INTRA-OPERATIVE DIFFICULTIES IN REPEAT CAESAREAN SECTIONS IN COLLEGE OF MEDICINE AND JNM HOSPITAL- A OBSERVATIONAL STUDY

2021 ◽  
pp. 33-35
Author(s):  
Arunashis Mallick ◽  
Sagar Shirsath ◽  
Debarshi Jana
Keyword(s):  
Caesarean Section ◽  
Surgical Techniques ◽  
Operative Management ◽  
World Health ◽  
Operative Morbidity ◽  
Management Of Complications ◽  
Potential Risks ◽  
The Mean ◽  
Health Organization ◽  
Health Experts

INTRODUCTION For nearly 30 years, the international healthcare community has considered the ideal rate for caesarean sections to be between 10% and 15%. This was based on the following statement by a panel of reproductive health experts at a meeting organized by the World Health Organization (WHO) in 1985 in Fortaleza, Brazil: “There is no justication for any region to have a rate higher than 10-15%”. AIM AND OBJECTIVES The Aim of study is focused on assessing importance of complications encountered by obstetrician and how to overcome it. Ÿ To look for the intra-operative difculties in a repeat Caesarean section. Ÿ To assess on table management of the complications Ÿ To estimate Post-operative management of complications. MATERIALS & METHODS Study design:It is an observational prospective study Target population:All women undergoing one or more caesarean in department of obstetrics and gynaecology. Study population:All women who have undergone one or more caesarean section. Study Duration:The study was conducted during a period of 10 months from 1stJuly 2019 to 30th April 2020. RESULTS AND ANALYSIS In our study, 88(83.8%) patients had previous 1 C/S, 16(15.2%) had 2C/S and 1(1.0%) patient had 3 C/S. In above table showed that the mean number previous C/S (mean± s.d.) of patients was 1.1714 ± .8636. The Present study revealed, 14(13.3%) patients had Preterm and 91(86.7%) patients had term. SUMMERYAND CONCLUSION Further clinical studies are needed to evaluate not only the effects of surgical techniques, andintra- operative management but also to investigate their effect son peri-operative morbidity that is associated with caesarean section. The best technique to reduce the multiple potential risks of repeat caesarean section is to reduce the rates of primary and repeat caesarean section s whenever possible.

scholarly journals How Experts React: The World Health Organization’s Appraisal of COVID-19 via Communication Patterns

2021 ◽  
pp. 0261927X2110263
Author(s):  
David M. Markowitz
Keyword(s):  
World Health Organization ◽  
Cognitive Processing ◽  
Communication Patterns ◽  
World Health ◽  
Working Through ◽  
The World ◽  
Internal States ◽  
Health Organization ◽  
The Relationship ◽  
Health Experts

How do COVID-19 experts psychologically manage the pandemic and its effects? Using a full year of press briefings (January 2020–January 2021) from the World Health Organization ( N = 126), this paper evaluated the relationship between communication patterns and COVID-19 cases and deaths. The data suggest as COVID-19 cases and deaths increased, health experts tended to think about the virus in a more formal and analytic manner. Experts also communicated with fewer cognitive processing terms, which typically indicate people “working through” a crisis. This report offers a lens into the internal states of COVID-19 experts and their organization as they gradually learned about the virus and its daily impact.

scholarly journals Vaccination Coverage for Routine Vaccines and Herd Immunity Levels against Measles and Pertussis in the World in 2019

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 256
Author(s):  
Pedro Plans-Rubió
Keyword(s):  
Vaccination Coverage ◽  
Action Plan ◽  
Herd Immunity ◽  
World Health ◽  
Immunization Programs ◽  
National Immunization ◽  
The World ◽  
Measles Vaccination ◽  
The Mean ◽  
Health Organization

In 2012, the World Health Organization (WHO) established the Global Vaccine Action Plan with the objective to promote essential vaccinations in all countries and achieve at least 90% vaccination coverage for all routine vaccines by 2020. The study assessed the mean percentages of vaccination coverage in 2019 for 13 routine vaccines, vaccination coverage variation from 2015 to 2019, and herd immunity levels against measles and pertussis in 2019 in countries and regions of WHO. In 2019, the mean percentages of vaccination coverage were lower than 90% for 10 (78.9%) routine vaccines. The mean percentages of vaccination coverage also decreased from 2015 to 2019 for six (46.2%) routine vaccines. The prevalence of individuals with vaccine-induced measles immunity in the target measles vaccination population was 88.1%, and the prevalence of individuals with vaccine-induced pertussis immunity in the target pertussis vaccination population was 81.1%. Herd immunity against measles viruses with Ro = 18 was established in 63 (32.5%) countries but not established in any region. Herd immunity against pertussis agents was not established in any country and in any region of WHO. National immunization programs must be improved to achieve ≥90% vaccination coverage in all countries and regions. Likewise, it is necessary to achieve ≥95% vaccination coverage with two doses of measles vaccines and three doses of pertussis vaccines in all countries and regions.

scholarly journals The use of vitreous renal chemistries in the discrimination of postmortem fresh water drowning

2021 ◽  
Vol 5 ◽  
pp. 239784732199752
Author(s):  
Eni-yimini Solomon Agoro ◽  
Charles German Ikimi ◽  
Tommy Edidiong
Keyword(s):  
Fresh Water ◽  
Biochemical Parameters ◽  
World Health ◽  
The World ◽  
Diacetyl Monoxime ◽  
Water Pond ◽  
The Mean ◽  
Health Organization ◽  
Post Hoc ◽  
Cover Up

Background: The World Health Organization (WHO) has estimated drowning as the leading cause of unintentional death in the world, with 372,000 deaths reported annually. Not all drowning are unintentional; some could be disguised to cover up an act of heinous criminality. This study was aimed at using some vitreous renal function biochemical parameters as a discriminant of postmortem fresh water drowning. Twelve albino rabbits constituted the sample size as validated by Mead’s formula. The study was divided into three groups; the control, postmortem-drowned and truly drowned as mimicked using an artificial fresh water pond. Vitreous humours were extracted using Coe method. The vitreous renal chemistries were analysed using diacetyl monoxime, Jaffe’s test, uricase and ion-selective electrode (ISE) methods respectively. Result: The mean of vitreous creatinine, urea, uric acid, Na+, K+, Cl−, Ca2+, glucose and CO2 of the control, postmortem-drowned and truly drowned groups were compared using One-way Anova (post-hoc-LSD) with the aid of SPSS Inc., Chicago, IL, USA; Version 18–21 package. The findings revealed a significant increase in concentrations of vitreous creatinine, glucose, Ca2+ and K+ of the drowned death group, whereas vitreous concentrations of CO2 and urea significantly decreased when compared to the controls and/or postmortem-drowned death. Conclusion: The study has shown that some of the studied vitreous biochemical parameters could be used as an ancillary tool in discriminating death due to fresh water drowning from that of disguised or postmortem-drowned death.

Accounting for the Rising Caesarean Section Rate in Canada: What Are the Roles of Changing Needs, Practices, and Incentives?

2021 ◽  
Author(s):  
Michael Baker ◽  
Maripier Isabelle ◽  
Mark Stabile ◽  
Sara Allin
Keyword(s):  
Caesarean Section ◽  
Financial Incentives ◽  
Health Care Systems ◽  
Caesarean Section Rate ◽  
The United States ◽  
World Health ◽  
Strong Increase ◽  
Primary Determinant ◽  
Care Systems ◽  
Health Organization

In most high-income countries, including Canada, the share of births by Caesarean section (C‑section) has risen over the past decades to far exceed World Health Organization recommendations of the proportion justified on medical grounds (15 percent). Although unnecessary C-sections represent an important cost for health care systems, they are not associated with clear benefits for the mother and the child and can sometimes represent additional risks. Drawing on administrative records of nearly four million births in Canada, as well as macro data from the United States and Australia, we provide a comprehensive account of rising C-section rates. We explicitly consider the contributions of the main factors brought forward in the policy literature, including changing characteristics of mothers, births, and physicians as well as changing financial incentives for C-section deliveries. These factors account for at most one-half of the increase in C-section rates. The majority of the remaining increase in C-sections over the period 1994–2011 occurred in the early 2000s. We suggest that some event or shock in the early 2000s is likely the primary determinant of the recent strong increase in the C-section rate in Canada.

scholarly journals Dental caries in 6-12-year-old indigenous and non-indigenous schoolchildren in the Amazon basin of Ecuador

2008 ◽  
Vol 19 (1) ◽  
pp. 83-86 ◽  
Author(s):  
Widman Medina ◽  
Anna-Karin Hurtig ◽  
Miguel San Sebastián ◽  
Edy Quizhpe ◽  
Cristian Romero
Keyword(s):  
Amazon Basin ◽  
Ethnic Origin ◽  
World Health ◽  
Caries Experience ◽  
Cross Sectional ◽  
Health Response ◽  
Indigenous Children ◽  
Prevention And Health Promotion ◽  
The Mean ◽  
Health Organization

The purpose of this study was to evaluate the caries experience among 6-12-year-old indigenous (Naporunas) and non-indigenous (recent settlers of mixed ethnic origin) schoolchildren, living in the Amazon basin of Ecuador. Cross-sectional data were obtained from 1,449 clinical exams according to the World Health Organization criteria. Nine (7.6%) indigenous and 3 (4.5%) non-indigenous children had no caries experience in their primary dentition at the age of 6. The mean dmft value (SD) among indigenous and non-indigenous children aged 6 was 6.40 (3.36) and 8.36 (3.93), respectively. Sixty-four (54.2%) indigenous and 29 (43.3%) non-indigenous children had no caries experience in their permanent first molars at the age of 6. Only 7 (6.26%) indigenous and 2 (2.60%) non-indigenous children were caries-free at the age of 12. The mean DMFT values (SD) for 12-year-olds were 4.47 (2.85) among indigenous and 5.25 (2.89) among non-indigenous children. Fillings were almost non existent. Caries rates were high among both groups, with untreated carious lesions predominating in all ages. The data of indigenous children suggest adoption of a non-traditional diet. An appropriate oral health response based primarily on prevention and health promotion is needed.

scholarly journals Gross Total Resection of Large Cerebellopontine Angle Meningioma with a Supratentorial Extension via Retrosigmoid Approach with Suprameatal Drilling and Tentorial Sectioning

2018 ◽  
Vol 79 (S 05) ◽  
pp. S399-S401
Author(s):  
Sima Sayyahmelli ◽  
Adi Ahmetspahic ◽  
Mustafa Baskaya
Keyword(s):  
Surgical Resection ◽  
Cerebellopontine Angle ◽  
Surgical Techniques ◽  
Retrosigmoid Approach ◽  
World Health ◽  
Gross Total Resection ◽  
Total Resection ◽  
Facial Numbness ◽  
Magnetic Resonance Imaging Mri ◽  
Health Organization

Meningiomas are the second most common neoplasm in the cerebellopontine angle (CPA), and are challenging lesions to treat surgically. With significant refinements in surgical techniques, operative morbidity, and mortality have been substantially reduced. Total or near-total surgical resection can be accomplished in the majority of cases via appropriately selected approaches, and with acceptable morbidity. In this video, we present a 51-year-old woman, who had a 2-year history of vertigo with symptoms that progressed over time. She presented with blurry vision, sensorineural hearing loss, tinnitus, left-sided facial numbness, and double vision. Magnetic resonance imaging (MRI) showed a left-sided homogeneously enhancing mass at CPA with a supratentorial extension. MRI appearance was consistent with a CPA meningioma with supratentorial extension. The patient underwent surgical resection via a retrosigmoid approach. Suprameatal drilling and tentorial sectioning were necessary to achieve gross total resection. The surgery and postoperative course were uneventful. The histopathology was a WHO (world health organization) grade I meningioma. MRI showed gross total resection of the tumor. After a 1.5-year follow-up, the patient is continuing to do well with no residual or recurrent disease. In this video, microsurgical techniques and important steps for the resection of this challenging meningioma of the cerebellopontine angle are demonstrated.The link to the video can be found at: https://youtu.be/CDto52GxrG4.

scholarly journals PRESENCE AND LEVELS OF CONCENTRATION OF POLYCYCLIC AROMATIC HYDROCARBONS (PAHS) IN SMOKED FISH, HIDES AND SKIN OF SLAUGHTER CATTLE AND GOATS IN AWKA URBAN, NIGERIA

2019 ◽  
pp. 14-17
Author(s):  
IKECHUKWU OFOMATA ◽  
LYNDA ONYINYE OBODOECHI ◽  
REGINALD IKECHUKWU OBIDIKE ◽  
JOHN ANAELOM NWANTA
Keyword(s):  
World Health ◽  
Fish Tissues ◽  
Anambra State ◽  
Smoked Fish ◽  
Permissible Level ◽  
Flame Ionization ◽  
Slaughter Cattle ◽  
Polycyclic Aromatic ◽  
The Mean ◽  
Health Organization

Objective: This study evaluated the presence and concentration of PAHs in singed and unsinged hides and skin of slaughter cattle and goats and smoked and non-smoked fish in Awka urban area of Anambra State, Nigeria. Methods: Sixty samples of singed and unsinged hides and skin for were collected from Kwata slaughterhouse in Awka town where fish tissues were also collected from fish smoking spots in Awka urban. The samples were examined for the presence PAHs such as: benzo[a]pyrene; benzo[a]anthracene; benzo[k]flouranthene and indeno[1-2-3cd]pyrene using gas chromatography equipped with flame ionization detector. Results: The result showed that the mean concentrations (µg/kg) of benzo[a]pyrene and indeno [1-2-3cd]pyrene in unsinged cattle hides were 7.89±7.77 and 2.25±0.97 respectively. The mean concentrations upon singeing were of 15.81±14.93 and 3.55±2.89. The mean concentrations (µg/kg) of benzo[a]pyrene; benzo[k]flouranthene and indeno[1-2-3cd]pyrene in unsigned goat skins were 6.52±10.77; 6.58±5.93 and 3.48±0.00 respectively. When the goatskin was singed, the mean concentrations were 17.50±26.03; 10.84±11.19 and 8.79±11.77. The mean concentrations (µg/kg) of benzo[a]pyrene; benzo[k]flouranthene and indeno[1-2-3cd]pyrene in non-smoked fish were 8.65±9.67; 2.11±2.10 and 54.76±60.35 respectively. When the fish were smoked, the mean concentrations of 26.42±40.21; 6.64±11.11 and 599.36±1395.61 were recorded respectively. In all species of animals sampled, no trace of benzo[a]anthracene was detected. Conclusion: The mean concentrations of all carcinogenic PAHs detected in this work were below the maximum permissible level set by World Health Organization (WHO) and European Commission (30µg/kg) with the exception of indeno[1-2-3cd]pyrene in smoked and non-smoked fish, which was far above the permissible level.

scholarly journals Assessment of quality of life in type 2 diabetes mellitus patients using World Health Organization quality of life-BREF questionnaire and appraisal of diabetes scale - a cross-sectional study

2021 ◽  
Vol 15 (3) ◽  
Author(s):  
Supriya Patil ◽  
Yamini Patil ◽  
Sanjay Kumar Patil
Keyword(s):  
Quality Of Life ◽  
Cross Sectional Study ◽  
World Health ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Mean ◽  
Health Organization

Diabetes is a chronic metabolic disorder that disturbs the quality of life (QOL) of patients. Therefore, evaluation of diabetes- related QOL could be a key outcome measure for its management. This study assessed the QOL in type 2 diabetes mellitus (T2DM) patients using the World Health Organization (WHO) quality of life (QOL)˗BREF questionnaire and disease-specific appraisal of diabetes scale (ADS). In this cross-sectional study, 520 T2DM patients were included. Patients’ demographic data, clinical information was collected through interviews, and the WHOQOL-BREF instrument and ADS were used for the QOL of patients. Statistical analysis was performed by using R software (Version 3.6.0). The mean ADS scores were lower in controlled diabetic subjects (18.50±3.08) and higher in uncontrolled diabetic subjects (19.29±2.73) (P<0.05). For WHOQOL-BREF, the mean scores for all the domains (overall general health, physical, psychological, social, and environmental) were significantly higher in controlled diabetic subjects (P<0.001). In addition, the age, duration of diabetes, associated comorbidities, treatment, and HbA1c level of patients showed a highly significant correlation with WHOQOL-BREF (P<0.001). Diabetic patients had poor-to-average QOL. Therefore, public health measures and education of diabetic patients are essential to create more awareness for improving the QOL of T2DM.

scholarly journals Spinal surgery complications: an unsolved problem—Is the World Health Organization Safety Surgical Checklist an useful tool to reduce them?

2019 ◽  
Vol 29 (5) ◽  
pp. 927-936
Author(s):  
Giovanni Barbanti-Brodano ◽  
Cristiana Griffoni ◽  
Jarkko Halme ◽  
Giuseppe Tedesco ◽  
Silvia Terzi ◽  
...  
Keyword(s):  
World Health Organization ◽  
Spinal Surgery ◽  
World Health ◽  
The World ◽  
Oncological Diseases ◽  
Supplementary Material ◽  
The Mean ◽  
Health Organization ◽  
Surgical Checklist

Abstract Purpose To investigate whether the World Health Organization Safety Surgical Checklist (SSC) is an effective tool to reduce complications in spinal surgery. Methods We retrospectively evaluated the clinical and radiological charts prospectively collected from patients who underwent a spinal surgery procedure from January 2010 to December 2012. The aim of this study was to compare the incidence of complications between two periods, from January to December 2010 (without checklist) and from January 2011 and December 2012 (with checklist), in order to assess the checklist’s effectiveness. Results The sample size was 917 patients with an average of 30-month follow-up. The mean age was 52.88 years. The majority of procedures were performed for oncological diseases (54.4%) and degenerative diseases (39.8%). In total, 159 complications were detected (17.3%). The overall incidence of complications for trauma, infectious pathology, oncology, and degenerative disease was 22.2%, 19.2%, 18.4%, and 15.3%, respectively. No correlation was observed between the type of pathology and the complication incidence. We observed a reduction in the overall incidence of complications following the introduction of the SSC: In 2010 without checklist, the incidence of complications was 24.2%, while in 2011 and 2012, following the checklist introduction, the incidence of complications was 16.7% and 11.7%, respectively (mean 14.2%). Conclusions The SSC seems to be an effective tool to reduce complications in spinal surgery. We propose to extend the use of checklist system also to the preoperative and postoperative phases in order to further reduce the incidence of complications. Graphic abstract These slides can be retrieved under Electronic Supplementary Material.

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