SSMJ February 2015

Editorials

Maternal mortality can be reduced through task- shifting in South Sudan

In this issue of SSMJ there is an article entitled “The crucial role of medical doctors in reducing maternal deaths in South Sudan”. It is based on two circumstances. Firstly, South Sudan has the highest national maternal mortality ratio in the world, above 2000, which is roughly 1000 times higher than in Sweden. Secondly, leading cadres in the Ministry of Health in Juba have an open, evidence- based and scientifically updated attitude to the most fundamental underlying problem: the scarcity of human resources for health (HRH) to save maternal lives.

News, Reports and Policy

Feb 2015 Resources

Clinical Guidance

Making cassava flour safe using the wetting method

Cassava is the third most important food source in the tropics and the staple food of tropical Africa. Cassava: • is easy to grow, • produces a good yield of starchy roots in 6-9 months even in poor soils without added fertilizer, • is drought resistant; the roots are a reserve source of food in drought and famine conditions [1].

Task-shifting: The crucial role of medical doctors in reducing maternal deaths in South Sudan

Millennium Development Goal (MDG) 5 is related to reducing maternal mortality. Against the background of the failure of this MDG, South Sudan has two features that make it interesting for the international donor community:

The importance of coughs

‘Cough’ is so common we sometimes do not realise just how important it can be. It is at best annoying to patients (and families) especially if nocturnal and, at worst, very distressing particularly if associated with dyspnoea, copious sputum and/or pain. It may be associated with many serious diseases including lung cancer and tuberculosis.

Letter to the editor

Neonatal scalp seborrhoeic dermatitis or psoriasis?

Research

A longitudinal study of MUAC as a measure of paediatric malnutrition in Yei, South Sudan: Lessons from a hospital link: Lessons from a hospital link

Paediatric malnutrition is a significant problem in South Sudan, with rates of wasting up to 22% reported in some areas [1]. Severe acute malnutrition (SAM) is associated with a high mortality [2]. Affected patients require thorough assessment and holistic care including appropriate therapeutic feeding, treatment of associated complications and rehabilitation in order to achieve good outcomes.

Case Reports

Progressive dysarthria and ataxia

‘Guillain-Barre syndrome’ (GBS) is a broad term used to describe a collection of clinical syndromes which manifest as acute immune-mediated demyelinating diseases or more rarely axonal diseases of the peripheral nervous system. The most commonly recognised form is ‘acute inflammatory demyelinating polyradiculoneuropathy’ (AIDP), which classically presents as a proximal and distal weakness with diminished reflexes, often involving the cranial nerves and muscles of respiration [1]. It is a neurological emergency as these patients are at risk of developing respiratory failure; one third will require admission to the Intensive Care Unit (ICU) for ventilatory support, and mortality rates of 3-10% have been reported [2].

Summaries

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