Primary pulmonary hypertension during pregnancy: A case report

AbstractWe describe a case of a 25-year-old pregnant woman who presented with severe primary pulmonary hypertension (PPH). Her echocardiogram showed severe right ventricular hypertrophy with dilatation and Moderate right ventricular systolic dysfunction. Right ventricle systolic pressure (RVSP) was estimated to be 125mmHg. She had an elective caesarean section under general anaesthesia at 32weeks of gestation. Pulmonary artery pressures measured by a pulmonary artery catheter before anaesthesia were 102mmHg and pulmonary vascular resistance was 429. Intraoperative nitric oxide was used to reduce pulmonary artery systolic pressure (PASP). After the delivery of a healthy infant, PASP was controlled with nebulized iloprost and silandifil. Five days later she was transferred from intensive care unit after she was started on silandifil 50mg three times daily and a small dose of warfarin

Medical Students Perception of the Scope of Plastic Surgery

Background: Plastic surgery has developed to benefit in a variety of challenging areas formerly handled by other disciplines. Society lack a basic understanding of plastic surgery as a clinical area of expertise, including general practitioners, nursing staff, medical trainees, and the general public. Methodology: pre-clinical l and clinical year students of Kuwait University were rolled into the study.The purpose of the study was not declared, which was to assess student perception of plastic surgery, and rather disclosed that it was to assess general knowledge of various medical scenarios, preceded with questions on background information. The survey was generated by using Survey Monkey Software. Results: 244 students participated in the study including 121 males and 123 females, with a mean age of 21 (±2). Number of students who participated in the survey from 2nd, 3rd, 4th, 5th, 6th and 7th academic year were 37 (15.2%), 42 (17.2%), 39 (16%), 42 (17.2%), 42 (17.2%) and 42 (17.2%) respectively. 126 (51.6%) were pre-clinical students, while 118 (48.4%) were clinical students. 79.8% of the students believed that plastic surgery plays an essential role in trauma management, whereas 9.2% did not consider plastic surgery significant for trauma management. Conclusion: The teaching of medical students regarding the spectrum of plastic surgery needs improvement. This can be achieved through systematic education of students who cycle on the plastic surgery service and by providing students with a succinct but thorough overview of the spectrum of plastic surgery early on during medical school

Reforming MSWM in Sukunan (Yogjakarta, Indonesia): A case-study ofapplying a zero-waste approach based on circular economy paradigm

Over the past years, Indonesia, the world’s fourth most populous country, has confronted environmentalproblems due to uncontrolled generation of municipal solid waste (MSW). While the integrated solidwaste management (ISWM) represents a critical strategy for Indonesia to control its production, it is alsorecognized that economic approaches also need to be promoted to address the waste problemconcertedly. In this case study, empirical approaches are developed to understand how a volume-basedwaste fee could be incorporated into MSW collection services and how to apply a zero-waste approach inIndonesia by adapting resource recovery initiatives, adapted from Germany’s mature experiences inintegrating the CE paradigm into the latter’s MSWM practices. Currently, Sukunan village (Yogyakarta,Indonesia) promotes waste reduction at sources in the framework of community-based solid wastemanagement (CBSWM) by mobilizing the local community for waste separation (organic and non-organic) and waste recycling. As a result, about 0.2 million Mt of CO2-eqemissions was avoided annu-ally from local landfills. The economic benefits of recycling activities by the village’s community alsoresulted in 30% reduction of the waste generated. This CBSWM scheme not only saves the governmentbudget on waste collection, transport and disposal, but also extends the lifetime of local landfills as thefinal disposal sites. By integrating the CE paradigm into its MSWM practices through the implementationof economic instruments and adherence to the rule of law in the same way as Germany does, Indonesiacould make positive changes to its environmental policy and regulation of MSW. A sound MSWM inIndonesia could play important roles in promoting the effectiveness of urban development with resourcerecovery approaches to facilitate its transition towards a CE nationwide in the long-term