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Introduction: Despite improvements in health, maternal mortality remains a global public health problem. The haemorrhages of the third trimester are still responsible for a heavy mortality. Objectives: Contribute to the study of immediate postpartum hemorrhages (PPH) at the maternity department of Nabil Choucair Health Center (NBHC). Methodology: It was a retrospective descriptive and analytical study on cases of PPH treated between of January 1st, 2011 and December 31th, 2015 at the maternity department of NBHC. We included any patient who was being cared for in the maternity waedfor a PPH. We studied the sociodemographic characteristics of the patients, identified etiological factors and evaluated treatment and prognosis. Results: The frequency of PPH was 1.1%. The mean age of the patients was 27.5 years. Primiparas (34.3%) and pauciparas (33.3%) were the most affected. The main etiologies of PPH were traumatic lesions (39.6%), uterine atony (31%) and retained placenta (25.2%). Medical management was based on resuscitation using filling fluids, transfusion (22.4%) and administration of oxytocin (51.4%) and prostaglandin analogs associated with oxytocin (48.6%). Obstetrical care consisted of uterine revision and uterine massage (59.8%), uterine revision alone (20.4%) and uterine revision, uterine massage and sandbag placement (19.1%). The mechanical means were mainly represented by intra-vaginal tamponade (69.2%) and intrauterine tamponade (24.4%), including 2 with the balloon. The surgical treatment included 18 hemostasis hysterectomies (13.1%) and 118 (85.5%) restorative sutures. The main maternal complication of PPH was anemia (71%). The lethality related to PPH was 6.8% with 14 deaths including 7 from blood clotting disorders. Conclusion: The diagnosis and precise estimation of postpartum hemorrhage are the basic elements of the course to be taken.

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Introduction: Post–spinal anesthesia bacterial meningitis is an exceptional complication, most often caused by Gram-positive cocci originating from the oropharyngeal flora. Infections due to Escherichia coli are extremely rare and are generally reported as isolated cases. Case Report: We report the case of a 37-year-old woman with no previous medical history who developed altered consciousness twelve hours after a cesarean section performed under spinal anesthesia. Clinical examination revealed obnubilation, neck stiffness, and cloudy cerebrospinal fluid. Cerebrospinal fluid culture isolated Escherichia coli sensitive to ceftriaxone. A breach in aseptic technique was identified, involving the use of the paper inner packaging of a pair of surgical gloves as an operative drape. Early antibiotic therapy with ceftriaxone combined with corticosteroid therapy resulted in a favorable outcome without sequelae after 21 days of treatment. Conclusion: This case illustrates the rare but serious occurrence of Escherichia coli meningitis following spinal anesthesia and highlights the importance of strict aseptic technique, rapid diagnosis, and early antibiotic treatment. Exclusive use of certified sterile surgical drapes remains an essential preventive measure.

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Background: Preeclampsia (PE) remains a leading cause of maternal and perinatal morbidity and mortality, mainly due to complication, especially in resource-limited settings. This study aimed to identify maternal factors associated with PE complications, to help identify ways to orient limited resources. Methods: We conducted a case-control study at three tertiary hospitals in Yaoundé: the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, University Teaching Hospital, and Central Hospital. Records of women admitted for preeclampsia between January 2022 and December 2023 were reviewed. Cases were women with maternal complications of preeclampsia, while controls were those with preeclampsia and no complications, matched by maternal age. Data were analysed using R version 4.3.3. Pearson’s chi-squared test and Student’s t-test were used for comparisons, and adjusted odds ratios (aORs) determined using multiple logistic regression. Results: We recruited 291 participants (97 cases and 194 controls). The most frequent complications were eclampsia (59.2%) and HELLP syndrome (18.5%). Risk factors were alcohol consumption during pregnancy (aOR = 2.53; 95% CI: 1.19–5.40; p=0.016) and having a new partner (aOR = 3.63; 95% CI: 1.14–11.57; p=0.029). Age >20 years (aOR = 0.87; 95% CI: 0.80–0.94; p<0.001), and having ≥ 5 ANCs (aOR = 0.71; 95% CI: 0.58–0.88; p=0.001), were protective. Conclusion: Eclampsia was the most common complication of PE at these hospitals. Factors associated with complications were alcohol consumption, a new partner, and suboptimal ANC. We emphasize the importance of optimum antenatal care, and avoidance of alcohol, to promote prevention and early case detection and management.

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Introduction: Surgical jaundice, or obstructive jaundice, results from the blockage of bile flow due to benign or malignant conditions, leading to elevated bilirubin levels and associated symptoms. Early identification of the underlying cause is crucial for timely intervention and improved patient outcomes. This study aimed to evaluate the clinical aspects of surgical jaundice in patients admitted to DMCH. Methods: This prospective observational study was conducted at the Department of Surgery, Dhaka Medical College Hospital, over 12 months. A total of 100 patients were selected as study subjects by purposive convenient sampling technique. The diagnosis was established based on investigations. After data collection, all entries were checked for consistency and analyzed using SPSS version 26. Result: Among 100 patients with surgical jaundice (mean age 53.7±10.9 years), 57% had malignant causes, primarily carcinoma of the pancreatic head (32%), while 43% had benign causes, with choledocholithiasis (28%) being the most common. Jaundice was universal, and abdominal pain was the most frequent symptom, though malignancy was significantly associated with loss of appetite, weight loss, dark urine, and abdominal lump (p<0.05). Liver function tests showed significantly higher serum bilirubin and alkaline phosphatase levels in malignant cases (p<0.001). Conclusion: This study found that carcinoma head of the pancreas and choledocholithiasis are the most common causes of surgical jaundice. Overall, malignancy is the most frequent etiology of surgical jaundice. Abdominal pain was the most common clinical presentation in both malignant and benign cases. Loss of appetite and weight, dark urine, and a lump in the abdomen were found significantly higher among the malignant jaundice patients than in benign cases.

ABSTRACT
Healthcare systems are increasingly adopting artificial intelligence (AI) to improve clinical decision-making, yet many implementations fall short in practice because learning, decision support, and clinical workflows remain disconnected. Clinicians are often expected to use complex AI tools without continuous, context-specific training, leading to underutilization, mistrust, and inconsistent outcomes. This study presents a critical integrative review of the literature on AI-enhanced digital health education platform designed to improve clinical decision-making and workforce competency in the U.S. healthcare systems. Rather than treating these domains separately, the review synthesizes evidence to examine how they can be meaningfully integrated within routine clinical workflows. Four key evidence domains are analyzed: AI-driven clinical decision support systems, AI literacy and competency development, explainability and ethical governance, and implementation challenges in real-world healthcare settings. The findings reveal consistent agreement that AI improves diagnostic accuracy, efficiency, and clinical outcomes, but its effectiveness is limited by fragmented system design, lack of continuous learning mechanisms, and insufficient attention to trust and explainability. This study therefore proposes an implementation framework for workflow-integrated AI-enhanced digital health education platform. The framework explains how clinicians can receive guidance during decision-making, learn from immediate feedback, and build confidence and competence over time. In addition, practical design principles are outlined to guide the development of AI-enabled systems that are both effective and trustworthy. This study contributes to existing body of knowledge by reframing AI adoption in healthcare as a learning-centered process rather than pure technology. As such, AI moves from being a standalone tool to becoming a continuous learning partner, ultimately improving clinical decis