The mangrove oyster Crassostrea tulipa (syn. Crassostrea gasar) has been subjected to strong anthropic pressure. As in several West African countries, Senegal in particular in the Saloum delta, the ...oyster resource was severely strained. This situation had led to disturbances in the renewal of stocks and their productivity. The objective of this study was to determine the size frequency distribution, the size-weight relationship and the condition index in order to provide scientific arguments for sustainable management of C. tulipa. Monthly sampling from January 2021 to January 2022 at the Akat, Baobab Rasta, Falia 1, Falia 2 and Fandiongue stations revealed that the individual sizes of the oysters collected ranged from 0.63 mm to 93.19 mm, with an average height of 34.63 ± 16.12 mm. The size frequency distribution is unimodal with a modal class of 30 - 40 mm and the allometry coefficient is minorizing (2.57). The correlation coefficient is 0.86. However, from one site to another the differences are not significant. The monthly monitoring of the oyster condition index showed several variations in values throughout the year, with an overall average of 11.47±2.89% for the 5 stations. The maximum value (12.97±2.60) was observed in March while the minimum value (9.85±2.22) was recorded in November. This study suggests that C. tulipa is overexploited in the commune of Dionewar and that the best time to collect the oyster is around March.
Size distribution, length-weight relationship and condition index are some of the many parameters that contribute to the study of the growth, environmental conditions and reproduction of an aquatic ...species. For Tagelus adansonii, only a few studies were carried out on these parameters. This species is a bivalve of the solecurtidae family only found on the East Atlantic Coast between Mauritania and Angola. The objective of this study was to examine the biometric relationships as well as size and condition index variations, within the perspective of resource management. In this study, the average size obtained (47.78mm) from the monthly sampling in Joal Fadiouth lagoon was smaller compared to sizes obtained in other countries for the same genus and species. The size frequency distribution is unimodal, the most abundant class is 45-50mm. The mean condition index is 18.41±16.47 using the formula by Beninger and Lucas (1984). The values of the condition indices varied throughout the duration of the study. In the period of cold-to-warm transition (June) the maximum values of the condition indices were observed, while in the period of warm-to-cold transition (November to December), the minimum values were registered. The allometry is positive (3.07) in Joal as in most studies on this genus.
Perioperative management of emergency abdominal surgery remains a major concern for anesthesiologists due to hemodynamic and/or metabolic disorders often present preoperatively as well as to ...potential postoperative complications. This study aims to evaluate the epidemiological, diagnostic, therapeutic and prognostic factors of abdominal emergencies. We conducted a retrospective descriptive study involving patients over 16 years old undergoing emergency abdominal surgery at the Aristide Le Dantec University Hospital over a period of six months. The parameters studied were the epidemiological, diagnostic, therapeutic and prognostic factors of emergency abdominal surgery. We collected 161 cases, nearly 20% of the activity in the department. The average age was 41 years 16, 80 years. The sex ratio was 2.9. The mean consultation time was 4.6 days. Peritonitis was the most frequent pathologies (25.5%). The average heart rate in patients was 92 bpm (beats/ min) and 97 bpm in patients who underwent preoperative hemodynamic preparation. The average Mean Arterial Pressure (MAP) was 96.6 mmHg and 86.1 mmHg in prepared patients. 49.1% of patients were ASA class 1, 39.9% were ASA2, 8.7% ASA3, 2.5% ASA4 and 0.6% ASA5. Antibiotic prophylaxis was used in 46.30% of patients and 53.41% of them underwent antibiotic therapy. 95.6% of patients underwent general anesthesia and 4.4% underwent spinal anesthesia. The frequency of perioperative incidents was 11.08%. Morbidity was 4.3% and mortality was 4.96%. The management of emergency abdominal surgery requires a multidisciplinary approach that involves anesthetists, surgeons and biologists to further reduce morbidity and mortality rate which remains significant even today.
Emergency anesthesia in elderly patients aged 65 years and older is complex. The occurrence of intraoperative incidents and arterial hypotension is conditioned by patients' initial health status and ...by the quality of intraoperative management. This study aimed to determine the incidence of intra-anesthetic arterial hypotension in elderly patients during emergency surgery and to assess the involvement of certain factors in its occurrence: age, sex, patient's history, ASA class, anesthetic technique. We conducted a retrospective descriptive and analytical study in the Emergency Surgery Department at the Aristide Le Dantec University Hospital from 1 March 2014 to 28 February 2015. We collected data from 210 patients out of 224 elderly patients aged 65 years and older undergoing emergency anesthesias (10.93%). Data of 101 men and 109 women were included in the analysis, of whom 64.3% had at least one defect. Patients' preoperative status was assessed using American Society of Anesthesiology (ASA) classification: 71% of patients were ASA class 1 and 2 and 29% were ASA class 3 and 4. Locoregional anesthesia was the most practiced anesthetic technique (56.7%). 28 patients (13.33%) had intra-anesthetic arterial hypotension, of whom 16 under general anesthesia and 12 under locoregional anesthesia. It was more frequent in patients with high ASA class and a little less frequent in patients with PAH and underlying heart disease. Arterial hypotension in elderly patients during emergency surgery exposes the subject to the risk of not negligible intraoperative hypotension, especially in patients with high ASA class. Prevention is based on adequate preoperative assessment and anesthetic management.
Differences in sensitivity to anesthetic drugs have already been described among races. This study was designed to comparatively investigate the anesthetic requirements of two different ethnic ...groups: Caucasians and African blacks. Forty-five Caucasians from Italy and 45 African blacks from Senegal, who underwent general IV anesthesia with propofol and remifentanil, were comparatively evaluated for anesthetic depth and time lapsed before recovery. We used an electroencephalographic-derived index of depth of anesthesia, the bispectral index (BIS), and evaluation of clinical variables to assess the depth of anesthesia and the recovery trend. Mean BIS values from Caucasians after propofol discontinuation returned to baseline (92-100) in approximately 8 min, whereas in African blacks BIS values remained <80 for some 30 min. Time to eye opening was 10.6 +/- 4.8 min in Caucasians versus 16.9 +/- 8.8 min in African blacks (P < 0.001). Time to respond to loud verbal commands was 14.8 +/- 9.1 min in African blacks versus 9.1 +/- 4.2 min in Caucasians (P < 0.01). During anesthetic induction, the mean arterial pressure decreased by 20% in Caucasians and by only 10% in African blacks. We conclude that the recovery from general anesthesia with propofol was slower in African blacks compared with Caucasian patients.
This study demonstrates statistically significant differences between Caucasians and African blacks in the arousal time from IV anesthesia with propofol and remifentanil. The authors conclude that the recovery from general anesthesia was slower in African blacks compared with Caucasian patients.
Postoperative urinary retention Rosseland, Leiv Arne; Stubhaug, Audun; Breivik, Harald ...
Tidsskrift for den Norske Lægeforening,
2002-Apr-10, 20020410, Letnik:
122, Številka:
9
Journal Article
Recenzirano
Retention of urine is a common postoperative problem.
We present two patients with postoperative urinary retention. Current opinions on monitoring and treatment are reviewed.
One male postoperative ...patient was transferred from the postanaesthesia care unit after orthopaedic surgery under spinal anaesthesia. Shortly thereafter he collapsed. Hypotension and bradycardia were treated with intravenous ephedrine and atropine. Urinary retention was suspected and the bladder catheterised for 1,000 ml urine. A follow-up examination revealed no sequelae. A female patient was operated for haemorrhoids under epidural anaesthesia. The second postoperative day she was catheterised for 1,500 ml of urine. Two years later she had an ovarian cyst removed under general anaesthesia. Postoperative urinary retention developed with bladder overdistension (volume > 1,000 ml). A follow-up examination showed rest urine of 25 to 75 ml, and a chronic bladder dysfunction. The incidence of postoperative urinary retention varies depending upon type of surgery, gender, age, and preoperative history of urinary tract dysfunction. Method of anaesthesia or postoperative pain treatment is not correlated to incidence of urinary retention, but excessive intravenous volume load during the operation is.
Postoperative urinary retention should be monitored in all patients after surgery. All patients with history of difficulties with micturition need close supervision to avoid urinary bladder overdistention.
Antibiotic resistance is a global public health issue, particularly in low- and middle-income countries (LMICs), where antibiotics required to treat resistant infections are not affordable. LMICs ...also bear a disproportionately high burden of bacterial diseases, particularly among children, and resistance jeopardizes progress made in these areas. Although outpatient antibiotic use is a major driver of antibiotic resistance, data on inappropriate antibiotic prescribing in LMICs are scarce at the community level, where the majority of prescribing occurs. Here, we aimed to characterize inappropriate antibiotic prescribing among young outpatient children and to identify its determinants in 3 LMICs.
We used data from a prospective, community-based mother-and-child cohort (BIRDY, 2012 to 2018) conducted across urban and rural sites in Madagascar, Senegal, and Cambodia. Children were included at birth and followed-up for 3 to 24 months. Data from all outpatient consultations and antibiotics prescriptions were recorded. We defined inappropriate prescriptions as antibiotics prescribed for a health event determined not to require antibiotic therapy (antibiotic duration, dosage, and formulation were not considered). Antibiotic appropriateness was determined a posteriori using a classification algorithm developed according to international clinical guidelines. We used mixed logistic analyses to investigate risk factors for antibiotic prescription during consultations in which children were determined not to require antibiotics. Among the 2,719 children included in this analysis, there were 11,762 outpatient consultations over the follow-up period, of which 3,448 resulted in antibiotic prescription. Overall, 76.5% of consultations resulting in antibiotic prescription were determined not to require antibiotics, ranging from 71.5% in Madagascar to 83.3% in Cambodia. Among the 10,416 consultations (88.6%) determined not to require antibiotic therapy, 25.3% (n = 2,639) nonetheless resulted in antibiotic prescription. This proportion was much lower in Madagascar (15.6%) than in Cambodia (57.0%) or Senegal (57.2%) (p < 0.001). Among the consultations determined not to require antibiotics, in both Cambodia and Madagascar the diagnoses accounting for the greatest absolute share of inappropriate prescribing were rhinopharyngitis (59.0% of associated consultations in Cambodia, 7.9% in Madagascar) and gastroenteritis without evidence of blood in the stool (61.6% and 24.6%, respectively). In Senegal, uncomplicated bronchiolitis accounted for the greatest number of inappropriate prescriptions (84.4% of associated consultations). Across all inappropriate prescriptions, the most frequently prescribed antibiotic was amoxicillin in Cambodia and Madagascar (42.1% and 29.2%, respectively) and cefixime in Senegal (31.2%). Covariates associated with an increased risk of inappropriate prescription include patient age greater than 3 months (adjusted odds ratios (aOR) with 95% confidence interval (95% CI) ranged across countries from 1.91 1.63, 2.25 to 5.25 3.85, 7.15, p < 0.001) and living in rural as opposed to urban settings (aOR ranged across countries from 1.83 1.57, 2.14 to 4.40 2.34, 8.28, p < 0.001). Diagnosis with a higher severity score was also associated with an increased risk of inappropriate prescription (aOR = 2.00 1.75, 2.30 for moderately severe, 3.10 2.47, 3.91 for most severe, p < 0.001), as was consultation during the rainy season (aOR = 1.32 1.19, 1.47, p < 0.001). The main limitation of our study is the lack of bacteriological documentation, which may have resulted in some diagnosis misclassification and possible overestimation of inappropriate antibiotic prescription.
In this study, we observed extensive inappropriate antibiotic prescribing among pediatric outpatients in Madagascar, Senegal, and Cambodia. Despite great intercountry heterogeneity in prescribing practices, we identified common risk factors for inappropriate prescription. This underscores the importance of implementing local programs to optimize antibiotic prescribing at the community level in LMICs.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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