W Indian Med J
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Day surgery is cheaper and allows for less time delay. In developing countries with limited health budgets, these factors lead to higher patient turnover and shortened waiting lists. The decreased psychological trauma for both parents and children is significant. ⋯ This review showed that the number of PDS has increased from 60% in 1984 to 75%. These procedures were performed safely with a low complication rate. Further expansion of the service is recommended.
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Comparative Study
Comparison of general anaesthesia and spinal anaesthesia for caesarean section in Antigua and Barbuda.
Regional anaesthesia has become the anaesthetic of choice for Caesarean section (CS) in developed countries, with use extended to smaller, less developed countries in the past decade. This study is a comparison of maternal and neonatal outcomes comparing general anaesthesia (GA) and the early experience with spinal anaesthesia (SA) for CS in Antigua and Barbuda. Data obtained included maternal age, gravidity, parity, indication for operation, emergent versus routine operation and type of anaesthesia used. ⋯ There were no maternal deaths. Babies demonstrated no difference in birthweight (mean 3238 vs 3258 g) but those born to mothers who underwent GA had significantly lower one minute (mean 6.84 vs 8.17, p < 0.0001) and five minute (mean 8.13 vs 8.91, p < 0.001) Apgar scores, with a trend toward more frequent neonatal special care unit admission (26.2% vs 17.7%, p < 0.20) and perinatal death (3.9 vs 0%, p < 0.30). GA and SA appear equally safe, but SA was associated with significantly better outcome for both mothers and babies.
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This study was done to assess the age-specific incidence of admission for acute myocardial infarction in Antigua and Barbuda from 1990 to 2001. A retrospective review of Intensive Care Unit admissions for possible acute myocardial infarction was performed. Data obtained included age, gender, country of residence, electrocardiogram, creatine kinase results and intensive care unit outcome. ⋯ The mortality rate in the Intensive Care Unit was 0.07 per year for men, 0.04 per year for women per 1000 aged 35 to 75 years. In the United States of America (USA), the admission rate is 4.1 for men and 1.8 for women per year per 1000 aged 35 to 75 years; the mortality rate is 1.0 for men and 0.5 for women per year per 1000 aged 35 to 75 years. Rates of admission to the Intensive Care Unit for acute myocardial infarction in Antigua and Barbuda are 20%, and mortality rates are 10% of those reported in the USA.