Impact of spinal anesthesia on cesarean section outcome in Omdurman maternity hospital - Sudan 2011

Background: The cesarean section is indicated when vaginal delivery is not safe for the mother or the baby.Objective: A descriptive study done in Omdurman maternity hospital–OMH to assess the impact of spinal anesthesia (SA) on cesarean section(C/S), including, intra and post operative maternal complications, neonatal outcome and patients’ satisfaction in 2011.Methodology: Women delivered by C/S under SA were included in the study after an informed consent. All women in the study were operated on by trained registrars or obstetricians, under SA given, either by anesthetist or assistant anesthetist under supervision with similar conditions andwere followed till discharge from hospital.Results: Total number of deliveries at OMH in 2011 were 30397, 21677 (71.3%) delivered vaginally, 8720 (28.7%) delivered by C/S, only 24 women (0.3%) delivered under general anaethesia- GA. Women included in the study were 1029, 517 (50.2%) were elective and 512 (49.8%) were emergency C/S. Intra- operatively, 79 women (7.7%) developed hypotension, their BP dropped by more than 30 mmHg, four women developed severe shivering for which they received intravenous 25 mg pethedine, and 44 neonates received oxygen by mask and only oneneeded endotranchial intubation. Post operatively, only two women had disabling headache, 24 women (2.4%) had episodes of vomiting and 199 (19.3%) had pain in their lower limbs, buttock and thigh, it disappeared completely before discharge. In this study, 880 women (85.5%) weresatisfied with SA, while 149 (14.5%) were not satisfied due to pain at the time of puncture, headache, or transient lower limb pain after operation.Conclusion:Spinal anesthesia is increasingly used for C/S in this hospital, with excellent patients’ satisfaction, without increase in maternal and neonatal mortality or morbidity.Key words: spinal anesthesia, Cesarean section, Suda

Acute psychosocial stress enhances visuospatial in healthy males

Previous research demonstrates that stress can disrupt a number of different cognitive systems, including verbal memory, working memory, and decision-making. Few previous studies have investigated relations between stress and visuospatial information processing, however, and none have examined relations among stress, visuospatial memory performance, and planning/ organisation of visuospatial information simultaneously. In total, 38 undergraduate males completed the copy trial of the Rey-Osterrieth Complex Figure Test. Those assigned randomly to the Stress group (n = 19) were then exposed to a laboratory-based psychosocial stressor; the others were exposed to an equivalent control condition. All then completed the delayed recall trial of the Rey-Osterrieth Complex Figure Test. Physiological and self-report measures of stress indicated that the induction manipulation was effective. Our predictions that control participants, relative to stressor-exposed participants, (a) take less time to complete the Rey-Osterrieth Complex Figure Test recall trial, (b) reproduce the figure more accurately on that trial, and (c) show better planning and more gestalt-based organisational strategies in creating that reproduction were disconfirmed. At recall, those with higher circulating cortisol levels (measured post-stress-induction) completed the drawing more accurately than those with lower circulating cortisol levels. Otherwise stated, the present data indicated that exposure to an acute psychosocial stressor enhanced visuospatial memory performance in healthy males. This data pattern is consistent with a previously proposed inverted U-shaped relationship between cortisol and cognition: Under this proposal, moderate levels of the hormone (as induced by the current manipulation) support optimal performance, whereas extremely high and extremely low levels impair performance