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Anesthesia for Cesarean Delivery in a low-resource Setting, an Initial Review

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Open Journal of Anesthesiology 2014年第9期4卷 217-222页

作者： Elizabeth Ogboli-Nwasor Abdulghaffar Adeniyi Yunus Department of Anaesthesia Ahmadu Bello University Teaching Hospital Zaria Nigeria

Background: Bearing in mind the recent advances in obstetric anesthesia, the safety of both mother and child is of paramount importance, especially in a setting where resources are limited. We set out to find the pattern of cases presenting for cesarean delivery and the types of anesthesias provided for the management of these patients. Methods: A retrospective survey was conducted involving all anesthetics provided for cesarean delivery from January 2006 to December 2009 in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Information such as age, indications and anesthetic technique, including drugs used, were extracted from patients’ records. Data were subjected to statistical analysis using Statistical Package for Social Sciences (SPSS) version 17.0. Results: There were a total of 577 anaesthetics conducted for cesarean delivery during the period under review out of 4277 live births, giving a cesarean delivery rate of 13.5%. General anesthesia (GA) was administered on 266 (46%) of these patients, while 279 (48%) cases were done under subarachnoid block(SAB). 16 (3%) patients had combined GA and SAB, while 16 (3%) patients received epidural anesthesia. There were 302 emergency cesarean deliveries out of 577 cases, giving an emergency cesarean delivery rate of 52%. The commonest indication for cesarean delivery was two previous cesarean deliveries. Conclusion: A large percentage of our obstetric cases are being done under general anesthesia. Though majority of the conducted regional anesthesia were spinals (SAB), only a few cases were done under epidural block. Subspecialty training of anesthetists will go a long way to improve the current trends.

关键词： Anesthesia Cesarean Delivery Epidural low-resource Sub-Arachnoid Block

Example-guided stylized response generation in zero-shot setting

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Science China(Information Sciences) 2022年第4期65卷 267-268页

作者： Guirong BAI Shizhu HE Kang LIU Jun ZHAO National Laboratory of Pattern Recognition Institute of Automation Chinese Academy of Sciences University of Chinese Academy of Sciences

Dear editor,Stylized response generation is a valuable task for conversational agents. However, due to the lack of conversational data in various styles, learning to generate responses in the desired style is challenging. In this study, we propose an example-guided stylized response generation method in a zero-shot setting, which is able to fast generate responses in the desired style by utilizing only few non-parallel style examples as guidance. To achieve it,

关键词： Example-guided Style Response generation low-resource Zero-shot

Single-Use Bag Valve Masks: Evaluation of Device Design and Residual Bioburden Analytical Methods

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Journal of Biomedical Science and Engineering 2018年第9期11卷 235-246页

作者： Sarah Zemitis Melinda Harman Zachary Hargett Donna Weinbrenner Department of Bioengineering Clemson University Clemson USA Department of Biological Sciences Clemson University Clemson USA

Background: A recent survey of in-hospital reprocessing in Tanzanian hospitals identified bag-valve masks (BVM) as a commonly reused single-use device. In low- and middle-income countries (LMIC), in-hospital reprocessing supports neonatal resuscitation strategies by helping to maintain adequate supplies of BVM. However, there is a need for device-specific protocols defining reprocessing procedures and inspection criteria to overcome variations in reprocessing practices between hospitals. The purposes of this study were: 1) to complete a comprehensive design review and identify challenges to reprocessing BVMs;and 2) to investigate three different residual bioburden analysis methods for assessing the efficacy of decontaminating a disposable BVM. Methods: New, unused bag-valve-masks were contaminated with Staphylococcus epidermidis and Artificial Mucus Soil to simulate the worst case soiling conditions. Devices underwent one of five disinfection protocols, including one currently used in a LMIC hospital. Three analytical (two quantitative and one qualitative) methods were selected to evaluate residual bioburden on the device following decontamination. Results: Of all protocols tested, only the positive control and the Soap and Bleach protocols met disinfection targets. Most cleaning outcomes were consistent from trial to trial for each protocol. However, cleaning outcomes varied greatly for the Alcohol Wipe protocol. For the residual bioburden analyses, the two quantitative methods produced similar results, but the qualitative measurement exhibited increased variability. Conclusion: While this study revealed positive disinfection outcomes for the Tanzanian hospital decontamination protocol, more studies are required to support these findings. Design features of the BVM mask presented challenges to cleaning and drying during different decontamination protocols, as seen in the variability in the Alcohol Wipe protocol performance. These findings support the case for a dev

关键词： Reprocessing low-resource Bag Valve Mask Single-Use Device low-and Middle-Income Countries Newborn Resuscitation

A Hospital-Based Cross-Sectional Study Assessing the Relation between Time of Birth and Perinatal Outcome

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Open Journal of Pediatrics 2020年第1期10卷 217-223页

作者： Mouhamadou Wade Papa Moctar Faye Mame Diarra Ndiaye Mamour Gueye Simon Birame Ndour Abdoulaye Diakhate Ndama Niang Khalifa Fall Moussa Diallo Omar Gassama Magatte Mbaye Gynecologic and Obstetric Clinic Aristide Le Dantec Teaching Hospital Cheikh Anta Diop University Dakar Senegal Philippe Senghor Health Center Yoff Cheikh Anta Diop University Dakar Senegal

Objectives:?Investigating the relation between perinatal outcomes and?hospital working shifts.?Methods:?We conducted a cross-sectional study at Philippe Maguilen Senghor health center (PMSHC) in Dakar, Senegal from January, 1st?2011 to December, 31th 2018. The study population was comprised of all mothers who had delivered at PMSHC and their newborns after completing 22 weeks of gestation. Time of delivery was?divided into three periods of working hours: morning shift (deliveries occurred between 7 am and 4:59 pm);evening shift from 5 pm to 10:59 pm and night shift from 11?pm to 6:59 am.?Maternal outcomes were assessed by mode of delivery, epsisotomy and perineal injuries.?The Apgar scoring system was used to assess newborns at first minute after they were born. Other adverse perinatal outcomes included fresh stillbirth, neonatal referral and early neonatal death. Data were analyzed using Statistical Package for Social Science software (SPSS 24, Mac version).?Results:?A total of 48,270 mothers and their newborns met eligibility criteria. Caesarean section deliveries were less likely to occur during evening (OR 0.84, 95% CI;0.79?-?0.89, p = 0.001) and night shifts (OR 0.45, CI;0.47?-?0.53, p = 0.001).?Evening shift deliveries had 1.1 the odds of poor perinatal outcome (Apgar score ?- 1.18, p = 0.012). No significant difference was found in the odds of neonate referrals and deaths across the three shifts.?Night shift deliveries had 1.1 the odds of perineal injuries compared to morning shift deliveries (OR 1.11, 95% CI;1.04?- 1.18, p = 0.001, for episiotomy and OR, 1.14;95% CI, 1.04?- 1.26, p = 0.008, for perineal tears). Conclusion:?Off-hours deliveries, particularly during the night shift, were significantly associated with higher proportions of perineal injuries compared to morning shift.?However, no significant difference was found in the odds of neonate referrals and deaths across the three shifts.?Our findings suggest to set up a Neonatology unit at the CSPMS as

关键词： Perinatal Outcome Time of Birth low-resource Setting

Introducing a Trauma Registry in Mozambique: An Ethics Case Study

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International Journal of Clinical Medicine 2014年第16期5卷 949-955页

作者： Fadi Hamadani Otilia Neves Ana Olga Mocumbi Tarek Razek Kosar Khwaja Paola Fata Andrew Beckett Eunice Jetha Dan L. Deckelbaum Centre for Global Surgery McGill University Health Centre Montreal Canada Instituto Nacional de Saúde (National Institute of Health) Ministério da Saúde (Ministry of Health) Maputo Mozambique

This paper presents a case study of implementing a trauma registry in Mozambique, a low-income country with limited current trauma surveillance. An outline of the importance of trauma registries is presented followed ... 详细信息

关键词： Global Burden of Injury Global Health Ethics Trauma Registry in low-Income Countries Trauma System in low-resource Settings Global Health Partnership