus           10.00
155 Kiribati            9.00
156 Belgium            8.00
157 Bosnia and Herzegovina            8.00
158 France            8.00
159 Switzerland            8.00
160 Montenegro            8.00
161 Malta            8.00
162 Portugal            8.00
163 Lithuania            8.00
164 Australia            7.00
165 Germany            7.00
166 Qatar            7.00
167 Norway            7.00
169 Ireland            6.00
170 Spain            6.00
171 Netherlands            6.00
172 Slovakia            6.00
173 Czech Republic            5.00
174 Finland            5.00
175 Poland            5.00
176 Japan            5.00
177 Iceland            5.00
178 Austria            4.00
179 Sweden            4.00
180 Italy            4.00
181 Belarus            4.00
182 Singapore            3.00
183 Greece            3.00
184 Estonia            2.00

Ref:

- the world factbook 

- http://www.who.int/healthinfo/statistics/indmaternalmortality/en/

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Pulmonary function tests PFT

PFT                                                                                                                                                                                  Home

Pulmonary function tests PFT:

Pulmonary function tests are a group of tests that measure how well the lungs take in and release air and how well they move gases such as oxygen from the atmosphere into the body's circulation.

PULMONARY FUNCTION TESTS  The major types of pulmonary function tests include spirometry, measurement of lung volumes, and quantitation of diffusing capacity. Measurements of maximal respiratory pressures and flow-volume loops, which record forced inspiratory and expiratory flow rates, are also useful in specific clinical circumstances.

Spirometry

Spirometry includes tests of pulmonary mechanics – measurements of FVC, FEV1, FEF values, forced inspiratory flow rates (FIFs), and MVV. Measuring pulmonary mechanics assesses the ability of the lungs to move large volumes of air quickly through the airways to identify airway obstruction.

The measurements taken by the spirometry device are used to generate a pneumotachograph that can help to assess lung conditions such as: asthma, pulmonary fibrosis, cystic fibrosis, and chronic obstructive pulmonary disease. Physicians may also use the test results to diagnose bronchial hyperresponsiveness to exercise, cold air, or pharmaceutical agents

Lung volumes

Common lung volume measurements include total lung capacity (TLC), functional residual capacity (FRC), and residual volume (RV) . Measurement of the total lung capacity (TLC) may be helpful when the vital capacity is decreased. For example, in the setting of chronic obstructive pulmonary disease (COPD) with a low vital capacity, measurement of the TLC can help determine if there is a superimposed restrictive disorder.

There are four methods of measuring TLC:

●Helium dilution

●Nitrogen washout

●Body plethysmography

●Chest radiograph measurements

The first two methods are used extensively in hospital pulmonary function laboratories, but they may underestimate the TLC in patients with moderate to severe COPD. The gold standard for measurement of TLC, particularly in the setting of significant airflow obstruction, is body plethysmography.

Measurements of TLC using the chest radiograph or high resolution computed tomography (HRCT) correlate within 15 percent of those obtained by body plethysmography . Since the TLC is equivalent to the amount of air seen in the lungs on a chest radiograph taken at maximal inspiration, it is important that the subject inhales maximally as the image is created.

Pulmonary function tests is an inclusive term that refers to several different procedures that measure lung function in different ways. Some of the more common values that may be measured during pulmonary function testing include:

·         Tidal volume (VT). This is the amount of air inhaled or exhaled during normal breathing.

·         Minute volume (MV). This is the total amount of air exhaled per minute.

·         Vital capacity (VC). This is the total volume of air that can be exhaled after maximum inspiration.

·         Functional residual capacity (FRC). This is the amount of air remaining in lungs after normal expiration.

·         Total lung capacity. This is the total volume of lungs when maximally inflated.

·         Forced vital capacity (FVC). This is the amount of air exhaled forcefully and quickly after maximum inspiration.

·         Forced expiratory volume (FEV). This is the volume of air expired during the first, second, and third seconds of the FVC test.

·         Forced expiratory flow (FEF). This is the average rate of flow during the middle half of the FVC test.

·         Peak expiratory flow rate (PEFR). This is the maximum volume during forced expiration.

The normal values for PFTs vary from person to person. The amount of air inhaled and exhaled in your test results are compared to the expected average in someone of the same age, height, sex, and race. In addition, results are compared to your previous test results, if previous testing has been done. If you have abnormal PFT measurements or if your results are different from previous tests, you may be referred for other diagnostic tests to establish a medical diagnosis.

Reasons for the procedure

There are many different reasons why PFTs may be ordered. They are sometimes ordered in healthy individuals as part of a routine physical. In others, the tests may be ordered when a specific illness is suspected. Some of the disorders that may be detected with PFTs include, but are not limited to, the following:

·         Allergies. An acquired, abnormal immune response to one or more substances that can cause a broad range of inflammatory reactions.

·         Chronic lung conditions. Conditions, such as asthma, bronchiectasis, emphysema, and chronic bronchitis, that can be treated but not cured.

·         Asbestosis. A lung disease caused by the inhalation of asbestos fibers.

·         Chest trauma. Trauma to the chest, such as fractured ribs or a recent surgical procedure, can restrict an individual’s ability to breathe adequately.

·         Restrictive airway conditions. Impaired lung expansion as a result of conditions, such as scoliosis, pulmonary tumors, or inflammation or scarring of the chest wall.

·         Respiratory infections.

·         Sarcoidosis. A condition that causes small, fleshy swellings in the tissue around the organs, usually in the liver, lungs, and spleen.

·         Scleroderma. A disease of the body’s connective tissue that causes thickening and hardening of the skin.

·         PFTs may be used to assess the lung function of patients prior to surgery or other invasive procedures in patients who have current lung and/or heart problems, who are smokers, or who have other conditions that might be affected by surgery or other procedures.

·         Another use of PFTs is the evaluation of treatment for conditions such as asthma, emphysema, and other chronic lung problems.

·         There may be other reasons for your doctor to recommend pulmonary function tests.

Before the procedure

·         Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.

·         Generally, no prior preparation, such as fasting, fluid restriction, or sedation is required. However, you may be asked to avoid eating a heavy meal before the test.

·         If you are pregnant or suspect that you may be pregnant, you should notify your doctor.

·         Notify your doctor of all medications (prescription and over-the-counter) and herbal supplements that you are taking.

·         If you are a smoker, you will usually be asked to refrain from smoking for a period of time before the test.

·         Your height and weight will be recorded so that your results can be accurately calculated.

·         Based on your medical condition, your doctor may request other specific preparation.

During the procedure

Pulmonary function tests may be done on an outpatient basis or as part of your stay in the hospital. Procedures may vary depending on your condition and your and your doctor’s practices.

Generally, PFTs follow this process:

·         You will be asked to loosen tight clothing, jewelry, or other objects that may interfere with the procedure

·         If you wear dentures, you will be asked to wear them during the procedure.

·         You will be asked to empty your bladder before the procedure to optimize comfort.

·         You will sit in a chair or stand for the procedure.

·         You will be given a soft nose clip to wear during the procedure so that all of your breaths will go through your mouth, rather than your nose.

·         You will be given a sterile mouthpiece that will be attached to the spirometer.

·         With your mouth forming a tight seal around the mouthpiece, you will be instructed to perform various breathing maneuvers. The maneuvers will be done by inhaling and exhaling. Depending on what measurements are ordered, you may be asked to repeat the maneuvers several times before the test is completed.

·         You may be given a bronchodilator after certain tests have been performed. These tests will be repeated several minutes later after the bronchodilator has taken effect.

·         You will be monitored carefully during the procedure for faintness, dizziness, difficulty breathing, or any other problems.

After the procedure

Generally, there is no special type of care following PFTs. You may resume your usual diet, medications, and activities unless your doctor advises you otherwise.

If you have a history of respiratory problems, you may be tired after the procedure. You will be given the opportunity to rest afterwards.

Your doctor may give you additional or alternate instructions after the procedure depending upon your particular situation.

Page PFT

Ref :

 UPTODATE

hopkinsmedicine

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The World Distribution of Human ABO Blood Types by Peoples !!

The World Distribution of Human ABO Blood Types by Peoples !!
                                                                                                                                               Home

There are racial and ethnic differences in Blood type and composition. We display these differences, in chart form, to show differences, purities and migration. The ABO Blood group system was discovered in 1901 and since it is of major importance in medicine, samples have been diligently collected from the most remote of people groups for a century. Of no other human characteristic is so much data available. Most populations have migrated and mixed. Unfortunately the reliability of the Blood data for assessing relationships between population groups is very limited. This is mostly due to the lack of availability and interchange of this important data. As the chart below reveals, the frequency and purity of the four main ABO Blood groups varies in populations throughout the world. Great variation occurs in different groups within a given country; even a small country, as one ethnic group mixes, or not, with another. Blood type purity depends on migration, disease, interrelational-reproductive opportunity, traditions and customs, geography and the initial Blood type assigned.
Publishing the ethnic differences in Blood type and the racial differences in Blood type is not, in the present-day world, considered to be politically correct. We compile and maintain this database through and thanks to, often times, reliable, confidential sources. Every Blood gathering entity in the world must gather this information to stay in business, but almost every one of them is afraid to publish the racial and ethnic differences in Blood type, given the emotionally charged political climate.

Distribution of the A type blood in native populations of the world

Distribution of the B type blood in native populations of the world

Distribution of the O type blood in native populations of the world

For more about Blood Type












REF :
- bibliotecapleyades
- anthro.palomar
- http://www.bloodbook.com/world-abo.html

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Free ... Program for convert Glucose units ( mg/dl or mmol/l)

Plasmatic level of sugar (glucose) is the main criterion in diagnostics and follow up of DM

Free ... Program for convert unites ( mg/dl or mmol/l)

Blood Sugar - this term describes the amount of glucose in blood. Usually described in moles per liter or milligrams per deciliter. the standard level of blood sugar in humans is around 4,5-5,5 moles / liter. Too high or too low levels of blood sugar can result in serious health problems.

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References
http://www.unit-conversion.info/blood-sugar.html 

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Smoking ... What is an adverse health effect?

Smoking ... What is an adverse health effect?               Home




The Smoking a lot of adverse health which threatens death and the body, for example, and not as a limitation:

- Lung cancer and show 70% in smokers more than others.

- Cancer of the larynx and shows 10% in smokers more than others.

- Various cardiovascular diseases

- High blood pressure and rapid heartbeat in more than usual

- Increase in the proportion of cholesterol in the blood.

- bad smell emitted from the mouth and tooth decay

- Inflammation of the gums.

- Lip cancer

- Cancer of the tongue.

- Loss of appetite

- Insomnia, fatigue

- Inflammation of gastric ulcers.

- A serious impact on the nerves, where smoking is considered cm nerves.

- Impact on the five senses

- Weakens the sexual ability in both sexes.

- On the nervous system, which impairs memory.

- Alsdat chronic recurrent.

- Impact on the fetus and the pregnant woman.

Smoking and other high risk

Smoking harms nearly every organ of the body and affects a person’s overall health.

Smoking can make it harder for a woman to become pregnant and can affect her baby's health before and after birth. Smoking increases risks for:

• Preterm (early) delivery
• Stillbirth (death of the baby before birth)
• Low birth weight
• Sudden infant death syndrome (known as SIDS or crib death)
• Ectopic pregnancy
• Orofacial clefts in infants

-Smoking can also affect men's sperm, which can reduce fertility and also increase risks for birth defects and miscarriage (loss of the pregnancy).

-Smoking can affect bone health.

Women past childbearing years who smoke have lower bone density (weaker bones) than women who never smoked and are at greater risk for broken bones.

-Smoking affects the health of your teeth and gums and can cause tooth loss.

-Smoking can increase your risk for cataracts (clouding of the eye’s lens that makes it hard for you to see) and age-related macular degeneration (damage to a small spot near the center of the retina, the part of the eye needed for central vision).

-Smoking is a cause of type 2 diabetes mellitus and can make it harder to control. The risk of developing diabetes is 30–40% higher for active smokers than nonsmokers.1,2

-Smoking causes general adverse effects on the body. It can cause inflammation and adverse effects on immune function.

-Smoking is a cause of rheumatoid arthritis.

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