Tropical and geographical medicine
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High caesarean birth rates are an issue of international public health concern. Determinants of caesarean birth are reviewed in order to formulate strategies to reduce these high rates. ⋯ The risks and safety of caesarean birth differ from place to place in this world. As the relative safety of the procedure is an important factor contributing to the rise of caesarean birth, the fact that this has only been achieved in some parts of the world should restrict the indications to perform the operation in the best interests of pregnant women.
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To assess prevalence of hair dyspigmentation, decurling, thinness and frailty, a random sample of more than 4,000 preschoolers, representative for a large area in Northern Zaire, was examined clinically and anthropometrically. Isolated dyspigmentation, isolated thinness and the combination of both were the most frequent signs (> 5%). Prevalence of hair signs did not differ according to sex or season. ⋯ Isolated dyspigmentation, however, was unrelated to WFA or marasmus. All signs occurred also in children with 'normal' WFA (SD > -2). In these children, hair signs were associated with the presence of clinical muscle wasting.
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During a two year community-based investigation of mortality 3.5% of the deaths to individuals over the age of 5 years were reported by bereaved relatives to have occurred to epileptics and 77% of these deaths were thought to have occurred whilst the patient was in status epilepticus. This prompted us to determine the prevalence of epilepsy in this rural population by interviewing 7,450 residents of a pre-defined study area. ⋯ Anti-convulsant prophylaxis is available at the district hospital but this service is only sporadically used by epileptics in this population. Uncontrolled and poorly managed epilepsy may result in an increased risk of premature mortality among epileptics living in this community.
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Comparative Study
The effect of henna paste on oxygen saturation reading obtained by pulse oximetry.
A controlled study was designed to examine the effect of red and black henna on the measurement of oxygen saturation by pulse oximetry. Fifty adult normal female volunteers had their left thumb coloured with red henna (40) or black henna (10). The uncoloured right thumb was used as a control. ⋯ In contrast, the thumb coloured with black henna gave no reading when compared to the uncoloured right thumb. On the basis of this study, pulse oximetry is not limited by red henna while black henna has a potential of causing major error in the measurement of oxygen saturation by pulse oximetry. In these cases we recommend to use ear oximetry for accurate measurement of oxygen saturation.
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The report concerns an outbreak of neonatal Klebsiella septicaemia at the University College Hospital, Ibadan, Nigeria, between October and November 1991. Mortality, 35.7%, was higher in the preterm babies than in the term babies (p < 0.05). ⋯ The Klebsiella species isolated from the babies and the hospital environment during the outbreak were of the multiple drug resistant type. Preventive measures and the need for a continual bacteriological surveillance are highlighted.