Z A Bhutta

..Strengthening MNCH at the primary health-care level should be a priority for countries to reach their Millennium Development Goal targets for reducing maternal and child mortality...

..Intervention strategies largely consist of administration of iron-folic acid supplements during pregnancy...

..However, much more can and should be done to address maternal and newborn health and improve coverage of interventions related to family planning, care around childbirth, and case management of childhood illnesses...

..What is needed is the political will and partnerships to implement evidence-based interventions at scale...

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..We sought to review the effect of aspirin, calcium supplementation, antihypertensive agents and magnesium sulphate on risk stillbirths...

..We reviewed the potential impact of early detection and control of diabetes mellitus during pregnancy on stillbirths for possible inclusion in the Lives Saved Tool (LiST)...

..There is much interest in the effectiveness of breastfeeding promotion interventions on breastfeeding rates in early infancy...

..The purpose of this review was to evaluate preventive effect of calcium supplementation during pregnancy on gestational hypertensive disorders and related maternal and neonatal mortality in developing countries...

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..This paper is a part of a series of reviews undertaken for getting estimates of effectiveness of an intervention for input to Lives Saved Tool (LiST) model...

..We have also reviewed effect of maternal body mass index (BMI) screening, symphysial-fundal height measurement and targeted ultrasound in detection and triage of IUGR in the community...

..The purpose of this paper was to get a point estimate of efficacy of vitamin A supplementation in reducing cause specific mortality by using Child Health Epidemiology Reference Group (CHERG) guidelines...

..Recommendations have been made for input to the Lives Saved Tool (LiST) model by following standardized guidelines developed by Child Health Epidemiology Reference Group (CHERG)...

..The purpose of this review was to study the possible impact of induction of labour (IOL) for post-term pregnancies compared to expectant management on stillbirths...

..We have updated and evaluated the available evidence according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria and tried to explain the difference in results of the previous reviews...

..This article aims to address the impact of iron with and without folate supplementation on maternal anemia and provides outcome specific quality according to the Child Health Epidemiology Reference Group (CHERG) guidelines...

..This review discusses the impact of skilled birth attendance (SBA) and the provision of Emergency Obstetric Care (EOC) on stillbirths and perinatal mortality...

..We have estimated the effect of providing oral, or injectable antibiotics at home or in first-level facilities, and of in-patient hospital care on neonatal mortality from pneumonia and sepsis for use in the Lives Saved Tool (LiST)...

..This paper is a part of a series to estimate the effect of interventions on stillbirths for input to Live Saved Tool (LiST) model...

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..03 million from complications of prematurity. No systematic assessment of mortality reduction from tactile stimulation or resuscitation has been published...

..This review presents the impact of interventions targeting various important infections during pregnancy on stillbirth or perinatal mortality...

..Interventions to reduce these risks could reduce the resulting burden of stillbirths, but the evidence for the impact of such interventions has not yet been comprehensively evaluated...

..Survival of preterm newborns may also be improved with interventions given during these times or soon after birth. This comprehensive review assesses existing interventions for low- and middle-income countries (LMICs)...

..The evidence for impact of intrapartum interventions on stillbirth and perinatal mortality outcomes has not yet been systematically examined...

..2 million estimated annual stillbirths, as well as minimise maternal and neonatal morbidity and mortality...

..This first paper in the series outlines issues in stillbirth data availability and quality, the global epidemiology of stillbirths, and describes the methodology and framework used for the review of interventions and strategies...

..Poorly recognised, untreated or inadequately treated maternal infections such as syphilis and malaria, and maternal conditions including hypertensive disorders, are known risk factors for stillbirth...

..The high mortality rates are partially attributable to scarcity of trained skilled birth attendants and paucity of resources. Empowerment of health care providers with adequate knowledge and skills can serve as instrument of change...

..The accumulation of pseudogenes is a key feature of these and other host-adapted pathogens, and overlapping pseudogene complements are evident in Paratyphi A and Typhi...

..This pilot study investigated the feasibility of delivering a package of community-based interventions for improving perinatal care using lady health workers (LHWs) and traditional birth attendants (Dais) in rural Pakistan...

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..There is an urgent need to define the role of community-based management for neonates with serious bacterial infections--both at home and at first-level facilities...

..The overall costs for these interventions are within the general estimates of cost-effective interventions for maternal care, especially in view of the effects on outcomes across maternal, fetal, and neonatal health...

..This would also allow for greater efficiency in training, monitoring, and supervision of health care workers and would also help families and communities to access and use services easily...

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..abstract:..

..This review focuses on recent advances in our understanding of undernutrition and micronutrient deficiencies during childhood from a review of the literature over the last 18 months (August 2006-January 2008)...

..Only through such proactive measures can we address the emerging ethical dilemmas and challenges that globalization and the genomics revolution will bring in their wake...

..In contrast to the conventional therapy, 14% of the children receiving CRO for 7 days had a confirmed bacteriological relapse within 4 weeks of stopping therapy...

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..Evaluation of nutritional recovery, intestinal permeability, and insulin-like growth factor I (IGF-I) response in malnourished children with persistent diarrhoea and their relation to concomitant systemic infection(s)...

..The Aga Khan University Medical Center in Karachi, Pakistan, established a neonatal intensive care unit in 1987. By 1993-4, very low birthweight infants remained in hospital for 18-21 days...

..Further research is needed to examine the validity and user friendliness of innovations in information sharing procedures for obtaining consent in different cultural settings...

..A comprehensive review of the evidence base for impact of interventions on neonatal health and survival in developing-country communities has not been reported...

..Evidence for the transition in nutrition in Indo-Asian developing countries is lacking. We conducted these analyses to determine the trends in nutritional status of school-aged children in urban Pakistan...

..Increasing antibiotic resistance against commonly prescribed drugs signify that treatment options have become difficult in cases of severe dysentery...

..Successful passive surveillance of febrile or diarrheal illness in these communities has to integrate private practitioners...

..To eliminate stunting in the longer term, these interventions should be supplemented by improvements in the underlying determinants of undernutrition, such as poverty, poor education, disease burden, and lack of women's empowerment...

..Low-cost, "bundled" interventions using systems quality improvement approaches for improved infection control are possible, but should be supported by evidence in developing country settings...

..In the face of these facts it is empirically important to develop a low cost effective vaccine that can protect these populations for a longer duration...

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..Maternal exposure to wood fuel smoke may lead to impaired fetal growth due to hypoxia and or oxidative stress from smoke constituents such as carbon monoxide and particulate matter...

..Therefore we conducted a prospective study to determine the frequency of isolation of Shigella serotypes and antimicrobial resistance...

..These results are useful for planning further research and for prioritising prevention programmes nationally and in other developing countries with similar situation...

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..We present a case report of a newborn with meningitis due to a quinolone-resistant strain of S. paratyphi B presenting to the Aga Khan University Hospital (AKUH)...

..Two periurban communities in Karachi were selected for an epidemiological study of typhoid fever. The aim of the study was to assess whether PCR increased the detection rate of typhoid fever in children in the community...

..001) at presentation and had higher mortality (p less than 0.002) than those with normal liver function. Two children presented with a picture of fulminant hepatic failure with fatal outcome...

..Notwithstanding these observations, there are evidence-based interventions available that, if implemented at scale, could make important contributions towards reducing the burden of maternal mortality in Pakistan...

..Geographically, cases were clustered during the first outbreak but not during the second. Person-to-person contact and water reservoirs appear to be the main transmission routes for cholera in this setting...

..Zinc deficiency is now widely recognized as a leading risk factor for morbidity and mortality and is estimated to be responsible for approximately 800,000 excess deaths annually among children under 5 years of age...

..The clinical parameters studied suggest a severe form of CF in Pakistani patients and provides a foundation for future studies to define genotype/phenotype correlations of the specific mutations involved in Pakistani CF patients...

..To review evidence supporting use of fluoroquinolones as first line agents over other antibiotics for treating typhoid and paratyphoid fever (enteric fever)...

..Rotavirus diarrhea has a worldwide distribution, infecting almost all children by the age of 3-5 years...

..Nonetheless, it is essential to include private health care providers when attempting to accurately estimate the burden of disease in such settings...

..influenzae, and 71,864 per year due to S. pneumoniae. CONCLUSION: Incidence of acute respiratory infections in children varies in different communities and is a common cause of morbidity...

..The prevalence and incidence of Helicobacter pylori in children in Pakistan is not known...

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..The growing body of evidence on the key role of zinc supplementation in accelerating recovery from diarrheal illnesses in developing countries supports its use in public health strategies...

..Morbidity of typhoid is quite high in Pakistan and needs public health intervention. Hot months have higher incidence of typhoid. Healthcare behavior studies will help to develop a better surveillance system...