Predictors of maternal mortality in institutional deliveries in Nigeria.

BACKGROUND: Maternal mortality in poor countries reflects the under-development in these societies. Global recognition of the burden of maternal mortality and the urgency for a reversal of the trend underpin the Millenium Development Goals (MDGs). OBJECTIVE: To determine risk factors for maternal mortality in institutional births in Nigeria. METHOD: Twenty one health facilities in three states were selected using stratified multi-stage cluster sampling strategy. Information on all delivered mothers and their newborn infants within a three-month period was culled from medical records. RESULTS: A total of 9 208 deliveries were recorded. About one-fifth (20.5%) of women had no antenatal care while 79.5% had at least one antenatal visit during pregnancy. Four-fifths (80.5%) of all deliveries were normal deliveries. Elective and emergency caesarean section rates were 3.1% and 11.5% respectively. There were 79 maternal deaths and 8 526 live births, giving a maternal mortality ratio of 927 maternal deaths per 100 000 live births. No antenatal care, parity, level of education, and mode of delivery were significantly associated with maternal mortality. Low maternal education, high parity, emergency caesarean delivery, and high risk patients risk independently predicted maternal mortality. CONCLUSION: Meeting goal five of the MDGs remains a major challenge in Nigeria. Multi-sectoral approaches and focused political will are needed to revert the high maternal mortality.

Rheological characterization of hair shampoo in the presence of dead sea salt.

In Jordan, a growing industry has been established to produce different types of Dead Sea (DS) cosmetics that have DS salt (contains mainly NaCl, KCl, and MgCl(2)) in their formulas. In this work, the effect of DS salt on the rheology of hair shampoo containing the sodium lauryl ether sulfate as a main active matter was studied. The effects of DS salt and active matter concentration, and the temperature and time of salt mixing, on the rheological properties of hair shampoo were investigated. The salt-free shampoo showed a Newtonian behavior at 'low active matter' (LAM) and shear thinning at 'high active matter' (HAM). The presence of DS salt changed the rheological behavior of LAM shampoo from Newtonian (for the salt-free shampoo) to shear thinning. On the other hand, the behavior of HAM shampoo switched from shear thinning to Newtonian behavior in the presence of high concentration of DS salt. The addition of DS salt increased the apparent viscosity of shampoo to reach a maximum value that corresponded to a salt concentration of 1.5 wt.%. Further addition of DS salt led to a decrease in the shampoo viscosity to reach a value less than that of the salt-free sample at high salt concentration. Changing the mixing temperature (25-45 degrees C) and mixing time (15-120 min) of DS salt with shampoo has no significant influence on the rheological behavior. However, the mixing process increased the apparent viscosity of salt-free shampoo. The power law model fitted well the flow curves of hair shampoo with and without DS salt.