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Risk factors for postpartum sepsis: A nested case-control study

Samina Bakhtawar, Sana Sheikh, Rahat Qureshi, Zahra Hoodbhoy, Beth Payne, Iqbal Azam, Peter von Dadelszen, Laura Magee,

Abstract Background: The Majority (99%) of maternal deaths occur in low and middle-income countries. The three most important causes of maternal deaths in these regions are postpartum hemorrhage, pre-eclampsia and puerperal sepsis. There are several diagnostic criteria used to identify sepsis and one of the commonly used criteria is systematic ... Read more >>

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Risk factors for postpartum sepsis: a nested case-control study.

Samina Bakhtawar, Sana Sheikh, Rahat Qureshi, Zahra Hoodbhoy, Beth Payne, Iqbal Azam, Peter von Dadelszen, Laura Magee,

BACKGROUND:The Majority (99%) of maternal deaths occur in low and middle-income countries. The three most important causes of maternal deaths in these regions are postpartum hemorrhage, pre-eclampsia and puerperal sepsis. There are several diagnostic criteria used to identify sepsis and one of the commonly used criteria is systematic inflammatory response ... Read more >>

BMC Pregnancy Childbirth (BMC pregnancy and childbirth)
[2020, 20(1):297]

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Adolescent food insecurity in rural Sindh, Pakistan: a cross-sectional survey.

Sana Sheikh, Romaina Iqbal, Rahat Qureshi, Iqbal Azam, Rubina Barolia,

Background:Food insecurity (FI) is alarmingly high in developing countries including Pakistan. A quarter of Pakistan's population consists of adolescents yet there is no information on their experience of FI. FI at adolescent age have long term effect on mental and physical health hence we aimed to determine the prevalence of ... Read more >>

BMC Nutr (BMC Nutrition)
[2020, 6:17]

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Dengue and malaria infections in pregnancy : Maternal, fetal and neonatal outcomes at a tertiary care hospital.

Mujtaba Mubashir, Kaleem S Ahmed, Hadika Mubashir, Ayesha Quddusi, Ayesha Farooq, Sheikh Irfan Ahmed, Bushra Jamil, Rahat Qureshi,

BACKGROUND:Malaria and dengue cause major morbidity in developing nations and are more severe in pregnancy. Maternal, fetal, and neonatal outcomes in pregnant patients infected with dengue or malaria were studied. METHODS:The medical records of pregnant women admitted with either dengue or malaria infections from 2011-2015 to this hospital were reviewed. Clinical ... Read more >>

Wien. Klin. Wochenschr. (Wiener klinische Wochenschrift)
[2020, 132(7-8):188-196]

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Self-reported maternal morbidity: Results from the community level interventions for pre-eclampsia (CLIP) baseline survey in Sindh, Pakistan.

Sana Sheikh, Rahat Najam Qureshi, Farrukh Raza, Javed Memon, Imran Ahmed, Marianne Vidler, Beth A Payne, Tang Lee, Diane Sawchuck, Laura Magee, Peter von Dadelszen, Zulfiqar Bhutta, ,

OBJECTIVE:Community-based data regarding maternal and perinatal morbidity and mortality are scarce in less-developed countries. The aim of the study was to collect representative community-level demographic health information to provide socio-demographic and health outcome data. METHODS:A retrospective household survey of women of reproductive age (15-49 years) living in two districts of Sindh ... Read more >>

Pregnancy Hypertens (Pregnancy hypertension)
[2019, 17:113-120]

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The incidence of pregnancy hypertension in India, Pakistan, Mozambique, and Nigeria: A prospective population-level analysis.

Laura A Magee, Sumedha Sharma, Hannah L Nathan, Olalekan O Adetoro, Mrutynjaya B Bellad, Shivaprasad Goudar, Salécio E Macuacua, Ashalata Mallapur, Rahat Qureshi, Esperança Sevene, John Sotunsa, Anifa Valá, Tang Lee, Beth A Payne, Marianne Vidler, Andrew H Shennan, Zulfiqar A Bhutta, Peter von Dadelszen, ,

BACKGROUND:Most pregnancy hypertension estimates in less-developed countries are from cross-sectional hospital surveys and are considered overestimates. We estimated population-based rates by standardised methods in 27 intervention clusters of the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised trials. METHODS AND FINDINGS:CLIP-eligible pregnant women identified in their homes or local primary health ... Read more >>

PLoS Med. (PLoS medicine)
[2019, 16(4):e1002783]

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A Randomized Trial of Prophylactic Antibiotics for Miscarriage Surgery.

David Lissauer, Amie Wilson, Catherine A Hewitt, Lee Middleton, Jonathan R B Bishop, Jane Daniels, Abi Merriel, Andrew Weeks, Chisale Mhango, Ronald Mataya, Frank Taulo, Theresa Ngalawesa, Agatha Chirwa, Colleta Mphasa, Tayamika Tambala, Grace Chiudzu, Caroline Mwalwanda, Agnes Mboma, Rahat Qureshi, Iffat Ahmed, Humera Ismail, Olufemi T Oladapo, Godfrey Mbaruku, Jerome Chibwana, Grace Watts, Beatus Simon, James Ditai, Charles Otim Tom, JaneFrances Acam, John Ekunait, Hellen Unzia, Margaret Iyaku, Joshua J Makiika, Javier Zamora, Tracy Roberts, Ilias Goranitis, Sarah Bar-Zeev, Nicola Desmond, Sabaratnam Arulkumaran, Zulfiqar A Bhutta, Ahmet M Gulmezoglu, Arri Coomarasamy,

BACKGROUND:Surgical intervention is needed in some cases of spontaneous abortion to remove retained products of conception. Antibiotic prophylaxis may reduce the risk of pelvic infection, which is an important complication of this surgery, particularly in low-resource countries. METHODS:We conducted a double-blind, placebo-controlled, randomized trial investigating whether antibiotic prophylaxis before surgery ... Read more >>

N. Engl. J. Med. (The New England journal of medicine)
[2019, 380(11):1012-1021]

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A comparison of maternal and newborn health services costs in Sindh Pakistan.

Asif Raza Khowaja, Craig Mitton, Rahat Qureshi, Stirling Bryan, Laura A Magee, Peter von Dadelszen, Zulfiqar A Bhutta,

Pakistani women suffer the highest rate of maternal mortality in South Asia. A lack of comprehensive knowledge about maternal and newborn health (MNH) services costs impedes policy decisions to maximize the benefit from existing, as well as emerging, MNH interventions in Pakistan. We compared MNH service costs at different levels ... Read more >>

PLoS ONE (PloS one)
[2018, 13(12):e0208299]

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The feasibility of task-sharing the identification, emergency treatment, and referral for women with pre-eclampsia by community health workers in India.

Umesh Charanthimath, Marianne Vidler, Geetanjali Katageri, Umesh Ramadurg, Chandrashekhar Karadiguddi, Avinash Kavi, Anjali Joshi, Geetanjali Mungarwadi, Sheshidhar Bannale, Sangamesh Rakaraddi, Diane Sawchuck, Rahat Qureshi, Sumedha Sharma, Beth A Payne, Peter von Dadelszen, Richard Derman, Laura A Magee, Shivaprasad Goudar, Ashalata Mallapur, Mrutyunjaya Bellad, , Zulfiqar Bhutta, Sheela Naik, Anis Mulla, Namdev Kamle, Vaibhav Dhamanekar, Sharla K Drebit, Chirag Kariya, Tang Lee, Jing Li, Mansun Lui, Asif R Khowaja, Domena K Tu, Amit Revankar,

BACKGROUND:Hypertensive disorders are the second highest direct obstetric cause of maternal death after haemorrhage, accounting for 14% of maternal deaths globally. Pregnancy hypertension contributes to maternal deaths, particularly in low- and middle-income countries, due to a scarcity of doctors providing evidence-based emergency obstetric care. Task-sharing some obstetric responsibilities may help ... Read more >>

Reprod Health (Reproductive health)
[2018, 15(Suppl 1):101]

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Availability and use of magnesium sulphate at health care facilities in two selected districts of North Karnataka, India.

Geetanjali Katageri, Umesh Charantimath, Anjali Joshi, Marianne Vidler, Umesh Ramadurg, Sumedha Sharma, Sheshidhar Bannale, Beth A Payne, Sangamesh Rakaraddi, Chandrashekhar Karadiguddi, Geetanjali Mungarwadi, Avinash Kavi, Diane Sawchuck, Richard Derman, Shivaprasad Goudar, Ashalata Mallapur, Mrutyunjaya Bellad, Laura A Magee, Rahat Qureshi, Peter von Dadelszen, ,

BACKGROUND:Pre-eclampsia and eclampsia are major causes of maternal morbidity and mortality. Magnesium sulphate is accepted as the anticonvulsant of choice in these conditions and is present on the WHO essential medicines list and the Indian National List of Essential Medicines, 2015. Despite this, magnesium sulphate is not widely used in ... Read more >>

Reprod Health (Reproductive health)
[2018, 15(Suppl 1):91]

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Prophylactic antibiotics to reduce pelvic infection in women having miscarriage surgery - The AIMS (Antibiotics in Miscarriage Surgery) trial: study protocol for a randomized controlled trial.

David Lissauer, Amie Wilson, Jane Daniels, Lee Middleton, Jon Bishop, Catherine Hewitt, Abi Merriel, Andrew Weeks, Chisale Mhango, Ronald Mataya, Frank Taulo, Theresa Ngalawesa, Agatha Chirwa, Colleta Mphasa, Tayamika Tambala, Grace Chiudzu, Caroline Mwalwanda, Agnes Mboma, Rahat Qureshi, Iffat Ahmed, Humera Ismail, Metin Gulmezoglu, Olufemi T Oladapo, Godfrey Mbaruku, Jerome Chibwana, Grace Watts, Beatus Simon, James Ditai, Charles Otim Tom, Jane-Frances Acam, John Ekunait, Helen Uniza, Margaret Iyaku, Margaret Anyango, Javier Zamora, Tracy Roberts, Ilias Goranitis, Nicola Desmond, Arri Coomarasamy,

BACKGROUND:The estimated annual global burden of miscarriage is 33 million out of 210 million pregnancies. Many women undergoing miscarriage have surgery to remove pregnancy tissues, resulting in miscarriage surgery being one of the most common operations performed in hospitals in low-income countries. Infection is a serious consequence and can result ... Read more >>

Trials (Trials)
[2018, 19(1):245]

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Household chores as the main source of physical activity: Perspectives of pregnant Pakistani women.

Zahra Hoodbhoy, Rahat Najam Qureshi, Romaina Iqbal, Qamarunissa Muhabat,

OBJECTIVE:To understand the level of physical activity in pregnant women and to identify perceived facilitators and barriers faced by them. METHODS:This cross-sectional study was conducted from January to June 2016 at Aga Khan Maternity and Child Care Centre, Hyderabad, Pakistan, and comprised pregnant women attending the antenatal clinics. They were ... Read more >>

J Pak Med Assoc (JPMA. The Journal of the Pakistan Medical Association)
[2018, 68(4):565-569]

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Antenatal corticosteroids for women at risk of imminent preterm birth in low-resource countries: the case for equipoise and the need for efficacy trials.

Joshua P Vogel, Olufemi T Oladapo, Cynthia Pileggi-Castro, Ebunoluwa A Adejuyigbe, Fernando Althabe, Shabina Ariff, Adejumoke Idowu Ayede, Abdullah H Baqui, Anthony Costello, Davy M Chikamata, Caroline Crowther, Bukola Fawole, Luz Gibbons, Alan H Jobe, Monica Lulu Kapasa, John Kinuthia, Alka Kriplani, Oluwafemi Kuti, James Neilson, Janna Patterson, Gilda Piaggio, Rahat Qureshi, Zahida Qureshi, Mari Jeeva Sankar, Jeffrey S A Stringer, Marleen Temmerman, Khalid Yunis, Rajiv Bahl, A Metin Gülmezoglu,

The scientific basis for antenatal corticosteroids (ACS) for women at risk of preterm birth has rapidly changed in recent years. Two landmark trials-the Antenatal Corticosteroid Trial and the Antenatal Late Preterm Steroids Trial-have challenged the long-held assumptions on the comparative health benefits and harms regarding the use of ACS for ... Read more >>

BMJ Glob Health (BMJ global health)
[2017, 2(3):e000398]

Cited: 10 times

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SOCIETAL PERSPECTIVE ON COST DRIVERS FOR HEALTH TECHNOLOGY ASSESSMENT IN SINDH, PAKISTAN.

Asif Raza Khowaja, Craig Mitton, Rahat Qureshi, Stirling Bryan, Laura A Magee, Peter von Dadelszen, Zulfiqar A Bhutta,

Understanding cost-drivers and estimating societal costs are important challenges for economic evaluation of health technologies in low- and middle-income countries (LMICs). This study assessed community experiences of health resource usage and perceived cost-drivers from a societal perspective to inform the design of an economic model for the Community Level Interventions ... Read more >>

Int J Technol Assess Health Care (International journal of technology assessment in health care)
[2017, 33(2):192-198]

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Implementation of warning tool to improve maternal newborn health outcomes in a developing country.

Sana Sheikh, Rahat Qureshi, Sidrah Nausheen, Rozina Sikandar,

OBJECTIVE:To improve health outcomes through the implementation of national early warning sign tool for babies delivered through emergency caesarean section in off-work hours. METHODS:This comparative clinical study was conducted at the Aga Khan Hospital for Women and Children, Karachi, from April to August 2014, and comprised women who had an ... Read more >>

J Pak Med Assoc (JPMA. The Journal of the Pakistan Medical Association)
[2017, 67(1):111-115]

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Referral pattern of emergencies in obstetrics: Implications for defining scope of services and policy.

Rahat Najam Qureshi, Rozina Sikandar, Zahra Hoodbhoy, Raffat Bano, Nigar Jabeen,

To analyse referral pattern of high-risk obstetric cases from secondary to tertiary care hospitals and to assess their maternal and neonatal outcomes.This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised all referred obstetric cases from secondary-level hospitals to tertiary-level care within and outside the Hospital ... Read more >>

J Pak Med Assoc (JPMA. The Journal of the Pakistan Medical Association)
[2016, 66(12):1606-1610]

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Obstetric patients in intensive care unit: Perspective from a teaching hospital in Pakistan.

Rahat Qureshi, Sheikh Irfan Ahmed, Amir Raza, Ayesha Khurshid, Uzma Chishti,

Review of obstetric cases admitted to the intensive care unit.Ten year retrospective review of individual patients' medical records.Records of obstetric patients admitted from 2005-2014.Aga Khan University Hospital Karachi.Diagnosis at the time of admission, associated risk factors, and intervention required aspects of management and rate of mortality.A total of 194 obstetric ... Read more >>

JRSM Open (JRSM open)
[2016, 7(11):2054270416663569]

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Community health worker knowledge and management of pre-eclampsia in southern Mozambique.

Helena Boene, Marianne Vidler, Orvalho Augusto, Mohsin Sidat, Eusébio Macete, Clara Menéndez, Diane Sawchuck, Rahat Qureshi, Peter von Dadelszen, Khátia Munguambe, Esperança Sevene, ,

Mozambique has drastically improved an array of health indicators in recent years, including maternal mortality rates which decreased 63 % from 1990-2013 but the rates still high. Pre-eclampsia and eclampsia constitute the third major cause of maternal death in the country. Women in rural areas, with limited access to health facilities ... Read more >>

Reprod Health (Reproductive health)
[2016, 13(Suppl 2):105]

Cited: 4 times

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Community health worker knowledge and management of pre-eclampsia in rural Karnataka State, India.

Umesh Ramadurg, Marianne Vidler, Umesh Charanthimath, Geetanjali Katageri, Mrutyunjaya Bellad, Ashalata Mallapur, Shivaprasad Goudar, Shashidhar Bannale, Chandrashekhar Karadiguddi, Diane Sawchuck, Rahat Qureshi, Peter von Dadelszen, Richard Derman, ,

In India, the hypertensive disorders of pregnancy and postpartum haemorrhage are responsible for nearly 40 % of all maternal deaths. Most of these deaths occur in primary health settings which frequently lack essential equipment and medication, are understaffed, and have limited or no access to specialist care. Community health care workers ... Read more >>

Reprod Health (Reproductive health)
[2016, 13(Suppl 2):113]

Cited: 7 times

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Health care provider knowledge and routine management of pre-eclampsia in Pakistan.

Sana Sheikh, Rahat Najam Qureshi, Asif Raza Khowaja, Rehana Salam, Marianne Vidler, Diane Sawchuck, Peter von Dadelszen, Shujat Zaidi, Zulfiqar Bhutta, ,

BACKGROUND:Maternal mortality ratio is 276 per 100,000 live births in Pakistan. Eclampsia is responsible for one in every ten maternal deaths despite the fact that management of this disease is inexpensive and has been available for decades. Many studies have shown that health care providers in low and middle-income countries ... Read more >>

Reprod Health (Reproductive health)
[2016, 13(Suppl 2):104]

Cited: 3 times

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Potential for task-sharing to Lady Health Workers for identification and emergency management of pre-eclampsia at community level in Pakistan.

Rehana A Salam, Rahat Najam Qureshi, Sana Sheikh, Asif Raza Khowaja, Diane Sawchuck, Marianne Vidler, Peter von Dadelszen, Shujaat Zaidi, Zulfiqar Bhutta, ,

An estimated 276 Pakistani women die for every 100,000 live births; with eclampsia accounting for about 10 % of these deaths. Community health workers contribute to the existing health system in Pakistan under the banner of the Lady Health Worker (LHW) Programme and are responsible to provide a comprehensive package of ... Read more >>

Reprod Health (Reproductive health)
[2016, 13(Suppl 2):107]

Cited: 4 times

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Frequency of Thyroid Peroxidase Antibody and its Association with Miscarriages Among Pregnant Women.

Sahar Iqbal, Farooq Ghani, Rahat Qureshi,

To measure the frequency of thyroid peroxidase antibody (TPO Ab) among clinically euthyroid pregnant women during first trimester and determine its association with pregnancy outcome as miscarriage or live birth by estimating the relative risk.Cohort study.Section of Chemical Pathology, Department of Pathology and Laboratory Medicine and the Gynaecology and Obstetric ... Read more >>

J Coll Physicians Surg Pak (Journal of the College of Physicians and Surgeons--Pakistan : JCPSP)
[2016, 26(10):831-834]

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Human resource constraints and the prospect of task-sharing among community health workers for the detection of early signs of pre-eclampsia in Ogun State, Nigeria.

David O Akeju, Marianne Vidler, J O Sotunsa, M O Osiberu, E O Orenuga, Olufemi T Oladapo, A A Adepoju, Rahat Qureshi, Diane Sawchuck, Olalekan O Adetoro, Peter von Dadelszen, Olukayode A Dada, ,

The dearth of health personnel in low income countries has attracted global attention. Ways as to how health care services can be delivered in a more efficient and effective way using available health personnel are being explored. Task-sharing expands the responsibilities of low-cadre health workers and allows them to share ... Read more >>

Reprod Health (Reproductive health)
[2016, 13(Suppl 2):111]

Cited: 3 times

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The feasibility of community level interventions for pre-eclampsia in South Asia and Sub-Saharan Africa: a mixed-methods design.

Asif Raza Khowaja, Rahat Najam Qureshi, Diane Sawchuck, Olufemi T Oladapo, Olalekan O Adetoro, Elizabeth A Orenuga, Mrutyunjaya Bellad, Ashalata Mallapur, Umesh Charantimath, Esperança Sevene, Khátia Munguambe, Helena Edith Boene, Marianne Vidler, Zulfiqar A Bhutta, Peter von Dadelszen, ,

Globally, pre-eclampsia and eclampsia are major contributors to maternal and perinatal mortality; of which the vast majority of deaths occur in less developed countries. In addition, a disproportionate number of morbidities and mortalities occur due to delayed access to health services. The Community Level Interventions for Pre-eclampsia (CLIP) Trial aims ... Read more >>

Reprod Health (Reproductive health)
[2016, 13 Suppl 1:56]

Cited: 10 times

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Determinants of health care seeking behaviour during pregnancy in Ogun State, Nigeria.

David O Akeju, Olufemi T Oladapo, Marianne Vidler, Adepoju A Akinmade, Diane Sawchuck, Rahat Qureshi, Muftaut Solarin, Olalekan O Adetoro, Peter von Dadelszen, ,

In Nigeria, women too often suffer the consequences of serious obstetric complications that may lead to death. Delay in seeking care (phase I delay) is a recognized contributor to adverse pregnancy outcomes. This qualitative study aimed to describe the health care seeking practices in pregnancy, as well as the socio-cultural ... Read more >>

Reprod Health (Reproductive health)
[2016, 13 Suppl 1:32]

Cited: 9 times

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